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INTRODUCTIONAcute leukemias are one of the most common malignancies in children aged <15 years, accounting for nearly 30%. Though several risk factors have been proposed, a specific etiology has not been determined till date. Fortunately, it is one of the curable malignancies in children and hence early diagnosis is essential.Studies from India have reported variable outcomes, with few specialized centers showing a favourable outcome in more than 70%.1 Not all children have access to the regional Cancer Institutes of India. Children managed at other centers must also receive a minimum standard of care. Multiple poor prognostic factors are described in ALL such as age <1 year or >10 years, male sex, very high leukocyte count, mature B-cell type and T-cell type of ALL, chromosomal abnormalities {ex: t (9;22) or t (4;11)}, which when present have a high chance of relapse and mortality. Whether the risk factors in our population are similar or any other unique risk factor operates in our patients, has to be confirmed.Flowcytometry has now become a standard tool for diagnosing and monitoring acute as well as chronic leukemia. Immunophenotyping by flow cytometry enables accurate diagnosis and treatment on the basis of which further treatment is planned. Immunophenotyping ABSTRACT Background: Acute leukemia contributes to nearly one third of the pediatric malignancies. For effective management of a curable malignancy, the epidemiology of childhood leukemias and audit of previously treated patients would be required. The objective was to study the clinical and immunophenotypic pattern of acute leukemia in children <12 years of age admitted in a tertiary centre. Methods: Prospective study done on 31 children, diagnosed as leukemia and treated over a period of 3 years in GRH, Madurai. Detailed history analysis, clinical examination, lab investigations including flowcytometry were done. Results: ALL was the most common acute leukemia in children (90.3%). 85.7% were identified as B-cell and 14.3% as T-cell. Of the B-ALL, 87.5% was pre-B, 8.3% pro-B and 4.2% mature B ALL. Myeloid antigen co-expression was seen in 35.7%. Fever was the most common symptom (87%) and hepatosplenomegaly was the most common sign (>90%). Poor outcome was noted in 42.3%. T-cell appeared to have worse prognosis than B-cell but did not retain independent prognostic significance in univariate analysis. Conclusions: B-ALL was more common than T-ALL. Extra medullary organ involvement indicates increased tumor burden and poor outcome. None of the clinical or laboratory parameters appeared to predict poor outcomes in our study and this may be due to small sample size. This study provides an insight into the data regarding the epidemiology, clinicopathologic feature and outcome of acute leukemia in a center with low resource settings.

Background: Snake bite is a neglected public health problem in the tropical countries, particularly in rural areas. Snake bite is more common in children and young adults. This study intends to bring out the burden of the issue in rural children of South India. Aims and Objectives: The objectives of the study are as follows: (1) To study the epidemiological profile, the clinical profile, complications, and outcome of pediatric snake bite cases and (2) to study the incidence, predictors, and outcome of acute kidney injury (AKI). Materials and Methods: A prospective and observational study carried out for 1½ years among 0–12-year-old snake bite children. The epidemiological details, details related to snake bite event, pre hospital events, clinical and laboratory parameters on admission, outcome, complications, incidence of AKI, and their possible predictive factors among the snake bite children are analyzed. Statistical analysis was done using SPSS software (IBM, USA) version 20. Results: Male children above 5 years of age in rural areas during outdoor activities are more commonly affected during the monsoon period and during night hours. Hemotoxic snake bites are more common. Incidence of AKI following snake bite is 10%. Possible predictive factors are long bite to admission interval, tender lymph nodes, anemia, increased total count, elevated serum bilirubin on admission, and increased requirement of Anti Snake Venom. Conclusion: This study proves the burden of snake bite among rural children and their morbidity and mortality following snake bite-induced AKI. A high index of suspicion should be kept in mind based on possible predictive factors for development of AKI in snake bite children.

Background: Low birthweight (LBW) is a critical health issue which accounts for nearly 50% of all perinatal deaths and associated with short- and long-term consequences. An understanding of the catch-up growth potential pattern of LBW babies is important which can give a hint for changes in current practice. Aim and Objectives: The aims of this study were to assess and compare the physical growth profile of various categories of LBW babies admitted in neonatal intensive care unit between January 2020 to march 2020 of a tertiary care center and to study factors associated with decreased growth profile of LBW babies. Materials and Methods: It was a longitudinal study involving 280 LBW babies. Assessment was done at corrected gestational age of 40 weeks, 3 months, 6 months, 12 months, and 18 months of age. Weight, length, and head circumference were measured. Chi-square test was used as test of significance. P < 0.05 was taken as significant. Results: About 72.5% of the LBW babies attained catch-up growth by 18 months. Preterm small for gestational age (SGA) has significant percentage of babies (53.4%) not attaining the catch-up growth. Babies who were breastfed (80%) exclusively had better catch-up growth compared to formula fed (4.8%). Conclusion: Preterm appropriate for gestational age had attained maximum catch-up growth followed by term SGA and preterm SGA which is least. Maternal breastfeeding and early initiation of complementary feeding had significant influence in postnatal growth. Mother’s educational status, maternal complications, and neonatal complications had no influence in postnatal catch-up growth.