Achalasia cardia is an esophageal motility disorder rarely reported in children and more so in young infants. Common clinical presentations include vomiting, dysphagia, regurgitation, recurrent pulmonary aspiration and failure to thrive. Diagnosis is made by barium swallow study and esophageal manometry, which is the gold standard test. Pharmocological management and endotherapy often fails and results in recurrence of symptoms. Laparoscopic Hellers myotomy, with or without anti-reflux procedure is the standard treatment of choice for children. Per-oral endoscopic myotomy is utilized for treatment of achalasia in adults, but its safety, efficacy, and feasibility is not studied in children.

The incidence of neonatal jaundice among aborigines is increasing with the morbidity and mortality among this group are well recognized. This study aimed to assess the knowledge and attitude status on neonatal jaundice among Orang Asli in Sepang, Selangor. Cross-sectional study was conducted within two weeks in Kampung Orang Asli in Sg. Pelek, Sepang, Selangor. A simple random sample of adults aged 18 years and above was selected. Data were collected by an interviewed structured questionnaire. Overall, out of 152 residents, 67% were aware about neonatal jaundice. Majority of them were female (72%), married (78.4%) and respondents who have children (86%). Among those who were aware, almost 68% have good knowledge, in which 70% recognized jaundice by yellow discoloration on the body. High pitched crying (12.7%) and not feeding (10.8%) were among symptoms they knew. Almost 50% of the respondents believed neonatal jaundice may cause mental retardation. As for management of neonatal jaundice at home, majority of them (47%) will expose the baby under the sun, 7.8% will take herbal medication whereas 2% will continue with breast feeding. Almost eighty percent of the respondents will send their jaundiced baby to the hospital immediately, whereas 23% prefer management by nurse at home. Although majority of respondents in Kg. Orang Asli Sg. Pelek have good knowledge & good attitude on neonatal jaundice, some mothers are still likely to resort to self-treatment with potentially harmful therapies.

Background: Inborn Errors of Metabolism (IEM) are a group of disorders occurring due to disruption of normal biochemical process. Prompt diagnosis is often only the beginning of a long medical journey for the affected children and their family. Pediatricians play a vital role in establishing the continuity of care, providing treatment when needed and referrals to specialists. Reported prevalence of IEM is 1 in 2497 newborn though, true pan India prevalence is still unknown. This study was carried to determine the clinical spectrum of inborn errors of metabolism in a tertiary care hospital in South India.Methods: Records of all patients suspected and diagnosed to have inborn errors of metabolism in Institute of Child Health and Hospital for Children, Madras Medical College from April 2018 to October 2019 were sequentially included in the study. Details of clinical presentation, investigations and treatment were noted and analysed.Results: In this study 65 children diagnosed to have inborn errors of metabolism were included in the study and of them 27(41.5%) had derangement in carbohydrate metabolism, 16(24.6%) in protein metabolism and 22(33.9%) in lipid metabolism. Mean age at presentation was 37 months with range of 2 months to 10 years of age. Most common clinical manifestation was poor feeding (67.7%) followed by fever (64.6%) and dyspnea (63.1%). Of these 65 children, mortality was observed in 10 cases (15%).Conclusions: IEM contribute to a significant cause of global child morbidity and mortality. A high index of suspicion is most important in making the diagnosis. IEM should be considered in children with features mimicking sepsis and unexplained course. Screening programmes and prenatal diagnosis of IEM will go a long way in preventing these disorders and early diagnosis helps initiate prompt therapy which is very much essential to prevent lethal complications.

Background: Subclinical hypothyroidism is quite a common clinical condition in pediatric population. Objective of this study was to understand the clinical and biochemical profile of Subclinical hypothyroidism in children attending endocrinology OPD at a tertiary care center in southern India. Methods: In this study 62 children diagnosed with subclinical hypothyroidism. Clinical assessment and laboratorial evaluation was carried out in a systematic way. Symptomatology, anthropometry, measurement of vital parameters such as heart rate, blood pressure, tests for anti-thyroid antibody, lipid profile, estimation of bone age, USG neck, assessment of left ventricular function using M-mode echo were carried out at the time of diagnosis. Results: Subclinical hypothyroidism is more common in female children, principle symptoms were neck swelling and weight gain, goitrous autoimmune thyroiditis is more common in female, significant number of children had positive anti-thyroid antibodies, mean TSH value of patients with positive anti-thyroid antibody was high, there was no delay in bone maturation in majority of children, both systolic and diastolic blood pressure were high, these children had abnormal lipid profile, heart rate and left ventricular function were normal. Conclusions: Subclinical hypothyroid children have higher risk of hypertension and pro-atherogenic lipid abnormalities. As there is a risk of progression to overt hypothyroidism these children needs regular follow up. Cite this article as: Poornachand V, Kumarasamy K, Seenivasan V, Karamath SP. Study of clinical and biochemical profile of subclinical hypothyroidism in children aged 2-12 years. Int J Contemp Pediatr 2017;4:43-7.