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> en-US (Dr D Sharad Gedam) (Dr. Sharad Gedam, Mob: 8989622793 (10 AM to 5 PM, Mon- Sat)) Wed, 11 Aug 2021 15:30:11 +0530 OJS 60 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 Wed, 11 Aug 2021 00:00:00 +0530 “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 Tue, 31 Aug 2021 00:00:00 +0530 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 Sat, 11 Sep 2021 18:49:20 +0530 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 Tue, 31 Aug 2021 00:00:00 +0530