South Indian Children Research Articles

Diagnostic accuracy of Gorelick 10 point scale in comparison to IMCI scale in identifying significant dehydration in South Indian children? - A prospective observational study

ABSTRACT Background: Unavoidable cause of mortality among under 5 children in India is dehydration resulting from acute diarrhoeal diseases. In spite of various dehydration scales available across the world, the most commonly used dehydration scale in India is IMCI.Gorelick 10 point scale having more clinical indicators could also be considered using if the diagnostic accuracy of the scale in identifying the significant dehydration is in par with that of IMCI scale. Our Objective was to classify the 1month - 60 month aged children admitted with diarrhoeal disease based on dehydration assessment using Body weight, Gorelick 10 point scale, IMCI scale and to compare the diagnostic accuracy of Gorelick 10 point scale vs IMCI scale in identifying significant dehydration. Methods: The prospective observational study was done among 224 , 1 month to 60 month aged children admitted with acute watery diarrhea. The children were assessed for severity of dehydration using Body weight, Gorelick 10 point scale, IMCI scale. The diagnostic accuracy of Gorelick 10 point scale vs IMCI scale in identifying significant dehydration was assessed using statistical methods like, Sensitivity, Specificity, Positive Predictive Value PPV,NPV,LR+, LR-, Youden index and accuracy and Kappa statistic to detect inter-rater reliability. Results: The proportion of participants classified as to have no dehydration, some dehydration and severe dehydration according to Gorelick 10 point scale, IMCI and percentage of weight loss was 79.9%, 18.8%, 1.3% vs 77.7%,21%,1.3% vs 79.9%,18.8%,1.3% respectively The diagnostic accuracy of IMCI scale in identifying Significant dehydration was higher than Gorelick 10 point scale, as noted by having Sensitivity, Specificity,PPV,NPV,LR+,LR-,Youden index and accuracy as 100%,97.2%,0%,100%35.8,0,0.97,97.7% vs 88.9%,97.2%,88.2%,97.2%,31.8,0.11,0.85,95.5% respectively and k value was 0.9. Conclusion: Though the diagnostic accuracy of IMCI was little higher than Gorelick 10 point scale in identifying significant dehydration, having obtained k value of 0.9, indicates posing an excellent agreement Gorelick 10 point scale can be used in place of IMCI to identify Significant dehydration.

Assessment Of Risk Factors For Recurrent Febrile Seizures Among Children Aged Below 5 Years

Background: Febrile seizures are seizures that occur between the ages of 6 and 60 months with a temperature of 100.4°F or higher, that are not result of CNS infection or any metabolic imbalance and that occur in the absence of a history of prior afebrile seizures. They occur in around 2% of 5% of children and recurrence is seen in about one-third of children. Very few studies till now reported the risk factors of recurrence of febrile seizure from India. Therefore, the present study was conducted to know the risk factors associated with recurrence of febrile seizures among South Indian children. Objectives: 1. To know the incidence of recurrence of febrile seizures among children. 2. To study the risk factors of recurrent febrile seizures among children aged below 5 years. Materials and Methods: 50 children with febrile seizures were included. The study was done in the Department of Pediatrics at ASRAM, Eluru, Andhra Pradesh, India. Male and females children aged 6 months to 5 years with clinical features suggesting febrile seizures were included. Results: Among 50 children included, 22 had recurrent febrile seizures and 28 had no recurrent febrile seizures. Overall 29 children were males. Family history of febrile seizures, young age, family history of epilepsy, temperature below 102°F, less duration of fever, complex febrile seizures are found to be risk factors for recurrence. Gender and duration of febrile seizures were not associated with the recurrence. Conclusion: The current study revealed that younger age at onset of 1 st episode of seizure, lower temperature during the episode, brief duration between onset of fever and seizure episode and family history of febrile seizures were associated with recurrence of febrile seizures.

Ocular biometric parameters in South-Indian children with myopia - A hospital-based retrospective descriptive analysis.

This study aims to profile the ocular biometric parameters in a large group of children of South-Indian ethnicity who visited our outpatient children's department and were diagnosed with myopia. Children <15 years old diagnosed with myopia (Jan 2022-Oct 2023) and who had ocular biometry readings recorded were included. Their demographics, axial length (AL), anterior chamber depth (ACD), spherical equivalent (SE), corneal radius of curvature (CR), and AL/CR ratio were analyzed. The study included 3728 myopic children; the mean age was 11.85 (4-15) years, and 52.8% were girls. Mean SE was -3.98 D. The mean (SD) AL, ACD, CR, and AL/CR ratio were 24.64 (1.32), 3.73 (0.40), 7.61 (0.27), and 3.24 (0.16), respectively. Female gender was associated with shorter AL, ACD, CR, and AL/CR ratios (P < 0.001) across all age groups. There was a significant increase in ACD with age in both sexes (P < 0.001). A 1-unit (mm) increase in AL was associated with an SE increase of -1.65 D (CL: -1.70 to -1.60). AL/CR ratio could explain 71% of the total variance in SE (P < 0.001). SE showed a mild correlation with age (rho = 0.14, P < 0.001) and ACD (rho = -0.03, P = 0.041) and a stronger correlation with AL (rho = -0.68, P < 0.001) and AL/CR (rho = -0.83, P < 0.001). In this hospital-based study, AL and AL/CR ratios strongly correlate with SE, and the AL/CR better explains the total variance in SE than AL alone in children with myopia.

Internet Addiction and Sleep Quality Among School Children in South India.

Today's internet is an unavoidable component of educational sources, the entertainment field, and telecommunication processes. Internet usage is more likely among adolescents and young adults in the form of surfing, chatting, playing games, and fulfilling their social needs. The present study has been planned to assess the effect of internet addiction (IA) on sleep quality in school children. This cross-sectional school-based study was conducted amongschool students in Pondicherry. A total of 350 school students of both genders studying in grades six to 10 and having access to at least one device with internet for more than one year were recruited from government and private schools located in five randomly selected communes in Pondicherry by convenient sampling method. Assessment of IA was done using Young's Internet Addiction Test (YIAT). The Pittsburgh Sleep Quality Index (PQSI) questionnaire assessed the participants' sleep quality. All the data was tested for normality using the Kolmogorov-Smirnov test. Chi-square and unpaired t-tests were used for analysis. The average age of the participants is 13 years. 49 (26.1%) are children and 139 (73.9%) are adolescents. The majority of them are females belonging to the adolescent age group(169, 89.4%). Around 17 (19.5%) children and 70 (80.5%)adolescents reported mild IA. Thirteen (59.1%)childrenand nine (40.9%)adolescents reported moderate IA. There is no significant difference in sleep quality between children and adolescents (4±2.33 vs. 3.62±2.61, p=0.37)but there is a considerable difference in their levels of IA(32.98±21.06 vs. 25.6±15.08, p=0.01). Conclusion: This study found a significant relationship between IA and poor sleep quality among adolescents. Thus, adolescents, parents, school authorities, and researchers should understand the importance of regulating internet usage and encouraging sleep hygiene. Thus, appropriate measures should be taken to address the effects of IA on sleep quality.

Parental Stress and Psychological Distress and Their Association With Spousal Support Among Parents of School-Age Children During the COVID-19 Pandemic in South India: A Cross-Sectional Observational Study.

The COVID-19 pandemic presented unprecedented challenges to families in the form of social isolation, economic difficulties and inaccessibility of educational and supportive services. To assess the levels of parental stress and psychological distress among parents of school-age children during the COVID-19 pandemic and to analyse its correlation with spousal support. A cross-sectional, web-based study was conducted among the parents of school-age children in south India. One hundred thirty-two completed responses were obtained. Study tools included Parental Stress Scale, Spouse Support Scale and Kessler's psychological distress scale-6 item version. The mean parental stress score was 42.39 ± 9.679. Sixty percent of the participants reported moderate to high levels of psychological distress. Parental stress and psychological distress scores were noted to have a significant negative correlation with spousal support scores (r=-.486, p=.000 and r=-.401, p=.000 respectively). Our study findings show that the COVID-19 pandemic has taken a toll on the psychological well-being of parents of school-age children. Supportive interventions to address parenting difficulties need to be undertaken to prevent long-term adverse mental health outcomes. Lessons learnt from the pandemic are important for clinicians and policymakers to take measures to alleviate parental stress as well as to promote the psychological well-being of parents and children.

Do cardiometabolic risk factors mediate the relationship between body composition and bone mineral content in South Indian children aged 5 to 16 years?

The complex interplay between adiposity, bone health and cardiometabolic risk (CMR) factors is unclear in Indian children. We aimed to investigate the mediating role of number of CMR factors on the relationship between fat % and bone mineral content (BMC) % in South Indian children aged 5-16 years. Healthy children (n = 317), from India, underwent anthropometric, blood biochemistry, blood pressure, along with body composition and BMC assessments using Dual-energy X-ray absorptiometry. Based on the number of CMR factors, children were categorised into three groups: 0, 1 and ≥ 2. Analysis of variance was used to compare the parameters between the CMR groups and mediation analysis was performed to examine if the number of CMR factors mediated the relationship between fat % and BMC %. The prevalence of 0, 1 and ≥ 2 CMR factors was 42.3%, 33.9% and 23.9% respectively; mean BMC % was lowest in ≥ 2 CMR group. In the whole group, BMC % had significant negative correlation with fat % (r = -0.68, p < 0.0001) and positive correlation with lean % (r = 0.64, p < 0.0001). Adjusted for age and sex, results suggested significant mediating effect of number of CMR factors on the relationship between fat % and BMC % (Average Causal Mediation Effects =-0.002, bootstrapped 95% CI: -0.0039, -0.0001, p < 0.01), but losing significance when adjusted for co-variates. Number of CMR factors mediates the relationship between fat % and BMC % in Indian children. Further studies are needed to confirm these findings, understand mechanisms and plan appropriate strategies.

Normative Data of Ulnar Length in Pediatric Indian Population.

Objective The aim of this study is to create clinical normative data for ulnar length in the pediatric population and to demonstrate the usefulness of such data. Materials and Methods A nationally representative sample of healthy children aged 1 day to 18 years from five centers across India was collected. The percutaneous length of the ulna was measured by using a certified calibrated measuring tape across all centers. Other variables such as geographical domicile, dominance of the hand, age, body mass index (BMI), and sex of the child were also recorded. Results In total, 1,300 children (883 males and 417 females) with age ranging from 1 day to 18 years were included in the study. Gradual lengthening of the ulna was seen in both male and female children with increasing age without a significant difference; however, at 8, 9, and 14 years, there was significant lengthening of the ulna in males compared with females although the difference was statistically insignificant at 17 years. Apropos BMI at 16 years of age, a longer ulna was observed in obese children. Later on, at 18 years, the difference in ulnar length was insignificant. South Indian children had a significantly longer ulna up to the age of 11 years, but after the age of 11 years there was no difference in ulnar length in all zones. The length of the ulna was not affected by hand dominance. There was good inter-observer agreement and reliability between different centres. Age, zone, and gender, had statistically significant effect on the length of ulna but BMI and hand dominance was not significant. Conclusion This multicentric study provides normative data on the percutaneous length of the ulna in the Indian pediatric population. Gradual lengthening of the ulna was seen in all children with increasing age. The length of the ulna was significantly more in male, obese, and in South Indian children. However, except for age, other factors become insignificant at maturity.

Utility of anthropometry in defining overweight and obesity in urban South Indian children.

Waist-based indicators of obesity are being used to detect central obesity and are predictive for metabolic syndrome (MS). The aim of the study is to assess the basic anthropometric indices in children, to determine the prevalence of overweight and obesity, and to determine the association between various waist-based measurements and body mass index (BMI). A cross-sectional study was conducted among children aged 10 to 15 years attending government corporation schools in Chennai. Basic anthropometric measurements were taken. BMI, waist circumference/height ratio (WHtR), and waist circumference/hip circumference ratio (WHR) were calculated. The percentiles (Indian reference cutoffs) were determined for waist circumference (WC) and BMI. The prevalence of overweight and obesity was determined and compared to waist-based parameters. Of 820 children, males constituted 47.1%. Stunting was seen in 9.8% and 7.8% were underweight. 8.2% had BMI less than the 3rd percentile. The prevalence of overweight and obese children was 9% and 3.2%, respectively, with female predominance. The majority had WC less than the 5th percentile. The prevalence of children under risk for MS based on WC >70th percentile was 4.5% and based on WHtR >0.5 was 8.2%. A significant association was identified between all waist-based anthropometric measurements to detect children at risk for MS and overweight/obese children as per BMI category. WHtR >0.5 was an indicator of overweight/obese children in logistic regression analysis. Early identification of children at risk of MS would require a combination of BMI to detect general obesity and waist-based anthropometric measurements to identify central obesity.

Population specific dental age estimation model for South Indian children based on normalized open apices method: A cross sectional study

Age estimation plays significant role in forensic science especially when there is unavailability of the information concerned to the deceased. Use of population specific models of age estimation results in questionable evidence legally when tried on Indian children. The present study was designed to assess the accuracy of Cameriere’s Italian and Balwant Rai Indian model on South Indian children and to derive and validate a novel model for south Indian children by considering a sample from a larger geographical area with a greater sample size of 2500. Accuracy of both the models for South Indian children was analysed using root mean square error. Significant differences were observed in estimated age across all age groups and between sexes, using above models. Root mean square error using Cameriere’s Italian model was 1.54 and for Balwant Rai Indian model, it was found to be 1.78. The error for all the age groups was found to be 1.49 to 1.60 using Cameriere’s model and 1.41 to 2.1 using Rai’s model. A novel Population specific model was derived based on open apices of left mandibular seven teeth. Root mean square error with novel derived Population specific model was found to be less than 1 year overall being 0.94 and for all the age groups ranged from 0.91 to 0.96. The derived Population specific model exhibits superior accuracy compared to both the models and hence it can be considered for dental age estimation of the south Indian children in medico-legal cases.

Estimation and Correlation of Alkaline Phosphatase Enzymatic Activity in Saliva with and without Early Childhood Caries in South Indian Children: A Randomized Clinical Trial.

Early childhood caries (ECC) is a major common problem seen in children and is the most prevalent chronic disease that leads to discomfort, pain, and poor quality of life, affecting the health of children. Alkaline phosphatase (ALP) is a nonspecific phosphomonoesterase that functions through a phosphoery 1 intermediate to produce free inorganic phosphate. It has different isoenzymes produced by different cell types such as polymorphonuclear leukocytes, osteoblasts, macrophages, and fibroblasts within alveolar bone and/or salivary glands. Various studies show that higher ALP activity is related to periodontal disease and dental caries. This study aims to estimate and correlate salivary Alkaline Phosphatase enzyme activity in the saliva of children with and without ECC. A total of 50 children were included in the study, divided into two groups-caries-active and caries-free, each consisting of 25 participants. Unstimulated saliva samples were collected and subjected to a spectrophotometer for analysis. ALP enzyme activity levels were estimated and correlated between caries-active and caries-free children. The correlation between caries score and ALP activity was statistically significant, with a moderate correlation. The comparison of mean ALP activity between caries-active and caries-free groups was statistically significant. However, the comparison of ALP based on different age-groups and gender was not statistically significant. There was a statistically significant correlation between caries scores and the caries-active group. In conclusion, there is a substantial correlation between ALP enzyme levels and the severity of dental caries. An increase in ALP enzyme level is linked to a considerable rise in caries severity. Therefore, prevention may be possible with early detection. Thimmegowda U, Kuri PN. Estimation and Correlation of Alkaline Phosphatase Enzymatic Activity in Saliva with and without Early Childhood Caries in South Indian Children: A Randomized Clinical Trial. Int J Clin Pediatr Dent 2024;17(5):528-531.

Normative data of corneal diameter and palpebral fissure height in a large cohort of South Indian children.

The purpose of this study was to establish the normative data of horizontal visible iris diameter (HVID), vertical visible iris diameter (VVID), and palpebral fissure height (PFH) in a cohort of South Indian children. The study included 1,234 children from six schools of different regions of Tamil Nadu state, India. HVID, VVID, and PFH were measured using a simple millimeter ruler by three optometrists. Based on their age, the children were divided into three groups: preprimary school children (4-5 years), primary school children (6-10 years), and high school children (11-15 years). Mean age was 4.49 ± 0.50 years, 8.00 ± 1.41 years, and 12.87 ± 1.42 years in the three groups, respectively. Mean HVID was 10.45 mm, 10.54 mm, and 10.73 mm, respectively. Mean VVID was 9.18 mm, 9.32 mm, and 9.57 mm, respectively. Similarly, mean PFH was 8.15 mm, 8.30 mm, and 8.52 mm, respectively. There was a significant difference in HVID, VVID, and PFH among the three age groups (P ≤ 0.001), as well as among male and female children in the 6-10 years age group (P ≤ 0.05) but not in the other groups. Intraclass correlation coefficient values (0.78-0.95) show good agreement among the three optometrists for all parameters. The normal range of HVID, VVID, and PFH presented in the current study can help practitioners in the diagnosis of corneal disorders, serve as a basis for the design of contact lenses, and enable accurate intraocular lens power calculations for South Indian children.

AMELX gene association to early childhood caries in south-Indian children: a case-control study.

Genetic variants of AMELX gene can affect the protein content, organization of enamel prisms, microstructure and microhardness of the enamel, thus altering the caries susceptibility. The present study aims to assess the association between polymorphisms rs17878486, rs5934997, and rs5933871 of AMELX gene and Early Childhood Caries (ECC). This case-control study was conducted on 200 participants, aged 3-6years, with 100 controls and 100 children with ECC. A questionnaire was used to collect demographic data, birth-weight, type of delivery, oral hygiene practices, feeding history and 24-h diet diary. DNA was isolated from blood and subjected to PCR followed by Sanger sequencing. The CC genotype of rs17878486 showed an OR of 1.93 (0.34-10.81; P = 0.73). In a recessive model, the CC genotype of rs17878486 reported an OR of 2.04 (0.36-11.40; P = 0.68); rs5593871 reported an OR of 1.00 (0.31-3.21). Statistically significant differences (P ≤ 0.05) between genotype and allele frequencies of rs17878486, rs5934997, and rs5933871 were not observed between children with ECC and the controls. Polymorphisms of AMELX gene did not show a significant association with ECC in this population. However, documentation of genetic data in a global context of ECC may be essential for the future.

Construct Validity and Reliability of the Affordances for Motor Behavior of Schoolchildren in South India

The Affordances for Motor Behavior of Schoolchildren (AMBS) is a standardized self-reporting tool comprising 73 questions, organized into seven sections aiming to assess affordances in children’s regular contexts. This investigation aims to establish the reliability and validity of the results obtained from the AMBS in South Indian children. The AMBS reliability and construct validity were evaluated in 393 Indian families whose children were aged between 6 and 10 years old. The internal consistency of the AMBS was evaluated by retesting the tool in a subsample of 30 families following a 14-day interval between assessments (intraclass correlation coefficient), showing a reliability level of .933. The validity of the scale was evaluated using the confirmatory factor analysis. The model that was tested indicated a very good fit, and the structural model presented significant loading coefficients from the identified variables to the theoretically specified latent factors. Positively significant correlation values were found between factors: home and materials (r = .78), home and school (r = .55), and materials and school (r = .77). Our findings suggest that AMBS is a reliable assessment tool and can evaluate the affordances provided to South Indian children. This information can be used to develop interventions to improve the physical activity levels of these children.

Growth Velocity in South Indian Children Between Three and 18 Years of Age.

Objective Height velocity is a crucial anthropometric parameter for the evaluation of mild- or recent-onset short stature; however, there is no data on height velocity in South Indian children. We undertook this study to establish the normative data. Methods This prospective longitudinal study included 3327 apparently healthy children aged three to 18 years from government and private schools of Krishna district, Andhra Pradesh. Height and weight were measured at baseline and three-monthly intervals for one year (October 2018 to October 2019). Results Age- and sex-specific height velocity percentiles were generated. The data was available in 1627 boys and 1700 girls. The mean peak height velocity (PHV) was 7.18±2.56 cm in boys observed at 12-12.9 years and 5.8±2.56 cm in girls at 10-10.9 years. Conclusion Normative height velocity data for South Indian children has been presented.

Association of polymorphisms of vitamin D gene in children with asthma and allergic rhinitis – Hospital based study

Vitamin D gene polymorphisms are known to be associated with asthma and allergic rhinitis in children. However, the genetic association of the same in South Indian children with above condition is still unknown. The present study was designed with the objective to analyze the association of polymorphisms of vitamin D receptor gene (VDR) (rs797532, rs154410, rs2258470, rs731236) and transport gene of vitamin D (rs7041) in children with asthma and allergic rhinitis in South India. Children (1–18years) presenting with symptoms suggestive of asthma and allergic rhinitis to hospital based outpatient department, in Vellore, South India were recruited as cases and children presenting with minor illness without respiratory complaints were enrolled as controls during January 2018 to September 2021. Polymorphisms were genotyped using tetra-arms PCR. Significant increase in levels of absolute eosinophil counts and serum IgE levels with decrease in vitamin D levels was seen among the cases. Significant association between levels of vitamin D and serum IgE was also observed. Analysis of polymorphisms showed that, in comparison to homozygous major allele the odds of having heterozygous (OR0.55 (0.3, 0.99) and homozygous minor form (OR0.52 (0.28, 0.97) of rs7975232, homozygous minor (OR 0.51 (0.34, 0.76)) and alternate allele (OR 0.7 (0.53, 0.93)) of rs154410 and homozygous minor form (OR 0.57 (0.37, 0.88) of rs731236 was significantly lesser among the cases. Genotypic model of rs154410 (p0.023) and allele form of rs7041 (p 0.041) were significantly associated with vitamin D levels however no association of gene blocks with cases was seen in haplotype analysis. There was an apparent gene pool difference noted in comparative analysis between Indian studies. The study is the first in south India to analyze levels of serum IgE, Vitamin D levels, association of VDR polymorphisms, and rs7041 in children with asthma.

Reference exophthalmometric values in south Indian children between 3-7 years old

To provide the reference exophthalmometric values in Indian children aged between 3-7 years.The study consisted of 528 children of both gender (age range from 3-7 years old), who were randomly selected from six schools in the two districts of south India. Normal children free of orbital diseases and other ocular abnormalities were included in the study. Exophthalmometry values were measured in right eye and left eye using a monocular Luedde exophthalmometer in the primary position. The mean absolute exophthalmomeric values among 3-7 years old children in OD and OS were 11.38 ± 0.93 mm (CI: 11.26-11.42) and 11.32 ± 0.93 mm (CI: 11.24-11.40) respectively. The mean absolute exophthalmomeric values of the OD and OS of male children were 11.28 ± 0.93mm and 11.25 ± 0.94 mm respectively. Similarly, for female children mean absolute exophthalmomeric values of the OD and OS were 11.41 ± 0.93mm and 11.39 ± 0.91mm respectively. The range of exophthalmometry values in these group of children is ranging from 9-15.5 mm. There is no significant difference (P=0.35) in exophthalmometry values among male and female children. There is a significant positive correlation between absolute exophthalmomeric values and age (r = 0.62, P &amp;#60; 0.05). None of the children in this study have shown relative exophthalmometry of more than 2mm. In order to diagnose orbital diseases and craniofacial deformities in clinical contexts, ophthalmologists and other healthcare professionals might use the exophthalmomeric values of Indian children aged 3 to 7 presented in this study.

Influence of indoor volatile organic compounds and its relative respiratory effects among children living in rural biomass cooking households of Tamil Nadu and Andhra Pradesh.

Exposures to volatile organic compounds (VOCs) cause respiratory symptoms among children, a known vulnerable group. Reports on exposures to VOCs and respiratory symptoms among South Indian children living in biomass-using households are not available thus far. A cross-sectional study was conducted among 313 rural children to assess the influence of emitted VOCs on their respiratory health. Standard analytical procedures for VOCs and Pulmonary Function Test (PFT), allied questionnaires, and all ethical considerations were fulfilled in the study. The increase in VOC concentrations was observed proportional to the amount of burnt biomass fuel in two selected sites in Tamil Nadu (TN) and Andhra Pradesh (AP). Houses cooked for more than 60min showed a remarkable increase in VOC concentrations and was observed as statistically significant (p < 0.01) in AP households. Among the younger children, the peak expiratory flow rate (PEFR) values were found significantly higher than comparatively older children in both the sites, TN and AP. However, the trend with respect to FEV1 is statistically significant (p < 0.01) among AP children. This study reports reduced lung function for a considerable proportion of the VOC-exposed selected children. Based on PFT, the children who were interpreted to be normal were found to be exposed to lesser indoor TVOC concentrations in comparison with the children of the households having restrictive or obstructive impairments. Diagnostic ratios with Benzene/Toluene (B/T) and Xylene/Ethyl benzene (X/E) confirmed the presence of VOCs-emissions from adjacent cooking fuels only. The observed results of this study recommends cleaner cooking fuel-use for better respiratory health among the citizens across the country, which in turn, in line with the Pradhan Mantri Ujjwala Yojana (PMUY), Government of India.

Clinical Characteristics and Treatment Outcome of Eosinophilic Meningoencephalitis in South Indian Children: Experience From a Prospective Registry

BackgroundTo describe the clinical features and therapeutic outcomes of a prospective cohort of children with eosinophilic meningoencephalitis. MethodsChildren admitted with clinical features suggestive of meningitis along with cerebrospinal fluid (CSF) eosinophilia during the period of 14 years (2008 to 2021) were included. Their baseline characteristics, epidemiologic associations, and treatment outcomes were analyzed and compared with the previous studies. ResultsWe identified 25 children (13 males) satisfying the inclusion criteria. The median age at presentation was 3.9 years (range 0.8 to 17 years); 68% were aged less than two years. Fourteen (56%) children had a history of exposure to snails. Most of them presented with fever, headache, irritability, lateral rectus palsy, and early papilledema. Symptoms started three to 42 days (median duration: 14 days) before admission to our center. All children had peripheral eosinophilia, which ranged from 9% to 41%. The mean CSF white blood cell count was 416/mm3 (range 50 to 1245 cells/mm3) with CSF eosinophilia ranging from 11% to 80%. Brain magnetic resonance imaging was done in 24 children and was normal in 15 (62.5%). Leptomeningeal enhancement was seen in two (8.3%) children, and other nonspecific changes were noted in seven (29.1%) children. All children recovered without any neurological deficits with a standard treatment regimen of albendazole and oral steroids. All were asymptomatic at the last follow-up. None of them had any recurrence during the follow-up period. ConclusionWe report one of the largest clinical series of children with eosinophilic meningoencephalitis from an endemic area of South India.

Recovery From Otitis Media and Associated Factors Among 1- to 6-Year-Old Children in South India: A Longitudinal Study.

This study was aimed at assessing recovery from otitis media (OM) and variables associated with it among 1- to 6-year-old children. Subjects and. We assessed 87 children with OM otologically and audiologically. Medicines were prescribed, and medication compliance was ensured. The children were followed up after 3 months to judge the status of OM as resolved or recurrent. Data were statistically analyzed to derive the risk of recurrence of OM with effusion (OME) and acute OM by degree of hearing loss, type of tympanogram, age group, and sex. The overall recurrence rate was 26%. The risk of recurrence was higher for OME (odds ratio [OR]=4.33; 95% confidence interval [CI]: 1.90 to 9.83); at AC auditory brainstem peak V responses up to 40 dBnHL (OR=5.20; 95% CI: 2.05 to 13), 50 dBnHL (OR=3.47; 95% CI: 0.5 to 23), and 60 dBnHL (OR=16.09; 95% CI: 4.36 to 1.2); in B (OR= 3.16; 95% CI: 1.36 to 7.33) and C tympanograms (OR=2.83; 95% CI: 0.70 to 11.41); and in the age group of 5-6 years (OR=8, 95% CI: 2.23 to 28). The risk of recurrence of OM did not differ between male and female patients. The rate of recurrence was comparable to or lower than that reported in the pediatric population of other countries. The findings suggest that children with OME, severe pathology, or age of 5-6 years require more attention and frequent monitoring to minimize the risk of recurrence.

Laron syndrome in South Indian children – A descriptive study

Objectives: The objectives of this study were to describe the clinical and biochemical features of five children with Laron syndrome (LS) from South India. Material and Methods: This is a prospective descriptive case series of five children with clinical and biochemical features of LS managed over 5 years. Results: Five children (two girls and three boys) with LS with the mean age group of 5.9 ± 1.7 years and the mean age at diagnosis of 2.7 ± 0.8 years are described. All children were born out of consanguinity and all had typical phenotypic facies of LS. The mean Z-scores of height, weight, and body mass index on follow-up for the cohort were −7.0 ± 1.6, −5.9 ± 2.8, and −0.1 ± 0.7, respectively, and they were within ± 2 SD of the mean for children in LS chart. The median basal growth hormone level for age was 13 ng/mL and the median growth hormone levels at 30 min, 60 min, 90 min, and 120 min post-stimulation test were 35 ng/mL, 35 ng/mL, 44 ng/mL, and 50 ng/mL, respectively. All of them had insulin-like growth factor-1 (IGF-1) levels less than the 3rd percentile and no increment during the IGF-1 generation test. The prevalence of micropenis was 100% and one child had symptomatic hypoglycemic episodes. Genetic analysis was performed in two boys and both harbored variants in the growth hormone receptor gene. Conclusion: LS should be suspected in children with clinical features of growth hormone deficiency along with elevated growth hormone levels and low IGF-1 levels with no increment of IGF-1 in the IGF-1 generation test.