ABSTRACT
Background: We describe the clinical, biochemical and echocardiographic characteristics in children diagnosed with multisystem inflammatory syndrome (MISC) temporally associated with severe acute respiratory syndrome coronavirus 2 (SARS-Co-V-2), admitted to a tertiary care hospital in Goa, India.Methods: This was a retrospective observational study conducted at Goa Medical College, Goa, India. Parameters including demographics, clinical features, laboratory markers, medications and outcomes were obtained from patient hospital records; analyzed for patients treated for MISC (as per WHO case definition) for a period of 11 months from 01 July 2020 to 31 July 2021.Results: 30 patients (18 males) with median age of 7 years (IQR: 2 months – 12 years) were included. The proportion of children with gastrointestinal symptoms was 20 (64.5%), shock was a presenting feature in 15 (48%) and coronary ectasia and/or low ejection fraction was seen in 12 children (38.7%).Conclusions: A high index of suspicion for the diagnosis of MIS-C in children presenting with fever and Kawasaki disease like symptoms or signs of shock is recommended; since early aggressive therapy with Intravenous Immunoglobulins and methylprednisolone can have favourable outcomes.
ABSTRACT
Background: Malignancy is one of the leading causes of childhood deaths in developed nations while diarrheal and respiratory infections continue to compete in many developing nations. Since the state of Goa, has health statistics comparable to the western world, an attempt has been made to look at the childhood cancer mortality in proportion to overall deaths in the only tertiary care hospital in the stateMethods: In the absence of a population registry, information was obtained from the hospital mortality statistics during the period from January 2007 to December 2017.Results: A total of 118 cancer deaths were seen over a period of 11 years with a male/female ratio of 1.34:1. The proportion of cancer deaths to total deaths due to any cause, per year was 11.9%. Most of the deaths were noted in the 1-10 years age group (53.4%) with maximum deaths seen' in hematological malignancies (50.8%).Though sepsis was the immediate cause of death in 42(35.6%), a significant drop was noted in last 5 years wherein it was observed to fall from 22.8% in the initial 6 years to 12.7% in the latter 5 year period.Conclusions: Proportion of cancer related deaths were seen to reduce over the study period with a significant drop, in sepsis, as the major cause. Simple measures to control sepsis may help to reduce cancer mortality.