There is no robust evidence of a definite biological benefit, either for therapy or prevention, to suggest a routine megadose supplement of vitamin D3 for under-five children with severe pneumonia.

Ten out of 20 children, treated with usual doses of vincristine for various types of childhood cancers, developed neurotoxicity during treatment. Peripheral neurotoxicity (mixed motor-sensory 4/10, pure motor 3/10, pure sensory 3/10) was seen in the form of weakness of lower limbs, areflexia, neuropathic pain, or sensory loss. Autonomic neuropathy presented as constipation and urinary retention in 2 children, while 2 children developed encephalopathy in form of seizures, confusion, aphasia, and transient blindness. In children with severe neuropathy, vincristine administration was withheld/dose reduced till clinical improvement started, which took about 2-3 weeks time. Nerve conduction velocity showed motor-sensory axonal polyneuropathy. Electrophysiological abnormalities were found to persist even six months after clinical recovery in children with neurotoxicity. We found a relatively higher incidence of vincristine induced neuropathy in Indian children, which was probably due to coexistence of severe malnutrition in them.

No abstract

This systematic review identifies and explores factors associated with the prevalence of CRS in India. There is a need for urgent action in terms of revamping the national immunization policy and introduction of RCVs in the national immunization program. Active surveillance of rubella and CRS is needed to redress the burden of CRS in India.

Objective structured clinical examination (OSCE) was introduced in 1975 as a standardized tool for objectively assessing clinical competencies - including history-taking, physical examination, communication skills, data interpretation etc. It consists of a circuit of stations connected in series, with each station devoted to assessment of a particular competency using pre-determined guidelines or checklists. OSCE has been used as a tool for both formative and summative evaluation of medical graduate and postgraduate students across the globe. The use of OSCE for formative assessment has great potential as the learners can gain insights into the elements making up clinical competencies as well as feedback on personal strengths and weaknesses. However, the success of OSCE is dependent on adequacy of resources, including the number of stations, construction of stations, method of scoring (checklists and or global scoring), the number of students assessed, and adequate time and money. Lately, OSCE has drawn some criticism for its lack of validity, feasibility, practicality, and objectivity. There is evidence to show that many OSCEs may be too short to achieve reliable results. There are also currently no clear cut standards set for passing an OSCE. It is perceived that OSCEs test the students knowledge and skills in a compartmentalized fashion, rather than looking at the patient as a whole. This article focuses on the issues of validity, objectivity, reliability, and standard setting of OSCE. Presently, the Indian experiences with OSCE are limited and there is a need to sensitise the Indian faculty and students. A cautious approach is desired before it is considered as a supplementary tool to other methods of assessment for the summative examinations in Indian settings.

No abstract

Plasmodium vivax is traditionally known to cause benign tertian malaria, although recent reports suggest that P. vivax can also cause severe life-threatening disease analogous to severe infection due to P. falciparum. There are limited published data on the clinical and epidemiological profiles of children suffering from ‘severe malaria’ in an urban setting of India. To assess the clinical and epidemiological profiles of children with severe malaria, a prospective study was carried out during June 2008–December 2008 in the Department of Pediatrics, Guru Teg Bahadur Hospital, a tertiary hospital located in East Delhi, India. Data on children aged ≤12 years, diagnosed with severe malaria, were analyzed for their demographic, clinical and laboratory parameters. All patients were categorized and treated as per the guidelines of the World Health Organization. In total, 1,680 children were screened for malaria at the paediatric outpatient and casualty facilities of the hospital. Thirty-eight children tested positive for malaria on peripheral smear examination (2.26% slide positivity rate). Of these, 27 (71%) were admitted and categorized as severe malaria as per the definition of the WHO while another 11 (29%) received treatment on outpatient basis. Most (24/27; 88.8%) cases of severe malaria (n=27) were infected with P. vivax. Among the cases of severe malaria caused by Plasmodium vivax (n=24), 12 (50%) presented with altered sensorium (cerebral malaria), seven (29.1%) had severe anaemia (haemoglobin <5 g/dL), and 17 (70.8%) had thrombocytopaenia, of which two had spontaneous bleeding (epistaxis). Cases of severe vivax malaria are clinically indistinguishable from severe falciparum malaria. Our study demonstrated that majority (88.8%) of severe malaria cases in children from Delhi and adjoining districts of Uttar Pradesh were due to P. vivax-associated infection. P. vivax should, thus, be regarded as an important causative agent for severe malaria in children.

Energy drinks are widely consumed by adolescents as these claim to improve performance, endurance and alertness. Recent reports have shown that there are no real health benefits of these drinks. On the contrary, certain adverse effects due to energy drinks have come to the forefront, casting a big question-mark on their safety and utility. This review discusses the present status of energy drinks, their active ingredients and their safety. We conclude that energy drinks, despite having some short pleasant effects, can be harmful for the body and are best avoided.