Indian pediatrics
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Comparative Study
Nutritional status of tribal preschool children in three ecological zones of Madhya Pradesh.
A health and nutrition survey was conducted on tribals in three ecological zones of Madhya Pradesh namely Jhabua (West Zone), Bastar (South Zone) and Sarguja (East Zone) taking into consideration the relative contribution of agriculture, forest and a combination of both to the economy, respectively. The consumption of both foods and nutrients appear to be worse among preschool children of Jhabua compared to Bastar and Sarguja. ⋯ However, 4% of children in Sarguja exhibited signs of goitre. Both by extent and severity of malnutrition, the children of Jhabua appear to be worse followed by Bastar and Sarguja.
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Comparative Study
Hyponatremia in sick children seeking pediatric emergency care.
This prospective study evaluated the frequency, clinical characteristics and causes of hyponatremia (serum sodium < 130 mEq/L) in 727 children upto 12 years of age, who were brought for emergency care, and needed hospitalization. Hyponatremia was found in 29.8% and was more frequent in summer (36%; 123/341) than in winter (24%; 94/386) (p < 0.001). ⋯ Clinical evaluation and concurrent plasma and urinary osmolality and urine sodium suggested that hyponatremia associated with pneumonia, meningitis/encephalitis, septicemia, seizures and miscellaneous diseases was of hypotonic-euvolemic (dilutional) type in more than 80% patients while in all children with acute diarrhea it was of hypovolemic type. The study has shown that hyponatremia occurs frequently in sick children requiring emergency care, especially in summer months, and should receive appropriate attention in the management plan.
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Ninety neonates were ventilated over a period of 33 months of whom 50 (55.5%) survived. Fifty seven babies received IPPV while 33 CPAP. IPPV mode was being used more frequently recently and survival rates have steadily improved over past 3 years. ⋯ Two babies developed BPD and one ROP. Neonatal ventilation should be ventured in centres where basic facilities for level II care already exist. It may not be cost effective to ventilate extremely low birth weight neonates.
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Two hundred and three multi-transfused children with thalassemia attending the Thalassemia Clinic of the Charak Palika Hospital, New Delhi were screened for human immunodeficiency virus (HIV) antibodies by ELISA and all positive cases were confirmed by Western Blot. Of the 203 children screened, 18 (8.9%) were HIV positive, and in these children a detailed immunological work up was done and compared to 18 age-matched HIV negative thalassemics as controls. The tests included absolute lymphocyte counts (ALC), absolute and percentages of CD4+ and CD8+ cells and their ratios (CD4/CD8), immunoglobulin levels (IgG, IgM and IgA) and delayed cutaneous hypersensitivity (DCH) test by Multitest CMI in all the cases and the controls. ⋯ By these criteria, 11 children were classified as P1 A (asymptomatic infection, normal immune function), 1 child as P1 B (asymptomatic infection, abnormal immune function), 2 children as P2 A (symptomatic infection with non-specific findings), 1 child as P2 C (lymphocytic interstitial pneumonitis), 1 child as P2 D1 (Pneumocystis carinii pneumonia) and 2 children as P2 D2 (symptomatic infection with infections). In this paper, the clinical features of the children with AIDS is described, and the immunologic functions of these children are compared with the HIV positive asymptomatic children and with controls. These are the first cases of AIDS in the pediatric age group from India.