Indian Journal of Child Health <pre><strong>ISSN:</strong> <strong>p-ISSN</strong> - 2349-6118; <strong>e-ISSN</strong> - 2349-6126 <br /><strong>Discipline:</strong> Pediatrics and Neonatology<br /><strong>Starting Year:</strong> 2014<br /><strong>Current volume:</strong> Volume 7<br /><strong>Issue per year:</strong> 12 (monthly)<br /><strong>Editor-in-chief:</strong> Dr. Girish Chandra Bhatt, India<br /><strong>Indexing:</strong> Index Copernicus, EZB, BASE, World Cat, Journal Guide, Google Scholar<br /><strong>E-mail: <a href="" target="_blank" rel="noopener"></a> </strong></pre> en-US (Dr. Girish Chandra Bhatt) (Dr. Rashmi Agrawal) Mon, 11 Jan 2021 17:21:30 +0530 OJS 60 Rare association of septic arthritis with neonatal diabetes in a patient with PDX-1 mutation <p>We present a 58-day-old male infant with neonatal diabetes and septic arthritis of hip. He was born of a consanguineous marriage at 35 weeks of gestation and was asymptomatic till presentation. Family history revealed his older sibling had suffered from meningitis and a second sibling had neonatal diabetes (died due to an unknown infection). Our patient underwent arthroscopy for septic arthritis and symptoms resolved after antibiotic therapy. Genetic testing was performed for the lipopolysaccharide-responsive beige-like anchor (LRBA) mutation (known to be associated with neonatal diabetes and autoimmune disorders); however, the result revealed a homozygous mutation in PDX-1 gene which is known to cause neonatal diabetes with or without exocrine pancreatic insufficiency. Our case suggests that in neonatal diabetes with atypical infections, genetic causes other than LRBA mutation, like PDX-1 mutation, may be suspected. A genetic diagnosis aids both in treatment and prognostication of neonatal diabetes.</p> Madhura Karguppikar, Nikhil Shah, Anuradha Khadilkar, Vaman Khadilkar Copyright (c) 2021 Mon, 11 Jan 2021 00:00:00 +0530 Unusual cardiac manifestation of Hepatitis A virus infection in children – A case report <p>Hepatitis A virus infection is one of the major causes for acute viral hepatitis in children. Many extra-hepatic manifestations have been described in the literature. Only three cases of cardiovascular involvement in Hepatitis A in children have been reported till now. We here report two pediatric case of Hepatitis A infection with bradycardia.</p> Afreen Khan, Aparna Chakravarty, Jagannath Mohapatra Copyright (c) 2021 Mon, 11 Jan 2021 00:00:00 +0530 Vitamin D deficiency prevalence among healthy term infants at the age of 4–6 months: A cross-sectional observational study from tertiary care hospital setting <p>Background: Role of Vitamin D has expanded from bone health to a myriad of physiological and pathological conditions in humans. Although guidelines recommend supplementation of Vitamin D in infants, evidence for healthy term infants at 4–6 months is limited in Indian settings. Objectives: The objectives of the study were to estimate the prevalence of Vitamin D deficiency and its risk factor in healthy term infants at 4–6 months of age before initiation of complementary feeding. Materials and Methods: Four–six-month-old infants (n = 93) were enrolled. The healthy term infants &gt;37 weeks, birth weight &gt;2.5 kg with no diagnosed medical disorders in the mother or baby, and not on Vitamin D supplementation were included. Levels of calcium, phosphorus, alkaline phosphatase, parathormone, and Vitamin D were also assessed. Results: The prevalence of Vitamin D deficiency (25OHD ? 20 ng/ml) and insufficiency (20–30 ng/ml) was 76.3% and 15.05%, respectively, with a mean (SD) 25(OH) D level of 13.42 ± 10.08 ng/ml and median level of 11.58 ng/ml. On multivariate analysis, rural children continued to have lower odds of severe Vitamin D deficiency (? 5 ng/ml) as compared to urban children (OR 0.18; 95% CI: 0.03–0.92) (P = 0.04). In addition, odds of severe Vitamin D deficiency (?5 ng/ml) increased significantly by 20% for everyone unit increase in socioeconomic score by Kuppuswamy (modified) (OR 1.20; 95% CI: 1.04–1.40, P = 0.01). Conclusions: High level of Vitamin D insufficiency in our study among apparently healthy infants with uncomplicated antenatal and neonatal period clearly supports current guidelines for daily supplementation of Vitamin D for infants and children for optimizing their Vitamin D levels and preventing complications.</p> Uma Devi Karuru, Bhavneet Bharti, Sanjay Verma, Naresh Sachdeva Copyright (c) 2020 Mon, 11 Jan 2021 00:00:00 +0530 Effect of hand exercises on grip strength and manual dexterity in children with severe congenital visual impairment <p>Background: Vision is important in planning and performing motor skills. Early reduction or lack of visual function may alter or delay the development of basic motor and visual-motor skills. Developing skilful hands is a necessity in blind children as it often compensates for their missing vision. Objective: The objective of the study was to focus on the efficacy of hand exercises on grip strength and manual dexterity in children with severe congenital visual impairment. Materials and Methods: The study included 60 children aged 7–15 years who were diagnosed with severe bilateral congenital visual impairment. Hand exercises were given to all the 60 children at least 4 days in a week for a period of 6 weeks. Grip strength and manual dexterity values were analyzed using Jamar dynamometer and Purdue Pegboard test, respectively. Results: The mean age was 12.15±2.284 years. We observed a significant improvement in grip strength (p&lt;0.001) and manual dexterity (p&lt;0.001) post-intervention as compared to the pre-intervention scores. Conclusion: The findings of the present study indicate that hand exercises can be a useful training method in improving grip strength and manual dexterity in children with severe congenital visual impairment.</p> Sumayya Faiz Shaikh Copyright (c) 2020 Mon, 11 Jan 2021 00:00:00 +0530 Continuous Skin-to-skin Care Assists Breastfeeding Mothers to Adapt to Sleep Patterns of Night feeds: A Case–control Follow-up Study <p>Introduction: Mothers suffer disturbed sleep caused by the nocturnal patterns of breastfeeding. Skin-to-skin care (SSC) between mothers and babies has known comforting effects on mother and baby. Aim: The aim of the study was to examine the effect of daily practice of SSC in the 1st weeks after delivery in assisting mothers to adapt to the sleep patterns of her baby. Materials and Methods: This is a prospective cohort study of 90 breastfeeding mothers and their infants who were followed up from birth for 6 weeks. They were randomly divided into three groups: 30 performed SSC only at birth, 30 continued SSC on a daily basis, and 30 controls. Child development and weight gain were assessed at 6 weeks using Denver scale and maternal post-partum depression by the Beckwith depression tool. Sleep, activity, fatigue, appetite, health, and sex status were derived from the tool and correlated to parameters under study. Results: At 6 weeks, mother’s satisfaction with sleep, depression score, child’s weight gain, and development were significantly improved in the intervention group. Sleep correlated with activity, less fatigue (r0.5 at p=0.000), appetite (r0.4, p=0.001), and sex (r0.3, p=0.004) but not with maternal weight loss or health (p&gt;0.05). Maternal sleep, activity, less fatigue, and appetite were positively correlated with child development at p=0.000, but not infants’ weight gain (p&gt;0.05). Conclusions: Daily SSC in the early weeks can support adaptation of mother to her infant’s night feeds, promotes child growth and development and maternal well-being.</p> Azza Abul-Fadl, Ayoub Al-Jawaldeh, Mohammed Khaled Ghalia, Rania E Abdelatey, Ayman Abouelnour, Mohamed Abdel Hady Copyright (c) 2021 Mon, 11 Jan 2021 00:00:00 +0530 Outcome of infants with antenatally detected hydronephrosis <p>Background: It is estimated that genitourinary anomalies comprise 20% of all antenatally detected fetal anomalies, of which hydronephrosis is the most common anomaly affecting 1–5% of all pregnancies. Depending on diagnostic criteria and gestation, the prevalence of antenatal hydronephrosis (ANH) ranges from 0.6 to 5.4%. Aim: The aim of the study was to find the causes and outcome of antenatally detected hydronephrosis. Methods: Babies diagnosed with antenatally detected hydronephrosis from January 2016 to December 2016 were followed up for 6 months postnatally. Based on anteroposterior diameter of renal pelvis babies were classified as mild, moderate and severe according to Society for Fetal Urology consensus statement on evaluation and management of ANH and these babies were followed up. Results: Two percent of babies born during the study period had significant ANH (68/3251). Three were lost to follow-up. Among the remaining 65 babies, three (4.6%) had severe, 13 (20%) had moderate, and 49 (75.4%) had mild ANH. During follow-up 39 (60%) resolved spontaneously, ten (15.3%) showed resolving hydronephrosis and 16 (24.6%) required some form of intervention. All babies with severe ANH required intervention (100%). Nine (69.2%) babies with moderate and four (8.1%) babies with mild ANH required intervention. Among babies who required intervention, majority had vesicoureteric reflux (12.3%) and pelviureteric junction obstruction (9.2%). Sixteen babies (24.6%) developed urinary tract infection. Conclusion: Majority of the ANH are mild and resolve spontaneously. Size at detection decides the likelihood of need for intervention as all those with severe hydronephrosis required intervention. Majority of babies with ANH are asymptomatic at birth and postnatal abnormality could be detected only by follow-up scans. Hence, this study reinforces on the regular follow-up of babies with ANH.</p> Pushpalatha Kariyappa, Rajashekhar Basavaraj Kenganal, Sreejesh Lal Kizhakkayil Copyright (c) 2020 Pushpalatha Kariyappa, Rajashekhar Basavaraj Kenganal, Sreejesh Lal Kizhakkayil Mon, 11 Jan 2021 00:00:00 +0530 Understanding H-type anorectal malformation in females for a suitable surgical approach – A single center experience from central India <p>Background: H-type anorectovestibular fistula is a rare anorectal malformation (ARM) in females where the child passes stool through a vestibular opening in addition to the normal anus. The diagnosis is easy and largely clinical but controversies exist regarding the most suitable surgical approach and technique to minimize complications. Objectives: This study aims to discuss the different possible presentations of the anomaly and the most suitable surgical approach to it. Materials and Methods: We analyzed a total of ten patients with this condition treated over a period of 3 years from January 2017 to December 2019. All underwent definitive surgery by the anterior perineal approach without any protective colostomy. They were analyzed with respect to age, presentation, coanomalies, fistula location, internal opening to anus distance, wound related complications or recurrence, need for colostomy later, and presence of constipation over 8 months of follow-up. Results: Incidence was 8.77% (10/114) of all ARMs in females. Mean age at presentation was 47.1 days and 3 (30%) had coanomalies. Vestibular staining was the most common manifestation. Mean internal opening to anus distance was 2.04 cm. Two (20%) had wound breakdown postoperatively and one (10%) had recurrence in long-term follow-up. These patients underwent colostomy. Two had constipation but all allowed adequate dilatation during mean follow-up of 8 months. Conclusion: H-type ARM in females can be suitably managed with the anterior approach. However, a proximal colostomy appears to significantly decrease the complication rate of the definitive surgery.</p> Samir Kant Acharya, Goutam Chakraborty, Amit Kumar Jadhav, Nidhi Sugandhi, Deepak Bagga, Rajat Piplani Copyright (c) 2021 Mon, 11 Jan 2021 00:00:00 +0530 Incidence of periventricular leukomalacia in preterm very low birth neonates – A tertiary care experience <p>Background: The periventricular leukomalacia (PVL) is the most common white matter injury in preterm very low birth weight (VLBW) neonates. It occurs due to ischemic injury to developing oligodendrocytes. It can be detected by cranial ultrasonography (CUS). Objective: The objective of the study was to find incidence of PVL in preterm VLBW babies and its correlation with gestational age, birth weight, and arterial blood PH. Materials and Methods: A total of 80 preterm low birth babies admitted in our neonatal intensive care unit over 1 year were included who met the inclusion criteria. All babies were subjected to CUS starting from the 1st week of their life and repeated weekly by trained radiologist to find changes suggestive of PVL till clinically indicated or normal scan on the 14th day of life. Results: Among 80 preterm low birth babies in our study, 54 (67.5%) were male and 26 (32.5%) were female. Three babies had gestational age of 30 weeks or less, 25 had gestational between 30 and 32 weeks, 35 had gestational age between 32 and 34 weeks, while 17 had gestational age more than 34 weeks. A total of 62 (77.5%) were born through normal vaginal delivery and 18 (22.5%) were born by cesarean section. The incidence of PVL was 2.5%. The most common change was periventricular flare. The incidence of PVL was more in extreme preterm and those with PH &lt;7.2. The mortality was 50% in babies with PVL. Conclusion: The incidence of PVL in preterm low birth weight babies is 2.5% with a mortality of 50%. Prevention and early detection are the keys to mitigate the effects of this disastrous complication of prematurity.</p> Mohd Irshad, Saika Bashir, Waseem Iqbal, Mohd Ashraf Copyright (c) 2021 Mon, 11 Jan 2021 00:00:00 +0530