Background: Cutaneous manifestation of COVID 19 in children has not yet been reviewed systematically and hence this review gives a future direction to the clinicians to be vigilant for skin presentations during such pandemic.Methodology: The review was done as per the guidelines of PRISMA and literature search was done on PubMed database using keywords as COVID-19, children and skin in different combinations. Articles published in English with cases of age 1 month to 18 years were eligible. The outcome included varied aspects of cutaneous and COVID-19 infection. The review protocol was not registered.Results: Of 51 publications identified, 13 studies containing 149 children met the eligibility criteria. Acrally located erythematous maculopapular lesion was the most common finding in 138 children. Erythema multiforme, varicella like exanthem and Kawasaki disease like presentations were reported in the rest of the cases. The duration of the skin lesion was 1-2 weeks in 43%. Skin biopsy done in 18 cases revealed superficial & deep perivascular and peri-eccrine lymphocytic infiltrate & lymphocytic vasculitis. RT-PCR was positive in 13.8% cases. Serological markers for HSV, parvovirus B19 analyzed across various studies, were found negative, except for mycoplasma pneumoniae in 2 of 20 cases tested.Discussion: Clinicopathologic analysis established chilblains like lesion in 43% cases with no confirmed etiology like cold exposure, autoimmune dysfunction, drug reaction, or viral infection. The usual cephalo-caudal spread of a viral exanthem was also missing. However, a low number of discussed cases was a limitation of the study.Conclusion: In the absence of any confirmed etiology for such cutaneous manifestations, the possibility of COVID-19 should be explored and evaluated thoroughly during such pandemic.
Context:Malnutrition in children is common globally and may result in both short- and long-term irreversible negative health outcomes. It is not a simple disease with single causative factor but it is a disease with multifactorial causation.Aims:1) To estimate prevalence of malnutrition in underfive children using “Z” score. 2) To evaluate the role of epidemiological and maternal factors on the nutritional status of children.Settings and Design:Community-based cross-sectional study.Methods and Materials:Randomly 10 slums were selected and under five-year-old children and their mothers from urban slums were examined and interviewed.Statistical Analysis:Data was analyzed with SPSS ver 20 and appropriate tests were applied.Results:Four-hundred children were examined. According to Z score classification, 39.8%, 36.5%, and 24.8% of children are underweight, stunted, and wasted, respectively. Family size (P = 0.02, χ2 = 7.7), initiation of breastfeeding (P = 0.009, χ2 = 6.8), maternal education (P = 0.001, χ2 = 13.9), underweight mothers (P = 0.05, χ2 = 4.8), and maternal dietary intake (P = 0.03, χ2 = 6.5) are significantly associated with underweight children. Similarly, stunted children show strong association with increasing age of child (P = 0.001, χ2 = 18.1), birth weight (P = 0.006, χ2 = 7.6), and not seeking medical opinion (P = 0.03, χ2 = 7.0). Primary immunization (P = 0.05, χ2 = 3.5), maternal education (P = 0.002, χ2 = 12.4), employed mothers (P = 0.02, χ2 = 4.9), and underweight mothers (P = 0.05, χ2 = 5.3) are associated with wasting in children.Conclusions:This study reveals very high prevalence of malnutrition status among underfive children of urban slums of commercial capital of India. Various maternal and epidemiological factors affect child nutritional status.
Cutaneous manifestation of COVID 19 in children has not yet been reviewed systematically. Hence, this review gives the clinicians a future direction to be vigilant for skin presentations during pandemics. The Pubmed database used for literature search with keywords COVID 19, children, and skin in different combinations. Articles published in English with cases of age one month to 18 years were eligible. The outcome included varied aspects of cutaneous and COVID 19 infection. The authors did not register review protocol. Of 51 publications identified, 13 studies containing 149 children met the eligibility criteria. Acrally located erythematous maculopapular lesion was the most common finding in 138 children. The researcher reported Erythema multiforme, varicella like exanthem, and Kawasaki disease like presentations in the rest of the cases. The duration of the skin lesion was 1 2 weeks in 43%. Skin biopsy done in 18 patients revealed superficial and deep perivascular and peri eccrine lymphocytic infiltrate and lymphocytic vasculitis. RT PCR was positive13.8% cases. Serological markers for HSV, parvovirus B19 analyzed across various studies, were negative, except positive mycoplasma pneumonia in 2 of 20 cases tested. Clinicopathologic analysis established chilblains like lesion in 43% cases with no confirmed etiology like cold exposure, autoimmune dysfunction, drug reaction, or viral infection. The usual cephalo caudal spread of a viral exanthem was also missing. However, a low number of discussed cases was a limitation of the study. The absence of any confirmed etiology for such cutaneous manifestations, the possibility of COVID 19, should be explored and thoroughly evaluated and isolated during such a pandemic.
There are various classifications for grading the degrees of under nutrition. Weight for age classifications i.e. IAP classification, Gomez classification are the most commonly used. Height for age and weight for height ABSTRACT Background: There are various classifications for grading the degrees of under nutrition. Different reference values and cut off points has been a major hindrance in comparing data across various studies and countries. Methods: Community based cross sectional study. Children from urban slums were examined. Anthropometric measurements were taken. Data was analyzed with the help of SPSS ver 20 and appropriate tests were applied. Results: 400 children were examined. As per Z score classification, 39.8%, 36.5% and 24.8% of children are underweight, stunted and wasted respectively. As per IAP criteria, 44.7% are undernourished and 3.2% are severely undernourished (Grade III & IV). Compared to this, the Z score system identifies a much higher prevalence of severe undernutrition (15%) compared to IAP system. Composite index of anthropometric failure (CIAF) identifies 42% of underfive children are normal i.e. no failure, while 58% of children are undernourished. Conclusions:The current study suggests that conventional measures of undernutrition may be missing out a considerable proportion of undernourished children present in the population. CIAF can be used to measure overall prevalence of undernutrition.
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