The multi-dimensional impact on the quality of life (QOL) of families of children with the nephrotic syndrome (NS) has not been studied sufficiently in the literature. We aimed to study this aspect and the predictors of poor QOL among Indian families having children with NS. A cross-sectional study was conducted to compare the parents of children with chronic NS on treatment for at least one year with parents of a matched healthy control group. The parents of both groups were asked to complete the standard self-administered multi-dimensional questionnaire of Pediatric Quality of Life Inventory 4 (PedsQL TM ) Family Impact Module (FIM). Descriptive and analytical statistics were performed to compare scores between the two groups. Possible predictors of poor outcome in each of the summary scales among the cases were assessed by both univariate and multivariate analysis. The parents of 61 cases and 72 controls completed the PedsQL TM FIM questionnaire. The scores in each of the categories, namely FIM Total Scale Score, Parent HRQOL Summary Score, Family Functioning Summary Score and eight individual domains, were found to be significantly higher among controls. Female gender of the affected child was an independent risk factor for poor Family Functioning Summary Score. Also, presence of serious complications during the course of the disease independently predicted poor Total FIM and Parent HRQOL Summary Scores. Even a relatively benign and potentially curable chronic disorder in children, like the NS, can disturb the QOL of parents in multiple domains of functioning.

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Liver abscess (LA) is a common health problem among children in tropical countries. We conducted a prospective, observational study at a tertiary-care medical college in order to examine the clinico-socio-demographic profile and assess a possible association between certain predictors of a poor outcome in children admitted with LA. Of a total of 53 children, only 24.4% were malnourished. Staphylococcus aureus was the most common organism observed. Amoebic LA was noted in 7.5%. Right-sided pleural effusion was the most common complication recorded (20.7%). The most successful treatment modality was therapeutic percutaneous aspiration with antimicrobials (90.5% success). An elevated alkaline phosphatase and open surgery were associated with a poor outcome (P = 0.04 in each case). The rate of hospital admissions of children with LA remains high and most are of pyogenic origin. Of the different treatment modalities, therapeutic aspiration along with antimicrobials achieved the best results. Raised alkaline phosphatase and open surgery were predictors of a poor outcome.

Neonaticide is known to occur across the globe in both developed and developing countries, but has rarely been reported from India. Two similar cases of female neonaticide are presented which were committed by their mothers while in the maternity ward. The social issues and maternal provocation highlighted in this report are different from those reported in world reviews of neonaticide.

Cushing’s syndrome (CS) or hypercortisolism results from disruption of the hypothalamus-pituitary-adrenal (HPA) axis with the resultant increase in the circulating serum and urinary cortisol levels and lack of cortisol circadian rhythm. The resultant effects cause the physical manifestation of hypercortisolism. The appearance of Cushing’s disease in children is insidious, the most common features being growth failure, obesity, early puberty and facial appearance. We report a case of a 7-year-old male with a very unusual course of the disease, which could have led to diagnostic delays.

Impetigo is a common childhood skin infection. There are reports of increasing drug resistance to the currently used topical antibiotics including fusidic acid and mupirocin. Retapamulin is a newer topical agent of pleuromutilin class approved by the Food and Drug Administration for treatment of impetigo in children and has been recently made available in the Indian market. It has been demonstrated to have low potential for the development of antibacterial resistance and a high degree of potency against poly drug resistant Gram-positive bacteria found in skin infections including Staphylococcus aureus strains. The drug is safe owing to low systemic absorption and has only minimal side-effect of local irritation at the site of application.

No abstract

Pulse oximetry is a non-invasive non-cumbersome method, which can indirectly measure arterial oxygen saturations. Owing to its small size, portability, relative accuracy and wide use in tertiary centers to measure arterial oxygen saturations for screening cardiac and respiratory diseases in children. 4 This study was planned to determine the performance of pulse oximetry in children with diagnosed cyanotic heart diseases compared with arterial oxygen saturation measurements from arterial blood gas analysis and to assess the feasibility of recommending pulse oximetry as the first line of noninvasive investigation for screening cyanotic heart diseases in peripheral and rural healthcare facilities. The primary objective of the study:  To determine the performance and accuracy of pulse oximetry in children with cyanotic heart diseases ABSTRACT Background: A study was planned To determine the performance and accuracy of pulse oximetry in children with cyanotic heart diseases compared with arterial oxygen saturation measurements from arterial blood gas analysis and to use transcutaneous pulse oximeter as the first line of non-invasive investigation to diagnose cyanotic heart diseases in peripheral and rural health facilities where echocardiography may not be readily available. Methods: This was a prospective observational study conducted in Safdarjung Hospital. Children with cyanotic congenital heart disease were enrolled the data was analyzed by using PASW Statistics version 19.0 (SPSS Inc., Chicago, IL, US). Frequency and percentage was calculated for categorical variables. Mean and standard deviation was calculated for continuous variables. Chi-square test and Fisher's exact test was used to compare categorical variables. Correlation was assessed between ABG and SpO2. Results: A total number of 40 children were enrolled. There was a significant correlation between transcutaneous oxygen saturations and arterial oxygen saturation statistically. Conclusions: The pulse oximeter detected oxygen saturation comparable to arterial oxygen saturation in all the patients with cyanotic heart diseases, even though most of them did not present with clinically significant cyanosis.