European Journal of Molecular & Clinical Medicine

The object of the study were 97 patients, children with community-acquired pneumonia associated with mycoplasma and chlamydial infection aged from 1 to 7 years. Dynamic analysis has proven the benefit of differentiated treatment. In group II, during therapy on the 6th day from the start of treatment, a pronounced positive dynamics of physical data was observed. Analysis of the effect of differentiated treatment on the parameters of biochemical data of the examined patients revealed a positive effect on the studied parameters. There was a significant decrease in the content of NO₂(NO₃), HP, ONOO- and a significant increase in eNOS compared with the data of group I. After treatment, the concentration of MDA was 1.8 times higher than in practically healthy children and 1.4 times lower than in children who received basic therapy. A decrease in the level of MDA in the blood in patients with CAP associated with MI and CI during treatment states a decrease in free radicals and an increase in the intensity of AOS.

Aim: The study's objective was to evaluate the effectiveness of Kirschner wires (K-wire) and cannulated cancellous screws (CC) for internal fixation of paediatric patients with displaced lateral humeral condyle fractures.
Materials and Methods: The study comprised 46 individuals with a displaced lateral condyle fracture of the humerus. Open reduction and internal fixation were used to treat the patients using two K-wires or 4mm CC screw. Clinical outcomes were assessed using Hardacre et al. criteria, and fractures were categorised using Milch classification.
Results: Each group contained 23 patients, with a mean age of 6.57 years (range 2 to 12 years). Compared to Milch type I (n=12), Milch type II was more prevalent (n=34). The average time for fracture union was 4.13 weeks for the CC screw group and 4.61 weeks for the K-wire group. P value equals 0.026. K-wires and CC screws were typically removed at 4.57 weeks and 13.57 weeks, respectively. The average follow-up for the K-wire group was 12.52 months, compared to 13.83 months for the CC screw. In the K-wire group, three patients (6.5%) had superficial pin site infection, two patients (4.3%) had lateral condyle prominence, and only one patient (2.2%) had lateral condyle prominence in the CC screw group.
Conclusion: For displaced lateral condyle fractures of the humerus, open reduction and internal fixation with K-wires or cannulated cancellous screws are both effective treatment options. However, screw fixation offers absolute stability at the fracture site, improving fracture healing, lowering the risk of lateral prominence, and enabling early range of motion and activity in the affected elbow.

It determined the frequency, dimensions, treatment, and results of the COVID-19 pandemic in children who had endocrine problems and diabetes.
Methods: A worldwide network of endocrine societies was sent an internet survey in the form of a cross-sectional questionnaire. The professional and practice characteristics of respondents, the size of their clinics, the nation in which they practiced medicine, and the influence that COVID-19 had on endocrine illnesses were explored.
Results: The study was completed by respondents from 134 pediatric endocrine institutions located in 51 different countries and across all seven continents. The majority of pediatric endocrinology clinics have made adjustments to their standard checkups as well as their educational programming. More than twenty percent of clinics reported experiencing a lack of availability of crucial supplies or drugs. Patients diagnosed with diabetes and COVID-19 needed therapy in an intensive care unit. It has been clearly stated that pediatric patients with endocrine abnormalities have alterations in their biopsychosocial functioning as well as their behaviors.
Conclusions: This extensive worldwide study was carried out during the COVID-19 pandemic, and its findings underscore the fact that diabetes is more difficult to control than any other juvenile endocrine illness, and it also carries a higher risk of morbidity. It is necessary to acknowledge and treat the psychological anguish that has been caused by COVID-19. Every patient ought to have easy access to medical supplies, and it is essential that they maintain frequent interaction with the medical staff who are responsible for their treatment

Undernutrition is a condition in which nutrients are insufficiently consumed, poorly absorbed, or lost excessively. Overindulgence or excessive intake of particular nutrients are the main causes of overnutrition. Protein-calorie malnutrition (PCM), which is caused by a lack of macronutrients like protein, carbs, and fat, is one of the most significant nutritional issues, affecting hundreds of millions of pregnant women, the elderly, and small children in particular.
Methodology: Children with protein energy deficiency between the ages of 6 months and 5 years old participated in this study at the department of paediatrics. A thorough comprehensive examination and history were performed.
Results: The most frequent symptoms in our study were fever 85.34%, vomiting 49.50%, and cough 42.50%. In children decreased feeding was present in 35.29 percent of cases, loose stools were present in 36.28 percent of cases, oedema was present in 28.04 percent of cases, weight loss was present in 17.96% of cases, dyspnea was present in 17.84 percent of cases, abdominal pain was present in 20.16 percent of cases, and convulsions were present in 7.24% of cases. Prevalence of malnutrition in maximum in Grade II.

Pediatric HIV is a major world health problem, which is progressing at an alarming rate. Ocular complications in HIV patients make management of such patients more difficult; if such manifestations can be picked up early, better management results could be achieved with such patients. Present study was aimed to study ocular manifestations in children (<12 years) with positive HIV status at a tertiary hospital. Material and Methods: Present study was single-center, prospective, observational study, conducted in children of 2-12 years of age, affected with HIV/AIDS, attending antiretroviral therapy (ART) center of the institute, underwent a thorough ophthalmologic evaluation for ocular involvement. Results: In present study, total 460 children underwent ophthalmologic evaluation, 88 children had ocular involvement (19.13 %). Majority were from 6-9 years age group (43.18 %), were boys (54.55 %) & mean age was 7.53 ± 3.81 years. Anterior segment manifestations noted were allergic conjunctivitis (20.45 %), dry eye (19.32 %), hordeolum (12.5 %), molluscum contagiosum (1‑bilateral) (4.55 %), blepharitis (4.55 %), herpes zoster ophthalmicus (without keratitis) (3.41 %). Posterior segment manifestations were retinal perivasculitis (13.64 %), CMV retinitis (4.55 %), isolated cotton wool spot (4.55 %), toxoplasma (3.41 %), choroidal tubercle (2.27 %), Roth spots (2.27 %). In children with CD4 count of 200-500 cells/mm³ ocular manifestations noted were hordeolum, blepharitis, molluscum contagiosum, optic neuritis while in children with CD4 count of <200 cells/mm³ ocular manifestations noted were CMV retinitis, herpes zoster ophthalmicus, retinal vasculitis. Conclusion: Ophthalmic manifestations of HIV infection are diverse. Both anterior and posterior segments of the eye can be involved. Early detection of the ocular manifestations of HIV/AIDS is critical since this has implications for the prognosis of the disease.

Hepatitis A is one of the highly communicable diseases of mankind and remains one of the most common forms of acute viral hepatitis worldwide. Children with HAV most commonly present with nonspecific gastrointestinal symptoms in addition to fever. Present study was aimed to study clinical spectrum of hepatitis A in children at a tertiary hospital. Material and Methods: Present study was single-center, prospective, observational study, conducted in patients of age 0-14 years, either gender, with signs and symptoms of acute viral hepatitis with positive HAV IgM. Results: In present study, 100 children admitted with signs and symptoms of acute viral hepatitis (loss of appetite, jaundice, nausea, vomiting, pain abdomen and itching), with positive HAV IgM were included. Majority children were from 6-10 years age group (45 %), followed by ≤5 years age group (39 %) & 11-14 years age group (16 %). Mean age was 8.1 ± 3.9 years. Male (57 %) children were more as compared to Female (43 %). Common clinical manifestations noted were fever (79 %), loss of appetite (78 %), yellowness of the eyes (71 %), dark-colored urine (70 %), abdominal pain (61 %), vomiting (47 %) & nausea (45 %). Mean levels of various laboratory parameters were TLC (18,452 ± 6,345 /μL), total Bilirubin (2.6 ± 1.7 mg/dL), conjugated Bilirubin (2.1 ± 1.6 mg/dL), alanine Transaminase (ALT) (106 ± 71 IU/ml), aspartate transaminase (AST) (210 ± 98 IU/ml), albumin (3.9 ± 1.3 mg/dL) & prothrombin Time (14.6 ± 3.1 secs). Conclusion: Hepatitis A is one of the most common cause of acute viral hepatitis in pediatrics population. Common clinical manifestations noted were fever, loss of appetite, yellowness of the eyes, dark-colored urine, abdominal pain, vomiting & nausea.  

In the western region of the state of West Bengal, it is difficult to diagnose enteric fever using blood cultures or even the Widal test. The best method to make a diagnosis and start treatment is with a high index of suspicion. In this setting, research into potential haematological alterations associated with enteric fever may offer the physician a critical clue for the early initiation of treatment and prevent further complications.
Aims: The goal of this study was to examine the haematological profile of children with Widal-positive enteric fever.
Method: A hospital-based cross-sectional study was carried out at Bankura Sammilani Medical College and Hospital (BSMCH) from March 1, 2020, to August 31, 2021. The study population consisted of 120 children, aged 1 to 12 years, who were admitted to the children's ward with Widal positive enteric fever. A pre-designed questionnaire was used to collect the relevant information. The data was entered into a Microsoft Excel spreadsheet and analyzed with Epi Info (version 3.5.1) Software.
 Results: Anaemia (80%) was the most prominent haematological result in the current study. Raised ESR (65%), thrombocytopenia (28.33%), eosinopenia (23.33%), leucopenia (22.50%), erythropenia (20%), relative lymphocytosis (21.67%), neutropenia (17.5%), eosinophilia (5.83%), and leucocytosis (5.83%) were found in decreasing order. Leucocyte, platelet, haemoglobin, and ESR changes were all statistically significant (P-value = 0.000*). Changes in PCV, MCV, and MCH, with the exception of MCHC, were found to be statistically significant (P-value = 0.000*).
Conclusion: In the case of a 7-day fever with clinical features like anorexia, vomiting, diarrhoea, constipation, abdominal pain, a coated tongue, hepatomegaly, and headache, in addition to the aforementioned haematological changes, it may help the physician to initiate management of enteric fever without performing a serological test and testing for organism isolation via blood culture, which is not possible in remote areas

Over the past few decades, environmental modifications (lower availability to sunlight owing to operating indoors or use of protective clothing and sunblock; food modifications) have been mainly blamed for vitamin D and inadequacy in the wider public. Being overweight, living in the inner-city and having African American ancestry are possible causes for asthma and vitamin D insufficiency. While the musculoskeletal effects of chronic insufficiency of vitamin D are very well recognized, a variety of other illnesses, particularly respiratory problems, have recently been related to vitamin D insufficiency. The potential significance of vitamin D as an increasing mediator that supports lung health is becoming well understood. In children with asthma, vitamin D insufficiency appears to be more common. According to epidemiological data, children with asthma with low blood levels of vitamin D suffer from more pain, exacerbations, lung damage, medication usage, and severe illness. Research published in vitro has shown that adult asthmatics' steroid sensitivity is improved by vitamin D. By preventing disease, in particular by retaining regulatory T cells, and by directly inducing intrinsic antimicrobial systems, vitamin D may have a significant impact on lung health. To resolve the diagnosis and treatment significance vitamin D could have in treating asthma in the long term, more investigations are essential to completely comprehend the impacts of vitamin D in preserving airway homeostasis. Along with prospective defence mechanisms like antiviral impacts and augmented steroid attentiveness, considerable uncertainty concerning the impacts of vitamin D insufficiency and inadequacies in kids with asthma and a thorough analysis of present experimental and observational studies substantiation of relationship among vitamin D levels and asthma or bronchitis comorbidities.

A seizure is a transient occurrence of signs and or symptoms from abnormal excessive or synchronous neuronal activity in the brain. The commonly used treatment for epilepsy is antiepileptic drugs; there is an increased oxidative stress in epilepsy patients, this study was to look for effectiveness of vitamin E in children with treatment resistant epilepsy in the form of improvement in frequency, duration of seizure, number of hospitalization, and EEG change.
Subject and Methods: Randomized control trail conducted in 32 children with treatment resistant epilepsy, with supplementation of vitamin E in upper limit of RDA and placebo in addition to antiepileptic drugs after randomization and allocation for 6 months’ duration with prior recording history related to seizure prior to 6 months of trail. Patient kept on follow up with number of seizures, number hospitalization, duration each seizure occurred, changes in antiepileptic drugs made, an EEG after 6 months of intervention.
Result: Reduction in seizure frequency, number of hospitalization and duration of seizures occurred in both group, significant difference was observed in number of Impending status seizure episode (p=0.037), there is no significant positive changes in observed.
Conclusion: Supplementation of vitamin E as per the upper limit of RDA is effective in reducing the number of impending status seizure, hence the severity of epilepsy in treatment-resistant epileptic patients of the pediatric age group.

Background: To assess type of headache in children.
Materials and Methods: One hundred ten children age ranged 4 years to 10 years of both genders were selected. A thorough clinical examination and type of headache was recorded in case history proforma. A detailed neurological examination including ophthalmoscopy was performed on children with headache.
Results: Out of 110 patients, boys were 50 (45.4%) and girls were 60 (54.6%). Age group 4-6 years had 38, 6-8 years had 32 and 8-10 years had 40 patients. The difference was significant (P< 0.05). Type of headache was tension headache in 10, migraine in 46, migraine-like headache in 42, and non-specific headache in 12 patients. The difference was significant (P< 0.05).
Conclusion: The most common type of headache was migraine. Maximum number of pediatric headache was seen in 8-10 years of age.

The American Academy of Pediatric Dentistry (AAPD) recognizes that providing both primary andcomprehensive preventive and therapeutic oral health care to individuals with special health care needs (SHCN)is an integral part of the specialty of pediatric dentistry. Oral health care is the most common unmet need in the children with special needs.The dental condition of children with special health care needs (SHCN) may be directly or indirectlyassociated with their disabilities. Children with SHCN relatively have poor oral hygiene and increased prevalence of gingivaldiseases and dental caries. Parents of disabled children may face problems in providing dental treatment to their children as they might have theburden of medical treatment. The management of children with special health care needs(SHCN) requires specialized knowledge and training, increased awareness, accommodative measures, and resources.

Background: Fever is a typical symptom of common childhood health concerns, leading parents to seek medical attention for their children.
The purpose of this study is to evaluate the effect of health education on mothers' understanding of how to best care for their children while they are ill with a fever.
Methods: The study used a one-group pre-and post-test strategy for research. The mothers of children aged six and up admitted to the paediatric ward of a selected Karad tertiary care hospital constitute the study population. It was permissible to pick a sample of moms of children with fever using a non-probability purposive sampling technique. One hundred childbearing women were chosen from the Krishna hospital in Karad. In order to gather information, a formal questionnaire was used. The purpose of the pre-test was to gauge mothers' preexisting knowledge on the topic of food for children with fever. After 7 days of pre-testing, we repeated the knowledge quiz to see how much of the initial knowledge gained from the structured health education had stuck.
Result: After receiving systematic health education, 60% of moms improved to a sufficient level of knowledge. For mothers, the mean pre-test score on diet knowledge was 5.83; the post-test score was 14.6, and the paired "t" test value was 13.9. This improvement was statistically significant at the 0.0001 level.
Conclusion: Most mothers lacked information about what to feed their children with fever prior to receiving health education, so it's important that ongoing health education programmes emphasise the importance of a healthy diet for kids when they're sick. This will help prevent further complications and ensure that kids stay healthy in the long run

Background: To assess the prevalence of Rota virus gastroenteritis among immunised and unimmunised children below 5 years and to assess the prevalence of complications among Rotaviral gastroenteritis.
Materials and Methods: Eighty- six cases of gastroenteritis in children aged less than 5 years were enrolled and demographic data of each patient, immunization history, clinical history and other relevant information was collected. Stool collection was done and sample was processed in special media, Wilson blair and alkaline peptone water. All the samples were tested for Rota virus. Prevalence of complications in rotaviral gastroenteritis assessed using clinical examination and radiological and laboratory parameters.
Results: Out of 86 patients, Rota virus was seen in 46, parasites in 24, bacteria in 10 and unknown in 6 cases. The difference was significant (P< 0.05). Among the total 46 children with rotaviral gastroenteritis, 10 were immunised for rotavirus and 36 were unimmunised. The difference was statistically significant(P <0.05). There were 25 males and 21 females among Rota virus positive cases. The difference was non- significant (P> 0.05) (Table II). Rota virus positive and Rota virus negative cases, duration of diarrhea was 0-4 days in 5 and 8, 5 days in 7 and 20, 6-7 days in 34 and 12. Vomiting was seen in 30 and 24. Duration of vomiting in days (1) was seen in 10 and 18, (2) in 22 and 12 and (3) in 14 and 10. Fever was seen in 34 and 15 and blood in stools seen in 20 and 10 cases . Dehydration was mild in 14 and 18, moderate in 6 and 10, severe in 10 and 8 and very severe in 16 and 4 respectively. Children with rotaviral gastroenteritis  had higher rate of intussusception presenting in 12 out of 46 children whereas children with non rotaviral gastroenteritis had only one case of intussusception among 40. The prevalence of complications was more in rotaviral gastroenteritis than others. The difference was significant (P< 0.05) (Table III, graph I).Duration of stay in the hospital was 10 days in average for rotaviral gastroenteritis when compared to other infectious causes where the stay was 5 days in average. The difference was statistically significant (p<0.05).
Conclusion: There was high prevalence of Rota virus infection in  unimmunised children less than 5 years with gastroenteritis and the prevalence of complications were high among rotaviral affected children. In conclusion, rotaviral vaccination prevents gastroenteritis associated with severe complications which affect the quality of life in children below 5 years.

Aim: The purpose of the present study was to assess paediatric burn cases based on variables like- Total body surface area (TSBA) involved, parents literacy rates as well their employment status.
Methodology: A Retrospective study was conducted in Osmania general Hospital, Hyderabad, Andhra Pradesh, India,over a period of 24 months from January 2011 to January 2013.Paediatric burns comprise 12.99% of the total burns. All male, female in-Patients belonging to paediatric age group (0-15years), admitted in Burns Unit of our Hospital were included in the study. Maintenance fluids were given at hourly rate of 4ml/kg for first 10kg body weight+ 2ml/kg for second 10kg body weight+ 1ml/kg for >20kg body wt. Collagen was applied to all children with superficial burns and partial thickness burns that come before 24- 48hr from the time of incident.
Results: Burns occurred commonly in children with illiterate (76.48%) and unemployed (69.21%) parents. Dinner time (35%) and colder months of the year were more prone timings. Most of the burns were accidental (98.56%). Flame burns predominated (47.79%) scalds (37.5%). Most of the children sustained burns of 11-30% TBSA (40.56%).
Conclusion: It was evident that literacy as well as being employed helped prevent burn incidents in pediatric cases.

Aim: The purpose of the present research was to assess the pediatric burn cases describing time of injury, first aid provided and time taken to present in the specialized burn unit.
Methodology: A Retrospective study was conducted in Osmania general Hospital, Hyderabad, Andhra Pradesh, India, over a period of  24 months from January 2011 to January 2013.Paediatric burns comprise 12.99% of the total burns. All male, female in-Patients belonging to paediatric age group (0-15years), admitted in Burns Unit of our Hospital were included in the study. Maintenance fluids were given at hourly rate of 4ml/kg for first 10kg body weight+ 2ml/kg for second 10kg body weight+ 1ml/kg for >20kg body wt. Collagen was applied to all children with superficial burns and partial thickness burns that come before 24- 48hr from the time of incident.
Results: 2-5 years children were commonly affected followed by age group between 11-15, next in order by 6-10 years. Meal times (especially lunch, 11a.m.-2 p.m. and dinner 6p.m -9 p.m.) clearly had the highest number of burn accidents. Most of the children with burns were reported to the hospital within 24 hours because of increased public awareness (370 children -81.2%). Most of the children received first-aid in the form of Water (328 children-72%).
Conclusion: Most important step in prevention is public education and availability of good burn care facilities in all public institutions as near to the place of accident as possible.

The aim of the present study was to assess knowledge and awareness about the prevalence of diabetes mellitus due to consumption of junk food among the general population.
 
INTRODUCTION:
Junk food is also known as fast food due its ease of making and consumption. It is also called HFSS , High fat, salt or sugar. It’s concise packing and attractive colours draw children's attention.
 
MATERIALS AND METHODS:
A cross-sectional study in the form of a survey was conducted among the parents of the victims in particular along with the general population. Through the online platform the survey was done by distributing the questionnaire. Around 100 responses were collected, data was circulated, results were collected and statistically analysed through SPSS software.

Malnutrition is the major health burden in developing countries. Protein energy malnutrition is the underlying cause for child morbidity and mortality.  Under-nutrition continues to be a major public health problem in developing countries and various factors are involved in determining the nutritional status of the children. Objectives of this study was to assess the prevalence of protein energy malnutrition (PEM) among children (1-5 years) . 150 Children of age group 1 to 5 years, both male and female were included in study. Nutritional status of the children in less than five years were expressed by weight for age. Weight for age classification of Indian Academy of Pediatrics (IAP) and GOMEZ was calculated. 38.66 % children were normal. 25.33% had Grade 3 malnutrition. 26.66 % had Grade 2 malnutrition,9.33% had Grade 1 malnutrition. PEM is a critical problem with many determinants playing a role in causing this vicious cycle of undernutrition.

Background: To assess efficacy of nebulized magnesium sulphate in Bronchiolitis.
Materials and Methods: Seventy- two patients age ranged 1 month to 24 months of acute bronchiolitis were divided into 2 groups of 36 each. Group I received nebulization with 3 mL of 3.2% magnesium sulphate (MgSO4) every 4 hourly for 24 hours and group I received standard care alone. Parameters such as BSS, respiratory rate (RR), peripheral capillary oxygen saturation (SpO2), heart rate (HR) were recorded before treatment and at 1, 2, 4, 8, 12, 16, and 24 hours post- operatively. The need for noninvasive ventilation, need for admission to intensive care unit (ICU) were also recorded.
Results: Group I had 20 males and 16 females and group II had 18 males and 18 females. Duration of illness (days) was 4.6 and 3.4, heart rate (beats/min) was 172.4 and 150.2, respiratory rate (breaths/min) was 56.2 and 54.8, oxygen saturation (%) was 95.2 and 96.4, temperature (degree F) was 98.2 and      99.0, oxygen requirement (L/min) was 1.54 and 1.20 and BSS was 6.72            and 6.24 in group I and II respectively. The difference was non- significant (P> 0.05). BASS at 1 hour was 6.4 and 5.6, at 2 hours was 5.2 and 5.4, at 4 hours was 4.1 and 4.3, at 8 hours was 3.6 and 3.2, at 12 hours was 3.4 and 3.1, at 16 hours was 3.1 and 2.5 and at 24 hours was 2.5 and 2.2. Length of hospital stay was 2.87 days and 2.91 days and duration of oxygen requirement was 25.7 hours and 21.3 hours in group I and II respectively. ICU admission was among 2 in group I and 1 in group II and NIV requirement was seen in 3 in group I and 2 in group II. The difference was non- significant (P> 0.05).
Conclusion: Nebulized magnesium sulfate was comparable with standard care. However nebulized magnesium sulfate can improve the clinical score so it may have additive effect to reduce symptoms during hospitalization

Background and objectives: Dengue, important arbo viral infection transmitted by Aedes aegypti to a lesser extent, Ae. albopictus. There are 4 distinct, but closely related, serotypes of the virus that cause dengue (DEN-1, DEN-2, DEN-3 and DEN-4). There is increasing prevalence in tropical and subtropical countries in the recent times. This study was done to know the spectrum of various clinical manifestations of DF and radiological profile among dengue cases.
Materials and methods: This descriptive observational study was carried out in the department of Pediatrics, Government Medical College/Government General Hospital, Nizamabad, Telangana State during October 2017 to November 2018.
Results: Out of 106 cases examined, majority (63.2%) were in the age group of 6 – 10 yrs. Male to female ratio was 1.35:1. Fever was present in almost all cases i.e. 99%. Bleeding manifestations were noted in 53% cases. On ultrasound, hepatomegaly was found in most (35.8%) cases, followed by gallbladder wall edema (26.4%).
Conclusion: The wide varied presentation of dengue fever especially in children is very unpredictable. Knowing the scope of atypical manifestations, every case with fever, in endemic areas, should be thoroughly examined and investigated haematologically and radiologically to prevent the dreadful complications. Thus saving the lives of children by early initiation of treatment.

Background: Typhoid is a multi systemic bacterial illness caused by Salmonella species, subspecies enterica and serovar typhi. The present study was conducted to assess profile of typhoid pediatric fever patients.
Materials & Methods: 84 children with typhoid fever of both genders were included. A thorough clinical examination was carried out. Symptoms and antibiotic sensitivity pattern was recorded.
Results: Out of 84 patients, males were 54 and female were 30. Common clinical features were fever in 84, vomiting in 35, diarrhoea in 40, pain abdomen in 25 and headache In 31 patients. The difference was significant (P< 0.05). Sensitivity of ciprofloxacin was seen in 12, levofloxacin in 42, meropenam in 84 and ceftriaxone in 84 cases. The difference was significant (P< 0.05).
Conclusion: The most common clinical features were fever, vomiting, diarrhea etc. Maximum antibiotic sensitivity was seen for meropenam and ceftriaxone

Background: Post surgery is a painful experience for everyone, children are more vulnerable to stress and it is important to manage anxiety and pain after surgery. Aim: The aim of this study was to determine the effect of a play intervention in reducing anxiety and pain levels among post-operative hospitalized children admitted in a selected hospital. Methods: A randomized controlled Trial, 126 participants were recruited from paediatric surgery ward. Ages between 6-12 years, play activities were performed 63 children in intervention group provided play therapy and 63 in control group obtained the daily routine care without any play intervention. Children who received play intervention were less negative and had lower levels of anxiety and pain than children who received normal daily routine care.

Background: Snakebite remains one of the major public health problems throughout the world, affecting several million people each year. The majority of snakebites occur in rural areas and result from 4 species namely Russell's viper, Cobra, common krait, and saw-scaled viper. High mortality in rural areas is due to delayed visits to the hospital and a preference for traditional healers. There are limited studies available on the demographic and clinical profiles of snake bites from rural parts of Telangana, South India.
Aim: To study the clinical and socio-demographic profile of snake bites in children.
Materials and Methods: A record-based retrospective study was carried out at S.V.S Medical College and hospital, Mahabubnagar, Telangana, India. All the children aged less than 15 years with snakebite cases admitted to the hospital from January 2016 to July 2022 were included in the study. Socio-demographic, clinical manifestations, complications, management, and outcome were recorded. The data were entered into a Microsoft Excel sheet and analyzed using Statistical Package for Social Services (SPSS) software Version 23.
Results: Out of 58 snake-bite cases, 63.8% were males and 36.2% were females. Most snakebites were observed in the 5-10 age group (41.3%), and 82.8% were from rural areas. Snakebites commonly occurred between the May-August months (60.3%). Most of the people were bitten inside the house (62%), and Most of the victims (67.3%) were lying on the floor at the time of the bite; 40% of the bites happened between 00:01 to 06:00 hours of the day. Fang marks were seen in the majority of the victims (72.4%). The lower limb (44.8%) was the commonest site. Most of the patients developed neurotoxic symptoms and krait (52%) was the common snake responsible for envenomation. Ptosis (86%) was the most common clinical feature followed by difficultyin breathing (82.8%), pain at the bite site (68.9%), and epigastric pain (67.2%). ASV was administered in 94.8% of the children and 82.7% required mechanical ventilation. The majority of the children survived (91.4%) and three children died (5.2%).
Conclusion: Children between 5-15 years are vulnerable to snakebite due to outdoor activity, particularly in rural areas. Awareness must be created among the public on the early visit to health care after a snake bite. There is an urgent need to strengthen primary and secondary health care centers to manage snake bite cases. Training of healthcare providers is also essential to identify snake bite cases when the history of the bite is not obvious.

Background: Diarrhoeal disorders are considered to be a major cause of morbidity and mortality among children all around the globe. The present study was conducted to assess pattern of sodium disturbances in children suffering from diarrhoea with dehydration.

INTRODUCTION : Immunization is one of the most effective and efficient way of preventing various childhood infections. It is important to assess the current immunization status of children and various factors affecting it in order to plan interventions and strategies to improve the outcome of immunization programme.
AIMS AND OBJECTIVES : 1.To study the coverage of primary immunization and IFA(Iron and Folic acid supplementation) in urban slums and rural areas. 2.To assess the influence of socio-demographic factors on immunization. 3.To know the sources of immunization. 4.To assess the knowledge of mothers regarding necessity of immunization.
MATERIALS AND METHODS : A community based cross-sectional study was done in the rural and urban slums of a district among 150 children aged 12-23 months over a period of 2 months.Simple random sampling was used to select the children and data was collected through house visits using a predesigned semi-structured questionnaire. Data was entered into MS Excel and data analysis was done through proportions,percentages and Chi-square test using  Epi-Info software.
RESULTS : Among the study population of 150 children,108 children (72%) were fully immunized,41 children (27.33%) were partially immunized and only 1 child(0.6%) was unimmunized.Almost half of the children(45%) were receiving IFA(Iron and Folic Acid)supplementation twice a week.Maternal age,eduactional status of mother,knowledge of mother or caregiver regarding immunisation was significantly associated with immunisation status of children.Majority of the children(76%) were availing immunisation services only from government facilities.
CONCLUSION :  There were more children in urban areas who were fully immunized(72%) compared to children who were fully immunised in rural areas(65%).Socio-demographic factors were found to be associated with partial immunised or unimmunised status of children.

Background: The commonest cause of hearing loss in children is secretory otitis media. The present study was conducted to assess the effects of adenoidectomy in cases of secretory otitis media in children.
Materials & Methods: 65 children age ranged 4-12 years with history of SOM of both genders were assessed for Otoscopic findings. Pure tone audiometry (PTA) was performed for assessment of hearing threshold in both ears.
Results: Out of 65 patients, boys were 35 and girls were 30. Common symptoms were nasal discharge in 53, nasal obstruction in 58, sore throat in 32, fullness of ear in 26 and hard of hearing in 46. Tympanic membrane appearance was retraction in 5, air bubbles in 15, dull, lustreless, amber coloured in 45. Hearing loss (dB) was 16-25 (minimal) in 40, 26-40 (mild) in 25. Impedance audiometry showed peak in 10 and no peak in 55. Morbidity was sinusitis in 6 and tonsillitis in 12. The difference was significant (P< 0.05). The mean AG gap pre- operatively was 24.6 dB, at 1 month was 10.9, at 3 months was 10.4 and at 6 months was 11.7. The difference was significant (P< 0.05).
Conclusion: Secretory otitis mediais one of the common causes of hearing loss in children. Tympanic membrane appearance was retraction, air bubbles, dull, lustreless, amber coloured. Morbidity was sinusitis and tonsillitis.

Background:  Appendicitis is one of the most common surgical emergency among children .Nearly 30% of children present  to hospital with complicated appendicitis, which is associated with higher morbidity than simple appendicitis. Controversy exists in the treatment of complicated appendicitis in pediatric age group.The goal of this study was to review the results of laparoscopic surgery in complicated appendicitis in terms of safety, efficacy and complications
Methodology-  A Retrospective observational study  was  conducted in a Tertiary care hospital in Bangalore from  2015 to 2020 over a period of 5 years . All children who underwent laparoscopic surgery for  complicated appendicitis (perforated, gangrenous and mass) were included in the study. Thorough history with respect to symptoms and their duration were recorded followed by general and abdominal examination. Routine blood investigation and imaging were done before surgery. Intra operative data regarding the type of complication, presence or absence of  Fecolith, position of appendix were documented. Post operatively duration of stay and complications were analyzed.
Results- 60 cases were included in the study. Mean age of presentation was 10.11 ±0.855 years. Out of 60 children 53 were males and 7 were females. The mean operative time was 55.8333 ±4.806 min. The rate of conversion from the laparoscopy  to open surgery was 11.5%. Mean time of duration of intravenous antibiotics was4.2778 ±0.446 days. Mean time for starting of oral feeding was 2.8333 ±0.307 days. Mean duration  of  hospital stay was 5.11 ±0.545days . Wound infection in immediate post operative period was seen in 6.6% of the children. No long term complications were noted.
Conclusion- Laparoscopic appendectomy (LA) for complicated appendicitis is safe and effective. Therefore, it should  be the first choice for cases of complicated appendicitis in children

Background: To assess the etiology and clinical features of splenomegaly among children.
Materials & methods: A total of 40 children from 6 months to 15years, with varying grades of Splenomegaly of different etiologies, admitted to pediatric ward. Detailed History was taken. Physical examination and necessary investigations were done. Enlargement of the spleen is considered with measuring 1-3cms as mild, between 4-7cms as moderate and above 7cms as massive. Statistical analysis was done by analyzing data by SPSS software.
Results: Commonest etiology among the cases in the present study are due to infectious etiology which are 47.5% followed by hematologic disorders 35%.  Incidence of moderate Splenomegaly was observed commonly in infectious etiology that is 14 cases out of 26 (53.8%) and Massive Splenomegaly was observed in hematologic 5 cases out of 11 (45.4%).
Conclusion: Occurrence of Splenomegaly is commonly due to various infections.

Background: Conversion disorder is defined by the presence of deficits affecting the voluntary motor or sensory functions lacking any known neurological cause. It occurs as response to any underlying stressful situation. It is clinically important to evaluate the presence, type, and temporal relation of the stressors, resulting in conversion especially among children. The objective of this study was to study the socio-demographic and clinical profile of conversion disorder in children and attempt to identify the stressors in these children.

Background: The study is done to have a better understanding of the morbidity profile and outcome in a Paediatric Intensive Care Unit (PICU) of a rural-based tertiary care centre which can enable the caretakers to plan and plant possible interventions to enhance patient care. The study was carried out in a retrospective manner.
Methods: This retrospective study was carried out in the department of paediatrics in children aged 1 month to 12 years, who were admitted to the PICU during the period of 1st September 2021 to 31st August 2022. A total of 925 children were admitted and data were collected from PICU records using predesigned proforma and analysed accordingly.
Results A total of 925 children were admitted during the study period. The 61.62% of children were male and the rest 38.38% were female. The male to female ratio was 1.6:1. The infants excluding neonates constituted 59.89% of total admission.  The mean age of presentation was 2.63 ± 3.41 years. 67.46% of children were admitted with infections of different organ systems and the rest 32.54% with diseases of non-infectious aetiology. So far outcome is concerned, 13.62%, 56.10%, 3.24%, 3.78%, and 23.24% of children were discharged, transferred to the paediatric ward, referred out to elsewhere, left against medical advice (LAMA) and death respectively. Infants excluding neonates constituted 69.30% of total death and the most common aetiology of death being documented was infections (84.19%).
Conclusion: In our study, most of the admitted children were found to have died of infective causes and most of them were infants. This puts a much necessary focus on the control of infections among infants by various means and should be addressed promptly and meticulously.

Background: Assessment of association between Dietary Habits and Asthma Severity in Children.
Materials & methods: A total of 100 children with persistent asthma and 100 children with intermittent asthma were enrolled. Complete demographic details of all the subjects were obtained. A questionnaire was framed and dietary habits of all the subjects was recorded separately. The questionnaire was filled under the direct supervision of their parents/guardians. All the results were recorded and analysed using SPSS software.
Results: 62 percent of the subjects of persistent asthma group and 60 percent of the subjects of the intermittent asthma group were boys. Positive family history of asthma was seen in 65 percent of the subjects of the persistent asthma group and 69 percent of the intermittent asthma group. While comparing the association between Dietary Habits and Asthma Severity in Children, non-significant results were obtained.
Conclusion: While evaluating the association between the dietary habits and severity of asthma, it can be concluded that dietary habits does not affect the severity of asthma among children.

Background: Acute respiratory tract infection (ARTI) is the most common reason for antibiotic prescription in children and adults. The present study was conducted to assess antibiotic usage in upper respiratory tract infections in children
Materials & Methods:80 children with upper respiratory tract infection of both genders were recorded. A thorough physical examination was carried out in all children. Weight in kgs and height was measured in meters. Month of ARTI and type of antibiotic prescribed was recorded
Results: Out of 80 patients, boys were 30 and girls were 50. Age group 5-7 years had 10, 7-9 years had 15, 9-11 years had 30 and 11-13 years had 25 children. The difference was significant (P< 0.05). Antibiotic prescribed in children were co-amoxiclav in 28, amoxycillin in 24, ofloxacin in 18 and cefuroxime in 10. The difference was significant (P> 0.05). The month of upper respiratory tract infections in children was January- February in 34, March- April in 12, May- July in 4, Aug- Oct in 10 and Nov- Decin 20. The difference was significant (P< 0.05).
Conclusion: The most commonly antibiotic prescribed in children were co-amoxiclav, amoxycillin, ofloxacin and cefuroxime. Common month of use was December, January and February.

Background: Pyogenic granuloma (PG) is benign vascular tumour presenting as small, friable, reddish papule or nodule. Bleeding tendency of PGs warrants their removal.Various available treatment options require local anesthesia, cause pain, local side effects, scarring and become undesirable for treating children. Hence, topical beta blocker (timolol 0.5%) becomes a valuable option for treating PG in children.

Background: Supracondylar humerus fractures are one of the commonest fractures in the paediatric age group. Displaced fractures of these kind, that is, Gartland type III are treated by closed or open reduction and k wire fixation. Cross k wire and lateral wires are the commonest configurations used for fixation. The present study aims to evaluate the difference between the two configurations in terms of surgical technique, functional outcome and complications. Objectives: To compare the functional and radiological outcome of lateral and cross pinning of displaced supracondylar humerus fractures of children METHODOLOGY:This was a prospective comparative study of 40 paediatric patients with supracondylar fracture humerus in the department of Orthopaedics in a Tertiary care Centre after the inclusion & exclusion criteria were met. Immediately after admission , a detailed neurovascular examination was done. Anteroposterior & Lateral Radiographs of the elbow were taken & type of fracture was noted. Informed and written consent was taken from the parent/guardian. Then 20 patients were treated with Lateral K- wire technique  (Group A ) and another 20 patients with Cross K- wire (Group B) pinning technique of fixation. Results: The average follow-up period for patients in lateral K wiring technique  was 12.23 ± 1.9 months while that for patients in cross K wiring technique was 11.26 ± 2.5 months. This difference was not found to be statistically significant.  As per the Flynn criteria, 13 patients in group A had excellent results, 5 patients  had good results and 2 patient  had fair result. In group B, 12 patients had excellent results, 7 patients  had good results and 1 patients (20.0 %) had fair results. No patients in either group had a poor result. Conclusion: Both lateral and cross k wire fixation are similarly effective techniques for stabilising supracondylar humerus fractures, with comparable functional, radiological, and aesthetic results.

Introduction: Acute urticaria (AU) is a common manifestation with the relatively infrequent occurrence of chronic urticaria (CU) in childhood. Pediatric urticaria has specific features and remains poorly understood. Methodology: A prospective study was conducted in 100 patients below the age of 18 years with diagnosis of urticaria from 2014 to 2016. Patients were evaluated taking a detailed history, examination, and basic laboratory investigations. Results: Out of hundred children, males were 56 and females 44. Male to female ratio was 1.2:1. Youngest was 7 months male, oldest was 17 years male child and mean age was 7.1 years. Out of 100 cases, 89% presented with acute urticaria and 11% were chronic urticaria. In acute urticaria an underlying cause was present in 59.55 % (53) whereas 40.44 % (36) were idiopathic. Infection was the most common factor (75.47%). Family history was present in five cases. 71% patients presented with first episode whereas 29% gave a history of recurrence. All children were treated with non-sedative antihistamines along with avoiding underlying triggering factors. Conclusion: Acute urticaria is a common manifestation seen in our study. Triggering factors in urticaria were dominated by infections followed idiopathic in our study. 16.85% of acute urticaria evolved into recurrent disease and progressed into chronic form due to incomplete treatment and follow-up were observed in our study.

Nonspecific antidiarrheals (allopathic and ayurvedic) are routinely used in clinical practice along with routine treatment in the management of acute diarrhea.Studies comparing their efficacy are very few, although they are used extensively by clinicians. This prospective observational study was carried out at two private clinics run by pediatricians to compare the efficacy, safety, and tolerability of DIAREX, an ayurvedic formulation versus racecadotril in the treatment of acute diarrhea.
Children aged 2 years to 10 years who presented to the clinic with acute diarrhea and fulfilling selection criteria were enrolled and divided into two treatment groups viz, DIAREX and racecadotril. Data collection was done using predesigned forms and questionnaires. The groups were comparable clinically and demographically at enrolment.  
Outcome measures used were 1) Time required for improvement in stool consistency2)Frequency of stools until recovery 3) Duration of diarrhea, after initiation of treatment.
Racecadotril improved stool consistency in less time compared to DIAREX (23.07h vs 29.00h). Patients on racecadotril passed 3.85±0.11 stools before recovery, while patients on DIAREX passed 5.26± 0.27stools.Rapid improvement in stool consistency and frequency was found with racecadotril compared to DIAREX. However, there was no significant difference between racecadotril and Diarex as far as duration of diarrhea was concerned.  (39.43±1.47h Vs. 42.77±1.48h;P> 0.05).Although DIAREX was found to be clinically useful to relieve the symptoms of acute diarrhea in children, racecadotril was more effective.

Background: Cochlear implantation (CI) in children was originally described in the 1970s. The present study was conducted to assess the incidence of co-morbidities in children undergoing cochlear implant.
Materials &Methods: 120 patients who had undergone cochlear implantation procedure were studied. Parameters such as unilateral/ bilateral surgery, cause of deafness, co-morbidities, premedication, PONV & peri-operative complications were recorded.
Results: Out of 120 patients, males were 80 and females were 60. Unilateral surgeries were seen in 100 and bilateral in 20. Anaesthesia maintenance involved inhalational sevoflurane in 20, propofol in 40 and thiopentone in 60 patients. Intra-operative anti-emetics used was iv ondansetron in 95 and iv ondansetron+ dexamethasone in 32 patients. Complications included was mortality in 1, flap necrosis in 2 and the procedure was abandoned in 3 patients. The cause of deafness was congenital in all 120 cases.  Co-morbidities found were 2 operated cases of PDA.  The mean duration of the implantation procedures was 2.4 hours. 2 patients received blood transfusion. PONV was observed in 10 patients. The difference was significant (P< 0.05).
Conclusion: Cochlear implantation in children is a relatively safe procedure. It involves few perioperative complications.

Background: The term "obesity" refers to an abnormal expansion of the adipose tissue that can be caused by an increase in the number of fat cells (hyperplastic obesity), an increase in the size of the fat cells themselves (hypertrophic obesity), or a combination of both of these factors. The body mass index (BMI) is frequently used as a measurement of obesity.

Introduction: Myopia is a major health issue in our society. There is a large number of proportion remain undiagnosed. High myopia can be associated with multiple consequences as myopic retinopathy, myopic macular degeneration, retinal detachment and amblyopia. The aim of our study to focus on magnitude of childhood myopia, increase awareness for myopia in our society so that we can reduce vision threatening sequelae in children.
Methods: Study was conducted in ophthalmology department and ENT department government medical college Saharanpur, medicine department Uttar Pradesh medical sciences, Saifai and pediatric department GTB medical college New Delhi. Children between 7 to 16 years with ametropia included in the study to find out magnitude of myopia among them.
Result: A total of 1460 children between the age of 7-16 years with complains of eyeache, headache, heaviness of head diminution of vision, and with other asthenopic symptoms included in the study. Among these 320 children were myopic. It shows high magnitude of myopia in children. Out of these myopic children mild grade myopic children were in high proportion (35.9%).
Conclusion: The study showed the pattern of myopia in children in Indian population. Screening in schools and early diagnosis of refractive error affect the learning and performances of children. In our study we showed the pattern of severity of myopia in children. Study also showed the effect of digital screen time of children with myopia.

Background: Diabetes is fast gaining the status of a potential epidemic in India with more than 62 million diabetic individuals currently diagnosed with the disease. Conventional audiometric tests are not sensitive to detect the initial phase of sensory loss. A comparative study of Hearing evaluation of paediatric patients with IDDM between 6-17 yr and age and sex matched controls was done for evaluating the correlation between presence of type1 DM and auditory dysfunction, glycemic control and effect of duration of disease on hearing loss in IDDM conducted in Department of ENT in Rajindra hospital, Patiala.
Materials & methods: The present cross sectional observational study included 50 patients between age group of 6-17 years with confirmed diagnosis of Type 1 DM and an average disease duration of more than 1 year and 50 age and sex matched healthy controls. The patients were diagnosed as diabetic as per diagnostic criteria of The American Diabetes Association. The onset of diabetes was noted on the day of commencement of insulin therapy. A Performa was made where data recorded will include age, sex, duration of diabetes, insulin dose, BMI, frequency of acute complications like diabetic ketoacidosis (DKA), and severe hypoglycemia. This was followed by audiological testing, which will include pure tone audiometry (PTA) and Otoacoustic emission (OAE). Audiological assessment was done in a sound proof room in out - patient clinic of ENT Department, Rajindra hospital, Patiala. Hearing thresholds were tested using a commercially available AL Advanced digital audiometer AD21OOPS with headphones for speech frequencies and higher frequencies audiometry. The limitof normality was defined as a maximum intensity of 25 decibels for all frequencies.classic symptoms of hyperglycemia or hyperglycemic crisis.
Results: High frequency hearing loss was found to be present in 8 percent of the patients (4 patients) of the study group while it was absent in control group. While correlating the occurrence of high frequency SNHL with age-wise and gender-wise distribution of patients in the study group, non-significant results were obtained.While correlating the occurrence of high frequency SNHL with duration of diabetes in the study group, non-significant results were obtained. Significant results were obtained while comparing the mean RBS levels and HbA1c levels among the patients with and without high frequency SNHL.
Conclusion: Early detection is important in affected children and a range of intervention options (such as remotemicrophone listening systems) are available, and have proven beneficial in ameliorating the real-world listening effects of auditory neuropathy.

Background: Vitamin D has long been known to play a role in the skeletal system and
calcium homeostasis; the deficiency of which causes rickets and osteoporosis. There is
growing evidence that vitamin D also contributes positively to pulmonary health.
Vitamin D deficiency is a common and important nutritional deficiency in children in
India. Clinical and subclinical vitamin D deficiency in children has been reported to be
a significant risk factor for severe acute respiratory tract infection. The aim of this
study to compare the evaluation of the association of acute respiratory tract infections
with serum vitamin-D levels in children between 2 months to 5 years of age.

Osteoid osteomas have a male preponderance (approximate ratio of 3:1) and usually present in the second decade of life. The patients typically present with nocturnal pain which is relieved by the administration of NSAIDs, the cause of which is attributed to the vascular pressure and the production of prostaglandins in the nidus of the Osteoid osteoma. We present a case series of 4 children of spinal osteoid osteoma, who presented to our institute mainly with complaints of nonmechanical type of back pain, who on detailed clinical and radiological evaluation found to have osteoid osteoma.

Although the incidence of these fractures generally has been reported to be higher in boys, more recent reports indicate that the frequencies of supracondylar humeral fractures in girls and boys seem to be equalizing, and some series actually have reported higher rates in girls. As soon as the patient was admitted, a detailed history was taken and a meticulous Examination of the patient was done. The required information was recorded in the proforma prepared. The patients radiograph was taken in antero-posterior and lateral views. The diagnosis was established by clinical and radiological examination. Out of 30 extension type, 15 patients had posteriomedial displacement while 10 patients had posteriolateral displacement. 5 patient were of Type II Gartland classification with posterior displacement. We encountered loss of pulse in one patient which recovered as soon as fracture was reduced. Median and radial Nerve injury in one patient each was encountered out of 30 patients which spontaneously recovered by 4-6 weeks’ time.

Background: Shock is one of the most dramatic, dynamic and life-threatening problems
faced by the physician in critical care setting.The mortality rate of shock in pediatric
patients has declined as a consequence of educational efforts (pediatric advance life
support), which emphasize early recognition and intervention and rapid transfer of
critically ill patients to a PICU via a transport service. To know about the risk factors in
a critically ill child with shock and its association with outcome, will give us an early
clue in identifying and prioritizing management strategies.
Material & Methods: A descriptive study done on 100 children in the age group of one
month to 12 years presenting with shock (or) who later develop shock during PICU stay
at RUHS College of Medical Sciences, Jaipur, Rajasthan, India during one year period.
Children who had received inpatient treatment prior to admission in PICU, post
cardiac arrest shock and traumatic shock / Burns were excluded in our study. During
the PICU stay periodic vital signs and other measures like urine output and oxygen
saturation were recorded. IV fluid therapy, rate and duration of inotrope and other
organ support like ventilatory support were documented.
Results: In present study the frequency of shock was found to be 1.64%.Undernutrition,
decompensated shock, cardiogenic shock, duration of shock more than 6 hours,
leucopenia, hypocalcemia, inotrope requirement, ventilator support & MODS was
present in higher proportion of children who died(36.11%, 69.44%, 27.77%, 72.22%,
22.22%, 38.88%, 94.44%, 97.23% & 69.45 respectively) when compared to those who
had survived (20.32%, 14.06%, 9.37%, 26.56%, 4.68%, 10.93%, 57.82%, 47.25% &
15.62% respectively). Oddsof different variables were measure among the children who
died, when compared tothose who had survived (2.17, 13.78, 3.56, 7.45, 5.89, 5.11, 13.87,
104.2 & 12.78 respectively.
Conclusion: We concluded that under nutrition, decompensated shock, inotrope
requirement, MODS, leucopenia and ventilatory support are independently associated
with poor outcome.

In clinical practice, nonspecific antidiarrheals (allopathic and ayurvedic) are commonly
used by clinicians along with routine treatment to hasten the recovery and to give
psychological reassurance. Although they are used extensively in practice, studies
comparing their efficacy are few. This prospective observational study was carried out
at two private clinics run by pediatricians to compare the efficacy, safety, and
tolerability of DIAREX, an ayurvedic antidiarrheal formulation versus loperamide in
the treatment of acute diarrhea.
Children aged 5y to 10 y who presented to the clinic with acute diarrhea and fulfilling
selection criteria were enrolled and divided into two treatment groups viz, DIAREX and
loperamide. Data collection was done using predesigned case report forms and
questionnaires. Outcome Measures used were 1)Duration of diarrhea, after initiation of
treatment 2)Frequency of stools until recovery 3)Time required for improvement in
stool consistency. The groups were comparable clinically and demographically at
enrolment.
Loperamide improved stool consistency in less time compared to DIAREX (16.24h
vs 29.00h). Patients on loperamide passed 3.32± 0.16 stools before recovery, while
patients on DIAREX passed 5.26± 0.27stools. Rapid improvement in stool consistency
and frequency was found with loperamide compared to DIAREX. The mean duration of
diarrhea was less for loperamide group (30.35±1.43h Vs. 42.77±1.48h; P < 0.05).
DIAREX was found to be clinically useful to decrease the duration and symptoms in
acute diarrhea in children. However, loperamide was more effective. DIAREX may be
used, if there is concern about the adverse events with loperamide.

Background and Objectives: There is a rapid increase in the incidence of HIV/AIDS among children. Proportionally, there is a rise in mucocutaneous involvement in this population. Mucocutaneous manifestations can pose diagnostic and therapeutic challenges. This study was done to note the different mucocutaneous lesions present among pediatric HIV population attending NMCH&RC, Raichur and their relation to CD4 counts.
Methodology: 214 consecutive HIV-positive children attending the OPD, at a tertiary hospital and research centre, between January 2015 to June 2016 were screened for presence of any mucocutaneous lesions and 100 children were included in the study. CD4 count was done in all of them along with other relevant investigations.
Results: Among 100 patients there were 118 mucocutaneous manifestations noted with overlap in a few. Prevalence of mucocutaneous manifestation was 47%. M:F ratio was 2:1. Majority of patients belonged to 5-14 year age group. Among mucocutaneous manifestations, pruritic papular eruption was commonest followed by viral and bacterial infections. The majority of patients had CD4 count <25%.
Conclusion: Mucocutaneous manifestations in pediatric HIV population are common and have varied presentations. Mucocutaneous manifestations were common at lower CD4 levels. Mucocutaneous manifestations can be taken as marker for disease progression.

Rickettsial diseases are one of the most re-emerging infections of the present time. They are generally incapacitating and difficult to diagnose. Untreated cases can have fatality rates as high as 30-35% but when diagnosed properly, they are often easily treatable. It is a time bound prospective hospital based observational study and All children aged less than 12 years admitted in paediatric ward with fever without an identifiable source of infection and one or more of the following clinical features: rash, oedema, hepatosplenomegaly, Lymphadenopathy, an Eschar and a tick bite or tick exposure were suspected to have rickettsial infection. The most common age group of presentation was between 1 and 5 yrs. The common symptoms in these children included fever (100%), rash 79.4%), edema of limbs (32.4%), puffiness of face (29.4%), generalised edema (20.6%), cough (20.6%), pain abdomen (14.7%), vomiting (11.8%), convulsions (8.8%), headache (2.9%) and arthralgia (2.9%). Signs like Hepatomegaly, facial puffiness, pedal edema, splenomegaly, ecchymosis present in 53.3%, 41.1%, 38.2%, 8.8% and 5.8% of the cases respectively, mimicking common illnesses. Thus warrants high index of suspicion. There is emergence of rickettsial disease in this part of north Karnataka which might have been overlooked earlier due to low index of suspicion.

Background: The Asthma Guidelines of the National Asthma Education and Prevention Program
(NAEPP) published by the National Institutes of Health (NIH) emphasize the need to evaluate asthma
control as a key component for asthma treatment and management. Well-controlled asthma is associated
with improved health status, and fewer physician visits, hospitalizations and emergency room visits
among children and adults. In contrast, poor asthma control is directly linked with increased school
absenteeism and loss in work productivity among asthma children and adults/caregivers, respectively.
Unfortunately, studies report that asthma remains uncontrolled in many asthmatic patients, despite
receiving appropriate treatments. Present study has been designed to update the knowledge regarding
factors affecting asthma control and factors responsible for frequent exacerbations in children so that
corrective measures could be taken.

Background: Dengue infections vary in severity, ranging from influenza like self-limiting illness to life threatening dengue hemorrhagic fever (DHF) and dengue shock syndrome (DSS). Present study was aimed to study dengue fever in 1-12 years age group at a tertiary hospital.

Background:Hearing loss (HL) can be defined as complete or partial loss of the ability
to hear and understand information, which limits or restricts an individual’s ability to
perform hearing-related activities. The present study assessed efficacy of two different
hearing aids in patients with hearing loss.
Materials & Methods: 94 patients with hearing loss of both genders were divided into 2
groups of 47 each. Group I comprised of channels ranged from 1 to 16. Group II had
the number of channels ranged from 2 to 16. Patient satisfaction levels was recorded
using the international outcome inventory for hearing aids, Turkish edition (IOI-HATR).
Total individual subjective satisfaction (TISS) scores were also recorded.
Results: Group I had 27 males and 20 females and group II had 29 males and 18
females. The mean TISS score at 1 month in group I was 48 and in group II was 62, at 6
months was 53 and in group II was 68 and at 12 months in group I was 60 and 74 in
group II. The difference was significant (P< 0.05).
Conclusion: There was better hearing with devices with good technologic features such
as more channels and a lower minimum frequency.

Aim: The aim of this study to determine the Presentation, etiology and viral markers in
children presenting with hepatitis at a Tertiary care hospital.
Methods: 50 cases of acute hepatitis of age 1-13yrs were included in the study. Acute
hepatitis was diagnosed on the basis of history, clinical (Jaundice, pain in upper
abdomen, anorexia, nausea, vomiting, fever, pruritis, tender/non tender hepatomegaly
with or without ascites and without any stigmata of chronic liver disease) and
biochemical evaluation (LFT i.e. serum bilirubin, Alanine
aminotransferase(ALT),Aspartate aminotransferase (AST),alkaline phosphatase(ALK),
serum albumin, PT/INR). Acute liver failure was diagnosed by PT>15sec/ INR>1.5 with
features of encephalopathy or PT > 20 sec/ INR > 2 regardless of presence of clinical
hepatic encephalopathy.. Patients were also tested for viral markers i.e. anti HAV IgM,
anti HEV IgM, HBsAg, and anti HCV.
Results: In our study total number of cases were 50 of which 70% were male and 30%
were female. The most common cause of viral hepatitis was hepatitis A (80%). Hepatitis
B was found in 2 (4%) cases and in 16% cases no viral marker was detected. The most
common clinical presentations were jaundice (96%), fever (94%), fatigue (90%) and
nausea/vomiting (78%). In 80% of cases hepatomegaly was found and splenomegaly
was seen in 2% of cases. SGPT level was increased in all cases with 30% in the range
500 – 1000 units/ml, 22% in the range of 1000 – 3000 units/ml and 12% in the range of
3000 – 5000 range. 48% of cases has total bilirubin of more than 10mg/dl and in 40% of
cases the value was in the range of 5 – 10 mg/dl. In 35cases PT was < 15sec and in 15
cases it was more than 15 sec. The disease resolved in 40(80%) cases,1(2%)had chronic
disease and 9(18%) cases expired.
Conclusions: Majority of cases in children were hepatitis A cases. Most of the cases
were Boys. Those cases with INR >3 at admission has higher mortality. Peak values of
aminotransferase i.e. ALT and AST though reflect hepatocyte damage do not correlate
with mortality.

Introduction-Chronic obstructive pulmonary disease (COPD) is a common respiratory
condition involving the airways and characterized by airflow limitation.
According to the Global Burden of Disease Study 2010, COPD is the fourth leading cause
of death in the world and is projected to be third leading cause by 2020. The chronic course of
this disease is frequently accompanied by acute exacerbations, usuallydue to infections.
Materials and methods- A total of 50 patients were included in the study.The data was
collected using structured proforma including demographic data, clinical history and lab
investigations. Descriptive statistical analysis (such as mean, median, standard deviation and
percentage) has been carried out in the present study.
Results-In the present study of 50 study subjects comprised of 46 males and 4 females with
mean age of 70.5 years. In 38% of the patients, bacteria were determined to be the cause of
AECOPD. [ Klebsiella pneumoniae (52.63%), Escherichia coli ( 31.57%) and Streptococcus
pneumoniae (15.78%)]. Among viral etiology, parainfluenza(44.4%), influenza(27.8%) and
Respiratory syncytial virus(22.2%). Among Atypical organisms Mycoplasma, Chlamydiae and
Legionella accounted for 38.46%, 30.77% and 30.77% of the cases, respectively.
Conclusion-
Present study indicates that gram-negative bacteria play a major role in exacerbation of COPD
in our population .Among bacterial infections, Klebsiella was most common organism.
Para influenza followed by influenza and RSV are common viral etiological agents in
exacerbations.
Present study indicates that a good proportion of COPD exacerbations were caused by atypical
bacteria. Mycoplasma was the most commonly isolated organism followed by Chlamydia
pneumophila and Legionella species.

Undernutrition is a condition in which there is inadequate consumption, poor absorption or excessive loss of nutrients. Overnutrition is caused by overindulgence or excessive intake of specific nutrients. Deficiency in macronutrients such as protein, carbohydrates and fat provoke protein-calorie malnutrition (PCM), and when combined with micronutrient deficiencies, they are among the most important nutritional problems with hundreds of millions of pregnant women, elderly and young children particularly affected. This study was carried out in the department of paediatrics, in children between 6 to 60 months of age with protein energy malnutrition. WHO criteria was used to define protein energy malnutrition. Detailed history and systemic examination was done. In our study, fever 86.26%, vomiting 53.55% cough 45.50%, were the most common symptoms. Decreased feeding was present in 36.49% of cases, loose stool present in 35.07% of cases, oedema present in 27.01% weight loss was present in (18.96%) of cases, dyspnea were present in 17.54% of cases, pain abdomen was present in 16.11% and convulsions present in 7.11% of cases.

It is the most common and widespread arboviral infection in the world today caused by
Dengue virus. Dengue viruses (DV) belong to the family Flaviviridae and there are four
serotypes of the virus referred to as DV-1, DV-2, DV-3 and DV-4.The course of the disease
has changed in the recent years from milder form to severe form like dengue hemorrhagic
fever & severe dengue fever and with increasing outbreaks frequency.Data was collected by
face to face interview from the parents of the children admitted in pediatric emergency ward
with diagnosis of dengue fever and severe dengue fever in Department of pediatrics. The
presence of bleeding manifestations like melena, epistaxis, hematemesis, petechiae,
hematurias more in DF with warning signs(37.5%) and Severe dengue fever(55.6%). There is
significant association between bleeding manifestations and severity of dengue
fever(p<0.001). Thrombocytopenia was found in 83.8% in dengue fever, 93.8% in DF with
warningsignsand81.5%inseveredenguefeveranditisnotstatisticallysignificant(p=0.308).

Dengue virus, a mosquito-borne flavivirus, is the causative agent, currently one of the most
significant emerging disease challenges to global health. The dengue virus are single-stranded
positive-sense RNA viruses with a genome of about 11000 bases that codes for three
structural proteins, C(core protein), M (membrane protein), E (envelope protein); 7
nonstructural proteins, NS1, NS2a, NS2b, NS3, NS4a, NS4b, NS5; and short non-coding
regions on the 5' and 3' ends. This was a case control study design in which 201 cases of
dengue fever admitted in the pediatric emergency ward, were enrolled. After taking written
informed consent, data were collected in a predesigned semi structured questionnaire
regarding Socio-Demographic profile, medical history, clinical and hematological profile and
outcome. 8(4%) of cases had positive family h/o dengue fever, 3(1.5%) cases had positive
past h/o dengue fever and 8(4%) cases had positive h/o travel to dengue endemic areas.
201(100%) cases had fever, 94(46.8%) had persistent vomiting,91(45.3%) had
anorexia,78(38.8%) had abdominal pain, 59(29.4%) had headache, 30(14.9%) had rashes, 16
(8%) had facial puffiness, 14(7%) had convulsions and 12(6%) had abdominal distension.

Malnutrition in children continues to dominate the health scenario in India and other developing countries especially in South East Asia. More than one fourth of under 5 children worldwide (150 million) are under weight. 27% (182 million) are stunted, while 10% are wasted. Of all children under the age of five years in developing countries about 31% are under weight, 38% have stunted growth and 9% have wasting. All Children of age 6 months to 60 months admitted to the Paediatric ward, fulfilling the inclusion criteria, during the study period, was included in the study. In our study, ARI with 44.08% is the most common co-morbidity affected, followed by acute gastroenteritis with 27.96%, followed by sepsis with 8.53% followed by UTI with 8.06%, followed by meningitis with 4.27%, followed by malaria with 2.84%, Tuberculosis with 2.84% and skin infection with 1.42%.

Children in conflict countries are exposed to difficulties with an austere point of view for
their future. People residing in conflict-affected areas are denied their right to education,
admittance to aptitudes and information, and the path to a superior life for themselves and
their country. The present investigation is descriptive. In the current examination, the
investigator studied recent related literature and secondary data extensively like books, ebooks,
journals, editorials, and other reliable sources, which put forwarda more prominent
understanding of all possible and practical aspects of the research problem at hand.The
exploration reveals that conflict has taken a heavy toll on children and their right to
education concerning mental and physical health, school attendance, school closure, and
schooling capacity reduction. In addition to that, appalling levels of massacring,
mutilating, recruitment and denial of humanitarian access, committing rape and other
forms of sexual violence, engaging in attacks on schools; and abducting children in armed
conflict situations came under the domain of violations against children

Basic minimal information about the care of children in diarrhea and ORS use is important for early recovery. To plan an anti-diarrheal program, it’s important to know the knowledge, beliefs, practices of diarrhea understanding, and management including ORS; in the community [1]. the study to check out the Knowledge of mothers towards their children below 5 years of age for oral rehydration when attending primary health care centers in Baghdad. This study is a descriptive study with analytic purposes, where 166 mothers were interviewed when attending 5 primary health care centers in the al-Rusafa side of Baghdad city. They were divided into G1(116) cases where mothers of children presenting with cut gastroenteritis, while the remaining 50 children in G2 presented with cut disease other than gastroenteritis. The period of research and data collection was between April 2019 and August 2019 A questionnaire was developed by the researcher, fulfilled by the interviewer. Regarding the mother's ages of both groups, their ages were ranging between (15-65) years. 85%, 90% of both groups were from (15-20) years old respectively. Educational level revealed that most cases have not gone beyond secondary school (G198%, G2 100%). For the employment status (79.4) employed for G1 and (70%) for G2. The crowding index <1 forG1 = 17.2%, G2 = 6%. Regarding the mother’s knowledge of ORT, only ORS used in dehydration, vomiting, and diarrhea, the correct way in preparation of ORS, -and knowledge about signs of dehydration were significant. The previous practice by G1 and G2 was 38% and 82% respectively. Attitude and practice of Gl and G2 during the attack of diarrhea shows significant only in using over -the- counter medications. The high independence score of both groups of mothers Gl, G2 shows 8.6% and 14% respectfully. Most of the mothers in our study had moderate knowledge about oral rehydration salts and technique while the percentage that using ORS was few. Intensive media advertisement about the importance of ORS is required. A leading campaign by the -ministry of health among mothers of under-five children to stimulate them to use ORS for their children as long as diarrhea to lower child morbidity and mortality.

Background: Femoral diaphyseal fracture especially at the shaft of femur was
represented <2 % of all pediatric fractures. The aim of this Meta analysis study is to
supply a good idea about the optimal fixation methods for femoraldiaphyseal
fracture in school age children 5-14y based on the current evidence. Patients and
Methods: A computerized research was performed in PubMed, Medline, Google
scholar and Cochrane Library database to identify the relevant literatures that
published until May 2020. By using RevMAN5.4 software the data pooled and
analyzed for the meta-analysis. Results: the pooled data demonstrated a statistically
significant difference P value < 0.05 in Operative Time (OT), Estimated Blood Loss
(EBL) and Union Time (UT). Conclusion: According to the collected data from the
included studies demonstrated that operative time, estimated blood loss and union
time goes in favor to flexible nails. In the other side, using plate fixation is more
stable and has lower rate of fracture malalignment more than retrograde flexible
nail.So, based on the pooling data results we suggest the use of flexible nails with
the stable femoral diaphyseal fractures, due to the minimally invasive technique,
early union and weight bearing.

Congenital heart disease (CHD) is one of the most common congenital defects, present at birth, it can affect the walls, valves or the great vessels of the heart. CHD considered to be among the most common malformations in newborn infants with an incidence of 8 out of 1000 live births worldwide. Children with congenital disease certainly need special health care. Healthy teeth and gums are important for everyone, especially for children with heart conditions. Providing children with dental care during the COVID-19 pandemic, and in particular during the increased social restrictions, can be a challenging task. The purpose of writing this systematic review is to examine about oral health condition and dental care in children with congenital heart disease during the COVID-19 pandemic. Data source of Pubmed, published from 2011-2021. After eliminating duplicated articles, the titles and abstracts of each article were analyzed across 119 articles resulting in 86 articles being excluded. The full-text articles in the remaining 33 articles were re-analyzed and excluded 23 articles and produced 10 articles which were then entered into the analysis. Based on this systematic review shows that children with congenital heart disease (CHD) have poor oral health. Education and disease awareness about and prevention of dental illnesses have to be guided and steered by the parents. The role of dentists and pediatricians is very important in this case. Providing children with dental care during the COVID-19 pandemic, and in particular during the increased social restrictions, can be a challenging task.

Personal hygiene among children is considered as the best tool to improve community strategies and intervention practices to tackle the many communicable and infectious diseases. A cross-sectional descriptive study was carried out. The participants were school children who are 10-14-year olds. A questionnaire was used to collect information about demographic characteristics, and then the children were interviewed and inspected regarding their general hygiene, including the state of their uniform or clothes, bathing, oral care, hand washing before and after eating, hand washing after use of toilet, covering one’s mouth when sneezing and coughing, appropriate disposal of solid tissue and unkempt hair or nails. The prevalence of cleanliness and neatness among school children was 76.7%. Furthermore, these improved with age. Poor oral hygiene (47.6%) and not washing hands after eating (47.1%) followed by unkempt hair (44.0%) were the main types of poor personal hygiene. Health promotion programmes and health education lectures should be implemented for children and their families. School nurses, school staff and parents also have an important role in teaching the children how to practice good personal hygiene.

Background: Oral health is a part of general health and hence, has a direct bearing on the total well-being of individuals. Knowledge of oral health status and treatment needs of populations with different characteristics is important for developing appropriate preventive approaches.
Aim: The aim of the study is to determine the relationship between oral hygiene with socioeconomic status among 15 years old school going children of Lucknow city. Materials &
Methods: A descriptive cross-sectional study was conducted. The schools were selected by simple random sampling method following the lottery method of selection. Simplified Oral Hygiene Index with Kuppuswamy’s socioeconomic status scale has been used. Results: As socio-economic status decreases; mean OHI-S increases. Comparing the mean OHI-S between different SES groups, ANOVA revealed significantly different OHI-S among the groups (F=38.84, p<0.001). Conclusion: The mean scores of OHI-S revealed a significant relation with socio-economic status. It was reported that as the socioeconomic status decreased, oral hygiene status of the children deteriorated.

Background: In the last few decades, industrialization, urbanization, economic development and market globalization have had a significant impact on changes in lifestyle and diet. Thus, food choices and nutritional intake greatly affect oral health and body weight. This has a significant impact on health and nutrition, particularly through higher carbohydrate intake and lower physical activity, particularly among younger members of the population. High sugar intake, such as sugar-containing snacks and soft drinks, was reported it is more common in children/adolescents who are overweight and obesity than those of normal weight. Frequent sugar intake is also a risk factor for dental caries. Given this, there is strong evidence that supports the relationship between dental caries and dietary intake has been associated with the development of obesity at a young age. Thus, it is possible to conclude that there is a biological relationship between dental caries and body weight. Objective: To see the relationship between body mass index and dental caries in children. Methods: Scientific evidence and clinical cases were drawn from the literature to support this review and information on the relationship between body mass index and dental caries in children. Result/Discussion: There is some scientific evidence showing a specific relationship between body mass index and dental caries in children. Conclusion:Body mass index has a significantrelationshipwiththeincidenceof dental caries in children. However, thisconditiondoes not account for which category the incidence of dental cariesis greatest. This is associated with multifactorial interactions that mutually influence the occurrence of dental caries in children.

Allergy is a pathology of countries with a high index of socio-economic development and most of all residents of large cities. By 2025, according to the WHO, 50% of the world's population will suffer from allergies [14]. This article examines the main risk factors for the development of allergic diseases in children under the age of 18 in Tashkent. The most significant factors were: the presence of an inherited predisposition on the line of one (RCh 1.9) or both parents (OR 5.6), closely related marriages between parents (RCh 2.8), the age of parents over 40 at the time of conception of the child (RCh 1.4) and some others.

Anti-corruption education for Sunday school children is a form of non-penal policy to eradicate corruption. The purpose of this study was to analyze how the form of non-penal policies to eradicate corruption committed through formal church education, namely Sunday school by instilling anti-corruption values in Sunday school children (ASM). The research method used is normative juridical research using a conceptual approach and a statutory approach. The data collection technique used was literature study and then analyzed qualitatively. The results showed that religious institutions through Sunday School Teachers (GSM) can play a role in tackling corruption through character education that contains anti-corruption values which are taught to Sunday school children every time they go to church. Anti-corruption values such as honesty, justice, discipline, responsibility, hard work, courage, independence, simplicity and care can be clearly explained to children through the method of telling stories about Bible characters, playing and singing together. By introducing and instilling anti-corruption values from the start to children, especially Sunday school children, through religious messages conveyed by GSM, children are expected to have anti-corruption characters from an early age so that they can form individuals with anti-corruption characteristics and high integrity.

Basically. educational institution program suits to the needs of each institution. And
educational institution program is closely related to the needs of teachers, the number of
students, facilities and infrastructure, financial possession, curriculum, learning strategies,
guidance and counseling, educational supervision, and community relations. In the toddlerhood
stage, the children seek to explore freedom as a process of self-discovery. Children have their
own rituals to control and organize the environment. A big toddler has the motto "I can do it
myself". When they do something positive, they develop a sense of autonomy. They imagine as
people who can manage the situation well to meet their own needs. In the final stages of
toddlerhood, children can already experiment with autonomy, as a strong basis for selfconfidence
and the pleasure of being free. Toddlers keep struggling with activities until they can
master them.

The article presents the results of a study of 52 children with various forms
of cerebral palsy. The analysis of risk factors for the development of cerebral palsy. The
diagnosis of cognitive impairment, including memory impairment in children with cerebral
palsy, is one of most significant tasks, since it determines the characteristics and prognosis of
both medical and social rehabilitation, while the differentiation of retardation of mental
retardation and marked retardation is extremely significant.

Application of three-stage therapy of giardiasis in 250 children with CHB, using MACMIROR®, Albendazole, and Metronidazole at the second stage of effecting the parasite and its elimination from the organism, provided achievement of clinical-biochemical remission in 91.1%, 72.5% and 52,5% cases, and parasite elimination in 93.3%, 32.5% and 60.0% cases, respectively. It should be noted, that in the conditions of administration of Trichopolum, in spite of the high rate of G.Lamblia elimination, the therapy was associated with the expressed hepatic toxicity, making recommendation of it for that category of children impossible. Thus, the first line agent for a specific therapy of giardiasis in children with CHB is MACMIROR®, due to its efficacy and safety.

Introduction. Affective-respiratory paroxysm (ARP) or breath-holding spells is a
common phenomenon that occurs in children from 6 months to 6 years. Up to 90% of
children experience ARP for the first time before the age of 18 months. The mechanism of
the condition is still unclear. Scientists have found that children with breath-holding spells
are much more likely to be diagnosed with iron-deficiency anemia and, perhaps, it
contributes to the development of pathology. 20-35% of children have a burdened family
history. Some families have a dominant type of inheritance.
Materials and Methods. The algorithm for examining children included: general
clinical, neurological and psychological examination of children, conducting laboratory
research, registration of an electroencephalogram, according to indications, conducting an
echocardiographic study. We examined 50 children with ARP aged 6 months to 6 years.
Research was carried out in the clinic of the Tashkent Pediatric Medical Institute. The
diagnosis of ARP was established based on the history provided by mothers and
observations of seizures. Paroxysms were defined as stopping the baby's breathing at
exhalation after deep inhalation during crying. Paroxysms were classified as cyanotic,
pale, and mixed.
Results. A detailed study of the passage of the ante-, intra- and postnatal periods
made it possible to determine the significance of various unfavorable factors such as
anemia (p <0.05), toxicosis (p <0.01), acute respiratory infections (p <0.1), stress, use of
obstetric aids (p <0.05) and birth trauma. (p <0.1). In addition to perinatal risk factors, 13
(28%) children were found to have a hereditary predisposition to ARP and 4 children (8%)
to epilepsy. In most cases, seizures began at 6–12 months of age (38%). According to our
observations, the main provoking factors of seizures were: anger, inability to get what you
want - 70%, pain - 18%, fear - 12%. At clinical and neurological examination in children,
ARP of neurotic nature (82%) prevailed over affectively provoked syncope (10%) and
"epileptic" ARP (8%). The seizures in most cases were characterized by a typical course,
medium duration and high frequency. When assessing psychoemotional and behavioral
characteristics, children with ARP were more sensitive, intense, persistent, active, less
distracted, and differed in mood variability compared to healthy children. According to the
indicators of the functional state of the autonomic nervous system in children of the main
group, the initial autonomic tone was characterized by sympathicotonia, normal autonomic
reactivity was recorded significantly less than in the control group (p <0.05). According to
the results of laboratory studies, anemia (88%) and hypocalcemia (82%) were significantly
more common in children with ARP. Analysis of electroencephalographic data revealed:
signs of age norm - in 14 (28%) children, signs of dysfunction of nonspecific midline
structures of the brain - in 6 (12%) children, general cerebral changes. - in 3 (6%)

The data obtained as a result of the studies carried out indicate the heterogeneity of patients with epilepsy from the point of view of molecular mechanisms, the development of the causes of epileptic seizures. One of the leading mechanisms of the pathogenesis of idiopathic epilepsy is a complex restructuring of neuroimmune relationships, manifested by a unidirectional increase in the level of autoantibodies to neurospecific proteins S100, GFAP, NF-200, MBP and the neurotransmitters glutamate, GABA, dopamine, serotonin and serotonine-channel. At the same time, the key link in the pathogenesis of idiopathic epilepsy is neurotransmitter imbalance. Circulating AATs to neurotropic proteins and neurotransmitter receptors in the blood serum of patients with epilepsy can be used as additional prognostic “immuno-biochemical” criteria for the course of the disease and the effectiveness of antiepileptic treatment.

61 patients aged 3 to 14 years were treated with a diagnosis of postoperative anal incontinence (AI). Gel plastic surgery of the anal canal in patients with postoperative AI is the method of choice and is an alternative to reconstructive plastic interventions. During the operation, the creation of an internal nephosphincter from a bypass muscle coupling is advisable to perform with preliminary stomatization of the colon. The final result is largely determined by the quality and timing of rehabilitation measures in the near and remote postoperative period.

Chicken pox is one of the leading places in prevalence after acute respiratory infections. The urgency of the problem is determined by the high incidence of chickenpox, the widespread spread of the pathogen, an increase in the specific gravity in the general infectious pathology, and the ineffectiveness of preventive measures implemented in practice (isolation of patients, quarantine). Despite the low incidence of chickenpox in adults, the risk of severe complications and even death is higher than in children. The greatest risk of the dysfunctional course of chickenpox is noted in people with immunodeficiency. This is characteristic, first of all, for patients with HIV infection and patients with chronic diseases (diabetes mellitus, autoimmune diseases, bronchial asthma, chronic hepatitis, systemic diseases of the connective tissue).
The aim of the study was to conduct a retrospective analysis of the clinical and laboratory features of the course of chickenpox in children and among the adult population of the Samarkand region, as well as to offer practical measures for the prevention of disease in practical health care.

Abstract. The study aimed to study the content of toxic and essential microelements in
the hair of children with cardiomyopathy living in areas with different climatic and
geographical conditions. 96 hair samples of children with cardiomyopathy living in different
environmental conditions were examined. The research results showed that the problem of
microelements is typical not only for the Aral Sea region but also for other regions: deficit
and/or deficiency of 2 or more vital microelements is found in 96% of children with CMP. The
frequency of trace elements in children in all regions was high in Ca, Cr, Co, Cu, He and Zn.
Children living in the Aral Sea region were characterized by excessive levels of manganese,
bromine, and iodine; children living in relatively advantaged regions were characterized by
reliably high levels of potassium, chlorine, and iodine.

Abstract. This article presents the results of a study of the nasopharyngeal carriage of
Streptococcus pneumoniae in 76 organized children before vaccination and 77
unorganized vaccinated children in Tashkent. It was found that the frequency of
nasopharyngeal carriage of pneumococcus is higher in children of closed children's
groups. The disappearance of the most common pneumococcal serotypes after vaccination
indicates the effectiveness of vaccination

In recent years, special attention has been paid to in-depth study of
perinatal lesions of the central nervous system, and this is not accidental,
since the problem of perinatal lesions of the nervous system has acquired
particular relevance in connection with the increase in the frequency of this
pathology. Perinatal brain damage accounts for more than 60% of all
pathology of the nervous system of childhood, is directly involved in the
development of diseases such as seizures, cerebral palsy, and minimal brain
dysfunction.

In connection with the continuing chemicalization of agriculture in the republic and the increasing intensification of industrial production, the danger of chemical pollution of objects of the human environment, disturbance of the ecological balance and their negative impact on the health of the population increases. As you know, in the conditions of Uzbekistan, the main sources of environmental pollution in rural areas are large-scale use of pesticides and mineral fertilizers, and in industrial cities - emissions from various industrial enterprises; in some cotton-growing regions, there is a combined pollution of the environment with pesticides, mineral fertilizers and industrial emissions

Background: Anxiety is a condition characterized by strong fear, followed by somatic symptoms that indicate a hyperactive autonomic nervous system. This is a type of emotional disorder that is associated with unexpected and considereddangerous situations. The anxiety of pediatric patients will reduce the treatment success rate. Reducing the anxiety of pediatric patients is very important to increase thetreatment success rate. Purpose: The purpose of this study was to analyze the effect of sandalwood aromatherapy and bossa nova music on the anxiety levels of pediatric patients undergoing dental treatment. Methods: This research was conducted in four groups with four different treatments: the control group, the sandalwood aromatherapy group, the bossa nova music group, and the combination group. Each group consisted of 26 subjects. All 104 patients were treated with topical fluoride treatment for the first time. Blood pressure and pulse measurements asindicators of anxiety were performed twice on each sample, before treatment and after treatment. Blood pressure and pulse were measured with a digital sphygmomanometer. Results: There was a significant enhancement in the difference in blood pressure and pulse in the control group and a significant reduction in the difference in blood pressure and pulse in the other group (p <0.05).Conclusion: Sandalwood aromatherapy and bossa nova music can reduce anxiety levelsin pediatric patients undergoing dental treatment, with the largest reduction in anxiety levels in the group treated with a combination of sandalwood aromatherapy and bossa nova music.

Currently the case of children pornography addiction has entered a high percentage. According to Indonesian Children Protection Commission, about 65.34 percent of children aged 9 to 19 years in Indonesia access Pornography Via Gadget. The percentage makes Indonesia change its status to a sexual violence emergency. The purpose of this research is to analyze the communication model conducted by parents towards children addicted to pornography. In this research, the researcher uses qualitative approach. Data collection is conducted with in-depth interviews and participant observations. The number of informants in this research consist of three people. The data analysis in this research use the interaction model proposed by Miles and Huberman through the stages after the data was obtained and then in reduced, displayed, and verified. Meanwhile, checking the validity of data is done by triangulation of sources and method. The result of this research is the model used in this research is Permissive Communication Pattern and Militaristic Communication Pattern. Besides by communicating with children, a religious approach is also taken by parents in order to children do not more fall down and addicted to access pornography through internet media.

This article presents the results of evaluating the therapeutic efficacy of
specific allergic vaccination in 77 children with allergy of micro-mite etiology. The age of
children was in the range of 7-14 years, including 7-12 years old  29 (37.7%), 12-14 years
old  48 (62.3%).In general, of the total number of patients (77) who received specific
treatment, excellent results were observed in 26 (33.7–4.2%). In this group of patients,
after treatment, all the main symptoms of the disease completely disappeared. Good results
were observed in 39 (50.6–4.4) patients. In this group of patients, most of the symptoms of
the disease disappeared or the intensity of their severity was weakened. Satisfactory results
were observed in 11.7% of patients. In this group of patients, the symptoms of the disease
remained, but the intensity of their manifestation was weakened. In 3.9% of patients, the
treatment effect was absent. It turned out that the therapeutic effectiveness of specific
therapy lasts for 1-3 years. So, good and excellent results were achieved after 1 year 
62.8%, after 2 years  55.4%, and after 3 years  50.0%. The use of a new method of
allergen-specific immunotherapy of children suffering from allergic diseases: the
combined method (inhalation of the allergen + its electrophoresis through the skin) of
immunotherapy compares favorably with the known traditional (multiple injection
methods) with great therapeutic efficiency, does not cause negative side local and general
reactions, does not give complications, lengthen remission.

COVID-19 pandemic significantly affected dentistry due to high coronavirus infectivity and dangerous consequences. Special recommendations were developed for dentists to limit the infection of staff and patients. to study the reasons for children visiting dental clinics during COVID-19 pandemic and give the characteristics of the patients and provided dental treatment. The cross-sectional study was conducted in four dental clinics, which worked for dental emergency in the cities of Volgograd and Volzhky during the peak of COVID-19 pandemic. The data about 166 paediatric dental patients aged 1-17 years were collected. The reasons for children’s dental visits, age and behavior of the children, the tooth types, and the types of provided treatment were analyzed. The children’s behavior was assessed according to Frankl’s Behavior Rating Scale. Proportions (%), 95% Confidence Interval (CI), mean-value with standard error (M±m) were calculated. The differences were assessed by Pierson’s Chi-square test at p-value 0.05. Microsoft-office Excel-2019 programs were used for the statistic analysis. The majority (98.8%, 95% CI 95.7-99.7%) of the children visited dental clinics due to acute toothache. The primary teeth needed urgent treatment significantly more often than permanent teeth: 83.7% (95% CI 77.8-88.3%) and 16.3% (95% CI 11.7-22.2%) respectively, x2 = 172.171, p < 0.0001. Among the primary teeth the most affected ones were the first and second molars, among the permanent teeth – the first molar. The common reasons for urgent dental treatment in children were caries consequences: apical periodontitis (51.6%, 95% CI 44.5-58.6) or pulpitis (35.3%, 95% CI 28.8-42.3). The other reasons were dental trauma, caries, periostitis, physiological primary tooth mobility. Acute pain in the primary teeth was caused mainly by apical periodontitis, in the permanent teeth by pulpitis. The applied treatment methods were aimed at limiting the use of aerosol generating procedures, reducing the duration of the treatment and preventing the patients’ hospitalization. Almost all the primary teeth with apical periodontitis were extracted; the number of extracted and endodontically treated permanent teeth was approximately equal. The current methods of pulpitis treatment (pulp capping, pulpotomy and pulpectomy) were applied along with the pulp necrotizing agent use. Many (39.7%, 95% CI 32.6-47.4%) children demonstrated negative behavior. Behavior management techniques were used, including tell-show-do (54.5%, 95% CI 42.6-66.0%), sedation (3.0%, 95% CI – 0.8-10.4%), general anesthesia (3.0%, 95% CI – 0.8-10.4%), passive restraint (39.4%, 95% CI 28.5-51.4%). In the limitation of this study we can conclude that COVID-19 pandemic changed the profile of paediatric dental patients and dentist’s treatment options. In 1-17-year-old children the main reason for an emergency dental visit was acute dental pain due to caries consequences. The primary teeth needed urgent dental treatment significantly more often than the permanent teeth. The children often demonstrated negative behavior and required behavior management. The applied treatment methods were aimed at limiting the use of

Abstract: The paper presents an analysis of the data of ultrasound, CT, MRCP and
intraoperative cholangiography in patients with bile duct cyst. Echographic data are
presented in 86 patients, CT in 61, MRCP in 8 and intraoperative cholangiography in 73
patients with this pathology. Ultrasound is a highly sensitive and informative screening
method for the diagnosis of choledochal cysts in children. To increase the specificity of
ultrasound with cysts of the common bile duct, a dynamic study of the contractility of the
biliary system after taking a "choleretic breakfast" is proposed. Currently, in the diagnosis
of pathology of the biliary tract, CT of the abdominal cavity and MRCP are effective noninvasive
methods, alternative to invasive ERCP. It has been established that the final
verification of the form of bile duct cysts, abnormal fusion of the pancreatic duct into the
cyst cavity is determined using MRCP and intraoperative cholangiography, which allows
you to choose the optimal method of surgical treatment.

Abstract: We examined the data of appeals to outpatient clinics in order to detect the
incidence of pneumonia in children in areas with different intensities of pesticide usage. It
was found that in the areas of intensive usage of pesticides (cotton growing area) in
children aged 0-4 years, acute pneumonia is recorded 3-5 times more often than in the
zone of limited usage of pesticides (livestock area). The static differences are significant.
The prevalence of acute pneumonia among girls is 7–20% higher than among boys. The
highest level of respiratory diseases is found at the age of 1 to 4 years. With the increase in
the territorial burden of pesticides, the level of perinatal pathology and the number of
premature infants increase. The data confirm that acute pneumonia and other respiratory
diseases are more common in the cotton growing area than in the livestock one. However,
the study of the regional characteristics of the incidence of children has established that in
the general structure of the respiratory diseases, pneumonia occupies the first place.

Background: The objective of the study is to develop a program of scoring for determining the degree of impairment of urodynamics and the preservation of renal function in children with obstructive uropathy on the basis of data from ultrasound - Doppler studies.
Methods: The work is based on the results of ultrasound and Doppler examination of 484 children with congenital obstructive uropathy. In accordance with the obtained data, a point assessment of the degree of impairment of urodynamics and preservation of renal function was carried out in 60 children with obstructive uropathies (30 children with congenital hydronephrosis and 30 children with congenital ureterohydronephrosis).
Results: Analysis of ultrasound and Doppler studies in congenital obstructive uropathy in children by comparing the data, depending on the severity and level of obstruction, revealed 3 degrees of congenital obstruction of the upper urinary tract in children. A comparative study of the urodynamics and state of the renal parenchyma, depending on the degree of obstruction, established a close relationship between the indicators of the functional state of the renal parenchyma and the degree of dilatation and disorders of the urodynamics of the upper urinary tract.
Conclusion: The developed program allows the safe and most informative methods to reliably determine the functional state of the renal parenchyma and the degree of urodynamic impairment in children with obstructive uropathy. Study Registration (ClinicalTrials.gov) ID NCT04605835.

The article provides data on the influence of environmental factors on the development of bronchial asthma in children living in the industrial regions of the Tashkent region. The increase in the air pollution index has led to an increase in the number of children suffering from bronchial asthma. The clinical features of bronchial asthma in children living in industrial regions is the predominance of the cough variant.

After the 2019 pandemic Coronavirus (COVID-19), caused by Extreme Acute RESS 2 coronavirus syndrome was identified (SARS-CoV-2), our ways of managing ourselves socially and on a regular basis have changed unprecedentedly. The sudden isolation from education, social life and recreational sports has had great impacts on children and teenagers. In certain cases, domestic abuse has also increased. Due to heightened anxiety, changes in their diet and school dynamics, fear or even lack of a component of the issue1,2, stress has a direct effect on their mental health. Our purpose is to address the need to supervise and treat persons in various areas and to alert public health and government agents. We hope that effective and prompt action will minimise harm to your mental health as a result of the side effects of this pandemic.

As early as infancy, children immerse themselves in playful activities with the purpose of making sense of the world around them. However, their effort to achieve this is most frequently halted by parents, care givers and teachers who work around with them. There have been questions surrounding the importance of play for children in Tanzania. The major question has been what children learn when they play. Lack of knowledge on the importance of play for children has led parents, care givers and pre-school teachers deny children their rights to play, instead they have placed more emphasis on reading and arithmetic. This paper is based on literature review, and presents the developmental stages of childhood and discusses the importance of play for cognitive, social, emotional and physical development of children. The paper suggests that parents, community and preschools, and society as a whole should create conducive and safe environment for children to play, so as to help children to develop their capabilities to their full potentials.

Cardiomyopathy is a severe pathology, which requires careful
study of clinical parameters and data of functional diagnostics methods (ECG,
ECHO) for early detection. The study aimed to study the role of clinical and
instrumental, biochemical, and immunological investigation methods for early
detection and prognosis of cardiomyopathy course in children. Materials and
methods of study: 85 children with cardiomyopathy under 18 years of age were
examined, including 60 children with dilated cardiomyopathy (DCMP), 16
children with hypertrophic cardiomyopathy (HCMP) and 9 children with
restriction cardiomyopathy (RCMP) who were hospitalized in the
cardioreumatology department of the Republican Specialized Scientific-
Practical Medical Center of Pediatrics of the Ministry of Health of the Republic
of Uzbekistan. The control group consisted of 30 practically healthy children.

Background: The objective of the study was to study the influence of the combined use of hemodialysis (HD), chemisorption (HS), and metabolic plasmapheresis (PP) for the hemodynamic and defective reduction of intoxication in children with ARF.
Methods: Investigations were performed in 63 children (at the age from 2 to 14 years old) with ARF that was developed as a result of prerenal (hypovolemia, septic shock) and renal (acute glomerulonephritis, pyelonephritis) factors. Depending on the devised detoxification methods, patients were divided into the control group (5) whom it was performed only HD-method and the control group (58) with the use of methods of gravitational surgery, such as HS, HD, and PP.
Results: General clinical presentation in all patients during admission was noted by the significance of intoxication syndrome, signs of respiratory, cardiovascular insufficiencies, in 84,2% of cases it was noted by mental confusion, in 72% of cases it was noted by anemic syndrome, in 78% of cases it was noted by hypoproteinemia and in 93% of cases it was noted by anuria. In 63 cases methods of complex treatment of children were performed once depending on the severity of the condition, a significant degree of the intoxication syndrome, and the level of changes in internal organs.
Conclusion: The influence of sorption methods of detoxification in patients with AKI has a significant advantage over the sessions mono hemodialysis. The corrective effect of complex therapy affects the restoration of organ functions, reduction of intoxication syndrome, and improvement of the clinical condition of patients.

Background: The objective of the study was to evaluate the effectiveness of montelukast sodium in the treatment and prevention of recurrent obstructive bronchitis in children.
Methods: 80 children aged 1 to 7 years with recurrent obstructive bronchitis were enrolled and randomly divided into 2 groups. Group I (control) included 40 patients who received standard therapy. Group II (main) included 40 patients who received oral montelukast sodium. The effectiveness of the therapy was evaluated by cough relief, sputum separation, RDAI scale, and modified bronchophonography indicator.
Results: Patients who received montelukast had significantly accelerated elimination of cyanosis (by 0.7 days; P<0.05), cough relief (by 0.9 days; P<0.05), disappearance of respiratory failure (by 0.7 days; P<0.05) in comparison with the control group. Positive dynamics of indicator E:I index was observed on average starting from 3 days (P<0.05) until the last day of inpatient treatment (P<0.01) in patients of the main group in comparison with the control group. The anti-relapse effect of montelukast sodium, detected during follow-up of patients for 12 months after discharge, was established, so the frequency of repeated episodes of the disease was 33-59% less frequent in patients of the main group (P<0.01; P<0.001).
Conclusion: Using of montelukast sodium in recurrent obstructive bronchitis in children contributes to significant progress in the dynamics of the disease, leads to a significant decrease in the severity of bronchial obstruction according to the E: I index. The use of the drug causes a decrease in repeated relapses of the disease within 12 months.

This study was conducted in Kirkuk city for the period from December, 2019 to June 2020, and included 50 children with acute appendicitisand 50 children without any other disease, where the ages of children in both groups ranged from 3-12 years. The study included collecting information from children in both groups, including gender, age, living situation, number of family members, standard of living and social as well as the number of family members, number of rooms in the house. Amount of 5 ml of blood samples were collected from all the children included in this study, where the blood samples were separated by the centrifuge device and the serum samples were separated from them and kept in the refrigerator until the tests for determination of calprotectin and lactoferrin by ELISA and CRP by immunofluorescence. In this study, there were no significant difference between the 2 groups regarding age, sex and residence. The study found that, 95% of children with appendicitis was suffered from abdominal pain , 50% with fever and weight loss, 48% with nausea and 40% with vomiting. The study revealed a significant elevated level of calprotectin in children with appendicitis as compared with healthy children(18.54±4.25 vs 11.37±3.28 ng/ml) (P<0.001). The study also exposed a significant higher level of lactoferrin in children with appendicitis as compared with healthy children(10.51±1.52 vs 2.18±0.19 ng/ml) (P<0.001).The study showed that the maximum means of calprotectin and lactoferrin in children with appendicitis were observed in those with abdominal pain, followed by vomiting. The study revealed a significant positive correlation between calprotectin and lactoferrinlevel among children with acute appendicitis.The mean serum level of CRP was significantly elevated in children with acute appendicitiscompared to control group (27.57 ± 4.22 and 5.57 ± 3.9 mg/dl) respectively at a P value < 0.001. Conclusions:The study showed a significant relation of calprotectin and lactoferrin withappendicitis.

Autism is a neurological developmental disorder characterized by impaired social interaction, speech, and limited, repetitive behaviour . The cause of autism is not known . Autism risk factors include gender, males are three to four times more likely than females to get autism, family history, age of parents, and other disorders such as fragile, tuberous syndrome. Most of the autism work is conducted in high income countries. Therefore this study was conducted to check the knowledge of dental students regarding autism. This is a cross sectional survey was conducted among dental students through a self administrated questionnaire through an online survey link (I.e.) google forms . The responses were collected and statistically analysed. Chi square test was used to analyze and compare the education level of students and their knowledge on toothbrushes and it‟s replacement .The data was represented as pie Charts and bar graphs . The survey was conducted among dental students within the age group of 17 to 23 years. This survey was responded by 56.4 percent of females and 42.9 percent of males among them 91.7 percent of the people were aware of autism and only a few people were not aware of it. In this study we conclude that most of the dental students are aware of autism and they have sufficient knowledge about it.

Performing dental procedures on children is usually a challenge for dentists especially on those children who are anxious and lack the ability to cooperate. Depending on the child's emotional and psychological state of mind and the usual behavior management techniques may not help in carrying out the dental procedures effectively.In these circumstances, an alternative such as conscious sedation and general anesthesia may become necessary.This study was undertaken to assess dental treatment under general anaesthesia preferred by parents for their children.Data was collected from patient management software and analysed using SPSS software. Chi square test was done to check the association and a p value of < 0.05 was considered to be statistically significant. All children who underwent general anaesthesia from September 2019 to February 2020 were included in the study . Assessment for the reason of general anaesthesia was done. Parental preference for general anaesthesia was also assessed. It was observed that out of 80 children , parents of 53 children preferred treatment under general anaesthesia . Parents preferred treatment under general anesthesia more for male children as compared to female children. Parents preferred general anesthesia more in the age group of 2 to 3 years as compared to 4 to 5 years . Single visit treatment was the most preferred reason for general anaesthesia. We observed that parents preferred treatment under general anaesthesia for children between 2-5 years of age.

Oral health is a vital part of overall infant health.An early age between 6 months to 12 months dental visit is important in rendering prevention,intervention and parental counselling regarding oral health. Pain is an unpleasant sensory and emotional experience associated with actual potential tissue damage according to internal association for the study of pain. Aim of the study is to assess the association between age of the first dental visit and pain in children. A retrospective cross-sectional study was conducted using the patient records from the Department of pedodontic, Saveetha Dental College,visited from February 2019 to February 2020.The children with first dental visit without the past dental history were collected and from which whosoever first visit with chief complaint of pain data were gathered . The collected Data was then subjected to statistical analysis using spss version 20.0.Overall prevalence of chief complaint of pain during first visit was (96.5%). Among first dental visit with pain about 47.2 % was seen in the age of 6-8 years while the least was (14.0%) seen at the age of 11-13 years.The results proved that many parents were unaware about the right age of the child first dental visit.Most of the parents bought their children to the dentist after their child experienced or suffered from pain.There is a need to raise awareness about the importance of oral health care of their children sensitively at the budding stage of life

Introduction:
The permanent first molar teeth are the most caries prone teeth in mixed dentition. Reasons for permanent molar teeth loss include poor prognosis, caries,orthodontic and periodontal reasons. This study was done with the aim to assess the common reasons for extraction of first permanent molars in children between 6-17 years of age.
Materials and methods:
A total of 89000 case sheets were reviewed and cross verified from June 2019 to March 2020. Data related to permanent molar extractions were retrieved by searching with Patient ID, age, gender ,tooth number and treatment relevant to the study. Data was tabulated in the excel sheet. Statistical analysis was done using Statistical Package for the Social Sciences software(version 9.0.3). Results were statistically analysed using association analysis.
Results:
Higher number of males (64.47%) had first permanent molar extractions when compared to females (35.53%). In males, dental caries with pulpitis (22.37%) was the most common reason for extraction of permanent molars. In females, root stumps(13.16%) was the most common reason for extraction of permanent molars. In both 8-12 years age group and 13-17 years age group, dental caries with pulpitis (34.21%) was the most common reason for extraction of permanent molars.
Conclusion:
Within the limitations of the current study, first permanent molars were commonly extracted among males and dental caries with pulpitis was the most common reason for extraction of first permanent molars.

Dental caries in the form of early childhood caries is more prevalent in children. Severe form of caries extending throughout the coronal structure in the root can result in tooth pain. These kinds of teeth with caries extending to the pulp may require pulpectomy or extraction. Pulpectomy is a restorative treatment done in primary teeth which is used to extirpate the coronal and radicular pulp and seal the entire root canal using an obturating material. The obturating material is of different types. The commonly used material is the Metapex, which helps in the natural resorption of the roots, exfoliation and does not irritate the periapical region. Extraction in children can be due to trauma or grossly decayed teeth in children due to caries extending subgingivally or presence root stumps. Children presenting with class 2 caries have been exposed to caries involving the pulp. Early childhood caries is one of the most infectious diseases of childhood having a chronic progression rate resulting in the destruction of tooth structure. They are of different types and patterns being rampant caries, nursing bottle caries. This is generally associated with unusual dietary patterns and improper feeding patterns in children with prolonged use of baby bottles for milk feeding. Caries in children are mainly caused by the bacteria Streptococcus mutans. The aim of this study is to evaluate the primary teeth with caries requiring pulpectomy and extraction in children between 5-7 years old. A retrospective study was carried out using digital records of 903 subjects. These data were collected from DIAS and coded in MS Excel sheets. The collected data was analysed by computer software SPSS version 21 using Chi square test and graphical illustration was done. From the above study, it was found that extraction and pulpectomy was common in males, with prevalence of extraction in the maxillary arch among children of 7 years and pulpectomy in children of 5 years , and seen in the mandibular posterior region.

Malocclusion is one of the common dental problems reported in children that refers to the malalignment of the teeth or improper relationship of the dental arches due to altered developmental systems of the orofacial complex. Several studies have reported on the relationship between malocclusion and dental caries in which the presence of malocclusion such as crowding and spacing may act as predisposing factors in the development of dental caries. The aim of this study is to evaluate the prevalence of dental caries among 12-16 years old school children with malocclusion. It is a retrospective study conducted by reviewing 86,000 patient case records of the Saveetha Dental College and Hospital, Chennai, India. A total of 313 consecutive case records of patients for a period of June 2019 to March 2020 with signed informed consent were retrieved and analysed. Patient’s name, patient’s identification number (PID), age, gender, malocclusion and dmft score were collected from the patients’ case records. Data collection and analysis were done using the SPSS version 23.0. Descriptive analysis was done for the assessment of age, gender, malocclusion and dental caries. Chi square test was used to evaluate the association of dmft score with malocclusion. A total of 134 children with malocclusion were affected by dental caries (42.81%). The overall dmft score was 1.5. Most of the children present with dental caries were within the 12-14 years age group (60.45%), followed by those within the 15-16 years age group (39.55%). High prevalence of dental caries was seen in males (52.24%) as compared to females (47.76%). Most of the children had Class I malocclusion (70.93%), followed by Class II malocclusion (29.07%). In terms of crowding, mandibular crowding (57.19%) was more common among the children when compared to maxillary crowding (38.98%). There is a statistically significant association between maxillary crowding and dental caries. No association of dental caries with mandibular crowding and dental malocclusion. Within the limits of the present study, dental caries is seen in 134 of the patients with an average dmft score of 1.5. There is a positive association between maxillary crowding and dental caries but no significant association of dental caries with dental malocclusion and mandibular crowding.

Accurate localization of the seizure onset zone is important for better seizure outcomes and preventing
deficits following epilepsy surgery. Recent advances in neuroimaging techniques have increased our
understanding of the underlying etiology and improved our ability to noninvasively identify the seizure
onset zone. Using epilepsy-specific magnetic resonance imaging (MRI) protocols, structural MRI allows
better detection of the seizure onset zone, particularly when it is interpreted by experienced
neuroradiologists. Ultra-high-field imaging and postprocessing analysis with automated machine learning
algorithms can detect subtle structural abnormalities in MRI-negative patients. Tractography derived from
diffusion tensor imaging can delineate white matter connections associated with epilepsy or eloquent
function, thus, preventing deficits after epilepsy surgery. Arterial spin-labeling perfusion MRI,
simultaneous electroencephalography (EEG)-functional MRI (fMRI), and magnetoencephalography
(MEG) are noninvasive imaging modalities that can be used to localize the epileptogenic foci and assist in
planning epilepsy surgery with positron emission tomography, ictal single-photon emission computed
tomography, and intracranial EEG monitoring. These advanced structural and functional imaging
modalities can be combined with postprocessing methods to better understand the epileptic network and
obtain valuable clinical information for predicting long-term outcomes in pediatric epilepsy.

Background: Epilepsy is the most prevalent neurological condition and is one of the most prevalent non-infectious diseases in the world. It has been reported that epilepsy is the commonest disorder encountered in most pediatric neurology clinics in the developing world.Epilepsy is a neurological disease characterized by two or more unprovoked seizures. It is an abnormal electrical firing of neurons. The morbid fear of having an unpredictable seizure not only affects the patients' physical function, but also emotional well-being, cognitive function, and social function, Epilepsy is a category of progressive and complicated neurological diseases characterized by epileptic seizures of an intermittent and crippling nature . It is the most prevalent non-infectious, neurological condition in the world. It has been reported that epilepsy is encountered in most pediatric neurology clinics, especially in the developing world. It is characterized by various neurological abnormalities, one of them is epilepsy. Epilepsy is difficult to control, as it is able to aggravate motor disorders and disrupt cognitive function, ultimately worsening the long-term outcome.
 Aim of the study: To Assessment of the traits of Epilepsy in Cerebral Palsy Children in the in the outpatient neurology clinics in Makkah, at Saudi Arabia 2019.
 Method:A cross-sectional study has be conducted using snowball sampling strategy. A self-administered questionnaire was designed and will be sending to the study participants through social media platforms and email. Study participants will be recruited across in the outpatient neurology clinics in Makkah in Saudi Arabia about awareness of the epilepsy in Cerebral Palsy Children and association with socioeconomic status in KSA. Our total participants were (120).
Results: In our study showed that the only (44.00%)of the participated were(25-35)years while (33.00%)were(<25)years, regarding the Education the majority of the participated school were (47.50%), the majority of the participant were Saudi  (65.00%) while non-Saudi were(35.00%) . The majority of the participated the family monthly income < 5000 SAR were (68.33%), followed by 5000 to 10000 SAR were(16.00%). 
Conclusion:the geographic variables were significantly associated with the risk of epilepsy in children with CP. Patients with epileptic CP had a higher odds ratio of several neuropsychiatric diseases, including mental retardation, ophthalmologic problems, hearing impairment, and hydrocephalus.

Background
Children with asthma face multiple challenges that encompass learning how to cope with. Bronchial asthma is a public health problem in all countries irrespective of their level of development, being generally under-diagnosed and undertreated, and most asthma-related death commonly occurs in low-income and lower-middle income countries. Family management of asthmatic children is affected by several factors, primarily the parent’s knowledge and attitude toward asthma. In 2004, the highest prevalence of asthma was reported by physicians in Saudi Arabia (25%). Bronchial asthma is a serious disease since it is very common disease in Saudi Arabia, and it doesn’t only affect the individual physiologically, however it also affects the individual’s quality of life, leading to missing days from school or work, emergency hospital visits, hospitalization, and caregivers and parents’ time and effort. Consecutively, it affects the whole community, asthma, the most common chronic illness in children is responsible for more school absenteeism than any other single chronic childhood condition. Aim of the study: To assessment the level of Knowledge of parents about asthma in their children at MakahMethod: A cross-sectional study was conducted   attending the primary health care centers in Makkah, Saudi Arabia. An asthma Knowledge of parents about childhood asthmawas used to measure the knowledge. During the October toNovember, 2019, participants were (200).
Results:Knowledge of the participant toward asthma study results show the majority of participant had average information Myths and beliefs regarding asthma were(65.0%) while Range (9-18) Mean± SD(12.144±4.15), regarding the General knowledge about asthmashow the majority of participant had average information were(51.0%) while Range (4-15) Mean± SD(11.58±3.15), also Knowledge about associated aspects of asthmathe majority of participant had average information were(78.0%) while Range (5-10) Mean± SD (7.108±2.011).
Conclusion:The asthma knowledge in the Saudi Arabian population is insufficient, and efforts should be carried out to spread asthma knowledge to the people among the parents and guardians of asthmatic children. asthma management should include patients, parents, and public awareness regarding the disease, its symptoms, medications, and highlight the misconceptions about asthma medications at both hospital level and community, for better control of asthma, more effort is needed to educate caregivers and to enhance them.

Asthma is a global problem, its prevalence varies among different countries and cities and age groups. In children, asthma is one of the most common chronic diseases and one of the leading causes of morbidity and mortality.Bronchial asthma is the most common chronic disease of childhood. In recent years a consistent increase in the prevalence of asthma has been reported from various regions of the world. Concomitantly, the social and economic impact of the disease is also increasing. Children with asthma face multiple challenges that encompass learning how to cope with. Bronchial asthma (BA) is a public health problem in all countries irrespective of their level of development, being generally under-diagnosed and undertreated, and most asthma-related death commonly occurs in low-income and lower-middle income countries .As for Saudi Arabia, it is estimated that more than 2 million Saudis have asthma and the percentages range from 8% to 25% in Saudi children. In 2004, the highest prevalence of asthma was reported by physicians in Saudi Arabia (25%).
Aim of the study:To Assessment of knowledge of asthma and related symptoms in school-age children attending the primary health clinic inMakah city in Saudi Arabia 2019.
Method:A cross-sectional study was conducted attending the primary health care centers in Makkah, Saudi Arabia. An asthma knowledge questionnaire was used to measure the knowledge. During the March to June, 2019, participants were (80).
Results:General knowledge about asthma the majority of participant had average information were (43.75%) while weak Knowledgewere (12.25%) the data ranged from (4-15) by (Mean± SD) (12.113±4.12), while Knowledge about associated aspects of asthma the majority of participant had average information were (67.5%) while weak Knowledgewere (12.25%) the data ranged from (5-10.) (Mean± SD), (6.387±2.75).
Conclusion: In conclusion, the screening methodology adopted in this study could be applied for all children at the beginning of the school year, being simple and noninvasive measure. The prevalence of asthma in school children in is greater than that reported from most developing countries and closer to the rates reported indeveloped countries. Avoidance of pet's ownership at home, improving social class and premarital counseling for atopic persons are all recommended

The characteristic bulge in the groin which disappears at times and then recurs may not be present at the time of examination, however, and the surgeon may be compelled to rely on the description given by a competent observer. The most important aspect of the management of neonatal inguinoscrotal swellings relate to its risk of incarceration, strangulation which include gangrene of bowel, testis and ovaries. A prompt early and appropriate treatment is necessary to avoid various complications.