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Objectives: Studies on antimalarial kinetics in children or adults who are undernourished or malnourished are both limited and have yielded conflicting results. The present study was carried out with the objectives of evaluating the pharmacokinetics of single dose chloroquine and its metabolite desethylchloroquine in children who were undernourished and compare them with children who were normally nourished. Methods: Children of either gender between the ages of 5 and 12 years, smear positive for P. vivax malaria and classified either as well nourished or undernourished were included. Undernourishment was adjudged based on the Indian Academy of Pediatrics (IAP) classification of protein energy malnutrition [PEM] which in turn was based on Khadilkar’s growth charts. All participants received 10 mg/kg on the first day followed by 10 mg/kg on Day 2 and 5 mg/kg on Day 3 along with supportive treatment. Blood samples for the levels of chloroquine [CQ] and desethylchloroquine [DECQ] were collected at 0, 0.5, 1, 2 4, 8, 12, 24, 48, 72 hours and 14 days after the first dose and levels assessed by High Performance Liquid Chromatography. Results: A total of 12 children who were normally nourished and 13 who were undernourished were studied. Wide inter-individual variability was seen in the levels of both drug and metabolite in both groups of patients. However, the differences in Cmax, AUC 0-inf, Clearance, half life and Vd between the two groups were not significantly different. Discussion: Our results indicate that dosage requirement is unlikely to be needed for chloroquine in undernourished children with uncomplicated P. vivax malaria. [ABSTRACT FROM AUTHOR]

Background: About 12-24% of children with specific learning disability (SpLD) have co-occurring attention-deficit/ hyperactivity disorder (ADHD). According to "parent-proxy reports", co-occurring "untreated" ADHD adversely impacts the health-related quality of life (HRQoL) of children with newly diagnosed SpLD, especially in their psychosocial functioning. Aims: To analyze the impact of "untreated" co-occurring ADHD on the "self-perceived" HRQoL of children with "newly diagnosed" SpLD. Setting and Design: Cross-sectional questionnaire-based study in a learning disability clinic situated in a medical college. Materials and Methods: From February 2008 to December 2008, 136 consecutive children newly diagnosed as having "SpLD with co-occurring ADHD (SpLD/ADHD)" or "SpLD only" were enrolled. The DISABKIDS chronic generic module (DCGM-37-S (V31)) instrument was used to measure their HRQoL. DCGM-37-S (V31) mean facet and total scores were computed for "SpLD/ADHD" and "SpLD only" children groups and compared using independent samples t-test. Results: HRQoL of "SpLD/ADHD" children was significantly better in limitation facet (mean difference: 8.20; 95% confidence interval (CI): 1.75-15.29; P=0.024). Although not statistically significant, the HRQoL of "SpLD/ADHD" children was better in independence, emotion, social inclusion and social exclusion facets; and in total score. Conclusions: "SpLD/ADHD" children perceive their physical functioning to be significantly better. Also their perceptions of their psychosocial functioning are better. Contrary to parent-proxy reports, co-occurring "untreated" ADHD does not adversely impact the self-perceived HRQoL of children with "newly diagnosed" SpLD. [ABSTRACT FROM AUTHOR]

Background: In India, tuberculous meningitis (TBM) is still a major cause of neurological disabilities and death.Aim: To identify the clinical variables which predict the outcome in childhood TBM.Setting: Tertiary teaching hospital.Design: Prospective observational study.Materials and Methods: Thirty-six clinical variables were analyzed in 123 consecutive children with TBM admitted between May 2000 and August 2003. The outcome was assessed in terms of survival or death. Survival meant that the patient was discharged from hospital having made a complete recovery, or with disability.Results: Twenty-five (20%) children recovered completely, 70 (57%) survived with disability, and 28 (23%) died. Employing univariate analysis nine variables correlated with survival with disability outcome: presence of tonic motor posturing, cranial nerve palsy, focal neurological deficit, hypertonia, moderate to severe hydrocephalus, cerebral infarction on cranial CT, and requiring shunt surgery, and absence of extracranial tuberculosis and no antituberculous-related hepatotoxicity; two variables correlated with fatal outcome: presence of deep coma (Glasgow coma scale score P = 0.012, d.f. = 1, OR 0.12, 95% CI 0.02-0.62) correlated with survival with disability outcome, and presence of deep coma (P = 0.030, d.f. = 1, OR 0.35, 95% CI 0.14-0.90) with fatal outcome.Conclusion: In children with TBM, the presence of hypertonia at admission is an independent predictor of neurological sequelae in survivors, and deep coma is an independent predictor of mortality. [ABSTRACT FROM AUTHOR]

The editor ponders on his role as editor of the magazine and the journal's initiatives to maintain its position. He expresses gratitude to all his teachers and colleagues who have influenced him during his medical education and training in pediatrics. He also extends his gratitude to all his supporters and confirms that no changes will be made to the journal's basic structure and editorial policies. He also assures the role of the magazine as a source of support and encouragement.

A letter to the editor is presented in response to the article "Dyslexia: A Solution Through Ayurveda Evidences From Ayurveda for the Management of Dyslexia in Children: A Review" by A. Sharma and colleagues in the 2012 issue.