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Purpose: The aim of this study was to compare the levels of serum vitamin B12 of transfusion-dependent thalassemic (TDT) children with that of healthy controls. The other objectives were to compare the occurrence of vitamin B12 deficiency in cases and controls and to find out any correlation between serum vitamin B12 of cases with their clinical, hematological, and laboratory parameters. This study was proposed as routine supplementation with folic acid is advised in TDT, but there are no guidelines for screening and supplementation of vitamin B12 for these patients. Methods: Thirty TDT children under 18 years and an equal number of age- and sex-matched controls were evaluated. Results: The mean levels of vitamin B12 in TDT group (260.17 ± 86.26 pg/mL) were lower than that of controls (337 ± 213 pg/mL) (P= 0.57). Correlation analysis of serum vitamin B12 levels with several parameters did not reveal any significant result. Conclusions: Similar largescale multicentric studies are warranted before formulating guidelines for vitamin B12 screening and supplementation in thalassemics. Till then it may be prudent that TDT must be regularly screened for deficiency if the resources permit or else they must be routinely supplemented. [ABSTRACT FROM AUTHOR]

Millions of microorganisms inhabit the human body and affect its homeostasis in multiple ways. Alterations in this microbial community have implications for the health and survival of the human hosts. It is believed that these microorganisms should be included as part of the human genome because of their influence on human physiology hence the term "microbiome" is commonly used to refer to these microbes along with their genetic make-up and their environmental interactions. In this article we attempt to provide an insight into this recently discovered vital organ of the human body which is yet to be fully explored. We herein discuss the composition and role of microbiome in human health and disease with a special emphasis in children and culture-independent techniques employed in mapping of the microbiome. Alteration in the gut microbiome has been associated with causation of several paediatric diseases like infantile colic, necrotizing enterocolitis, asthma, atopy, obesity, type-1 diabetes, and autism. Atopic dermatitis and psoriasis have also been associated with changes in the cutaneous microbiome. Respiratory microbial imbalances during infancy have been linked with wheezing and bronchial asthma. Dysbiosis in the regional microbiome has been linked with caries, periodontitis, and chronic rhinosinusitis. The future therapeutic implications of this rapidly evolving area of research are also highlighted. [ABSTRACT FROM AUTHOR]

Adolescents and youth, together addressed as “young people”, form the future building blocks of any society. They being most energetic and dynamic, tend to get involved in high-risk behaviors making themselves susceptible to criminal offences, accidents, physical injuries, emotional trauma, and medical problems — some of them extremely serious like transmission of human immunodeficiency virus (HIV). The concept of vulnerability is applicable to all the people who are more exposed to risks than their peers like the young people. In order to deal with social evils like criminal offences, domestic violence, sexual abuse, HIV, etc. we need to define vulnerability and understand the factors that influence it. This review also attempts to summarize the indicators of vulnerability and the data currently available to estimate its burden in India. Measuring the magnitude of vulnerability by means of certain indicators/variables might help us in devising tools to assess this poorly defined entity. This may also evolve a conceptual framework on which targeted remedial interventions can be devised and implemented. [ABSTRACT FROM AUTHOR]

We report a 9-year-old girl who presented with focal seizures, hemiparesis, headache, vomiting and bilateral optic atrophy. CT scan revealed a giant solitary cyst in the left parietal lobe. Serology and histopathology of the excised cyst confirmed the diagnosis of neurohydatidosis which is a rare cause of childhood seizure. [ABSTRACT FROM AUTHOR]

The article presents case studies of two children with dengue encephalitis. One patient suffered from fever and body-ache for 10 days, headache, dizziness and vomiting, while the other subject experienced fever for five days, headache, vomiting and malena. Both cases showed no signs of neck rigidity or focal neurological deficit. The article discusses the different categories of clinical manifestations of dengue encephalitis and the nature of dengue virus.

Prematurity is a significant contributor to neonatal mortality in India. Conventionally, assessment of gestational age of newborns is based on New Ballard Technique, for which a paediatric specialist is needed. Anthropometry of the newborn, especially birthweight, has been used in the past to predict the gestational age of the neonate in peripheral health facilities where a trained paediatrician is often not available. We aimed to determine if neonatal anthropometric parameters, viz. birthweight, crown heel-length, head-circumference, mid-upper arm-circumference, lower segment-length, foot-length, umbilical nipple distance, calf-circumference, intermammary distance, and hand-length, can reliably predict the gestational age. The study also aimed to derive an equation for the same. We also assessed if these neonatal anthropometric parameters had a better prediction of gestational age when used in combination compared to individual parameters. We evaluated 1,000 newborns in a cross-sectional study conducted in Guru Teg Bahadur Hospital in Delhi. Detailed anthropometric estimation of the neonates was done within 48 hours after birth, using standard techniques. Gestational age was estimated using New Ballard Scoring. Out of 1,250 consecutive neonates, 1,000 were included in the study. Of them, 800 randomly-selected newborns were used in devising the model, and the remaining 200 newborns were used in validating the final model. Quadratic regression analysis using stepwise selection was used in building the predictive model. Birthweight (R=0.72), head-circumference (R = 0.60), and mid-upper arm-circumference (R = 0.67) were found highly correlated with gestation. The final equation to assess gestational age was as follows: Gestational age (weeks) = 5.437 x W-0.781 x W(2) + 2.815 x HC-0.041 x HC(2) + 0.285 x MUAC-22.745 where W=Weight, HC=Head-circumference and MUAC=Mid-upper arm-circumference; Adjusted R = 0.76. On validation, the predictability of this equation is 46% (+/-1 week), 75.5% (+/- 2 weeks), and 91.5% (+/- 3 weeks). This mathematical model may be used in identifying preterm neonates. [ABSTRACT FROM AUTHOR]

Objective: To estimate the change in serum hepcidin levels and its correlation with change in hemoglobin (Hb) level during the initial two weeks of oral iron therapy in children with iron deficiency anemia (IDA)., Methods: A prospective observational study was carried out in children aged 2-12 years with IDA. Children with severe anemia (Hb < 7 g/ dL), those with fever, infections, history of oral iron intake or blood transfusion within the preceding three months, or intolerant to oral iron were excluded. Serum hepcidin-25 was assessed using ELISA-based kits on day 0 (pre-therapy), after 24 hours and 14 days of starting oral iron therapy., Results: Out of 78 children who were screened for inclusion, we included 64 children with IDA with a mean (SD) hemoglobin of 8.81 (1.22) g/dL. The baseline mean (SD) serum hepcidin-25 levels [7.81 (4.88) ng/mL] increased significantly to 8.38 (4.96) at 24 hours and 9.51 (5.2) on day 14 of oral iron therapy (P < 0.001). 63 children showed a good response to oral iron therapy. No significant correlation was observed between baseline hepcidin levels with change in hemoglobin on day 1 (r = -0.10, P = 0.40) or day 14 (r = -0.10, P = 0.43) of therapy., Conclusion: Serum hepcidin levels rise significantly as early as 24 hours after starting oral iron therapy and should be explored to assess response to oral iron therapy in children with anemia.