International Journal of Contemporary Pediatrics

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https://imsear.searo.who.int/handle/123456789/156149

Editor-in-Chief: Dr. Bhaven Kataria
ISSN: 2349-3283 (Print); 2349-3291 (Online)

Frequency: Quarterly

Language: English

Open Access Peer-reviewed journal

Web site: https://www.ijpediatrics.com/

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Now showing 1 - 20 of 1890

Efficacy and safety of deflazacort in children with an initial episode of idiopathic nephrotic syndrome - a randomized controlled trial
(Medip Academy, 2025-07) Islam, MR; Mia, AA; Ahmed, T; Jahan, N; Kabir, R; Baki, MA; Al-Aziz, SMAK.
Background: Idiopathic nephrotic syndrome (INS) is the most common glomerular disease in children. Prednisolone has been the standard first-line therapy, but deflazacort, a synthetic corticosteroid, has shown promise with potentially fewer side effects. This study aimed to compare the efficacy and safety of deflazacort versus prednisolone in children with an initial episode of INS. Methods: This randomized controlled trial was conducted in the Department of Pediatric Nephrology, National Institute of Kidney Diseases and Urology (NIKDU), Dhaka, Bangladesh, from June 2019 to January 2021. In this study, we included 83 children, aged 2 to 12 years, who had Idiopathic nephrotic syndrome and visited the outdoor department and were admitted to the pediatric nephrology department of NIKDU. Patients were divided into two treatment groups � group A patients were prescribed prednisolone, and group B patients were prescribed deflazacort. Results: The mean age was significantly higher in the deflazacort group (4.97�11 years) compared to the prednisolone group (3.87�23 years), with a statistically significant p value of 0.007. The mean time to induce remission was significantly shorter in the deflazacort group (7.87�33 days) compared to the prednisolone group (9.82�43 days; p=0.02). Although relapse rates were higher in the prednisolone group at 3 and 6 months, the differences were not statistically significant. Complications like moon face and buffalo hump occurred more frequently in the prednisolone group, but without statistical significance. No significant differences were observed in growth parameters, blood pressure, cholesterol, or random blood sugar (RBS) levels between the two groups during follow-up. Conclusions: This study showed that deflazacort induced remission in a shorter time compared to prednisolone in children with an initial episode of INS. While both treatments were similarly effective in achieving remission, the deflazacort group experienced fewer relapses and a lower incidence of side effects during the follow-up period.
Profile of poisoning in children and adolescents at a tertiary care centre
(Medip Academy, 2025-07) S. A., R; K., A; P., P; R. V., D; R., J; S., S; Durai, L.
Background: This study examines exogenous poisoning-related hospitalizations among children and adolescents at Chengalpattu medical college hospital. It aims to identify risk factors for unintentional poisoning in individuals aged 1-18 and assess clinical outcomes. Additionally, it seeks to characterize the types and outcomes of poisonings in this demographic. Methods: A retrospective analysis was conducted using medical records of all admissions with confirmed poisoning diagnoses from January 1, 2022, to December 31, 2022, at Chengalpattu medical college hospital. Patients aged 1 to 18 years were included. Cases involving food poisoning, adverse drug reactions, and animal-related envenomation were excluded. Data collected included demographic details, type of poisoning, time to hospitalization, treatment given, and outcomes. Results: Out of 2,123 total poisoning cases, 389 (18.3%) involved patients under 18 years. A majority were female (58.4%), with a mean age of 11.61 years. Most cases (64%) originated from rural areas. The leading agents were corrosives (52.5%), organophosphorus compounds (14.1%), and oleander (13.6%). Corrosive poisoning was predominant among children under five, indicating accidental ingestion. The median time to hospital admission was 3.29 hours, and the Glasgow coma scale score was 12.83. Medical management was successful in 98.9% of cases, while the overall mortality rate was 1%, with organophosphorus poisoning being the most fatal. Conclusions: Preventive strategies and public education are essential, especially in rural areas, to reduce poisoning incidents. The study also highlights the growing concern of intentional poisonings and underlines the importance of mental health support for adolescents, particularly girls.
Profile of pediatric medico-legal cases admitted in Department of Pediatrics at a tertiary care hospital in Eastern Uttar Pradesh
(Medip Academy, 2025-07) Singh, A; Agarwal, P; Aggarwal, P; Gupta, V; Patel, R
Background: There is lack of data regarding medico-legal cases in paediatric population. To define the clinical, demographic and etiological profile of medico-legal cases admitted and managed in pediatric department of a tertiary care centre. Methods: The prospective observational study is conducted over a period of 1 year; all children up-to age of 18 years admitted with medico-legal implications were included in study. Results: Total 57 children were enrolled in study; mean age of study participants was 8.05�52 years. Majority of medicolegal cases were accidental (52.6%) followed by suicidal (28.1%), homicidal (10.5%) and intentional (8.7%). Accidental injuries are significantly associated with male sex and better outcome when compared suicidal injuries. Conclusions: Most frequent type of injury was poisoning followed by abandoned baby. Poor outcomes are associated with poisoning in cases involving suicidal ingestion, the presence of stressors, and the need for respiratory/vasopressor support.
Transient neonatal hyperthyrotropinemia: prevalence and its associated materno-fetal factors: a hospital based prospective observational study
(Medip Academy, 2025-07) Karnam, PS; Sathiyamoorthi, S.
Background: Transient neonatal hyperthyrotropinemia (TNH) should be interpreted with caution in newborns, to assess the risk of unnecessary treatment. There are very few studies reporting prevalence of TNH which ranges from 0.02 to 6.0%. Hence, this study was conducted to estimate the prevalence of TNH among neonates and factors associated with it. Methods: A prospective observational study was conducted among neonates born for a period of one year. All neonates were subjected to thyroid hormones screening on day 3-5, and if TSH level was elevated (10-20 mIU/l), a repeat TSH and T4 after 2 weeks were done. Elevated TSH levels at 3-5 days with normal T4 levels, normalizing on re-examination at 2-4 weeks was diagnosed as TNH. Descriptive data were reported as frequencies. Chi square and unpaired 憈� test was used to study association. Odd抯 ratio was calculated to study the strength of association using regression analysis. Results: Out of 333 neonates studied, 17 (5.1%) had elevated TSH levels with normal fT4 on initial screening. Of 15 newborns who returned for follow up at 2 weeks, 14 (4.1%) neonates returned to normalcy, indicating the prevalence of TNH as 4.1%. Prevalence of TNH among neonates born to hypothyroid mothers (45) was 11.1%. Maternal hypothyroid status, birth weight, head circumference and gestational age were statistically significant with TNH. Conclusions: Screening of all newborns for congenital hypothyroidism (CH) is useful, as they benefit from early initiation of treatment. However, interpretation of thyroid hormones must be done with utmost caution.
Weight loss of term babies in 48 hours of life as a tool to predict non-pathological neonatal hyperbilirubinemia
(Medip Academy, 2025-07) Wadhwa, L; Uma Divya, Tejaswini G; Kakarala, G.
Background: The aim of this study is to analyse the percentage of weight loss in 48 hours in term neonates as a predictor of non-pathological neonatal hyperbilirubinemia. Methods: The study was carried out in Department of Paediatrics in GITAM Institute of Medical Sciences and Research. A total of 120 babies were studied. Babies with pathological jaundice were excluded from the study. Results: While 45% of participants in the current study had normal bilirubin levels, 55% had hyperbilirubinemia (TSB>12). Percentage weight loss at 48 hours was positively correlated with total serum bilirubin with correlation coefficient (r) of 0.525 which was statistically significant (p value <0.001). On performing ROC analysis between percentage weight loss at 48 hours and hyperbilirubinemia, it was found that, at an optimum cut off >6.3% weight loss at 48 hours, patient will have hyperbilirubinemia. Conclusions: According to the above study, there is a clear link between hyperbilirubinemia and weight loss in newborns. Increased levels of bilirubin are strongly correlated with notable weight loss within the first 48 hours of life. Jaundice has been demonstrated to occur if the weight loss is more than 6.3% in the first 48 hours of life.
Behind the hashtags: a review of Instagram posts on pediatric ADHD
(Medip Academy, 2025-07) Mahindrakar, NR; Natarajan, SK; Negi, A; Prajapati, V; Rajput, V; Tabassum, S; Sharma, V.
Social media has become an influential source of mental health information in recent years, raising concerns about the spread of misinformation. This study aimed to evaluate the reliability of Instagram posts related to pediatric attention-deficit/hyperactivity disorder (ADHD). A total of 761 posts were analyzed across 10 popular hashtags, with data collected on content relevance, type, gender representation, content creators, and engagement metrics such as likes, comments, and follower counts. Relevance was assessed using criteria from the DSM-5 and CDC guidelines. Only 31% of posts were found to be relevant to ADHD, with a majority being educational in nature. ADHD coaches were identified as the most frequent content creators. Gender representation in the posts represented females more than males. The overall engagement rate was calculated to be 16%. These findings highlight the widespread presence of potentially unreliable ADHD-related content on Instagram. Physicians must recognize the influence of such platforms on public health literacy and take proactive steps to counter misinformation, as it may contribute to misdiagnosis, inappropriate management, and confusion among patients and caregivers.
The unseen onset: myelitis and nephritis as the first clue to juvenile lupus
(Medip Academy, 2025-07) Mogiligari, S; Parimi, VP
Juvenile systemic lupus erythematosus (SLE) is a multisystem autoimmune disorder that commonly affects the kidneys and central nervous system. While lupus nephritis and neuropsychiatric manifestations are well-recognized complications, the concurrent onset of lupus nephritis and acute transverse myelitis (ATM) as the initial presentation is exceptionally rare, particularly in the pediatric population. Such an atypical presentation poses significant diagnostic challenges and requires a high index of clinical suspicion to enable early recognition and timely management.
Assessment of physical functioning domain on quality of life of children with cerebral palsy-experience in rural Bangladesh
(Medip Academy, 2025-07) Begum, R; Pervez, M; Yasmin, F; Nag, BC; Fatema, K; Mollah, MAH
Background: Cerebral palsy (CP) is the most prevalent health condition linked to childhood disability in Bangladesh. This study was intended to evaluate the physical functioning domain of quality of life (QoL) of children with CP using Peds QLTM inventory in a tertiary care hospital. The aim of this study was to find out physical aspects of the child抯 QoL by using PedsQLTM inventory (physical, emotional, social, schooling), to identify co-morbidities, socio demographic profile of child and parents and to find out relationship between physical functioning domains of QoL score with types, co-morbidities and of socio demographic characteristics. Methods: To evaluate health related QoL (HRQOL), PedsQL 4.0, a generic tool, validated in Bangladesh was applied to and the questionnaire was answered by parents. Main outcome variable was physical functioning. Results: Majority of patients (28.16%) have both speech impairment and behavior problem. Intellectual disability was found 13.79%, 14.94% had epilepsy. Overall physical functioning summary score (PFSS) was 21.65 (95% CI). Multiple regression analysis of generic scale core and the variables associated independently with QoL. No statistically significant difference was found between types, co-morbidities of CP, father抯 and mother抯 education, family income, place of residence with physical domains of QoL score. Among all the types of CP only quadriplegic CP had significant effect on physical functioning score with (p<0.05), but this does not explain the variations in physical functioning score well (R square=0.208). Conclusions: The results of this study concluded that QoL pertaining to physical functioning domain in children with CP was found low which was most significant among children with quadriplegic CP. Most of the patients had speech impairment and behavior problem.
A rare and challenging case of Rasmussen抯 encephalitis: a pediatric case report
(Medip Academy, 2025-07) Dasari, T; Ahamed, MN; Priya, CS; Issac, I.
Rasmussen抯 encephalitis (RE) is a rare, chronic, and progressive neurological disorder characterized by unilateral hemispheric inflammation, intractable seizures, and neurological decline, primarily affecting children under 10 years old. This case report describes a 9-year-old male child born to consanguineous parents presented with a 9-month history of progressive myoclonic jerks, generalized tonic-clonic seizures (GTCS), and right-sided hemiparesis. Despite undergoing left temporo-parieto-occipital craniotomy and aggressive pharmacological management with antiepileptics, immunosuppressants, and corticosteroids, the patient developed super-refractory status epilepticus. Diagnostic imaging revealed left hemispheric atrophy, and cerebrospinal fluid analysis ruled out infections, leading to a diagnosis of Rasmussen抯encephalitis with drug resistant epilepsy. The patient underwent left vertical thalamic functional hemispherotomy, resulting in reduced seizure frequency, improved motor function, and decreased inflammatory markers postoperatively. This case underscores the challenges in managing RE, emphasizing the importance of early diagnosis, a multidisciplinary approach, and timely surgical intervention and challenging medication management.
Beyond the blink: a case report on Jeavons syndrome
(Medip Academy, 2025-07) Kumble, A; K. Phadke, A; Siriac, A; Jacob, M
Jeavons syndrome is a distinct syndrome characterized by the triad of eyelid myoclonia with or without absence seizures, eye closure induced generalized paroxysms, and EEG photosensitivity. We present a 5-year-old female child who was admitted for workup of high blood sugars. On evaluation child was diagnosed with type 1 diabetes mellitus (T1DM). At admission child had features of moderate diabetic ketoacidosis, requiring PICU admission for IV fluid correction and insulin infusion. Low C-peptide levels and elevated GAD antibodies confirmed the diagnosis of T1DM. Notably, the child had a 3-year history of eyelid myoclonus, prompting further evaluation. EEG revealed generalized 4-5 Hz spike-wave discharges with fixation-off phenomenon, leading to a diagnosis of Jeavons syndrome, a rare epileptic disorder. Child was started on antiepileptics. Now child is on regular follow up.
Psychiatric crisis to abdominal tuberculosis
(Medip Academy, 2025-07) Thampi, F; Vakayil Francis, J; Kokkat, A; Louis, V; K K., A.
We report a case of a 15-year-old female presenting with alprazolam overdose, psychiatric symptoms, and subsequent diagnosis of ileocecal tuberculosis (TB). Initial management addressed acute overdose and psychiatric illness, followed by identification of TB through imaging, colonoscopy, and histopathological confirmation. Drug-induced liver injury (DILI) complicated first-line anti-TB therapy, necessitating a modified regimen. This case highlights the diagnostic challenges in patients with overlapping psychiatric and systemic presentations, underscoring the critical role of thorough clinical and diagnostic evaluation in adolescents presenting with psychiatric symptoms and gastrointestinal complaints and the importance of monitoring for hepatotoxicity during ATT.
BioFlx smiles: aesthetic rehabilitation of primary anterior teeth using bioflx crowns - a case report
(Medip Academy, 2025-07) A. V., S; Mallappa, JS; Pai, KR; Pallavi K., L; Bhat, A; Dsouza, EN
Restoring primary anterior teeth poses a unique challenge in pediatric dentistry, requiring a balance between function, esthetics, and durability. BioFlx crowns, an innovative alternative to traditional zirconia and composite crowns, offer enhanced flexural strength, biocompatibility, with a consistent appearance that ensures reliable esthetic outcomes. This case report presents the rehabilitation of maxillary primary central and lateral incisors (teeth 51, 52, 61, and 62) using BioFlx crowns in a young child. The treatment approach, including case selection, crown adaptation, and clinical outcomes, is discussed. The patient exhibited significant aesthetic and functional improvement, with high parental satisfaction. BioFlx crowns demonstrate promising potential as a reliable and aesthetically pleasing restorative option for anterior pediatric dental rehabilitation.
Pediatric systemic lupus erythematosus with macrophage activation syndrome: navigating immune dysregulation under immunosuppressive therapy
(Medip Academy, 2025-07) Gandhi, T; Kumar, D; Agarwal, S; Venkatesh, S.
Systemic lupus erythematosus (SLE) is a multisystem autoimmune disease that can escalate into a more dangerous situation when accompanied by macrophage activation syndrome (MAS)梐 rare but potentially deadly hyperinflammatory condition. This report explores the case of a 15-year-old female patient with an established history of systemic lupus erythematosus who developed MAS while on immunosuppressive therapy for chronic immune thrombocytopenic purpura. The patient presented with persistent high-grade fever, severe anemia, pancytopenia, and profound hyperferritinemia, yet notably lacked renal involvement梐 feature that challenges conventional pediatric SLE presentations. Rapid deterioration necessitated aggressive treatment with high-dose corticosteroids, intravenous immunoglobulin, cyclosporine, and Rituximab, ultimately stabilizing her condition. This case underscores the diagnostic complexity and therapeutic challenges inherent in managing MAS in pediatric SLE, particularly when traditional markers are absent. This report offers insights into the timely diagnosis and treatment of rare MAS in SLE.
Unresolved Coronary artery aneurysms in an adolescent with multisystemic inflammatory syndrome in children associated with SARS-CoV-2 infection- What happens in the long term?- Case report
(Medip Academy, 2025-07) Govardhan, C; Ragavaiah, Naidu P; D扴ouza, F.
MIS-C, a well-known association with SARS-CoV-2 infection, has been a topic of significant interest. It presents with Kawasaki-like illness along with coronary artery dilation or aneurysms. In this report, we describe a particularly intriguing case of an adolescent with MIS-C presenting with coronary artery aneurysms persisting at the end of a 6-month follow-up, underscoring the importance of this condition. An 11-years-old adolescent female presented with fever, livedoid vasculitis rash over lower limbs, abdominal pain and breathlessness. Diagnosis of MIS-C was established based on the clinical findings, elevated inflammatory markers and positive SARS-CoV-2 IgG antibodies. Echocardiogram evidenced myocardial dysfunction with moderate pericardial effusion and coronary aneurysm. She was treated with intravenous immunoglobulins, steroids and aspirin. Serial follow-up until 6 months showed persisting skin changes and coronary aneurysms with normalized inflammatory markers. MIS-C and its related long-term outcome have been well recognized; however, longer follow-up is not just essential, but urgent in understanding this known yet novel condition.
Technetium-99 thyroid scan as an aid to diagnosis of congenital hypothyroidism with normal initial thyroid function test
(Medip Academy, 2025-07) Khullar, N; Dutta, S; Shaikh, Z.
Congenital hypothyroidism (CH) occurs in 1:2,000 to 1:4,000 newborns, is often asymptomatic at birth, due to transplacental passage of maternal thyroid hormones and some thyroid production by the infant. CH is classified into permanent and transient forms, thyroid dysgenesis accounts for 85% while dyshormonogenesis 10-15% cases. CH is diagnosed through newborn screening, confirmation by elevated serum thyroid stimulating hormone (TSH) and low T4 or free T4 levels. Thyroid radionuclide uptake, thyroid sonography, serum thyroglobulin, help identify the underlying cause, although treatment may begin prior to these tests. Early diagnosis and treatment are crucial for preventing developmental delays and ensuring optimal growth and development in affected infants.
Sick kids, smart teachers: a cross-sectional study on teachers� knowledge of pediatric neurological diseases in Saudi Arabia
(Medip Academy, 2025-07) Basha, EA; Aljowaie, GM; Aldrees, A; Alkhalaf, H
Background: Recent medical advancements have decreased absenteeism in children with chronic illnesses, emphasizing the importance of inclusive education. Epilepsy remains a common neurological disorder worldwide, yet many teachers lack the training to manage it and other neurodevelopmental disorders such as attention deficit-hyperactivity disorder (ADHD) and Autism spectrum disorder (ASD). ADHD is prevalent among school-aged children, with studies in Riyadh and Madina showing limited teacher awareness. Similarly, increasing ASD diagnoses underscore the need for enhanced educator preparedness. This study assesses the knowledge of teachers in Riyadh regarding the management of common pediatric neurodevelopmental conditions in school environments. Methods: A cross-sectional analytical design was used. A self-administered questionnaire was distributed to 369 teachers across various schools. It comprised two sections: demographic data and assessment of knowledge regarding epilepsy, ASD, and ADHD. Questions covered disease definitions, symptoms, educational impact, school strategies, and management practices. Results: Among the 369 teachers, gender distribution was nearly equal. Most worked in private schools (56.9%). While 77.5% correctly identified epilepsy and 86.7% recognized its symptoms, only 54.2% felt confident managing it. Knowledge of ASD and ADHD was moderate (65% and 70.7%, respectively). The average knowledge score was 12.66/19, with 57.7% scoring above average. Male teachers showed slightly better overall knowledge, though teaching experience and school type were not significant predictors. Conclusions: Teachers in Saudi Arabia demonstrate basic knowledge of epilepsy, ADHD, and ASD, but notable knowledge gaps remain, especially in daily management. Targeted training is crucial to enable effective educational support for children with chronic neurodevelopmental disorders.
Griscelli syndrome type 2: a tragic tale of two siblings
(Medip Academy, 2025-07) Muppalla, M; Parimi, VP; Tejaswini, RN; Vaishnavi, A; Ranganath, P; Lanka, NK.
Griscelli syndrome (GS) is a rare autosomal recessive disorder classified as an inborn error of immunity. Among its three variants, GS type 2, caused by mutations in the RAB27A gene, is marked by partial albinism and recurrent episodes of hemophagocytic lymphohistiocytosis (HLH). This case report chronicles the poignant journey of two siblings tragically lost to this condition. GS type 2 carries a high mortality rate, primarily due to HLH complications. Currently, hematopoietic stem cell transplantation (HSCT) remains the sole curative treatment for this devastating syndrome.
A rare occurrence of complicated plasmodium vivax malaria in a 5-month-old infant
(Medip Academy, 2025-07) Bainade, K; Kotrashetti, V; Elon, N; Dhulaj, A.
Malaria is less frequently documented in infants under six months due to a focus on older populations in research. Despite protective maternal antibodies and fetal hemoglobin, infants in this age group remain susceptible to malaria. This case highlights the importance of recognizing and diagnosing malaria in this vulnerable population. Recognition and appropriate management are crucial to preventing severe complications and improving patient outcomes. It presents a diagnostic dilemma in infants under 6 months when distinguishing malaria from sepsis, as both conditions present with similar symptoms.
Rosai Dorfman disease: a rare entity
(Medip Academy, 2025-07) Goyal, S; Sharma, CM; Garg, C
Rosai Dorfman disease (RDD), a rare benign proliferative disorder of unknown etiology, stems from abnormal histiocyte accumulation within lymph node sinusoids and extra nodal tissues. While uncommon in paediatric population, RDD clinically simulates lymphoproliferative disorders. This report details a 4-year male patient presenting at a tertiary care centre with progressive bilateral cervical and submandibular lymphadenopathy lacking febrile symptoms. Diagnostic confirmation was achieved through excisional biopsy. RDD is an exclusion-based diagnosis which requires multidisciplinary collaboration and heightened clinical suspicion remains essential for paediatricians and oncologists to facilitate timely intervention and management of this rare entity.
Enthesitis related arthritis with systemic features
(Medip Academy, 2025-07) Bhavana, S; Parimi, VP; Tejaswini, RN; Narsimulu, G
Systemic juvenile idiopathic arthritis (SJIA), classified as a form of juvenile arthritis, constitutes around 10-20% of all cases of JIA, and is the most common form of arthritis in children. It has no sex predilection and affects children as young as one year of age. Enthesitis occurs in a form of JIA known as enthesitis-related arthritis (ERA), which has a male predilection and is associated with the HLA-B27 allele. Systemic features do not characterize it. We describe a rare presentation of systemic inflammation in ERA in a female child.

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