Pediatric Review: International Journal of Pediatric Research <p><em><strong>ISSN: <a href="" target="_blank" rel="noopener">2349-3267 (Online)</a>, <a href="" target="_blank" rel="noopener">2349-5499 (Print)</a></strong></em></p> Siddharth Health Research and Social Welfare Society en-US Pediatric Review: International Journal of Pediatric Research 2349-5499 Evaluation of Thyroid Hormone Levels in Full-Term Neonates Presented with Septic Shock <p>Introduction: The incidence of neonatal sepsis in India is 38 per 1000 live births. Many authors found an association between altered thyroid hormone levels and septic shock in neonates and it may be of prognostic importance in septic shock treatment. This study has been conducted to find the relationship between thyroid profile and septic shock in neonates and also to compare the thyroid profile in survivor and non-survivor groups of septic shock patients.</p> <p>Methods: This analytical prospective cohort study was conducted in the NICU of a tertiary care teaching institution in central India. Full-term neonates with late-onset sepsis were included in this study and estimation of thyroid hormones (TSH, T3, T4, fT3, and fT4) was performed. These neonates were divided into those with and without septic shock patients and levels of thyroid hormones were correlated between these patients to find significant relations. The Vasoactive-Inotropic Score (VIS) score was calculated.</p> <p>Results: A total of 195 full-term neonates were included in the study. The mean value of TSH, T3, T4, fT3, and fT4 among neonates with septic shock were 5.27 µg/ml, 80.01 ng/dl, 6.36 µg/dl, 1.40 pg/ml, and 1.40 µg/dl, respectively while the values were 5.29 µg/ml, 94.4 ng/dl, 7.25 µg/dl, 1.84 pg/ml, and 1.43 µg/dl, respectively in septic neonates without shock. This difference was statistically significant except for TSH (p&gt;0.05). The mean value of TSH, T3, T4, fT3, and fT4 among septic shock survivors were 5.27 µg/ml, 80.01 ng/dl, 6.36 µg/dl, 1.40 pg/ml, and 1.40 µg/dl and in septic shock non-survivors were 2.40 µg/ml, 37.33 ng/dl, 3.86 µg/dl, 0.99 pg/ml, and 0.84 µg/dl, respectively (p&lt;0.0001). Only T3 was found to be significantly co-related with VIS in septic shock in all the groups (&lt;0.001). The maximum mean value of T3 was observed with VIS less than 20 (84.89 ng/dl) while minimum T3 was observed with VIS more than 50 (35.33 ng/dl).</p> <p>Conclusion: Our study suggests that TSH, T3, T4, fT3, and fT4 levels are significantly low in patients suffering from the septic shock which may vary in the case of TSH. Also, there is a significant decrease in thyroid profile among septic shock non-survivors as compared to survivors.</p> Dr. Dhananjay Singh Dr. Jyotsana Shrivastava Dr. Amit Agrawal Copyright (c) 2021 Author (s). Published by Siddharth Health Research and Social Welfare Society 2021-08-11 2021-08-11 8 4 168 174 10.17511/ijpr.2021.i04.01 “Study of Estimation of Cerebrospinal Fluid C-Reactive Protein in Diagnosis of Acute Meningitis.” <p>Objectives: To assess the diagnostic role of CSF C-reactive protein quantitatively in acute meningitis and to evaluate the efficacy of CSF C-reactive protein in differentiating pyogenic meningitis from non-pyogenic meningitis.</p> <p>Material and Methods: It is a prospective observational study of total 102 children with suspected meningitis allocated into three groups based on initial investigations; group-I Pyogenic meningitis, group-II Non-Pyogenic meningitis and group-III No meningitis (Control group). Quantitative CSF C-reactive protein was detected by the latex agglutination method. Data were analyzed to establish the diagnostic role of CSF-CRP and to evaluate the efficacy of CSF-CRP in differentiating pyogenic meningitis from non-pyogenic meningitis.</p> <p>Results: A total of 102 clinically suspected meningitis patients were studied. Based on CSF findings, the study population (102 cases) was categorized into 3 groups. Group I was pyogenic meningitis consist 53 cases (51.96%). Group II was Non-Pyogenic meningitis consists 27 cases (26.47%). Group III was normal CSF findings consist 22 (21.56%). 98.1% cases of pyogenic meningitis had elevated CSF-CRP level &gt;1.1 µg/ml of CSF. In the case of Non-Pyogenic meningitis, 96.2% were found to have CSF- CRP in the range of 0.05-0.10 µg/ml. The mean value of CSF-CRP in groups I, II and III were 5.57±1.48,0.09±0.042 and 0.01±0.010 respectively.</p> <p>Conclusion: Detection of CSF-CRP provides a new dimension to establish the diagnosis of pyogenic meningitis. It is a rapid, reliable and sensitive diagnostic test. From this study it is concluded that CSF-CRP can be used to differentiate pyogenic from non-pyogenic meningitis. Early, accurate and appropriate therapy can ameliorate the morbidity and mortality rates in such cases.</p> Dr. Keshav Bansal Dr. Dhaval Bhatt Dr. Sunil Kumar Dadhich Dr. Deep Kariya Copyright (c) 2021 Author (s). Published by Siddharth Health Research and Social Welfare Society 2021-08-31 2021-08-31 8 4 175 181 10.17511/ijpr.2021.i04.02 Clinical, Microbiological and Radiological Characterises of Lower Respiratory tract Infection in Children with Established Congenital Heart Diseases. <p>Introduction: Acute Lower Respiratory Tract Infection (ALRTI) is the most common cause of death in children under five. Various demographic, socio-economic and environmental factors have been associated with ALRTI, with conflicting results. Children with congenital heart diseases are more vulnerable to lower respiratory tract infections following the fact that they had an anatomical defect that causes hemodynamic disturbance of lung circulation and mucosal oedema finally leads to decreased lung compliance and recurrent lower respiratory tract infections.</p> <p>Methods: Children aged between1 month and 18 years with clinically established congenital heart disease confirmed by echocardiography and presenting with signs and symptoms suggestive of lower respiratory tract infection were enrolled in the study. A detailed history was taken and routine blood investigations were done in all cases. Chest X-Ray was done to confirm the clinical diagnosis.</p> <p>Results: Mean age of the study subjects was 2 years. VSD was seen in 64.9% of cases while 10.5% of cases had VSD and ASD. The most common presenting symptoms were: cough (98.2%), reduced feeding (97.4%), fever (89.5%), running nose (67.5%) and wheeze (49.1%). Leucocytosis and raised ESR were seen in 66.7% and 64.9% cases respectively. In Throat swab Commensals were seen in 36% of cases while gram-positive cocci were seen in 3.5% cases respectively. In blood culture Streptococcus pneumoniae being the commonest organism isolated. Bilateral and unilateral opacities on chest x-ray were seen in 16.7% and 12.3% cases respectively.</p> <p>Conclusion: Bronchopneumonia was the commonest LRTI in children with the predominance of VSD.</p> Dr. Sandeep Bhaskar Dr. Afzal K M Dr. Manjunatha Babu R Dr. Subramanya NK Copyright (c) 2021 Author (s). Published by Siddharth Health Research and Social Welfare Society 2021-09-11 2021-09-11 8 4 182 188 10.17511/ijpr.2021.i04.03 The echocardiographic and radiological profile of Clinically diagnosed congenital heart disease in children <p>Introduction: Congenital heart disease (CHD) if diagnosed clinically early and confirmed by Chest X-ray and ECHO, can be appropriately managed.</p> <p>Objectives: To observe the clinical profile of CHD in clinically diagnosed CHD in children To correlate the clinical profile with radiological and echocardiographic findings in the study group.</p> <p>Methods: It’s a cross-sectional study. The duration was 18 months. All children in the age group of 1 month to 18years of age with history &amp; clinical findings suggestive of CHDs were taken, assessed, subjected to Chest X-ray &amp; 2 DECHO &amp; were correlate.</p> <p>Results: Total no. of cases admitted during the study period was 5423, 624 had CHD among which 50 fulfilling the criteria were taken. Clinically CCHD was in 34%, ACHD in 66%. Clinical correlation with X-ray was 83% and with ECHO was 87 %.</p> <p>Conclusion: ACHD is more common, Chest x-ray findings correlated closely. ECHO correlation with the clinical diagnosis was very accurate especially in isolated lesions and some cases were identified which had been missed clinically. Hence Clinical Diagnosis with X-ray and ECHO helps in increased identification &amp; earlier intervention of CHDs.</p> Dr. Sandeep Bhaskar Dr. Sneha P Dr. Manjunath Babu R Dr. Chithambaram Copyright (c) 2021 Author (s). Published by Siddharth Health Research and Social Welfare Society 2021-08-31 2021-08-31 8 4 189 195 10.17511/ijpr.2021.i04.04 Assessment of knowledge and practice of menstrual hygiene among adolescent girls of government school of Jabalpur and impact of health education on menstrual hygiene <p>Introduction: India is a developing country, it has made advancements in every field, but still menstruation is a topic of social taboo in many rural and suburban parts of the country, as people feel shy and difficult to discuss it openly, even mothers, sisters and teachers are not able to provide correct information regarding menstruation physiology and its hygiene.</p> <p>Objective: To educate adolescent girls and assess the impact of health education on them.</p> <p>Methods: About 400 adolescent girls aged 11-19 years from 3 government schools of Jabalpur were interviewed using a pretested and predesigned questionnaire in the local language. Health education regarding hygienic practices during menstruation was given through audiovisual aids after filling out the questionnaire.</p> <p>Results: out of 400 girls, 291(72%) girls already knew that menstruation is a physiological process which increased significantly to 307(76.8%). Knowledge was poor about the source and type of bleed; only 99 (24.8%) knew that the original was the uterus. Only 59(14.8%)girls were using sanitary napkins. In contrast, most of them were using old cloth 265(66.3%)of which 86.3% were washing it with soap and water, and 67.3% used to dry them inside their houses, which increased significantly after imparting health education to 99%and decreased to 6% respectively.</p> <p>Conclusion: The result of this study indicates that there is a need for the establishment of a comprehensive school health education programme with solid familial input. Teachers should be trained to provide health education about menstruation, its physiology and correct hygienic practices, as the adolescent girls will turn into mothers one day.</p> Dr. Preeti Singh Dr. Monica Lazarus Dr. S Priyadarshini Copyright (c) 2021 Author (s). Published by Siddharth Health Research and Social Welfare Society 2021-08-31 2021-08-31 8 4 201 206 10.17511/ijpr.2021.i04.06 Chronic Subdural Hygroma in Battered Baby. <p>The battered baby syndrome is a condition in which a child is seriously physically abused by the caregiver or parents. The World Health Organization (WHO) estimates 40 million children are subjected to abuse and neglect around the world. Most of the industrialized countries have their reporting and surveillance system and data on child battery but in developing countries including India, there is a lack of data regarding the extent of child battering that takes place within the households or institutions. India published a report on one of the largest surveys done on child abuse and found that two out of every three children were physically abused and 88.6% of them suffered at the hands of their parents. Unfortunately, the methodology restricted the study to only older children who could give a history of abuse. Therefore, the magnitude of the problem given only highlights among children above the age of 5 years. [1]. we are reporting a case of an Infant with Febrile encephalopathy, detailed examination and investigation found out a case of chronic Subdural Hygroma with classical neuroimaging features of Abusive trauma. We have done a multidisciplinary approach with a Neurosurgeon, a social worker who treated the child with burr hole surgery for subdural hygroma &amp; the child recovered with consciousness. This case is Special because a 5-month Male infant was subjected to abuse due to a psychological problem in a Family Member, suspicion was lacking as males are unlikely to undergo gender-biased in India and Early age of presentation.</p> Dr. Kiran Bhaisare Dr. Sunil Holikar Copyright (c) 2021 Author (s). Published by Siddharth Health Research and Social Welfare Society 2021-09-30 2021-09-30 8 4 196 200 10.17511/ijpr.2021.i04.05 A Case of Anterior Mediastinal Mass treated as Bronchial Asthma. <p>Anterior Mediastinal Masses (AMM) can range in presentation from an asymptomatic incidental finding to significant cardiorespiratory compromise. Symptoms do not always correlate to the degree of compression. Patients with AMM are at high risk for hemodynamic instability and cardiovascular arrest with induction of anesthesia. This report describes a child with a large AMM who presented with classic symptoms of recurrent wheezing and was inadequately evaluated. It is imperative, especially in these unexpected presentations, to have a high index of suspicion.</p> Dr. Renuka Jadhav Dr. Pooja Motwani Dr. Sharad Agarkhedkar Copyright (c) 2021 Author (s). Published by Siddharth Health Research and Social Welfare Society 2021-08-31 2021-08-31 8 4 207 211 A Case series of Childhood-onset Takayasu Arteritis <p>Childhood-onset Takayasu disease(c-Tak) is a rare chronic granulomatous disorder involving large vessels. It is the 3rd most common vasculitis in childhood. It is diagnosed based on criteria laid by European League Against Rheumatism/ Pediatric Rheumatology International Trials Organization/Pediatric Rheumatology European Society criteria. Treatment is mainly based on corticosteroids and immunosuppressive therapy. We are reporting case series of c-Tak due to their varied presentations.</p> Dr. Manas Ranjan Sahoo Dr. Sunil Natha Jondhale Dr. Anil K Goel Dr. Tushar B Jagzappe Copyright (c) 2021 Author (s). Published by Siddharth Health Research and Social Welfare Society 2021-08-31 2021-08-31 8 4 212 217