Background: Fever is an extremely common sign in pediatric patients and the most common cause for a child to be taken to the doctor. There are no guidelines or consensus in India about symptomatic management of fever and hence there can be too many misconceptions and conflicting results about fever management. Aims: In this study the aim was to identify knowledge gaps of primary care doctors regarding fever in children. Methods: This cross-sectional study was conducted from August 2019 -December 2019 involving Pediatricians and family physicians (n=935). A questionnaire was administered to convenient samples of pediatricians and family physicians eliciting information about fever definition, methods of temperature measurement, and antipyretic use. Differences in responses between the doctors were evaluated. Results: The data was analyzed using the SPSS 16.0 program and descriptive statistics were used. In the present study 40% of the doctors knew that a body temperature of above 37.5°C according to an axillary measurement is defined as fever. Only 36% of the doctors took into consideration signs and symptoms other than fever to prescribe antipyretics. Almost 85% of the doctors prescribed antipyretics to control fever or prevent complications of fever especially febrile seizures. Most of the doctors (76.3%) in this study reported that the intensity of fever may be used as an indicator for severe bacterial infection. A great majority of doctors (65.3%) stated that they advised parents to alternate the use of ibuprofen and paracetamol. Conclusions: There were significant misconceptions about the management and complications of fever. There is a perceived need to improve the recognition, assessment, and management of fever with regards to underlying illnesses in children and a national consensus statement on fever and antipyresis in children.
<abstract> <p>Hydrocephalus is a neurodevelopmental, X-linked recessive disorder caused by mutations in the <italic>L1CAM</italic> gene. The <italic>L1CAM</italic> gene encodes for L1CAM protein which is essential for the nervous system development including adhesion between neurons, Myelination, Synaptogenesis etc. Herein, the present study has reported mutations in L1 syndrome patient with Hydrocephalus and Adducted thumb. Genomic DNA was extracted from patients whole blood (n = 18). The 11 exons of the <italic>L1CAM</italic> gene were amplified using specific PCR primers. The sequenced data was analysed and the pathogenicity of the mutation was predicted using the various bioinformatics programs: PROVEAN, PolyPhen2, and MUpro. The results revealed that the proband described here had nonsense mutation G1120→T at position 1120 in exon 9 which is in extracellular immunoglobulin domain (Ig4) of the <italic>L1CAM</italic> gene. This nonsense mutation is found to be truncated with a deleterious effect on developing brain of the child, and this is the first report of this novel mutation in patient with X-linked Hydrocephalus in India.</p> </abstract>
Introduction: Poisoning in children is an important Paediatric emergency and is a worldwide problem. It is a common and preventable cause of morbidity and mortality in children. Objectives: The aim of this study was to determine the profile and outcome of children less than 13 years admitted to the Paediatric department presenting with acute poisoning at a Teaching district hospital in southern Karnataka. Methods: Prospectively, 134 acute poisoning cases, admitted to Paediatric intensive care, SIMS Shivamogga from November 2018 to May 2019 were included in this study. Results: During the study period, 134 patients presented with acute poisoning. The incidence of poisoning in Paediatric patients was 2.84%. The median age of our patients was 5.2 years (range 0.75-12 years). The male to female ratio was 1.58:1. Animal bites (27.61%), Petroleum products (26.87%), Household chemicals (15.67%), Drugs (11.19%), Poisonous plant derivatives (8.96%) and Insecticides (6.72%) were the agents most frequently implicated. Almost all (98.41%) cases in 1 to 5 years age group were accidental in nature, whereas in the >10 years age group, the majority (71.43%) were suicidal. Thirteen patients (9.7%) remained asymptomatic. The specific antidote was given to 19 (14.18%) patients. Three patients (2 snake bite and 1 rodenticide child) died. The mean duration of hospital stay was 4.49 days (range was 1 day to 22 days). Conclusions: Accidental poisoning was common in children below 5 years of age. Minimal age of suicidal poisoning was 8 years. The most common agent implicated was a snake bite.
Background: Globally, each year malnutrition is implicated in about 40% of the 11 million deaths of under-five children in developing countries. Under nutrition is still the major problem in our country especially in underserved areas such as urban slums and rural areas. So we undertook this study to assess the factors associated with malnutrition and risk of infections among malnourished children. Methods: Study design: Analytical cross-sectional study. Duration: January 2013-December 2013 (1 year). 182 malnourished children admitted to department of paediatrics during the study period. Prestructured-pre tested closed ended questionnaire was used to collect the data. The parents were interviewed; case sheets and other records were searched to get the necessary information. Results: The study was conducted among 182 under nourished children who admitted to department of paediatrics, in the calendar of 2013. Out of 182 children, 80 (43.96%) were boys and 102 (56.04%) were girls. More than 2/3 rd (68.6%) under nourished children were in the age group of 0-3 years. Most common co-morbidity found was respiratory tract infection (44%) followed by acute gastro enteritis (22.5%) and fever (Pyrexia of unknown origine-22.5%). Conclusion: Children of relatively younger age, from rural areas and girls are the common victims of malnutrition. Respiratory tract infections and acute gastro-enteritis were the common co-morbid conditions found among malnourished children. Nutrition education has to be imparted to the people regarding consumption of cost effective nutritious diet (Emphasize it in Village health and Nutrition day).
Background: The Babkin Reflex belongs to the group of rarely defined and used primitive reflexes, being easily elicited in normal newborns during wakeful state particularly before feeding. To the best of our knowledge there have been no studies in India about the validity and usefulness of this reflex. Aim: The purpose of this study was to observe the consistency in duration of appearance and disappearance of the reflex in normal Term infants. Settings and Design: Hospital based, prospective, observational, longitudinal, single ethnicity study. Method: A prospective observational study was conducted to study the Babkin reflex in two thousand normal infants and also analyzed the average time of disappearance of the reflex. Descriptive statistics with rate were used. Results and Conclusion: In normal term infants, the Babkin reflex can be elicited from the time of birth, becomes increasingly suppressed with age, and disappears in the great majority by the end of the fifth month of age. Babkin reflex is surprisingly a fairly consistent primitive reflex which can be used as a screening reflex in all infants. Persistence of this reflex beyond 5 months of age mandates frequent neurological assessment.
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