Background: Multisystem inflammatory syndrome in children (MIS-C) is a severe hyper inflammatory post infectious complication of acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection, which typically occurs 2-6 weeks after exposure to SARS-CoV-2. Aim was to determine the clinical profile, cardiac involvement and outcome of children admitted with multisystem inflammatory syndrome in pediatric intensive care unit. Methods: This prospective observational study was conducted in pediatric intensive care unit over period of two years. After informed consent from parents, all those patients meeting inclusion criteria were subjected to complete history, general and systemic physical examination. Routine baseline investigations included CBC, LFT, KFT, ABG, serum calcium and phosphorous, and other investigations like echocardiography, COVID-19 RAT and RTPCR and various inflammatory markers like serum ferritin, pro-calcitonin, CRP and ESR whenever required were done. Results: In our study out of 77 MIS-C patients 40 were males and 37 were females with a male female ratio of 1.1:1. The mean average age was 7.4 years. Out of them 47 (61%) patients had a history of COVID-19 infection/contact with positive COVID-19 cases 3 to 4 weeks before presentation. In our study gastrointestinal, respiratory, and cardiac systems were mostly involved. Rash and conjunctival congestion was seen in 81% of MIS-C patients. On echocardiography out of 77 MIS-C patients, 15 (19.5%) had pericardial effusion, 25 (32.5%) had coronary artery dilatations and 32 patients (41.5%) had left ventricular systolic dysfunction with LVEF <55%. Conclusions: Pediatric multisystem inflammatory syndrome is a serious and life-threatening illnesses having a significant impact on morbidity and mortality.

We present the case of a term male neonate who was apparently well baby and deteriorated with hypoglycemic episode followed by deterioration with the child going in for respiratory failure and subsequently shock requiring ventilation and inotropic support which was refractory to all treatment, eventually resulting in a mortality. Investigative panel reports later showed that the baby had a mitochondriopathy-primary mitochondrial myopathy, which was the diagnosis responsible for the baby’s clinical presentation. Although mitochondriopathies do not have a specific treatment, early diagnosis of milder variants and understanding their pathophysiology helps in further facilitating diagnostic approach for the future.

Background: Neonatal hyperbilirubinemia, defined as a total serum bilirubin level above 5 mg/dl (86 μmol/l). Haemolytic disease of the newborn due to blood group incompatibilities between mother and foetus is one of the commonest cause of hyperbilirubinemia in the newborn. Methods: A Hospital based cross sectional study was conducted among newborns admitted with jaundice. Results: In our study 51 cases of neonatal jaundice were due to ABO incompatibility and among them 24 were having O-A incompatibility and 27 were having O-B incompatibility. The mean serum bilirubin in patients with ABO incompatibility were higher (24.8) than those without ABO incompatibility. Conclusions: In the present study, one third of newborns with neonatal jaundice were having ABO incompatibility. The mean serum bilirubin in patients with ABO incompatibility were higher than those without ABO incompatibility. This highlights the importance of recognizing ABO Rh incompatibility in neonatal jaundice.

Background: Congenital heart disease (CHD) may be present with a syndrome containing known anomalies with specific physical findings or can be present with manifestations of a systemic defect that affects the heart and other systems. Aim of the study was to determine the prevalence and spectrum of extra-cardiac defects associated with CHD. Methods: This prospective and observational study was conducted in the age group of 1 day to 12 years with CHD chosen by purposive sampling technique. Informed consent was obtained from parents or guardians. The CHD was diagnosed on the basis of detailed clinical examination, chest X-ray and Electrocardiography and confirmed by 2D echocardiography. The extra-cardiac defects were diagnosed based on standard definitions and various investigations like CBC, LFT, KFT, USG abdomen and skull, CT, MRI, G-Band karyotype, fluorescence in situ hybridization (FISH) studies for micro-deletions, audiometry, ophthalmologic evaluation and thyroid hormone profile. Results: A total of 61,254 patients were examined during the study and 640 children were identified with CHD. So, the prevalence was 10.14 per 1000 live births. Out 640 children enrolled in the study 352 (55%) were males and 288 (45%) were females with a male female ratio of 1.2:1 and 520 (81.3%) had acyanotic CHD (ACHD) and 120 (18.3%) had cyanotic CHD (CCHD). The majority of the children with CHD belonged to the second birth order 360 (56.2%). The extra-cardiac anomalies were present in 128 (20%) cases. Out of them 77 (12%) cases had extra-cardiac anomalies associated with acyanotic CHD and 51 (8%) cases had extracardiac anomalies associated with cyanotic CHD. Out of 128 cases with extra-cardiac defects 64 (50%) cases were syndromic, 51 (39.8) cases had multiple congenital defects and 13 (10.2%) had laterality defects. Conclusions: The CHD is often associated with various extra-cardiac abnormalities.

Background: Pain management in paediatric dental care is a critical aspect of anxiety, which is frequently related to the induction of pain and exacerbates pain perception local anaesthetics are used to relieve and prevent pain. However, the administration of these drugs causes fear and anxiety in patients. As a result, there is an urgent need to develop methods for reducing pain during injection. Aim and objectives were to evaluate and compare the pain perception in pediatric patients by comparing different local anesthesia delivery system before local anesthesia (preanesthetic procedure) using Buzzy system, topical anesthesia and precooling agent with conventional technique. Methods: A total of 140 children aged between 8-13 years visiting department taken for study. Patients indicated for invasive procedure and requiring administration of LA taken for study. The blood pressure, oxygen saturation, Wong Baker pain rating scale and FLACC scale was recorded in patients before and after administration of LA. Groups are, group A conventional syringe technique without any preanesthetic procedure. Group B: Buzzy system group C: Topical anesthetic gel (Progel B-20% benzocaine), group D: Precooling agent (flouron-1,1,1,2 tetraflouroethane). Obtained data statistically analysed by using one way ANOVA and paired t test in SPSS software 21.0. Results: Statistically significant results were obtained in intergroup comparison where group B buzzy system found to be effective compared to another group. In intra group, comparison, there was statistically significant in all 4 groups. Conclusions: Buzzy system can be used as a preanesthetic medication to decrease the pain perception in children during administration of local anesthetic.

Preeclampsia affects 3-10% of pregnancies worldwide. It has significant adverse effect on both the fetus and the neonate. Hence there is a need to study the impact of pregnancy induced hypertension (PIH) on the fetus and the neonate. Databases like PubMed and Cochrane are searched independently by two authors to identify relevant studies. Data were collected for outcomes like birth weight, gestational age, fetal death/stillbirth and intrauterine growth retardation (IUGR). Preeclampsia is associated with significant increase in the incidence of low birth weight (LBW), IUGR and prematurity compared to normotensive women. Also, there is an increased rate of fetal death/ stillbirths in preeclampsia. In addition, there is an increased need for neonatal intensive care unit (NICU) admission in neonates born to PIH mothers. Maternal preeclampsia results in significant adverse effect on the fetus and neonate. There is an increased incidence of stillbirth, LBW, IUGR and preterm deliveries in neonates born to preeclamptic mothers. There is an overall increase in the composite outcomes of neonates of PIH mothers. The objective of the study is to compare the neonatal outcomes of preeclamptic or women with gestational hypertension with that of normotensive women.

Background:Salmonella typhi causes typhoid illness. In India, it is a huge public health issue. Several impoverished nations have endemic typhoid fever. The wide range of clinical symptoms of typhoid fever makes diagnosis difficult. The purpose of this study was to better understand the vast range of clinical symptoms, comorbidities, and drug sensitivity patterns associated with typhoid fever in children. Methods: From March 2021 to October 2022, 100 children hospitalised to the paediatric unit at Al-Ameen Medical College and Hospital in Bijapur with proven typhoid fever were included in the study. Age, gender, presenting complaint, laboratory tests, and antibiotic sensitivity pattern are all gathered and analysed in each patient. Results: There were 58 men (58%) and 42 females (42%) among the 100 cases. The most typical age range was 5 to 15 years. Fever was the most prevalent symptom, occurring in 100% of patients, headache (80%), coated tongue (100%), vomiting (45%), and abdominal pain (70%). In 68% of cases, the most prevalent indication was a toxic look, and hepatomegaly in 44%. In 28% of instances, leukocytopenia was discovered. In every case, the blood culture proved positive. The length of hospital stay ranged from 3 to 10 days. There was no recorded death. Conclusions: Unhygienic habits and consuming meals from the outside are the main causes of typhoid fever. By raising people's understanding of disease transmission and its many preventative methods, this serious public health issue can be resolved.

Background: COVID-19 pandemic is endangering the psychosocial health of Indian children and adolescent. The psychosocial morbidity can get manifested as psychiatric diseases if not addressed properly. This study aims to see the effects of an online Mindfulness-based intervention on the health-related quality of life (HRQoL) of apparently healthy but ‘vulnerable’ children in Indian community, during the COVID-19 pandemic. Methods: A randomized controlled trial with 43 children and one of their interactive parents as participants from the community. An online eight-week Mindfulness program was selected as the psychosocial intervention. 22 participants in group M attended the Mindfulness program (parents in group PM) while 21 participants in group C attended placebo sessions (parents in group PC). The quantitative measure was the HRQoL, measured by the KIDSCREEN10 questionnaire. Qualitative data was in form of a response to a question “Which aspect of the mindfulness program appealed to you the most from your child’s perspective?” The post-program parent responses were analyzed on basis of some emergent themes. The statistical analyses used were independent samples t-test, Chi-square test and one-way analysis of variance (ANOVA) for the outcome variables. Results: The KIDSCREEN10 score significantly improved (p value <0.0001) in the cases (group M and PM), compared to the control groups. ‘Calm’ and ‘focus’ were the prominent emergent themes, reported by the parents post-program. Conclusions: The online mindfulness-based intervention positively impacts the health-related quality of life of Indian children and adolescents during the COVID-19 pandemic. The results need to be substantiated by further studies.

Background: Sepsis is defined as “life-threatening organ dysfunction, caused by a dysregulated host response to infection”. Neonatal sepsis is the most common cause of morbidity and mortality in the neonatal period. Early diagnosis of neonatal sepsis is difficult. Therefore, this study was conducted with the objective to assess the diagnostic accuracy of procalcitonin as marker of neonatal sepsis and its comparison with C-reactive protein. Methods: The present study was a hospital-based descriptive comparative study. A total of 59 neonates were enrolled. All suspected neonates for the sepsis admitted to NICU were enrolled in study on the basis of inclusion and exclusion criteria. A detailed clinical examination was done. Blood sample was collected for procalcitonin, C-reactive protein and blood culture. Statistical analysis was performed. Results: In our study diagnostic accuracy of procalcitonin in diagnosis of neonatal sepsis was sensitivity (88.46%), specificity (87.88%), positive predictive value (85.19%), negative predictive value (90.63%) and diagnostic accuracy (88.14%). Diagnostic value of C-reactive protein in diagnosis of neonatal sepsis was sensitivity (88.46%), specificity (69.70%), positive predictive value (69.70%), negative predictive value (88.46%) and diagnostic accuracy (77.97%). Diagnostic accuracy of procalcitonin is maximum followed by C-reactive protein. Conclusions: In our study all patient with gram negative organism were procalcitonin positive whereas 50% Staphylococcus aureus were procalcitonin positive and in candida positive cases out of 6 cases, 5 (83.3%) were procalcitonin positive.

The pandemic of COVID-19 initially appeared to cause only a mild illness in children. The paediatric age group comprises only less than 7% of total COVID-19 worldwide. Multi system inflammatory syndrome in children (MIS-C) is a rare, but life-threatening complication of SARS-CoV-2 infection. We report a case series of 24 children with suspicion of multisystem inflammatory syndrome related to COVID-19 were assessed using diagnostic criteria established by ministry of health and family welfare, government of India using detailed history, clinical examination and relevant laboratory investigations. Among total 24 patients ranging from 23 days to 11 years with mean age of 4.5 years includes 10 patients (41.67%) presented with mild illness, 7 patients (29.12%) with persistent fever to Kawasaki disease (KD) like illness and 7 patients (29.12%) with fatal disease with MODS and shock. These children were managed as per guidelines with modifications for individual case if necessary and includes supportive management with main stays of IVIG and steroids. Three children died.