Risk factors for relapse in pediatric nephrotic syndrome in Ranchi.

Introduction: The nephrotic syndrome (NS) is a common childhood illness characterized by massive proteinuria, hyperlipidemia, and hypoalbuminemia. It is a disease of relapse, and therefore, it is a major problem to manage cases with frequent relapses. Prediction and prevention of risk factors is the key to successful management of childhood NS. An understanding of the risk factors that determine the course is useful in taking decisions regarding therapy and enables counseling. Materials and Methods: Sample size of 100 children of age 1-12 years of age with steroid sensitive nephrotic syndrome over duration of 1 year from April 2020 to May 2021. Results and Conclusion: Risk factors for relapse were presence of infection during initial attack and first relapse as well as less time interval between remission in first episode of nephrotic syndrome and first relapse.incresed risk was also associated with inadequate treatment duration and less serum albumin level and high cholesterol level.

To study the association between various levels of cord serum albumin (CSA) and significant neonatal hyperbilirubinemia requiring interventions like phototherapy or exchange transfusion.

Introduction: Hyperbilirubinemia is most common normal physiological phenomenon in neonates affecting almost one third of newborn.it may lead to neuro disability leading to deafness and cerebral palsy which can be prevented if detected and treated as soon as possible. Albumin is produced in seventh week of intrauterine life and it can be measured by cord blood and in this study we can establish serum albumin with neonatal hyperbilirubinemia and can be treated by phototherapy or exchange transfusion. Material and Method: The study consists of 55 randomly selected eligible term neonates delivered at Rajendra Institute of Medical sciences from March 2019 to August 2020. Conclusion: In this study, in term neonates, level of serum albumin in umbilical cord less than 2.8 g/dl has no correlation with occurrence significant hyperbilirubinemia, so a level <2.8 gm/dl of serum albumin in umbilical cord blood can be used as critical value indicator in triaging predict the risk of occurring of significant hyperbilirubinemia in term neonates.level >3.4 gm/dl is considered safe in neonates who are the candidates for early discharge in the absence of other risk factors.

An Observational Study on Clinical and Epidemiological Profile of Pediatric Patients with Coronavirus Disease 2019 (COVID-19) Presenting With Comorbidities at RIMS, Ranchi.

Introduction: SARS COVID-19 infection leads to wide range of symptoms in comorbid pediatric patient. In view of its susceptibility affecting pediatric age groups with comorbidities and its potential to increase the mortality rate, it may have adverse effects on the outcome of such children. This study aims at better understanding of clinical profile and its outcome of pediatric population. Method: A total of 50 pediatric patients aged 1 to 17 years with comorbidities and laboratory confirmed COVID-19 that were admitted at the RIMS, Ranchi from 1st April 2020 to 31st December 2020 were studied. Result: 34 (68%) resided in the hot spot areas of the region, 8(16%) resided in the non- hot spot areas and 8(16%) had migrated from elsewhere. Higher proportion of males between 11-15 years of age were affected (64%).Our study shows that the majority of the children that were affected were of the age group 11-15 years (52%). 38(76%) of these children presented with fever as their major complaints, cough in 28(56%), sore throat in 2 (4%), diarrhea in 6(12%), vomiting in 11 (22%), breathing difficulty in 20 (50%) and 30 (60%) had other symptoms. Out of 50 patients admitted, 3 died. In our study majority of comorbid condition was thalassemia major. Conclusion: The presenting characteristics, comorbidities, and severity of illness of pediatric patients with COVID-19 were different, and milder, compared with adults.

To assess the magnitude of autism spectrum disorder in Jharkhand by M-CHAT-R as a screening tool.

Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder which is a clinically heterogenous condition with a wide range of etiological factors and causing significant public health burden. If diagnosed at an earlier age, early interventions can be started this leads to functional outcome of children with ASD with respect to social, behavior and occupational sphere. Therefore, early detection and intervention are widely recommended in these children. So screening of toddlers who were identified to be "at risk" can be diagnosed using screening questionnaires by interviewing parents. Overall with this study we can conclude that, toddlers identified to be "at risk" and those diagnosed with ASD were not uncommon and M-CHAT-R is a useful screening test for the identification of "at risk" toddlers for Autism Spectrum Disorder in Jharkhand.

To study thyroid hormone levels (FT3, FT4, and TSH levels) in critically ill children and their correlation with disease severity and clinical outcome in Rajendra Institute of Medical Sciences, Ranchi, Jharkhand.

Introduction: There are manifold effects on neuro-endocrine and metabolic systems due to critical illness. Abnormalities in thyroid hormone levels in a critically-ill patient with no pre-existing hypothalamo-pituitary-thyroid dysfunction is seen in Euthyroid sick syndrome or Non thyroidal illness syndrome. The understanding of different endocrinal changes in acute phase of critical illness may help us to intervene early and improve by pharmacological intervention. Materials and Methods: Critically ill children admitted in PICU, RIMS, Ranchi, aged 29 days to 17 years. Results: In our study, it was seen that FT3 and FT4 were low at admission at admission in critically ill children. And among them, the non-survivors had significantly lower values compared to survivors. Discussion: Among this critically ill patient, more than 70% of patients have shown low free T3 (Type I NTIS) and around 50% of low free T4 levels and free T3 levels (Type II NTIS). We have done this study to assess the thyroid dysfunction in critically ill children admitted in our PICU and its correlation with disease severity and clinical outcome.