Serum Periostin Level in Children with Asthma

Objectives To determine the average serum periostin level in children with asthma between 6 and 16 y of age, and to fnd out if the levels correlated with markers of eosinophilic infammation, asthma control, and severity. Methods Children under follow-up at a tertiary care centre were enrolled. Children with conditions causing elevated serum periostin other than asthma, or history of systemic steroid use in the past 6 mo were excluded. Serum total IgE and periostin were estimated by ELISA. Results The median (IQR) serum periostin level was 52.6 (45.4, 58.3) ng/mL. Levels did not vary with age, gender, duration of symptoms, positive family history, or history of exacerbations in the last 6 mo. There was no signifcant correlation with anthropometric parameters or their z scores, or markers of eosinophilic infammation in blood including serum total IgE, eosinophil percentage or absolute eosinophil count. There was no diference in median periostin levels of children with diferent asthma symptom control or asthma severity. Conclusions In a group of 26 Indian children with physician-diagnosed asthma, serum periostin showed no signifcant correlation to markers of eosinophilic infammation.

Epidemiology, Clinical Profile, Intensive Care Needs and Outcome in Children with SARS-CoV-2 Infection Admitted to a Tertiary Hospital During the First and Second Waves of the COVID-19 Pandemic in India

Objectives To compare the epidemiological, clinical profle, intensive care needs and outcome of children hospitalized with SARS-CoV-2 infection during the frst and second waves of the pandemic. Methods This was a retrospective study of all children between 1 mo and 14 y, admitted to a dedicated COVID-19 hospital (DCH) during the frst (1st June to 31st December 2020) and second waves (1st March to 30th June 2021). Results Of 217 children, 104 (48%) and 113 (52%) were admitted during the frst and second waves respectively. One hundred ffty-two (70%) had incidentally detected SARS-CoV-2 infection, while 65 (30%) had symptomatic COVID-19. Comorbidities were noted in 137 (63%) children. Fifty-nine (27%) and 66 (30%) children required high-dependency unit (HDU) and ICU care respectively. Severity of infection and ICU needs were similar during both waves. High-fow oxygen (n=5, 2%), noninvasive ventilation [CPAP (n=34, 16%) and BiPAP (n=8, 5%)] and invasive ventilation (n=45, 21%) were respiratory support therapies needed. NIV use was more during the second wave (26% vs. 13%; p=0.02). The median (IQR) length (days) of DCH stay among survivors was longer during the frst wave [8 (6–10) vs. 5.5 (3–8); p=0.0001]. Conclusions Disease severity, associated comorbidities, PICU and organ support need and mortality were similar in the frst and second waves of the pandemic. Children admitted during the second wave were younger, had higher proportion of NIV use and shorter length of COVID-19 hospital stay.

An Infant with Interstitial Lung Disease

Interstitial lung disease in infants, unlike older children and adults, has diverse etiology, including infective, metabolic, autoimmune,genetic, malignant and idiopathic causes. Clinical recognition of the interstitial pattern of lung involvement is important as the etiology andmanagement is entirely different from that of recurrent or chronic lung parenchymal pathologies. We discuss the clinical and pathologicalfindings of an infant with interstitial pneumonia, who succumbed to hospital-acquired sepsis.

Recurrent Ventricular Tachycardia and Peripheral Gangrene in a Young Child.

A 10-year-old girl presented with sudden onset recurrent ventricular tachycardia and symmetrical distal peripheral gangrene. She also had pulmonary thromboembolism and cerebral sinus venous thrombosis. Investigations revealed anemia, hemolysis, hypocomplementemia, and elevated IgM anti-beta2 glycoprotein antibody levels. Electrocardiogram and echocardiogram suggested features of a rare cardiac anomaly, which was confirmed at autopsy.

Primary Lung Abscess in Early Infancy.

Background: Lung abscess is rare in early infancy. Case characteristics: We report two infants with lung abscess, who presented with short respiratory illness.Intervention: Infants were managed with broad spectrum antibiotics including Clindamycin. Needle aspiration was attempted in one case. Message: High index of suspicion in infants with respiratory distress of prolonged duration can help in reaching the diagnosis.