Indian Pediatrics
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Item Age profile of neonatal deaths.(2008-12-09) ,Neonatal survival has emerged as the key to further reduction in child mortality. Distribution of neonatal deaths in first week of life in the community is poorly understood. In a cross sectional survey covering a population of 13,16,681, information was collected retrospectively for one-year reference period on 30,473 births, 1,521 neonatal deaths and 2,218 infant deaths from five rural sites in India. Of all neonatal deaths, 39.3% occurred on first day of life, and 56.8 % during the first three days. The study highlights importance of first three days as the most hazardous phase in life and provides evidence base for postnatal care guidelines.Item Consensus guidelines for pediatric intensive care units in India.(2002-01-24) Khilnani, Praveen; ,; ,Item Consensus guidelines on pediatric acute rheumatic fever and rheumatic heart disease.(2008-07-13) ,; Saxena, Anita; Kumar, R Krishna; Gera, Rani Prem Kumar; Radhakrishnan, S; Mishra, Smita; Ahmed, ZJUSTIFICATION: Acute rheumatic fever and rheumatic chronic valvular heart disease is an important preventable cause of morbidity and mortality in suburban and rural India. Its diagnosis is based on clinical criteria. These criteria need verification and revision in the Indian context. Furthermore, there are glaring differences in management protocols available in literature. These facts prompted Indian Academy of Pediatrics to review the management of rheumatic fever. PROCESS: Management of Rheumatic fever was reviewed and recommendation was formulated at national consultative meeting on 20th May 2007 at New Delhi. OBJECTIVES: To formulate uniform guidelines on management of acute rheumatic fever and rheumatic heart disease in the Indian context. Guidelines were formulated for the management of streptococcal pharyngitis, acute rheumatic fever and its cardiac complication as well as secondary prophylaxis for recurrent episodes. RECOMMENDATIONS: (1) Streptococcal eradication with appropriate antibiotics (Benzathine penicillin single dose or penicillin V oral or azithromycin). (2) Diagnosis of rheumatic fever based on Jones criteria. (3) Control inflammatory process with aspirin with or without steroids (total duration of treatment of 12 weeks). (4) Treatment of chorea according to severity (therapy to continue for 2-3 weeks after clinical improvement). (5) Protocol for managing cardiac complication like valvular heart disease, congestive heart failure and atrial fibrillation. (6) Secondary prophylaxis with benzathine penicillin and management of anaphylaxis.Item Consensus on timing of intervention for common congenital heart disease.(2008-02-04) ,JUSTIFICATION: Separate guidelines are needed for determining the optimal timing of intervention in children with congenital heart diseases in India, because of their frequent late presentation, undernutrition and co-existing morbidities. PROCESS: Guidelines emerged following expert deliberations at the National Consensus Meeting on Management of Congenital Heart Diseases in India, held on 26th August 2007 at the All India Institute of Medical Sciences, New Delhi, India, supported by Cardiological Society of India. OBJECTIVES: To frame evidence based guidelines for (i) appropriate timing of intervention in congenital heart diseases; (ii) assessment of operability in left to right shunt lesions; and (iii) prophylaxis of infective endocarditis in these children. RECOMMENDATIONS: Evidence based recommendations are provided for timing of intervention in common congenital heart diseases including left to right shunt lesions (atrial septal defect, ventricular septal defect, patent ductus arteriosus and others); obstructive lesions (coarctation of aorta, aortic stenosis, pulmonary stenosis); and cyanotic defects (tetralogy of Fallot, transposition of great arteries, total anomalous pulmonary venous connection, truncus arteriosus). Guidelines are also given for assessment of operability in left to right shunt lesions and for infective endocarditis prophylaxis.Item Consensus recommendations on immunization, 2008.(2008-08-30) ,JUSTIFICATION: There is a need to formulate recommendations regarding use of new vaccines which have become recently available/will soon be available and to review/revise recommendations about existing vaccines in light of recent information. PROCESS: Following an IAPCOI meeting in March 2008, a draft statement was prepared and circulated among the meeting participants to arrive at a consensus. OBJECTIVES: To formulate recommendations pertaining to use of Tdap, human papilloma virus (HPV) vaccines and rotavirus vaccines and to revise recommendations pertaining to use of pneumococcal and inactivated poliovirus vaccines (IPV). These recommendations are primarily for pediatricians in office practice. RECOMMENDATIONS: IAP COI recommends (i) offering Tdap vaccine instead of Td/TT vaccine to all children/ adolescents who can afford to use the vaccine at the age of 10-12 yrs; (ii) offering HPV vaccine to all females who can afford the vaccine at the age of 10-12 years; (iii) offering both seven valent pneumococcal conjugate vaccine (PCV 7) and 23 valent pneumococcal polysaccharide vaccine (PPV 23) in all high risk children who can afford the vaccine; (iv) offering IPV in addition to oral poliovirus vaccine (OPV) in all children who can afford the vaccine at the age of 6, 10, 14 weeks and a booster at 15-18 months; (v) the use of oral rotavirus vaccines after one-to-one discussion with parents beginning age 6 weeks; and (iv) the use of PCV 7 in healthy children aged below 2 years after one-to-one discussion with parents at the age of 6, 10, 14 weeks and booster at 15-18 months.Item Consensus Statement of IAP National Task Force: status report on management of acute diarrhea.(2004-04-05) Bhatnagar, Shinjini; Bhandari, Nita; Mouli, U C; Bhan, M K; ,Item Consensus statement on evaluation of hematuria.(2006-11-08) Phadke, K D; Vijayakumar, M; Sharma, Jyoti; Iyengar, Arpana; ,Item Consensus statement on management of urinary tract infections.(2001-10-26) Bagga, A; Babu, K; Kanitkar, M; Srivastava, R N; ,Item Drug therapy of cardiac diseases in children.(2009-04-23) ,; Saxena, Anita; Juneja, Rajnish; Ramakrishnan, SJustification: The indications and doses of most drugs used for heart ailments in children are extrapolated from data in adult patients. Separate guidelines are needed for neonates, infants and children because of the differences in underlying heart diseases and metabolic clearance of some of these drugs. Process: Consensus emerged following expert deliberations at the National Meeting on Management of Congenital Heart Diseases in India, held on 13th September 2008, at the All India Institute of Medical Sciences, New Delhi, India, supported by Pediatric Cardiac Society of India. Objectives: To review the literature and frame evidence based guidelines for (i) indications, doses, adverse effects and safety profile of commonly used drugs in pediatric cardiology practice; and (ii) to provide an algorithm for treatment in various clinical settings. Recommendations: Consensus review and recommendations are given for drugs used in children for heart failure, hypertension, thrombosis, supraventricular tachycardia and intensive care. Guidelines are also given for use of intravenous immunoglobulins and sildenafil in children.Item Guidelines 2000 for neonatal resuscitation.(2000-11-22) Gupta, P; ,Item IAP Committee on Immunization.(2007-05-31) Singhal, Tanu; Amdekar, Y K; Thacker, Naveen; ,Item IAP guidelines for graduate medical education in pediatrics.(2001-06-22) Srivastava, R N; Mittal, S K; Paul, V K; Ramji, S; ,Item IAP National Task Force for Childhood Prevention of Adult Diseases: Childhood Obesity.(2004-06-06) Bhave, Sheila; Bavdekar, Ashish; Otiv, Madhumati; ,