BACKGROUND: There has been a recent upsurge in the cases of Multisystem inflammatory syndrome in children (MIS-C) associated with Coronavirus disease . We performed a systematic review and meta-analysis on the demographic profile, clinical characteristics, complications, management, and prognosis of this emerging novel entity. METHODS: Using a predefined search strategy incorporating MeSH terms and keywords, all known literature databases were searched up till 10th July 2020. The review was done in accordance with PRISMA guidelines and registered in PROSPERO (CRD4202019757). RESULTS: Of the 862 identified publications, 18 studies comprising 833 patients were included for meta-analysis. The sociodemographic profile showed male predilection (p = 0.0085) with no significant racial predisposition. A higher incidence of gastrointestinal symptoms (603/715, 84.3%), myocarditis (191/309, 61.8%), left ventricular dysfunction (190/422, 45.0%), pericardial (135/436, 31.0%) and neurological symptoms (138/602, 22.9%) was reported. Serological evidence of SARS-CoV-2 had higher sensitivity compared to rtPCR (291/800, 36.4% vs 495/752, 65.8%; p < 0.001). Coronary artery anomaly (CAA) was reported in 117/681 in 9 publications (17.2%). A total of 13 (1.6%) fatalities were reported. CONCLUSION: Clinicians need to be vigilant in identifying the constellation of these symptoms in children with clinical or epidemiologic SARS-CoV-2 infection. Early diagnosis and treatment lead to a favorable outcome.
Background: Neonatal sepsis forms the second most common cause of neonatal mortality resulting in more than one million neonatal deaths per year. Neonatal sepsis, pneumonia and meningitis together result in one- fourth of all newborn deaths. Objectives of the study was to correlate sepsis markers with blood culture in neonatal sepsis.Methods: A cross sectional study was carried out in the NICU unit under department of Pediatrics, between November 2017 and May 2019. Sample size was 50. Babies admitted to NICU with clinical suspicion of sepsis were included in the study. Blood samples from these babies were collected under aseptic precautions and subjected to rapid diagnostic tests- sepsis markers and blood culture.Results: Male were predominant (64%). Important risk factors were preterm and low birth weight. Blood culture positivity was 20% (E. coli being most commonly isolated organism). CRP had a high sensitivity of 90% and low specificity of 47%. Procalcitonin had highest sensitivity of 100% and low specificity of 47.5%.Conclusions: CRP and PCT were found to be statistically significant (p=0.036 and 0.01), can be used as a diagnostic tool in neonatal sepsis.
Background: Pneumonia is a major cause of childhood mortality and morbidity worldwide. Chest radiography has been used as a modality for diagnosing but has the disadvantage of radiation exposure and inter-observer variability. Hence studies have explored the possibility of using lung ultrasound in the diagnosis of pneumonia. To assess lung ultrasound (LUS) findings in childhood pneumonia and to correlate lung ultrasound findings with clinical findings.Methods: 210 children between 2 months to 5 years admitted in the hospital with diagnosis of pneumonia were enrolled in the study. They underwent LUS within 24 hours of admission and the results were analysed.Results: Out of the 210 patients enrolled in the study, 41 (19.5%) had positive LUS findings. However, LUS findings correlated well with clinical findings in cases with very severe pneumonia.Conclusions: This study showed that lung ultrasound cannot be used a sole diagnostic tool in childhood pneumonia, but it has a valuable role in detection of complications. Lung ultrasound will require more training for detection of early indicators of pneumonia.
Background: Hypertensive disorders of pregnancy pose several problems to both mother and newborn. Complications in new-born like intrauterine death (IUD), intrauterine growth retardation (IUGR), perinatal asphyxia, neonatal sepsis and bleeding disorders are associated with toxemia of pregnancy. To decrease the perinatal morbidity and mortality, babies of hypertensive mothers should be carefully monitored and managed. Aim of this study was to establish the changes in total platelet count in umbilical cord blood.Methods: This is a hospital based prospective observational study which included the babies born to mothers having hypertensive disorders of pregnancy, total cases accounting about 158. Detailed clinical history taken including details of labour and clinical examination done. In all the subjects, 2 ml of umbilical cord blood anticoagulated with EDTA was collected and haematological tests for total platelet count (TPC) count was done.Results: This study shows that the incidence of neonatal thrombocytopenia is 43.67%. The incidence of sepsis among thrombocytopenia group accounts for about 60% in gestational hypertension, 64.2% in pre-eclampsia and 50% in eclampsia group.Conclusions: With respectively, these findings it can be concluded that the incidence of Neonatal Thrombocytopenia is significantly higher in babies born to HDP mothers and it can be taken as a marker to evaluate Sepsis in such a situation in resource limited setting. As less number of studies is available in this area of interest, this study supports the cause.
Kartagener`s syndrome, a rare autosomal recessive disorder is a type of Primary Ciliary Dyskinesia (PCD) associated situs inversus, bronchiectasis, sinusitis and male infertility. We present a case of a 5-year-old girl who came with features of bilateral glue ear, recurrent sinusitis, recurrent hemoptysis and dextrocardia. She was diagnosed to have Kartagener`s syndrome and was evaluated for recurrent hemoptysis.
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