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Byline: Suresh. Angurana, Shivani. Randev, Vishal. Guglani A 1½-year old exclusively breast-fed male child belonging to lower socio-economical status (SES) presented with regression of milestones since 3 months and abnormal [...]

Byline: Suresh. Angurana, Vishal. Guglani Sir, We read with interest the recently published research article titled, “Correlation of Serum Vitamin D Level with Mortality in Patients with Sepsis” by Vipul [...]

Byline: Abhimanyu. Tiwari, Vishal. Guglani, Kana. Jat Background: There is a lack of consensus regarding second-line therapy in children with acute asthma who fail to the standard therapy. Ketamine had [...]

Scrub typhus has reemerged with a different geographical distribution and varied clinical presentation like acute encephalitis syndrome (AES), which is a less known entity in scrub typhus. In this case series, we studied the clinical profile and outcome of eight patients who presented with AES and a positive scrub serology without any other identifiable cause of encephalopathy. All these patients had fever, altered sensorium, and nuchal rigidity, while seizures were present in six (75%) patients and papilledema in two (25%) patients. Complications like shock, pulmonary edema, and gastrointestinal (GI) bleed were observed in three (37%) patients. All patients except for one responded well to the treatment and recovered completely. Scrub typhus should be suspected early in patients presenting with AES. [ABSTRACT FROM AUTHOR]

Background: The 23-hour Observation Unit (OU) is a novel and an effective means for tackling overcrowding in busy Paediatric Emergency Departments (PED) worldwide. However, unexpected hospitalisations in the OU involve transfer of care and they reduce the efficiency of the OU. Hence, we aimed to study the presenting diagnoses which were responsible for the unexpected hospitalisations in a 23-hour OU. Methods and Design: A prospective cohort study Setting: The PED at a tertiary care teaching hospital. Duration: 15th Feb-15th March 2011. Protocol: Consecutive children were triaged at presentation to the PED, according to the WHO paediatric emergency triage algorithm. Those who were transferred to the 23-hour OU, were further followed up for duration of the stay, the hospital course, and the outcome (discharge/hospitalisation). Results: Three hundred (228 males, 72 females) consecutive children who attended the PED over one month were enrolled. All the children, at presentation, were triaged by the medical intern/s who was/were posted in the PED, and they were crosschecked by a PED consultant. A majority (55%, n=165) of the children were triaged as non-urgent, 32% (n=97) as priority and 13% (n=38) as emergent. Out of the 300 children, 173(58%) were transferred to the 23-hour OU. Of these, 16 (9.1%) required unexpected hospitalisations. The children who required hospitalisations had the following diagnoses: bronchiolitis (4), bronchopneumonia (4), seizure (2), viral hepatitis (2), high fever (1), bronchial asthma (1), severe anaemia (1), and urticaria (1). The mean duration of the stay in the OU was 19 hours for those who needed hospitalisation, as against 13 hours for those who were discharged from the OU. Conclusion: The children with respiratory complaints (bronchiolitis and bronchopneumonia) need frequent monitoring in the 23-hour OU, as they have high hospitalisation rates in the OU. [ABSTRACT FROM AUTHOR]

With an objective to study the bacteriological profile of neonatal sepsis a retrospective study was conducted in the neonatal unit of a referral teaching hospital in Northern India. Among neonates born over 5-year period (n=22363) incidence of culture-positive sepsis was 7.5/1000 live births (7.5%). Staphylococcus aureus (47.3%), Klebsiella pneumonia (14.9%) and Acinetobacter (14.9%) were most common organisms isolated. Sensitivity pattern of isolated organisms is presented. [ABSTRACT FROM AUTHOR]

Background & objectives: Multidrug-resistant Salmonellae have emerged worldwide as also in India. The aim of this study was to study the antimicrobial susceptibility pattern of Salmonella enterica serovars isolated at a tertiary care hospital in northern India. Methods: A total of 106 S. enterica serovars isolated from various clinical samples from January 2011 to June 2012 were tested for antimicrobial susceptibility by Kirby-Bauer disk diffusion method. The minimum inhibitory concentration (MIC) of ciprofloxacin, chloramphenicol and ceftriaxone was determined both by agar dilution method and E-test for all the isolates. Results: Salmonella Typhi (73.6%) was the predominant isolate followed by S. Paratyphi A (15.1%), S. Typhimurium (9.4%) and S. Enteritidis (1.9%). Of these, 34 (32.1%) were resistant to ciprofloxacin (MIC ⩾1 µg/ml by agar dilution) with MIC90 of ciprofloxacin for S. Typhi, S. Paratyphi A and S. Typhimurium being 32, 4 and 1 µg/ml, respectively. All the isolates were sensitive to chloramphenicol (MIC ⩽8 µg/ml) and ceftriaxone (MIC ⩽1 µg/ml). Disk diffusion method showed high susceptibility rates to cefotaxime (100%), azithromycin (93.4%) and co-trimoxazole (97.2%). Nalidixic acid resistance was seen in 105 (99.1%) isolates. Of the nalidixic acid-resistant strains, only 34 (32.3%) were found to be resistant to ciprofloxacin (MIC ⩾1 µg/ml). Interpretation & conclusions: This study showed an alarming increase in MIC to quinolones and re-emergence of susceptibility to conventional antibiotics among Salmonellae. [ABSTRACT FROM AUTHOR]

The article offers information on vancomycin-resistant enterococci (VRE) and healthcare-associated risk factors in paediatric intensive care unit. Topics discussed include high antimicrobial resistance of VRE species; the results according to which VRE colonization was higher for children with low birth weight or poor nutritional status, but the difference was not significant.

Background and Objectives:  Beginning in December 2019, COVID-19 rapidly emerged as a global pandemic. Though its severity in children was reported to be less than that in adults, data on its epidemiology in relation to severe acute respiratory illness (SARI) caused by other microbes needed to be generated. This study compares the clinical profile and outcome of children hospitalized with COVID-19-positive and negative SARI., Methods:  This is a prospective observational analytical study involving children 1 month to 18 years old, hospitalized with COVID-19-positive and negative SARI during the pandemic. All eligible patients were enrolled after obtaining informed parental consent. Their clinical manifestations, investigations, and outcomes were documented on a predesigned case record form. A nasopharyngeal swab sample for COVID-19 reverse transcription polymerase chain reaction was sent, and results were noted., Results:  From May 2020 to July 2021, 267 children were hospitalized with a diagnosis of SARI. Out of these, 146 (54.7%) were boys and 78.7% were under five years of age. Other presentations included fever and cough, breathlessness, nausea, vomiting, diarrhea, rash, seizures, and altered sensorium. Twenty-eight patients (10.5%) tested positive for COVID-19. COVID-19 patients were similar in terms of demographic characteristics and presenting symptoms to non-COVID-19 patients but had a lower absolute lymphocyte count (p = 0.019) and higher serum alanine transaminase levels (p = 0.013). Acute respiratory distress syndrome (OR, 4.3; 95% CI, 1.8-10.0), shock (OR, 3.9; 95% CI, 1.9-7.9), and need for intensive care unit admission (OR, 9.9; 95% CI, 6.9-14) were more common in COVID-19 SARI patients. Death occurred in 18% of COVID-19 and 9% of non-COVID-19 patients (p = 0.07). SARI nonsurvivors had significantly lower blood pH and platelet counts than survivors., Conclusions: Comparison of COVID-19-positive and negative SARI patients showed subtle differences between the two groups, with COVID-19-positive children having an increased severity of illness. Also, laboratory evidence of multiorgan dysfunction at admission was associated with higher mortality., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Institutional Ethics Core Committee, GMCH, Chandigarh issued approval GMCH/IEC/2020/417/197. The Institutional Ethics Committee (IC) of Government Medical College & Hospital, Sector-32, Chandigarh, at its meeting held on April 20, 2021, has approved your research project titled "Clinical Profile and Outcome of Severe Acute Respiratory Illness (SARI) in Children Amidst the COVID-19 Pandemic.". Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Jain et al.)

In a prospective hospital-based surveillance of 958 under five children admitted with acute gastroenteritis in Chandigarh (May 2011 to July 2012), 239 stool samples were collected. Rotavirus antigen was detected in 18.8% of samples by reverse transcriptase polymerase chain reaction. Genotypes G1P[8] (53.3%), G12P[6] (15.6%) were prevalent, and G3 not detected.