Objective Intussusception has been linked with rotavirus vaccine (RVV) as a rare adverse reaction. In view of limited background data on intussusception in India and in preparation for RVV introduction, a surveillance network was established to document the epidemiology of intussusception cases in Indian children. Methods Intussusception in children 2–23 months were documented at 19 nationally representative sentinel hospitals through a retrospective surveillance for 69 months (July 2010 to March 2016). For each case clinical, hospital course, treatment and outcome data were collected. Results Among the 1588 intussusception cases, 54.5% were from South India and 66.3% were boys. The median age was 8 months (IQR 6, 12) with 34.6% aged 2–6 months. Seasonal variation with higher cases were documented during March-June period. The most common symptoms and signs were vomiting (63.4%), bloody stool (49.1%), abdominal pain (46.9%) and excessive crying (42.8%). The classical triad (vomiting, abdominal pain, and blood in stools) was observed in 25.6% cases. 96.4% cases were diagnosed by ultrasound with ileocolic location as the commonest (85.3%). Management was done by reduction (50.8%) and surgery (41.1%) and only 1% of the patients’ died. 91.1% cases met Brighton criteria level 1 and 3.3% Level 2. Between 2010 and 2015, the case load and case ratio increased across all regions. Conclusion Intussusception cases have occurred in children across all parts of the country, with low case fatality in the settings studied. The progressive rise cases could indicate an increasing awareness and availability of diagnostic facilities.
Background: Congenital heart disease (CHD) is not an uncommon entity in our country. The prevalence of CHD is 9.3 per 1000 life birth in Asia which is found to be highest globally. Not much of Indian data is available particularly from this part of the country. So we conduct a retrospective study to know the spectrum of congenital heart disease in our set up.Methods: This is a retrospective hospital based study carried out over a period of 20 months (2015 March - 2016 November) where all suspected children (< 14 years) of CHD were subjected to echocardiographic study. The age, sex, clinical presentation and echo findings were well documented. Results: The total number CHD diagnosed were 231 and were more common among males (54.5%) with male to female ratio is 1.2:1. CHD were diagnosed more commonly between 1 month to 1 Year (40.25%). The commonest type of acyanotic CHD in our study was ventricular septal defect (VSD) (36.3%) and cyanotic CHD is tetralogy of Fallot (11.25%). The major clinical finding was a detection of a murmur (84.8%) followed by tachycardia (41.5%) and tachypnea (36.3%).Conclusions: In this era of most accurate diagnostic modalities, any clinical suspicion of congenital heart disease should be confirmed by echocardiography to hasten the diagnosis, timely management and prevention of complications.
Enterovirus 71 (EV71) is an infectious virus affecting all age groups of people around the world. It is one of the major aetiologic agents for HFMD (hand, foot and mouth disease) identified globally. It has led to many outbreaks and epidemics in Asian countries. Infection caused by this virus that can lead to serious psychological problems, heart diseases and respiratory issues in children younger than 10 years of age. Many studies are being carried out on the pathogenesis of the virus, but little is known. The host immune response and other molecular responses against the virus are also not clearly determined. This review deals with the interaction between the host and the EV71 virus. We discuss how the virus makes use of its proteins to affect the host's immunity and how the viral proteins help their replication. Additionally, we describe other useful resources that enable the virus to evade the host's immune responses. The knowledge of the viral structure and its interactions with host cells has led to the discovery of various drug targets for the treatment of the virus. Additionally, this review focusses on the antiviral drugs and vaccines developed by targeting various viral surface molecules during their infectious period. Furthermore, it is asserted that the improvement of prevailing vaccines will be the simplest method to manage EV71 infection swiftly. Therefore, we summarise numerous vaccines candidate for the EV71, such as the use of an inactivated complete virus, recombinant VP1 protein, artificial peptides, VLPs (viral-like particles) and live attenuated vaccines for combating the viral outbreaks promptly.
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