Introduction: Severe Acute Malnutrition (SAM) is a unique type of severe malnutrition and is different from severe underweight and severe stunting. This study evaluated the clinical manifestations among the children admitted to the SCB medical college and SVP PGIP and elucidated further the factors associated with severe malnutrition among the undernourished children and finally the outcome in terms of cured or mortality. Materials and Methods: This hospitalbased cross-sectional time-bound study with follow-up component was conducted by using technique of sampling without replacement. Children aged 1-60 months admitted to SCB MCH and SVPPGIP during September 2013 to September 2015, having features of SAM were considered for the study population. After detailed history and physical examination, relevant investigations were done and critical analysis made. Results: Total 130 patients with SAM constituted the study population. The overall prevalence of SAM was 2.5%. Majority were non edematous SAM (Marasmus) (77%) and rest were oedematous (Kwashiorkor).There was no variation in sex as both male and female patients were with equal percentage (50%). About 12.3% of children with SAM were less than 2 months, 47.7% between 2 to 12 months, and 40% were above 12 months. Conclusion: Malnutrition is predicted by age less than two years, living with single parent, taking unbalanced diet, lack or incomplete immunization and low level of maternal education. Comorbidities associated with malnutrition were pneumonia, pulmonary tuberculosis, urinary tract infection. Mortality is predicted by age less than one year, peasant parents, having severe malnutrition, dehydration, hypothermia, and hypoglycemia.

The main aim is to find out the clinical feature and outcome of status epilepticus (SE) in children managed in a teaching hospital. The secondary aim is to identify the risk factors influencing the adverse outcomes. Methods In this prospective cohort, children aged 1 month to 14 years with SE as per the International League Against Epilepsy's new guideline (2016) who presented to the emergency department during the period of November 2017 to October 2019 were enrolled. Clinical profile, treatment, and outcome of cases (n = 94) were noted. Results The majority of children, 60 (63.82%), were less than five years of age. Prior history of seizures was present in 33 (35.1%) cases, whereas 61 (64.9%) cases presented with SE as the first episode of seizure. In 14 (42.4%) previous seizure cases, SE was due to drug default. No response to first-line antiepileptic drug (AED) was seen in 84 (89.37%) cases. Acute symptomatic etiology was the commonest etiology of SE in 64 (68%) cases, of which neuro-infections accounted for 44 (46.80%) cases. Longer duration (>60 minutes) of status (p < 0.01), ventilator support (p < 0.0001), and circulatory impairment (p < 0.0001) were attributable risk factors for mortality. A total of 28 children died (mortality rate, 29.8%), and 11 showed the persistence of their neuro-deficit. Conclusions Neuro-infection is the most common etiology of SE in children. Longer duration of SE, more lag time for receiving the first AED, respiratory failure, and presence of shock are independent predictors for poor outcome. Hence, cessation of convulsion at the earliest leads to improved outcomes.

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BackgroundMalnutrition is prevalent in 41% of children less than five years old in developing countries. ObjectiveTo determine the clinical spectrum, identify the risk factors, and find out the factors responsible for the adverse outcomes of severe acute malnutrition (SAM) in children. MethodsIn this prospective cohort, children aged one month to five years with SAM from October 2016 to September 2018 were enrolled. Clinical profile, contributing factors, treatment, and outcome of cases (n=198) were noted. ResultsSAM was diagnosed in 323 (1.6%) of admitted cases. The unimmunized children were 123 (62.1%). Common co-morbidities were acute gastroenteritis (n=89, 44.9%), respiratory tract infection (n=88, 44.4%), and septicemia (n=54, 26.7%). Children not on exclusive breastfeeding (n=157, 79.1%), early complementary feeding (<6 months) (n=157, 88.2%), bottle-feeding (n=138, 77.55%), low birth weight (157, 79.1%), living in kutcha houses (115, 58.2%), and unavailability of safe drinking water (131, 66.4%) were the significant risk factors. Pneumonia, diarrhea, nutritional edema, hypothermia, and circulatory shock at the time of admission were responsible for adverse outcomes. One hundred and eighty-three (92.4%) children were cured and discharged and 15 (7.6%) children died. ConclusionsWrong feeding practices and unavailability of safe drinking water have an important bearing on the development of SAM children. Pneumonia, diarrhea, nutritional edema, hypothermia, and circulatory shock at the time of admission were responsible for adverse outcomes.

Background: Retinopathy of prematurity (ROP) is a multifactorial vasoproliferative retinal disorder that increases in incidence with decreasing gestational age. India shares 20% of the world childhood blindness. Besides congenital cataract, congenital glaucoma and ocular injuries, ROP is emerging as one of the important causes of childhood blindness in India.Methods: This hospital based prospective study was undertaken during October 2016 to September 2018 in the Department of Ophthalmology, SCB Medical College. Authors included (a) all preterm infants weighing less than 1750gm or gestational age less than 34 weeks at birth, (b) infants with birth weight between 1750gm to 2000gm and gestational age more than 34 weeks (late preterm and term infants) those were considered as high risk.Results: Among the 328 babies included in our study, the incidence of ROP was 29.57%. Bilateral ROP was found in 76.29% with nearly equal stages in both eyes and only 23 neonates showed unilateral involvement.Conclusions: Low birth weight, lower gestational age, blood transfusion, Respiratory Distress Syndrome (RDS), apnoea, supplemental oxygen therapy, maternal anaemia and gestational diabetes mellitus (GDM) were strongly associated with development of ROP.

This hospital based observational cross sectional study having a sample size of 100 was undertaken at S.C.B. Medical College and S.V.P.P.G.I.P.,Cuttack,with an objective to study the clinical profile and risk factors for wheezing in infancy from November 2018 to November 2020. Wheezing is accountable for a high demand of medical consultations and emergency care services with relatively high rates of hospitalization.In this study, several risk factors were identified for wheezing in less than one year of age which had little resemblance to similar studies made in various other age groups.However,maternal smoking as a risk factor could not be found in our study due to social cultural lifestyle in the study population. Factors like caesarean section, history of birth asphyxia, NICU admissions and living in kuccha house were not found to impose risk for wheezing in infancy in the study in contrary to similar such studies in other age groups.The present study revealed, that among all other etiology, the viral respiratory tract infections including bronchiolitis was the most common cause of wheezing in infancy (64%) followed by WALRI (wheeze associated lower respiratory tract infection). In conclusion, if an infant with wheezing has risk factors like male sex, preterm, more than six months age, family history of atopy or repeated upper respiratory tract illness or overcrowding in family, anticipating the severity recurrence should be suspected. These infants should be monitored closely for signs of clinical deterioration. Proper health education,ante natal and neonatal care,promoting of breast feeding and creating awareness to the public regarding modifiable risk factors like separation of family members having upper respiratory illness from young infants will reduce the severity of wheezing and will help prevent their recurrence to much extent.

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Background: Chronic arthritis, the most common chronic rheumatic disease of childhood, is one of the more frequent chronic illnesses of children. Besides clinical examination, various hematological and immunological markers are being used to diagnose Juvenile Idiopathic Arthritis (JIA). The present study was designed to be conducted in our institution to find out the clinico-serological profile of JIA. Materials and Methods: All children under 14 years, attending the OPD and suspected to be suffering from Juvenile Idiopathic Arthritis, during September 2010 to September 2012 were included in the study. They were screened for the diagnosis of JIA. All the cases were subjected to hematological, immunological, biochemical and radiological investigation. Analysis was made on clinico-serological profile of the disease. Results: Majority out of 40 cases belonged to the age group 5-10 years and males outnumbered the females. Pallor was present in 100% of SOJIA and Polyarticular RF +ve JIA, 78.5% in Polyarticular RF-ve JIA, and 60% of Enthesitis related arthritis (ERA). In systemic onset JIA, soft tissue swelling was found in 66.67% cases. No cases of psoriatic arthritis or undifferentiated types were detected. Juxta articular osteoporosis was found in 66.67% cases. Methotrexate, Oral steroid and Hydroxychloroquine were the drugs used for most of the varieties of JIA. Conclusion: Even though, different varieties of JIA were detected, no cases of psoriatic arthritis or undifferentiated types were found. Chronic arthritis in childhood shows very diverse clinical pattern. JIA is like an iceberg, the diagnosis of which is usually missed due to lack of definite diagnostic parameters and less accessibility of the common man to the health facility.