Indian Pediatrics
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Item Noninvasive Ventilation Strategies in Neonates(Indian Academy of Pediatrics, 2025-06) Kumar, Jogender; Kumar, Praveen; Bhandari, VineetWe provide recommenda?ons on neonatal noninvasive ven?la?on (NIV) strategies used in the delivery room (DR) and neonatal intensive care unit (NICU). A systema?c search was performed in the PubMed, Embase, and CENTRAL databases to iden?fy relevant literature from the past 5 years. A cri?cal review of the available literature was conducted to provide context- specific recommenda?ons. In the DR, we recommend using nasal con?nuous posi?ve airway pressure (NCPAP) or nasal intermi?ent posi?ve pressure ven?la?on (NIPPV) with a T-piece resuscitator (TPR). Surfactant replacement therapy should be administered early (< 2 h of life) in infants requiring NCPAP of 6–7 cm H 2 O and FiO 2 >0.3, using less invasive surfactant administra?on techniques. Infants should be transported to the NICU on posi?ve pressure support using NCPAP or TPR. In extremely preterm infants with severe respiratory distress requiring intuba?on in the DR, surfactant should be considered during the intuba?on. If equipment and exper?se are available in the NICU, NIPPV is the preferred mode of NIV. Nasal masks or short binasal prongs are the preferred nasal interfaces. A heated, humidified, high flow nasal cannula is not recommended as the primary mode of NIV. Addi?onal clinical trials are needed for nasal high frequency ven?la?on and noninvasive ven?la?on neurally adjusted ven?latory assist modes of NIV. Guidelines for the recommended ini?al and maximal se?ngs for primary, post-extuba?on, and weaning off NIV in neonates are provided in this ar?cle. NIPPV and NCPAP are the preferred modes of NIV in neonates with respiratory distress.Item Association of Specific Dietary Fatty Acids with Asthma in Urban School Children and Adolescents: Inferences from a Cross-Sectional Multicentric Study From India(Indian Academy of Pediatrics, 2025-01) Awasthi, Shally; Kumar, Divas; Pandey, Anuj Kumar; Agarwal, Girdhar G; Anish, Thekkumkara Surendran; Bharti, Bhavneet; Mahanta, B N; Singh, CM; Khera, Daisy; Shekhawat, Dolat Singh; Mathew, Joseph L; Singh, Kuldeep; Bhat, Mushtaq A; A R, Somashekar; Kar, Sonali; Nair, SumaOBJECTIVE To assess the association of dietary fa?y acids with asthma in Indian school children. METHODS Children aged 6-16 years were enrolled from randomly selected urban schools in 10 ci?es. The Interna?onal Study on Asthma and Allergies in Childhood Phase III Ques?onnaire was used to assess the prevalence of asthma. Three-day dietary intake data was obtained using 24-hr dietary recall method. Intake of saturated fa?y acids (SFA), monounsaturated fa?y acids (MUFA), polyunsaturated fa?y acids (PUFA) and trans fa?y acids (TFA) was calculated using DIETSOFT so?ware. RESULTS Between April 2019 and February 2020, 2428 par?cipants were recruited (49.8% males) from 60 schools. The prevalence of asthma was 2.4% (95 % CI 1.8, 3.1). The mean (SD) intake of various FA (g per kg) were 0.19 (0.22) for SFA,18 (0.22) for MUFA, 0.17 (0.18) for PUFA and 0.003 (0.005) for TFA. SFA intake in those with asthma was 0.35 (0.34) as compared to 0.18 (0.21) without asthma (P value < 0.001). On uncondi?onal logis?c regression, dietary intake of TFA was associated with asthma in children [OR 2.16 (95% CI 1.27, 3.68)]. CONCLUSION Dietary intake of SFA and TFA is associated with asthma in children.Item Effectiveness of Bubble Continuous Positive Airway Pressure for Treatment of Children Aged 159 Months with Severe Pneumonia and Hypoxemia: A Systematic Review and Meta-Analysis of Randomized Controlled Trials(Indian Academy of Pediatrics, 2025-06) Tanashat, Mohammad; Manasrah, AlMothana; Bataineh, Omar Abdullah; Abdelrazek, Ahmad; Abouzid, MohamedOBJECTIVE Con?nuous posi?ve airway pressure (CPAP) is a standard treatment for children with moderate to severe respiratory distress; however, ven?lators are o?en unavailable in developing countries. Bubble CPAP (bCPAP) is considered a simple, cost effec?ve and less invasive alterna?ve to CPAP, however, its efficacy has not been assessed for children with pneumonia un?l recently. This meta-analysis aims to compare the effec?veness of bCPAP with low-flow oxygen for trea?ng severe pneumonia and hypoxemia in children. METHODS PubMed, EMBASE, Cochrane Library, Web of Science, and CENTRAL were searched to iden?fy eligible randomized controlled trials reported up to March 23, 2024. Outcomes were reported as risk ra?os (RRs) or mean difference (MD) and confidence intervals (CIs) using Review Manager so?ware. P value < 0.05 was considered sta?s?cally significant. RESULTS Three studies with 2030 pa?ents were included and revealed no significant difference between bCPAP and control in overall mortality [RR (95% CI) 0.46 (0.09, 2.32); P = 0.348], death during hospital stay [0.48 (0.02, 9.09), P = 0.619], composite primary outcome [0.48 (0.12, 1.97), P = 0.301], pneumothorax [1.94 (0.16, 23.11), P = 0.601], leaving hospital against medical advice [0.63 (0.16, 2.39), P = 0.489], and length of hospital stay [MD (95%CI) 0.15 days (? 0.66, 0.96), P = 0.706]. Children on bCPAP had significantly fewer events of severe hypoxemia [RR (95% CI) 0.22 (0.10, 0.49), P < 0.001], and less requirement for mechanical ven?la?on [RR (95% CI) 0.38 (0.15, 0.99), P = 0.048]. CONCLUSIONS bCPAP is not superior to low-flow oxygen for improving survival and reducing hospital stay in children with pneumonia, albeit the need for mechanical ven?la?on decreases.Item Feed Intolerance With Short Term Use of Commercial Pasteurized Donor Human Milk Versus Preterm Formula in Addition to Mothers Milk: A Retrospective Analytical Study(Indian Academy of Pediatrics, 2025-01) Nalini, Rajesh Raghavan; Varikko?l, Mohamed Muneer; Pournami, Femitha; Prithvi, Ajai Kumar; Jain, NaveenThis retrospective study compared the rate of feed intolerance in preterm neonates delivered at £ 30 weeks gesta?on who received pasteurised donor human milk (n = 83) versus preterm formula (n = 41) to meet the deficits in available volumes of mother’s own milk in the first 2 weeks of life. Feed intolerance was not higher in neonates who received preterm formula than those who received pasteurized donor human milk (24.4% vs 20%; OR (95% CI) 0.79 (0.30, 2.19) P = 0.619]. Rates of necro?zing enterocoli?s, culture posi?ve sepsis and mortality were not significantly different in the two groups. The preterm formula group gained birth weight earlier, although the ?me needed to a?ain full feeds was similar in both groups.Item Efficacy and Safety of Intravenous Immunoglobulin (IVIg) in Acute Viral Myocarditis in Children: A Systematic Review of Randomized Controlled Trials(Indian Academy of Pediatrics, 2025-01) Jain, Lovely; Kaur, Davinder; Khalil, Sumaira; Pradhan, Pranita; Malik, Meenakshi; Dogra, Sarita; Kaur, Kulbir; Mathew, Joseph LCONTEXT Acute myocarditis is a rare but potentially life-threatening condi?on in infants and children. While immunosuppressive agents have shown limited effec?veness, intravenous immunoglobulin (IVIg) holds promise as a treatment op?on. OBJECTIVE To study the efficacy and safety of intravenous immunoglobulin (IVIg) in trea?ng acute viral myocardi?s in children. EVIDENCE ACQUISITION We searched five databases including PubMed, EMBASE, the Cochrane Library, Scopus, and Web of Science; and four trial registries for published studies on the topic. Grey literature was searched through ProQuest and Open Grey databases. The studies eligible for this review were randomized controlled trials in children (< 18 years) with acute viral myocardi?s (Popula?on), comparing IVIg (Interven?on), versus no IVIg i.e., any other treatment or placebo (Comparator), for efficacy and safety (Outcomes). RESULTS The literature search iden?fied a total of 9,524 records. Two reviewers independently screened these records. A total of 73 cita?ons were deemed poten?ally eligible, all of which were non-RCTs or review ar?cles on full text examina?on. There were no RCTs iden?fied to address the review ques?on. CONCLUSION There are no RCTs in children comparing the efficacy and safety of IVIg treatment in acute viral myocardi?s. Prospec?ve randomized trials are urgently required.Item Clinical and Laboratory Characteristics and Comorbidities in Asthma Endotypes in Children(Indian Academy of Pediatrics, 2025-01) Kumar, Gautam; Tripathy, Saroj Kumar; Das, Sarthak; Malik, Archana; V, VinayagamoorthyOBJECTIVE To estimate the proportion of eosinophilic and non-eosinophilic (NEA) endotypes in pediatric asthma, and to compare the clinical, and laboratory characteris?cs, and different comorbidities between the two endotypes in the children. METHODS Children aged 5 to 14 years of age with clinical and/or laboratory- confirmed asthma a?ending the pediatric outpa?ent department of a ter?ary care hospital in Eastern India between October 1, 2023 and March 31, 2024, were included in this cross-sec?onal study. Complete hemogram, absolute eosinophil count (AEC), IgE, and pulmonary func?on tests were performed in all patients. Comorbidi?es associated with asthma were recorded. All patients were managed as per the Global Initiative for Asthma (GINA) guidelines. RESULTS Of 150 pa?ents, 133 (88.7%) pa?ents belonged to eosinophilic asthma and 17 (11.3%) belonged to NEA endotypes. A family history of allergy and/or asthma was observed in 83 (55%) par?cipants. Allergic rhini?s (59.3%), exposure to cold (42%), and anxiety (26.7%) were common comorbidi?es associated with asthma. Prematurity and urticaria were significantly associated with NEA. On regression analysis, the odds of ur?caria among the NEA endotype were about 3.7 ?mes higher than the EA endotype, adjusted odds ra?o (95% CI) of 4 (1.3, 12.6), P value = 0.02. Other comorbidi?es, sociodemographic, clinical, and lung function values were similar in both endotypes of asthma. CONCLUSION Eosinophilic asthma is the commonest asthma endotype and allergic rhini?s is the commonest comorbidity observed in children. Comorbidities associated with asthma in children are usually similar in both endotypes except for ur?caria which is higher in NEA.Item Serosurvey For Measles, Mumps and Rubella in Children and Adolescents with Chronic Kidney Disease(Indian Academy of Pediatrics, 2025-01) A, Meyyan; Tyagi, Vernika; Dabas, Aashima; Mantan, Mukta; Manchanda, VikasOBJECTIVES Children with Chronic Kidney Disease (CKD) are at increased risk for vaccine-preventable diseases. The primary objec?ve of the study was to es?mate IgG an?body ?ters against measles, mumps, and rubella (MMR) in children with CKD and healthy controls who were previously immunized with measles/ MMR vaccine. METHODS This case control study was conducted between January 2019 and January 2020. Children aged 2-18 years with CKD and healthy controls who had received at least one dose of measles/MMR were included. Children on dialysis were excluded. Clinical details of immuniza?on were recorded, and an?body ?ters measured by ELISA based kits. RESULTS 120 children (60 cases and 60 controls) were enrolled; seroprotec?on rates for measles, mumps and rubella in the CKD group and control group were 90% vs 86.7%, P = 0.01; 71.7% vs 77.7%, P = 0.77; and 86.7% vs 88.3%; P = 0.05, respec?vely, with lower an?body ?ters for mumps and measles in late-stages (stage 4 or 5) CKD. CONCLUSIONS Seroprotec?on amongst children with CKD for measles, rubella and mumps is not inferior to that in controls. However, children with late- stage CKD (stages 4 and 5) have lower seroprotec?on especially for mumps and measles compared to those with early-stage (1-3) CKD.Item Double Burden of Malnutrition in Under-Five Children (NFHS-5 Data) Using Extended CIAF: WHO 2006 Growth Standard Versus 2019 Indian Growth References(Indian Academy of Pediatrics, 2025-06) Dange, Nimisha S.; Khadilkar, Vaman; Gondhalekar, Ketan; Khadilkar, Anuradha V.OBJECTIVES To compare the double burden of malnutri?on (DBM) in under-five children using extended composite index of anthropometric failure (eCIAF) using WHO 2006 and 2019 Indian standards. METHODS Data of 2,32,920 under-five children as per Na?onal Family Health Survey-5 were eligible for inclusion. Incomplete records and extreme z-scores were excluded. eCIAF categories included: A No failure; B Wasted; C Wasted + Underweight; D Wasted + Stunted + Underweight; E Stunted + Underweight; F Stunted; G Stunted + Overweight; H Overweight; Y Underweight; Underfailure (UF): A + B + C + D + E + F + Y; Overfailure (OF): G + H. RESULTS Records of 1,96,015 under-five children were analyzed. 50.1% versus 74% children were categorized as no failure using WHO and Indian standards, respec?vely ( P < 0.001). Prevalence of DBM, UF and OF using WHO reference was significantly higher than using Indian references [49.9% vs. 26%; 48.4% vs. 24.7%; 3.5% vs. 1.9%, respec?vely]. CONCLUSION Using Indian references prevents misclassifica?on of DBM in under- fives.Item Neurostimulation in Childhood Epilepsy(Indian Academy of Pediatrics, 2025-05) Ghosh, Soumya; Nagarajan, LakshmiEpilepsy is a common and debilita?ng neurological disorder in children, and approximately a third of them have ongoing seizures despite adequate trial of an?seizure medica?ons. Neuros?mula?on approaches may be an op?on for those with drug resistant epilepsy. Several invasive and non-invasive devices have been trialled and found to be effec?ve in reducing seizure burden in drug resistant epilepsy. These techniques appear to be safe and well tolerated. We review the available evidence for the use of these devices, including vagus nerve s?mula?on, deep brain s?mula?on, responsive neuros?mula?on, chronic subthreshold cor?cal s?mula?on, transcranial magne?c s?mula?on and transcranial direct current s?mula?on. The results of trials are promising but there are fewer studies in children. Apart from vagus nerve s?mula?on, none of the other neuros?mula?on techniques are currently approved for use in children and their use is off -label or in clinical trials. Further well-designed trials are needed, especially in children, to iden?fy the most effec?ve neuros?mula?on op?ons and op?mal parameters for improvement of seizure burden and quality of life. Neuros?mula?on techniques are also being trialled for treatment of refractory status epilep?cus, but lack of robust evidence (mainly case studies or case series reports) makes it difficult to predict therapeu?c benefit at present.Item School Teachers Perspectives on National Iron Plus Initiative Implementation: A Qualitative Study(Indian Academy of Pediatrics, 2025-06) Mishra, Kumar Guru; Patnaik, Nabnita; Pradhan, Nihar RanjanOBJECTIVES To explore the school teachers' perspec?ves on factors affec?ng the implementa?on of Na?onal Iron Plus Ini?a?ve (NIPI). METHODS A qualita?ve par?cipatory study was conducted in six schools in rural areas of Telangana, involving free lis?ng, pile sor?ng, and force fi eld analysis. Analysis included frequency calcula?ons, mul?dimensional scaling, hierarchical cluster analysis, and thema?c analysis. RESULTS Fi?y four teachers par?cipated; 25 barriers and 14 enablers were iden?fied. Key barriers included lack of educa?on and health literacy, nega?ve a?tudes, lack of faith in public services, and unhygienic prac?ces. Major enablers were school-based anemia- related ac?vi?es, government awareness programs, and programma?c interven?ons. Force fi eld analysis revealed a?tudes and awareness gaps as significant barriers, while school-based ac?vi?es emerged as the primary enabler. CONCLUSION School-based interven?ons, addressing a?tudinal and educa?onal barriers, and adop?ng a holis?c approach are crucial for effec?ve anemia preven?on in rural se?ngs.Item Role of Proton Pump Inhibitor as Stress Ulcer Prophylaxis in Sick Children: A Randomized Controlled Trial(Indian Academy of Pediatrics, 2025-06) Kavilapurapu, Ananya; Lalitha, AV; Ghosh, SantuOBJECTIVES To evaluate the efficacy of intravenous pantoprazole as a stress ulcer prophylaxis in sick children to prevent gastrointes?nal (GI) bleeding. METHODS A randomized controlled trial included children aged one-month to 18 years requiring intensive care. Par?cipants were randomly assigned to receive intravenous pantoprazole or a placebo (normal saline) daily. The primary outcome was the incidence of GI bleeding (clinically significant or overt). Secondary outcomes were the median ?me of onset of GI bleeding, incidence of ven?lator- associated pneumonia (VAP), dura?on of hospitaliza?on, organ dysfunc?on scores, and all-cause mortality. RESULTS A total of 151 and 150 children were allocated to group A (pantoprazole) and group B (placebo), respec?vely. No significant difference was observed in the incidence of GI bleeding between the groups (group A: 21/151 vs group B: 19/150 [RR (95% CI) 1.03 (0.18, 5.82), P = 0.985]. Comparable results were observed for clinically significant GI bleeding (1.3% vs 0.6%; RR (95% CI) 0.54 (0.21, 1.28); P = 0.653 and overt GI bleeding [12.6% vs 12%; RR (95% CI) 0.98 (0.39, 2.23); P value = 0.313]. On mul?variate analysis, there was a reduced incidence of GI bleeding in children with coagulopathy in pantoprazole group ( n = 29) as compared to placebo ( n = 25) [RR (95%CI) 0.52 (0.32, 0.87); P = 0.022]. CONCLUSION Among cri?cally ill children, pantoprazole prophylaxis did not reduce the incidence of gastrointes?nal bleeding, although, a notable decrease in gastrointes?nal bleeding was observed in children with coagulopathy.Item Advances in Neonatal Seizures (2024): An Update for Pediatricians(Indian Academy of Pediatrics, 2025-05) Elwadhi, Aman; Kandraju, Hemasree; Sharma, SuvasiniPurpose The diagnosis and management of seizures and epilepsy syndromes with onset in neonates has undergone several changes following the Interna?on League against Epilepsy (ILAE) guidelines. To update the Pediatricians regarding the recent advances, this update was planned. Methods Recently published revised guidelines for neonatal seizures (up to 2024) by ILAE were reviewed and synthesized. Results Video-EEG recording is considered gold standard for diagnosis, with less emphasis on clinical semiology. In resource limited se?ngs, levels of diagnos?c certain?es may be used. One must be aware of the mandatory, alerts and exclusion criteria for various neonatal-onset epilepsy syndromes. Early neuroimaging facilitates diagnosis. Treatment primarily involves phenobarbitone (PHB) with other drugs to be used in certain special condi?ons, with universal early stoppage of drugs. Precision therapy is available for some metabolic and gene?c e?ologies. Conclusions EEG monitoring in high-risk neonates is the standard of care. PHB s?ll remains the first choice. Early cessa?on of an?-seizure medica?ons in acute symptoma?c seizures is the norm.Item Non-Invasive Blood Pressure Measurement in Extremely Preterm Neonates: Comparative Analysis of Different Methods(Indian Academy of Pediatrics, 2025-06) Garg, Shalabh; Zafar, AdnanOBJECTIVES To compare non-invasive (Doppler and Oscillometric) and invasive (indwelling umbilical arterial catheter, UAC) methods for measuring blood pressure in extremely preterm neonates. METHODS Neonates < 28 weeks gesta?on were recruited if UAC was inserted as part of their clinical care. Blood pressure measured 4–6 hourly by Oscillometric and Doppler methods was compared with invasive method (10–15 readings/baby). RESULTS 438 blood pressure recordings were taken from 11 neonates. Compared to invasive method, non-invasive methods underes?mated ( P = 0.630) and overes?mated ( P = 0.431 for > 10% overes?ma?on, P = 0.960 for > 20% overes?ma?on) blood pressure. The frequency of blood pressure being within 10% of UAC reading was higher with the Oscillometric method compared to Doppler (41% vs 17%). CONCLUSIONS Compared to invasive arterial recording, non-invasive methods underes?mated as well as overes?mated blood pressure in extremely preterm neonates. Oscillometric methods are more reliable compared to Doppler methods.Item Intramuscular Versus Oral Ondansetron for Management of Children with Acute Dehydrating Diarrhea and Vomiting: A Randomized Controlled Trial(Indian Academy of Pediatrics, 2025-06) Satyesh, Shubham; Meena, Rajesh Kumar; Shah, Dheeraj; Saha, Rumpa; Gupta, PiyushOBJECTIVES To compare efficacy and safety of intramuscular (IM) ondansetron with oral ondansetron for improving u?liza?on of Oral Rehydra?on Therapy (ORT) by controlling vomi?ng in children with acute diarrhea and some dehydra?on. METHODS We enrolled children aged 3 months to 12 years presen?ng with acute diarrhea (dura?on < 14 days) with some dehydra?on, and at least two episodes of vomi?ng within last 6 h in an open-label randomized controlled trial. Par?cipants were randomized to receive single dose (0.2 mg/kg) of IM or oral ondansetron before star?ng ORT. Primary outcome was failure of ORT (persistence of some dehydra?on a?er 4 h of ORT or need for intravenous fluids). Secondary outcomes included need for unscheduled intravenous fluids, amount of Oral Rehydra?on Salt Solu?on (ORS) ingested a?er 4 h, frequency of vomi?ng episodes, adverse effects, and caregiver sa?sfac?on. RESULTS We randomized 60 children (31 IM, 29 oral); 58 (29 per group) were followed-up for all outcomes. There were no significant differences between IM and oral routes in terms of ORT failure (31% vs. 24.1%; RR (95% CI) 1.3 (0.5, 3.0), P = 0.557), need for IV fluids during ORT (24.1% vs. 20.7%; P = 0.753), mean (SD) ORS ingested (mL) in 4 h [616.2 (429.7) vs. 645.5 (403.5); P = 0.79], mean (SD) frequency of vomi?ng [1.4 (2.0) vs. 2.3 (2.4); P = 0.107] or caregiver sa?sfac?on. No adverse events a?ributable to the interven?on were observed. CONCLUSION Intramuscular ondansetron may not off er any advantage over oral use in management of children with acute diarrhea with vomi?ng and some dehydra?on.Item Telemedicine as an Adjunct to Follow-Up of Low-Risk Neonates: A Prospective Cohort Study(Indian Academy of Pediatrics, 2025-06) Rajkumar, Remya; Roy, Nabagata; Pournami, Femitha; Prithvi, Ajai Kumar; Jain, NaveenBACKGROUND Synchronous video teleconsulta?ons are being increasingly used in various fi elds of medical care. Its feasibility, safety and advantages have been demonstrated in neonatal office prac?ce in our unit. METHODS This prospec?ve study was conducted to measure propor?on of parents of low-risk neonates who u?lized teleconsulta?ons for postnatal follow-up. RESULTS Of 844 eligible families, 22.3% used the service. Lacta?on queries (57.1%) about feeding schedules and perceived less milk related excess cry predominated. Enquiries related to skincare (36.5%) and sleep-wake cycle (30.1%) were common. Only 3.8% were advised to report to the hospital for physical assessment. CONCLUSIONS The number of families who engaged in the teleconsulta?ons with the neonatologist were less than an?cipated. However among those who did, majority of the concerns could be resolved without the need for physical hospital visits.Item Perception of Pediatric Resident Physicians on Self-Directed Learning: A Multi-institutional Survey(Indian Academy of Pediatrics, 2025-05) Ahmad, Ayesha; Dhingra, Bhavna; Kumar, Kunal; Kaushik, Jaya Shankar; Dabas, Aashima; Mishra, DevendraOBJECTIVES To assess the opportuni?es and limita?ons of self-directed learning (SDL) among pediatric postgraduate trainees. METHODS A semi-structured anonymized ques?onnaire was administered to pediatric postgraduate trainees to assess their readiness towards SDL, current prac?ces, opportuni?es and limita?ons of SDL. Closed ended ques?ons were scored using a five-point Likert scale. Thema?c analysis of responses was conducted followed by focus- group discussion to ascertain the barriers and enablers of SDL. RESULTS One hundred ten trainees responded; majority (67.7%) were aged 26–30 years. The median (IQR) scores for different components of SDL were- iden?fying own learning needs 4 (3.5, 4), formula?ng own learning goals 4 (3, 4), iden?fying learning resources 3 (3, 4), choosing and implemen?ng learning strategy 3 (2, 4), evalua?ng learning outcomes 3 (2, 4), and willingness to drive one’s own learning 3.5 (3, 4). The majority (95%) used online resources for knowledge domain; 64.5% (71/110) prac?ced peer-assisted learning. The skill training was chiefly through simula?on and hands-on experience (97%). Lack of ?me was the commonest limita?on reported by 75% students. CONCLUSIONS The SDL prac?ce was not forthcoming among pediatric postgraduates.Item Cannabinoid Use in Pediatric Epilepsy(Indian Academy of Pediatrics, 2025-04) Whitney, Robyn; Jauhari, Prashant; Jain, PuneetCannabidiol has shown promising effects on reducing seizure frequency in children and adults with selected epilepsy syndromes. In this narra?ve brief review, we provide an update on the use of cannabidiol in pediatric epilepsy including theindica?ons for its use, clinical efficacy, adverse effects, requirements for monitoring and regula?ons.Item Profile of Injuries Among Under-Five Children in Rural Areas of Khordha District, Odisha-A Community-Based Cross-Sectional Study(Indian Academy of Pediatrics, 2025-05) Ravichandranl, Mythry; Singh, Arvind Kumar; Giri, Prajna Paramita; Behera, Priyamadhaba; Patro, Binod KumarOBJECTIVES To es?mate the prevalence, pa?erns, and risk factors for injury among under-five children. METHODS A community-based cross-sec?onal study was conducted in the rural areas of Khordha district among 600 underfive children. A mul?stage sampling technique was used to assess the prevalence, pa?erns, and factors associated with injuries using a semi- structured ques?onnaire, followed by an environmental hazard assessment of the built environment of the selected par?cipants. RESULTS Childhood injury prevalence was 44.6% (95% CI 40.6, 48.7). Falls were the commonest injuries; 87% falls occurred at home. Only 19% of the major injuries received formal healthcare. The child's age, parental awareness, and environmental hazard risk were associated with the occurrence of injuries. CONCLUSIONS The built environment plays a significant role in childhood injuries in the rural areas of Odisha. Public health measures such as a safe built environment for households and neighborhoods should be promoted.Item Oral Selenium as an Adjunct in the Treatment of Acute Lower Respiratory Tract Infections in Children: A Double-Blind Randomized Controlled Trial(Indian Academy of Pediatrics, 2025-05) Shaikh, Rubeena Jamir; Joshi, Trupti Amol; Mundada, Smita Madhusudan; Pawar, Shilpa Yashwant; More, Prabha Bhaskar KhaireOBJECTIVES To evaluate the role of oral selenium in clinical recovery of acute lower respiratory tract infec?ons (ALRTI) in under-five children. METHODS This double-blind, randomized controlled trial included children aged 6 months to 5 years hospitalised with ALRTI at a ter?ary care hospital. Par?cipants were randomized in 1:1 ra?o to receive oral selenium (20–30 mcg/day) or placebo, once daily un?l discharge, along with standard treatment. The primary outcome was the ?me for clinical recovery. The secondary outcomes were the dura?on of hospital stay, modes of oxygen support required and side effects of selenium. RESULTS A total of 60 children were randomized to either groups. The median (IQR) ?me required for clinical recovery was 72 (54, 144) h in the selenium group and 96 (54, 120) h in the placebo group ( P = 0.346). The median (IQR) dura?on of hospital stay was 6 (5, 7) days and 6 (6, 8) days in the selenium and placebo groups, respec?vely ( P = 0.680). Mechanical ven?la?on was required in 10 (16.6%) and 21 (35%) children in the selenium and placebo groups, respec?vely ( P = 0.020). No side effects were reported with the interven?on. CONCLUSIONS Oral selenium administered as an adjunct in a daily dose of 20–30 mcg orally for 5–7 days, does not reduce the ?me needed for clinical recovery or the dura?on of hospitaliza?on but reduces the need for mechanical ven?la?on in under-five children with ALRTI.Item FCGR2A Gene Polymorphism Association in Children with Multisystem Inflammatory Syndrome(Indian Academy of Pediatrics, 2025-05) Ye?iltepe, Esra; Duman, Derya; Kuyucu, Necdet; Bozdo?an, Sevcan Tu?; Ç??r?k, Lara; Ye?il, Edanur; Karpuz, DeryaOBJECTIVES Fc gamma receptor IIa ( FCGR2A ) gene polymorphism is associated with increased suscep?bility to autoimmune and infec?ous diseases. The aim of the present study was to evaluate the associa?on of FCGR2A rs1801274 polymorphism with the development and severity of mul?system inflammatory syndrome in children (MIS-C). METHODS This case-control study was conducted in a single center with MIS- C pa?ents and healthy children. Clinical and cardiac imaging data of the par?cipants was collected. The associa?on between the clinical severity of the disease and FCGR2A rs1801274 polymorphism were inves?gated. RESULTS There was no significant associa?on between FCGR2A rs1801274 polymorphism and cardiovascular complica?ons in MIS-C pa?ents. However, those with homozygous FCGR2A rs1801274 gene polymorphism developed severe cardiac dysfunc?on and required immunomodulatory agents other than intravenous immunoglobulin. The mean age of the pa?ents with severe MIS-C was significantly higher than those with mild MIS-C, and systolic dysfunc?on was significant. CONCLUSIONS Further mul?center studies in different ethnic groups are needed to evaluate the associa?on between differences in the FCGR2A rs1801274 gene and severity of MIS-C and/or other inflammatory diseases.