Acute viral hepatitis in children: a prospective hospital based study

Background: Viral hepatitis is a major public health issue throughout the world affecting millions of children despite the availability of vaccines, prophylactic measures and improved sanitation. The objective of the study was to analyze the etiology, clinical features, laboratory parameters and sonological findings of Acute Viral Hepatitis in pediatric population.Methods: A total of 88 children admitted in paediatric department and gastroenterology unit of medicine department with confirmed acute viral hepatitis from June 2016 to July 2018 at tertiary health care teaching hospital of north India were included. The patients were divided in 3 age groups; 1-5, 6-10 and 11-18 years. Clinical features, laboratory parameters, ultrasound findings were compared in three age groups.Results: Out of 88 cases 48 were boys and 40 girls. In the present study hepatitis A was the most common (85.2%) etiology. Jaundice (90.9%) is the most common symptoms followed by dark colored urine (86.3%), loss of appetite (83.3%) and fever (68.2%) reported in this study. Icterus (90%) is the most common sign reported followed by hepatomegaly (86%). Out of 88 cases 4 cases died. Out of 4 deaths, 2 cases of hepatitis A and 2 cases positive for Hepatitis B. The cause of death was hepatic encephalopathy in both the cases.Conclusions: Majority of cases in children were hepatitis A cases. Most of the cases were aged above 5 years with slight male predominance. Those cases with elevated liver enzymes (SGOT >5000) and those with PT INR >3.5 at admission has higher mortality.

Role of common salt in the treatment of umbilical cord granuloma

Background: Umbilical granuloma is an overgrowth of granulation tissue following the separation of umbilical cord. Treatment options for this common entity are limited and have side effects such as chemical burns. In this study, we want to highlight the salt application method for treatment of infants with umbilical granuloma.Methods: Thirty six infants were enrolled in present study after institutional ethics committee approval and consent from the parents. After thoroughly explaining the method to all mothers, they are advised to apply a pinch of salt on granuloma twice a day for 3 days .The area of application was cleaned, and common table salt was carefully applied over the lesion. The granuloma was then occluded with surgical adhesive tape for 30 minutes. Cases were followed up after 3 days for assessment of improvement.Results: All thirty six cases responded well to this approach with complete resolution of lesions after 3 days. Small clot like shrunken tissue was found at the site of granuloma, which was easily scraped off during gentle cleansing. No major complication or recurrence was noted in follow-up.Conclusions: The use of common salt in treating umbilical granuloma is simple, cost-effective, curative, and safe. It is easily administered and can be performed by parents at home.

Poland syndrome.

Poland’s syndrome is a rare congenital condition, characterized by the absence of the sternal or breastbone portion of the pectoralis major muscle, which may be associated with the absence of nearby musculoskeletal structures. We hereby report an 8‑year‑old boy with typical features of Poland syndrome, the first documented case from Uttar Pradesh, India.

Large facial congenital melanocytic nevus: a case report.

Congenital nevi are hyperpigmented macular lesions that are derivatives of the melanoblasts. Crude incidence estimates suggest that approximately 1 in 20 000 are born with a large CMN and 1 in 500 000 are born with a very large (giant) CMN. They occur in less than 1% of the neonates in any site of the body. The giant congenital nevus is greater than 20 cm in size, pigmented and often hairy. We report a classical case of large congenital melanocytic nevus present over face. The case report is being presented because of its rarity.

Perception of fever and management practices by parents of pediatric patients.

Background: The febrile child is a common pediatric presentation in both primary care and the emergency department. An assessment of parents’ perception to recognize fever in their child, as well as management practices was the focus of this study. Methods: The study was done prospectively in which interviews were taken by researchers. One hundred and sixty four parents, whose children were less than 14 years old, had fever as one of the presenting complaints and admitted in pediatric department of Rama medical college & research center, Kanpur, were included in this study. Results: Majority of the parents 114 (69.51%) managed the fever initially at home. Only a few parents (17.07%) correctly managed the fever by taking their children to hospital or to a qualified practitioner, rest of the parents primarily rely on local medical store or unqualified practitioner. Conclusion: Parents need to be educated, when they consult health facilities especially during vaccination visits. Decreased appetite was the most common presenting complaint along with fever in children and it should be taken as a significant factor during health education of fever for early and appropriate consultation.