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Background: Neonatal hyperbilirubinemia continues to be the most common cause of hospital admissions and readmissions in the neonatal population worldwide and this pattern continues despite attempts to identify neonates at risk of pathological hyperbilirubinemia. The aim of the study was to determine the clinical profile and etiology in neonates who were treated with double volume exchange transfusion (DVET).Methods: This was a hospital based prospective observational study in neonates ?35 weeks of gestation who were treated with DVET for severe hyperbilirubinemia in a tertiary care centre over a period of six months.Results: In our study 110 neonates with severe hyperbilirubinemia were treated with DVET. Majority of the neonates were males (59.1%). Lower segment caesarean section (LSCS) was the common mode of delivery observed in 66.4% of the study subjects. Rh incompatibility (36.4%) was the commonest cause of exchange transfusion followed by ABO incompatibility (20%). The mean age of neonates at admission and mean age at DVET in days were 4.03�46 and 4.25�44 respectively. The mean birth weight of neonates treated with DVET was found to be 2.81�57. The mean total serum bilirubin at pre-exchange and post exchange were 26.13�58 mg/dl and 11.63�24 mg/dl respectively.Conclusions: Rh incompatibility was the most common cause in neonates with severe hyperbilirubinemia requiring double volume exchange transfusion.
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Background: Acute liver failure is a life-threatening condition with sudden onset liver injury, decreased liver functions, hepatic encephalopathy, and coagulopathy in patients without preexisting liver disease. The objective of this study was to find out the clinical and etiological factors of acute liver failure in children.Methods: This study was a hospital based prospective observational study conducted from November 2017 to October 2019 at Pediatric Intensive Care Unit (PICU) of Postgraduate Department of Pediatrics, Government Medical College Srinagar, Kashmir. Fifty-one consecutive patients of ALF in the age group of 1 to 18 years were included in this study.Results: The most common clinical presentation in our study was jaundice which was present in all cases followed by anorexia (90.2%), vomiting (84.3%), fever (76.5%) and abdominal pain (64.7%). HE was present at admission in 54.9% cases and exaggerated DTR抯 was present in 49% cases. Of the other clinical manifestations, bleeding was present in 49% cases, ascites in 33.3% cases and edema in 5.9% cases. Infections (76.5%) were the most common cause of ALF in children followed by indeterminate (9.8%), autoimmune (5.9%), drug induced (3.9%), Wilson抯 disease (2%) and HLH (2%). In infectious etiology, the most common cause was Hepatitis A (66.7%) followed by Enteric fever (7.8%) and Hepatitis E (2%).Conclusions: The most common clinical manifestation of ALF in children is Jandice. Hepatitis A is the most common cause of ALF in children.
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Background: Neonatal jaundice is the most common problem in the first week of life leading to delayed hospital discharges and readmissions. Recognizing early neonatal hyperbilirubinemia plays a pivotal role in preventing serious complications. The aim of this study was to study the clinical profile and etiological factors leading to neonatal jaundice.Methods: This prospective observational study was conducted in the neonatal intensive care unit (NICU), department of pediatrics, government medical college, Srinagar, Jammu and Kashmir, India over a period of 6 months (August 2023 to January 2024). A total of 400 cases were enrolled for the study. Data collection was done by history taking, clinical examination and relevant laboratory investigations.Results: In this study, out of 400 jaundiced neonates, 236 (59%) were males and 164 (41%) were females, 342 (85.5%) were born at term and remaining 58 (14.5%) were preterm babies. Among 400 neonates studied, majority (80%) had birth weight ?2500 gm. Only 80 (20%) had birth weight less than 2500 gm. Physiological jaundice was seen in 162 (40.5%) of the total cases. This was followed by ABO incompatibility (20%), Rh incompatibility (16.5%), sepsis (8%), idiopathic (5%), prematurity (4%), cephalhematoma (4%) and breastfeeding jaundice (2%).Conclusions: This study concludes that physiological jaundice is the most common cause of neonatal jaundice in our hospital. This was followed by ABO incompatibility, Rh incompatibility and sepsis. This highlights the importance of appropriate monitoring of neonates with these underlying risk factors.
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Background Mumps is one of the oldest human illnesses known to humans. Mumps is caused by a paramyxovirus, which is a single-strand RNA virus. Mumps is characterized by painful, unilateral, or bilateral swelling of the salivary glands, in particular, the parotid glands.Methods: This is a hospital-based prospective observational study. All children of age ?18 years, both males and females with acute onset of unilateral or bilateral tender, self-limited swelling of the parotid or other salivary gland without other apparent cause.Results: Of the 150 clinically diagnosed mumps cases, 87 (58%) were male and 63 (42%) were female (male-to-female ratio of 1.4:1). There was no case below 1 year but there were 40 cases between 1 and 5 years. The 40% belonged to the lower middle class of socioeconomic status as per Kuppuswamy’s scale, followed by the upper-middle and lower-middle class. Only 15 patients (10%) were completely immunized whereas the immunization status of 8% patients was not known, and the rest of the patients were non immunized (82%). Fever was the most common presentation (150 patients;100%), followed by parotid involvement. Parotitis was present in 146 (97.3%) cases at some point during the illness, 36 patients (24%) had unilateral and 110 patients (73.3%) had bilateral involvement. 16% of patients had multiple salivary gland involvement. Mean duration of illness was 9.0±2 days.Conclusions: Mumps is a significant public health problem to warrant investment in prevention through vaccination.
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Background: Anemia is one of the leading causes of mortality and morbidity in children. The etiology of anemia is multifactorial including nutritional anemia, hemolytic anemia, aplastic anemia, storage disorders, hematological malignancies, anemia secondary to some chronic diseases. Methods: The study is an observational study. Physical signs of severe anemia were looked in patients attending outpatient department or admitted in hospital. Children with hemoglobin levels <7 g/dl and in the age group 6 months to 6 years were recruited in study. The aim is to look for non-nutritional etiology of severe anemia in children in Kashmir. Results: Out of 192 children, 97 (50.52%) females and 95 (49.48%) males, with a male, female ratio of around 1:1. A total of 147 (76.56%) children in our study were having nutritional and 45 (23.44%) were having non nutritional causes. Among non-nutritional anemia 30 cases were hemolytic anemia, 11 hypoplastic anemia, 3 leukemia and 1 patient were diagnosed as Osteopetrosis. Conclusions: Though nutritional deficiency anemias are predominant; it may not always be the case. Hemolytic anemia and leukemias should be ruled out while evaluating a patient of severe anemia and pancytopenia. Bone marrow failure syndrome, storage disorders should be ruled out in patients with skeletal anomalies.