Indian pediatrics
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Observational Study
Prediction of Severe Acute Kidney Injury using Renal Angina Index in a Pediatric Intensive Care Unit.
To determine the proportion of children in a pediatric intensive care unit with a positive Day 0 Renal angina index who develop severe acute kidney injury (AKI) on Day 3; and to compare the predictive ability of the index with that of individual markers of renal injury, for the development of severe acute kidney injury. ⋯ Day 0 Renal angina index positivity is a promising tool to identify critically ill children with impending severe AKI.
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Observational Study
Association of Fluid Overload with Mortality in Critically-ill Mechanically Ventilated Children.
To study the association of fluid overload with mortality and morbidity in critically-ill mechanically ventilated children. ⋯ There is no association of fluid overload with mortality. However, it is associated with poor organ function, longer duration of mechanical ventilation and PICU stay in critically-ill, mechanically ventilated children.
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Practice Guideline
Consensus Statement of the Indian Academy of Pediatrics in Diagnosis and Management of Hemophilia.
Despite having standard principles of management of hemophilia, treatment differs in various countries depending on available resources. Guideline for management of hemophilia in Indian setting is essential. ⋯ Specific factor assays confirm diagnosis and classify hemophilia according to residual factor activity (mild 5-40%, moderate 1-5%, severe <1%). Genetic testing helps in identifying carriers, and providing genetic counseling and prenatal diagnosis. Patients with hemophilia should be managed by multi-specialty team approach. Continuous primary prophylaxis (at least low-dose regimen of 10-20 IU/kg twice or thrice per week) is recommended in severe hemophilia with dose tailored as per response. Factor replacement remains the mainstay of treating acute bleeds (dose and duration depends on body weight, site and severity of bleed). Factor concentrates (plasma derived or recombinant), if available, are preferred over blood components. Other supportive measures (rest, ice, compression, and elevation) should be instantly initiated. Long-term complications include musculoskeletal problems, development of inhibitors and transfusion-transmitted infections, which need monitoring. Adequate vaccination of children with hemophilia (with precautions) is emphasized.