ABSTRACT
Background: The COVID-19 pandemic has forced the world to change its approach to medical education with most of the undergraduate (UG) teaching shifting to online mode. As in other colleges in India, we also switched to online classes for both UG and postgraduate (PG) students in April 2020. We intend to share our preliminary experience about the acceptance and performance of these online classes in Pediatrics. Methodology: For UGs, we studied the attendance and marks of term ending summative assessment of batch of 2020 who attended online classes and compared them to the attendance and marks of the term ending summative assessment of the previous three batches (2017, 2018, and 2019). We also obtained a feedback on a prevalidated questionnaire from the UG as well as PG students. Results: The mean +/- standard deviation (SD) attendance of the batch of 2020 was 81.6 +/- 16.2%, while that of the 2017, 2018, and 2019 batch during the same period was 84.9 +/- 10.9%, 92.6 +/- 4.8%, and 83.0 +/- 7.6% respectively. Similarly, the mean +/- SD marks for the batch of 2020 was 74.8 +/- 6.5% while it was 66.9 +/- 9.4%, 58.6 +/- 10.1%, and 60.9 +/- 9.7% for 2017, 2018, and 2019 batches, respectively. The feedback obtained from both UGs and PGs was satisfactory in relation to the acceptance of the online mode. Conclusion: The online classes in Pediatrics are a reasonable alternative to the onsite classes in the prevailing situation.
ABSTRACT
BACKGROUND: Coronavirus disease 2019 (COVID 19) usually causes a mild illness among children. However, in a minority of children, it may be associated with the life-threatening multisystem inflammatory syndrome (MIS-C), or thrombotic microangiopathy, or sequelae like type-1 diabetes mellitus (T1DM). We describe a previously healthy, 12-year-old boy with new-onset T1DM with diabetic ketoacidosis (DKA) in the setting of MIS-C, with a course complicated by thrombotic microangiopathy. CASE PRESENTATION: The patient presented with four days history of fever, non-bilious vomiting, polyuria and polydipsia. On evaluation, he was noted to have diabetic ketoacidosis. Although Diabetic ketoacidosis with insulin and intravenous fluids, his hospital course was notable for shock requiring vasopressor, purpura fulminans with eschar formation, neurological manifestations (left hemiparesis due to right middle cerebral artery territory infarct, mononeuritis multiplex) and thrombotic microangiopathy. MIS-C-like illness secondary to COVID-19 was suspected due to diabetic ketoacidosis, thrombotic microangiopathy, elevated inflammatory markers, history of contact with COVID-19-infected individual and detectable COVID-19 IgG antibodies. He improved following management with methylprednisolone, intravenous immunoglobulin, low-molecular-weight heparin and aspirin, and was discharged on hospital day 48. CONCLUSION: MIS-C-like illness should be considered in children and adolescents presenting with complex multisystem involvement in this era of COVID 19. Management with immunomodulatory agents can be lifesaving.