Background: Spectrum of renal disease varies in different population, geographical location, and by environmental factors. The purpose of this study was to find out the occurrence of different pediatric renal diseases at a teaching hospital in the rural part of Maharashtra, India.Methods: All cases of renal diseases from one month to 12 years of age, admitted to the wards during the period of July 2018 to December 2019, were included in the study. Detailed clinical and laboratory evaluations were performed on all patients. Diseases were categorized as per standard definitions and managed with hospital protocols.Results: Renal diseases accounted to be 235 cases (2.8%) of total pediatric admissions during study period, of which (61.3%) were male and (38.7%) female. Nephrotic syndrome (NS), was the most common disorder (34%) followed by congenital anomalies of the kidney and the urinary tract (CAKUT) (24.7%), urolithiasis (11%), urinary tract infection (10.63%), chronic kidney disease (CKD) (7.66%) and acute kidney injury (AKI) (3.83%). The causes of AKI were dehydration, urosepsis, septicemia, and acute glomerulonephritis (AGN). Mortality was found in 3.4% of cases and the etiologies were AKI, NS and CKD.Conclusions: A substantial number of children are hospitalized with renal and urinary tract diseases. NS and congenital defects were the leading renal disorders in this study. These patients need comprehensive services for early identification and management.

Background: Thyroid hormone is essential for growth and development especially the brain. Deficiency of thyroid hormone i.e. congenital hypothyroidism (CH) is the commonest cause of preventable mental retardation. As it is difficult to diagnose CH with clinical symptoms at birth, most patients with CH are diagnosed by laboratory results. Early detection is important, either by Thyroid Stimulating Hormone (TSH) or T4 estimation or both by newborn screening. Cord blood TSH (CB-TSH) estimation has high sensitivity, but various maternal and perinatal factors affect the CB-TSH levels, which may interfere with the interpretation.

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Background: Children with moderate acute malnutrition (MAM) have an increased list of mortality, infections and impaired physical and cognitive development compared to well-nourished children. The Objectives of this study were to diagnose Severe Acute Malnutrition (SAM) and Moderate Acute Malnutrition (MAM) using WHO growth charts as a criterion and to compare the WHO classification with the IAP classification in the diagnosis of SAM and MAM.Methods: A two-year duration cross-sectional study conducted in Pediatric outpatient clinic of a rural hospital from January 2013 to December 2014. In case of moderate acute malnutrition (MAM) was diagnosed as weight-for-height >-3 but <-2 Z scores of the median according to WHO growth standards. We defined MAM as mid-upper am circumference (MUAC) of >11.0 cm and <12.5 cm with no bilateral pitting edema and SAM as MUAC less than 11.5 cm. We compared the values with the IAP charts for diagnosis of malnutrition. Our set up is not a nutrition rehabilitation centre, feeding programmes were not implemented.Results: The distribution of prevalence of SAM and MAM differs significantly across three age groups studied (P-value <0.001). However, it did not differ significantly between boys and girls aged between 6 months to 6 years (P-value >0.05). Of 90 SAM cases, 55 cases (61.1%) had Grade 1 IAP grade of malnutrition, 28 cases (31.1%) had Grade 2 IAP grade of malnutrition, 7 cases (7.8%) had Grade 3 IAP grade of malnutrition. None of the SAM cases fell in Grade 4 IAP. The distribution of prevalence of SAM and MAM differs significantly across various IAP grades of malnutrition (P-value <0.001).Conclusions: The IAP charts used for diagnosing malnutrition did not have any comparative value with the WHO charts used for the SAM MAM detection. WHO grading of SAM and MAM is more sensitive than IAP grading in early diagnosis of under nutrition and facilitate early treatment. Not having a targeted nutrition-specific intervention to address MAM in this set up places these children with MAM at excessive risk of adverse outcomes. Further preventive and curative approaches should urgently be considered.

Background: Acute poisoning is a common cause for morbidity and mortality in children. The profile and outcome in children with acute poisoning depend a lot on the socioeconomic status, cultural practices, parental education status, and availability of health care. The present study was aimed to analyze the pattern and outcome of pediatric poisoning in rural area.Methodology: This is a retrospective study conducted over a period of twenty-four months in a rural hospital attached to medical college. Results:The poisoning constituted 4.7% of total admissions in Pediatric Intensive Care Unit (PICU). Male: Female ratio was 1.33. 98(87.5%) of children were less than 5 years of age. Organophosphorus compounds were most commonly (n=55, 49.1%), responsible for poisoning, followed by kerosene (n=20, 17.9%). Thirty percent children had short stay in hospital i.e., less than 48 hours. Overall survival rate noted in the study was 91% (n=103). Conclusion:Poisoning in Pediatric age contributes to significant number of admissions to Pediatric Intensive Care Unit in rural area. Insecticide/Pesticides, Kerosene, and plants were leading causes of poisoning.

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Introduction: Critically ill children require treatment in an intensive care unit which is not easily available in rural areas and costly resulting in more deaths in rural parts of India. The knowledge of pattern of disease prevalent in the local community plays an important role in planning appropriate health care facilities. Outcome findings help in evaluation of current medical practices and carrying out changes if necessary, leading to better patient care.Objectives: To analyse morbidity pattern and outcome in patients admitted in a Paediatric Intensive Care Unit (PICU) of a hospital in rural Maharashtra.Method: Descriptive data were collected retrospectively from the hospital medical records from January 2017 to December 2018 and analysed for morbidity pattern and outcome in children admitted in the PICU.Results: A total of 2386 children were admitted and treated in the PICU during the 2-year period. Mean age of the studied patients was 40.2 ± 42 months; 34% were infants and 58.9% were males. The mean length of stay (LOS) in PICU was 4.81 ± 4.89 days. Diagnoses included respiratory infection (27.3%), infectious diseases (20.5%), neurological disorders (18.2%), gastrointestinal (10.5%), haematological (5.8%), renal/endocrinal (3.2 %), cardiovascular (3.1%), and others (10.7%). Other causes included acute poisoning, snake / scorpion bite, trauma and foreign body ingestion / aspiration. The overall mortality rate was 9%.