Neurological involvement in the form of meningitis or meningoencephalitis, although well documented in scrub typhus, has not been extensively studied in the pediatric population. We report the clinical and laboratory profile of 96 children with scrub typhus and compared those with and without meningitis. Twenty seven (28%) children had clinical and laboratory evidence of meningitis. The most frequent presenting features were fever (100%), meningeal signs (66.6%), nausea and vomiting (56.3%), seizures (55.5%) and altered sensorium (51.8%). The children with meningitis presented early and had significantly lower respiratory and renal impairments when compared with the non-meningitis group. Cerebrospinal fluid (CSF) analysis revealed elevated total leukocyte count (86.73 ± 94.50 cells/mm(3)), mononuclear pleocytosis (lymphocyte percentage of 76.85 ± 15.86), elevated proteins (108.33 ± 52.63 mg%) and normal CSF glucose (64.18 ± 15.92 mg%). We conclude that meningitis is a common and early complication of childhood scrub typhus. The CSF reveals a lymphocytic pleocytosis, raised proteins and a normal glucose level. These children respond promptly to appropriate antibiotics as do children without meningitis.

Background and Objective:The study was carried out to find the profile of pediatric brain and spinal cord tumors during 2006–2015 in a tertiary referral center of North India.Materials and Methods:It was a retrospective medical record-based observational study. All children <18 years of age with confirmed histopathological diagnosis of cancer were included in the study.Results:Central nervous system (CNS) tumors constituted 5.6% of all pediatric solid malignancies in our hospital. A total of 54 brain tumors and 13 spinal cord tumors were studied. Medulloblastoma was the most common brain tumor (20.3%) followed by pilocytic astrocytoma (16.6%) and glioblastoma multiforme (9.2%). The most common spinal cord tumor was Ewing's sarcoma/primitive neuroectodermal tumor (30.7%) followed by ependymoma (23%). Mean age was 10.5 years and 12.1 years for brain and spinal cord tumors, respectively. There was male predominance in brain tumors while the sex ratio was almost equal in spinal cord tumors. Histomorphologically, necrosis and angiogenesis were associated with higher grades of tumor. Approximately 35% children were alive after a mean follow-up of 36 ± 6 months.Conclusion:Compared with most international studies, we found a higher percentage of medulloblastoma in the brain, thus stressing the role of regional and ethnic influences in the pathogenesis of CNS tumors.

The present study proposes a computer-aided diagnosis (CAD) system for the diagnosis of grades of fatty liver disease, namely mild, moderate and severe fatty liver along with normal liver tissue. Fifty-three B-mode ultrasound images consisting of 12 normal, 14 mild, 14 moderate and 13 severe fatty liver images are used. Based on the visual interpretations by the radiologists, region of interests (ROIs) from within the liver and one ROI from the diaphragm region are considered from each image. The texture features of these ROIs are combined in three ways to form ratio features, inverse ratio features and additive features. The sub-sets of optimal features are obtained by a differential evolution feature selection (DEFS) algorithm and a support vector machine (SVM) has been used for the classification task. The Laws ratio features have shown better performance with an average accuracy and standard deviation of 84.9±3.2. Hence, the CAD system could be useful to the radiologists in diagnosing grades of fatty liver disease.