The incidence of CRS is quite high in children with cardiac, renal or systemic diseases and is associated with a significant risk of mortality. Children presenting with these illnesses should be monitored for the occurrence of CRS so that early intervention may reduce mortality.

No abstract

Aim: To find out association between vitamin D level and early onset neonatal sepsis (EONS). Methods: This case control study was conducted at a tertiary care center in Northern India during June 2018 to May 2019. Neonates with culture-proven EONS were included as case and neonates without EONS were enrolled as control. 25OH-D levels were evaluated with other routine blood samples. Statistical analysis was done by using unpaired t test and chi-square test. Results: Sixty-two infants were enrolled in each group; baseline characteristics were comparable in both groups. Risk of EONS increased 8 times in neonates with 25OH-D level <30 ng/mL (odds ratio = 8.2; 95% confidence interval [CI]: 3.08-21.82; P = .000). The 25OH-D level was significantly lower in EONS group than control group. Optimal cut-off for 25OH-D was 25 ng/mL to predict EONS with a sensitivity and specificity of 88.7% and 79%, respectively (area under the curve: 0.84; 95% CI: 0.76-0.92; P = .000). Conclusions: Vitamin D insufficiency is significantly associated with EONS. Vitamin D deficiency significantly increases risk of EONS. Maternal vitamin D supplementation may improve neonatal vitamin D levels and may decreases risk of EONS. Further studies including maternal vitamin D level are required for implementation.

: Coronavirus infection 2019 (COVID-19) primarily has a respiratory system and multi-systemic involvement. Respiratory and gastrointestinal symptoms are predominantly seen in children. In adults, few COVID-19 cases are reported with cutaneous manifestations. Although children are less severely affected by COVID-19, there is increasing evidence for skin involvement, which is in the form of chilblain (e.g., lesions, vesicular, and maculopapular) and erythema multiforme (e.g., rash). Also, few COVID-19 cases are presented with a clinical picture of atypical Kawasaki disease and toxic shock syndrome, later defined as pediatric multisystem inflammatory syndrome (PMIS). The present study aims to summarize various skin lesions with COVID-19.

Introduction Prevalence of congenital heart disease (CHD) is variable depending on the region and setting of study ranging from 0.8 to 6/1,000. Age of presentation depends on types of CHD and its severity. Burden of CHD is not known in this tribal belt of Central India. Main objective of this study was to find out prevalence of CHD in children. We have also studied the pattern and age of presentation of various types of CHDs. Methods This retrospective observational study was conducted at tertiary care teaching institute in tribal belt of Central India. Children aged 0 to 15 years reported to pediatric outpatient department (OPD) were included. CHD was confirmed by echocardiography in suspected cases. Prevalence rate was calculated as number of CHDs per 1,000 OPD patients. Pattern of CHD was categorized as per standard guidelines and age-wise presentations of various types of CHD were studied. Results The prevalence rate of CHD in our study population was 27.7/1,000, which is high when compared with most of the other hospital-based studies. Most of the patients, 60.36 and 83.26% were detected before the age of 1 year and 5 years, respectively. All critical CHD cases were detected in early infancy. Conclusion There is a high burden of CHD seen in this study. Possible cause of this may be lack of specialized facility in this reason and study period included first and second wave of COVID. Further, large sample size studies and/or nationwide registry/database are needed to know the exact burden of CHD.

We report a case of a 6-year-old female child with Takayasu's aorto-arteritis (TA) with severe coarctation of the aorta which resulted in an aortic dissection post-ballooning. This happened despite ensuring that markers for disease activity were negative, with appropriate corticosteroid therapy started before the procedure, and using a low-profile, low-pressure, and slightly undersized balloon for dilating the stenotic segment. It required immediate endovascular stenting to tide over the crisis. Following the procedure, she became normotensive with well-palpable lower limb pulses.

Pulmonary agenesis is an extremely rare congenital malformation with an estimated frequency of 1 in 10000-15000 autopsies and 34 per million live births. In 50% cases it is associated with other malformations i.e. cardiovascular, musculoskeletal, gastrointestinal and renal. We report a rare case of a male neonate with right pulmonary agenesis associated with VACTERL sequence (L5 hemi-vertebra, right absent kidney with left ectopic kidney and right radial agenesis). This association was never reported in published literature.

Background: Gastrointestinal mucormycosis (GIM) is a rare potentially lethal fungal infection in neonates associated with rapid progression and high mortality. Case Characteristics: We herein report 2 preterm and 3 term cases of GIM; all term neonates had perinatal asphyxia. All cases were preoperatively diagnosed as necrotizing enterocolitis (NEC). Observation: All cases underwent laparotomy, and the diagnosis of GIM was made on postoperative histopathological examination. Results: Asphyxia might be an important risk factor for mucormycosis in term neonates, and to improve outcome, a high index of suspicion of GIM should be kept in cases of NEC in neonates, especially in term neonates.