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Indian children represent a unique population of bilinguals who learn two or more languages of different isochrony. Most of their native languages are syllable-timed, whereas in school the language of learning is English, which is a stress-timed language. Exposure to multiple languages with different types of rhythmic patterns as stimulus during the development stage differentiates these children from monolinguals acquiring rhythms of a single language. Thus, to partially fill this gap, a comparative study in 115 children (aged four to eight years) and 18 adults was carried out. We investigated the frequencies around the pitch and first formant which encodes prosodic information in speech. It was found that the harmonic content in speech increases even after four years (where children exhibit or possess intelligent speech) and the spectra of adults were more distributed and had more peaks at higher frequencies as compared to the power spectra of children, where energy in higher frequency was less. This study has implications in finding speech abnormalities in Indian children with speech disorders.

The objective of this study was to examine the prevalence and relationship between maternal periodontal disease and preterm low birth weight (LBW) babies among women delivering at Hindu Rao Hospital, Delhi, India. A case control study was performed on 150 women fulfilling the selection criteria over a period of one year. The study consisted of 50 cases, (women delivering preterm babies weighing ≤2.5 kg, Group I) and 100 controls (women delivering babies at ≥37 weeks and weighing >2.5 kg, Group II). Associated risk factors for preterm low birth weight (PT-LBW) were ascertained by means of a structured questionnaire and maternal notes. Women having any of the possible risk factors for preterm LBW were either excluded or confounded in the study. The prevalence of periodontal disease was assessed by the community periodontal index of treatment needs (CPITN) scoring method, with scores ranging from 0 to 4. Data were analyzed using Graphpad Prism-5 software. P value and odds ratio (OR) with 95 % confidence interval were calculated as and when required for statistical analysis. Prevalence of periodontal disease was 84.66 % (n = 150) in the study population. Prevalence of periodontal disease was high, at least in some form or other, in cases (100 %) as compared to controls (77 %). The prevalence of severe periodontal disease (CPITN score-4) was 8 % in cases and 3 % in controls. Periodontal disease is an avoidable risk factor for LBW as almost all of the known risk factors for LBW were either excluded or confounded during the study. Hence, routine periodontal examination and advice on good oral hygiene should be included as part of preconceptional care and antenatal checkups during pregnancy. Any dysfunction should be thoroughly investigated and treated for the sake of health of both mother and baby.

Development of speech is very crucial for good quality of life. People with learning disabilities face challenges in communication due to deficiencies in speech production and require interventions in terms of training and rehabilitation to become less dependent. For providing specific trainings, it will be valuable to know the exact nature of these deficiencies through acoustic analysis. This study investigated fundamental frequency and intensity in a speech of 95 subjects including 39 normal developing children, 20 adults and 36 subjects with mild to moderate intellectual disability (mental retardation). The results show significant differences in these acoustic measurements. This present study also developed a model that classify the normal developing and intellectually disable groups based on these acoustic features. The findings suggest that acoustic cues such as fundamental frequency along with intensity play a significant role in classifying the groups. It was shown that classifiers with good accuracy can be built based on these parameters which indicate differentiating capabilities of the said features. Such attempts to build classification models can also aid in early diagnosis of intellectual or learning disabilities.

Basic needs of humans are met by conveying information to each other. Most efficient way to do this is via speech signal. But looking in the society we find many people with mental impairment, their essential infrastructure of articulation, word stress, accent, pitch and other speech features are deeply affected by damage in their brain. There are many factors that affect speech but the fundamental frequency (perceived form: pitch) plays major role in prosodic development. This study is an attempt to observe the pattern of pitch development in normal developing and mentally retarded children and adults. It also investigates possible differences between them. Results reveal that younger children have a slighter difference in their pitch as compared to age matched MR (Mentally Retard), but significant difference is found between normal developing adults and those suffering from neurodevelopment disorder. These criteria can be considered as first step in diagnosis of these neurodevelopment disorders.

Fibroids arising from cervix are rare tumours accounting for 2% of all fibroids. A cervical leiomyoma is commonly single and is either interstitial or subserous, rarely it becomes submucous and polypoidal. Anterior cervical fibroid may press on urinary bladder and urethra and displace the urethro-vesical junction giving rise to urinary frequency and retention. Management of symptomatic cervical fibroid is hysterectomy or myomectomy and need an expert hand. Here we report a case of huge anterior cervical fibroid of 15x15x7cm with an unusual presentation of menorrhagia of only 2 days and no urinary symptoms. Inspite of the fibroid being huge and impacted, hysterectomy was done successfully without any injury to bladder and ureters.

This is a case of a 9-year-old boy with a congenital arteriovenous malformation (AVM) of the right upper extremity arising from the right subclavian artery. He underwent open surgical excision of the vascular tumor. Upon reviewing the literature, a high incidence of right-sided congenital AVM of the proximal upper extremity was identified. It has been suggested that this high incidence may be related to the complexity of the embryologic development of the right subclavian artery.

Thalassemia and thalassemic hemoglobinopathies pose serious health problem leading to severe morbidity and mortality in Indian population. Plethora of hemoglobin variants is prevalent in multiethnic Indian population. The aim of the present study was to analyze laboratory aspects, namely, hematological profile and HPLC findings of the hemoglobin variants detected, and to discuss problems that we faced in diagnosis in a routine clinical laboratory. We screened a total of 4800 cases in a hospital based population of North India in a 2-years period of by automated HPLC method using the Variant Hemoglobin Testing System (Variant II Beta Thalassemia Short Program, Bio-Rad Laboratories) under the experimental conditions specified by the manufacturer. Whole blood in EDTA was used and red cell indices were determined using automated hematology analyzer. We detected 290 cases with abnormal variants in which beta thalassemia was the most common followed by hemoglobin E. Here, we discuss the laboratory aspects of various hemoglobin disorders and diagnostic difficulties in cases like borderline HbA2 values, presence of silent mutation, alpha thalassemia gene, and few rare variants which at times require correlation with genetic study. Special attention was given to HbA2 level even in presence of a structural variant to rule out coinheritance of beta thalassemia gene.

The results and management of penetrating thoracic trauma are largely dependent upon the extent of injury to internal organs as well as the skills of the attending clinicians. Thoracic trauma in children may be associated with rib fractures, flail chest, soft tissue injury, intrapleural lesions such as haemothorax and pneumothorax, parenchymal lung injuries such as pulmonary contusion and lung laceration as well as mediastinal lesions, including cardiac injury,[1,2] and yet our patient fortuituously had none of these, despite suffering a major, and what could potentially have been a life-threatening accident. The sources of perioperative morbidity and mortality in subjects suffering penetrating thoracic injuries include airway obstruction, respiratory failure and haemorrhage. Clinicians need to be adequately trained to deal with these problems. Trauma mainly affects the younger population and happens to be the most common cause of mortality in patients in the first three decades of life. The technical difficulties encountered during the perioperative management of the patient with severe penetrating thoracic injury are highlighted here.

Background: Thyroid nodule is one of the most common endocrinopathies occurring children and adolescents. Though thyroid nodule is rare in the pediatric age group, the rate of malignancy is much higher in this age group compared to adult population. Aim: The objective is to study the application of The Bethesda System for Reporting Thyroid Cytopathology (TBSRTC) in pediatric patients and compare the findings with histology. Materials and Methods: A total of 218 cases younger than 18 years were studied in a 4-year period from August 2010 to July 2014. The smears were categorized according to TBSRTC into six categories — Nondiagnostic, benign, atypia of undetermined significance/follicular lesion of undetermined significance (AUS/FLUS), suspicious for follicular neoplasm (SFN), suspicious for malignancy (SM), and malignancy. Results: Out of 218 cases, 33 were males and 185 were females. Histological follow-up was available in 44 cases. The diagnosis according to TBSRTC included 12 (5.5%) nondiagnostic, 151 (69.26%) benign, 23 (10.5%) AUS/FLUS, 18 (8.2%) SFN, 5 (2.3%) SM, and 9 (4.1%) malignancy cases. On histological follow-up, the rate of malignancy in each category was 0%, 0%, 8.3%, 10% 100%, and 100%, respectively. Conclusion: The study demonstrates that TBSRTC in pediatric thyroid nodule is as sensitive and specific as in adults, especially with 100% accuracy in the diagnosis of benign and malignant categories.

Cantrell's pentalogy with ectopia cordis is an extremely rare and lethal congenital anomaly, with a reported incidence of 1:100000 births in developed countries. We report a neonate who presented with ectopia cordis along with cleft lower sternum, upper abdominal wall defect, ectopic umbilicus, diaphragmatic defect, and interventricular septal defect. The neonate had respiratory distress with peripheral cyanosis and died because of acidosis and electrolyte imbalance before surgical intervention could be undertaken. We discuss the case and present a brief review of literature and of embryogenesis