Indian Journal of Trauma and Emergency Pediatrics

 Ganglioneuroblastoma are a mix of malignant neuroblastoma and benign  ganglioneuroma tissue.  These lesions originate from sympathetic cells.  It is a rare tumor with an incidence of 5 per lakh children under 10 years of age.  We present a case of unusual presentation of this rare tumor.

 Kimura’s Disease is a rare chronic inflammatory disorder that characteristically manifests as enlargement of head and neck lymph nodes and salivary glands accompanied by eosinophilia and elevated serum IgE. It is a benign condition with unknown etiology and said to be predominantly seen in males of Asian descent. We are presenting here a clinically and histologically typical case of this disease in a 12 years old Bangladeshi boy. The diagnosis of Kimura’s Disease can be very difficult and misleading; it is important not to ignore histopathological characteristics.

 Objective: To assess the triage scoring system evolved by N. Kumar et al.  For severity of illness and outcome based on clinical variables related to systemic inflammatory response syndrome (SIRS) and advanced pediatric life support. Design: Prospective studyconducted in a tertiary-care hospital. Methods:   A Prospective observational study was done at tertiary care center of Navodaya Medical College and Hospital during the period of October 2013 to October 20015. All children admitted during this period in pediatric ward and pediatric ICU were included in the study and a triage score would be applied to each child at the time of first contact. The triage score consisted of temperature, heart rate, respiratory rate, blood pressure, capillary filling time, oxygen saturation (SpO2) based on systemic inflammatory response syndrome and sensorium level was assessed on AVPU score. Each study variable was scored as 0 or 1 (normal or abnormal) and a total score for each child obtained. The outcome at discharge was correlated with the study variables and the total score. ROC curve analysis was performed to see the overall predictive ability of the score as well as a cut off at which maximum discrimination occurred. Results: Of 252 children studied 36 died. Of the  7 variables 6 variables were abnormal in the study subjects. Except temperature all other variables showed significant association with mortality (p<0.05). Mortality increased with increase in the number of abnormal variables; 1%, 8.1%, 22.9%, 45.5%, 62.5%, 64.3% and 100% for scores of 0, 1, 2,3,4,5 and 6 respectively. Children with a score of 2 or more had significant higher mortality. The area under the ROC curve was 0.900, indicating that overall 90% of the subject could be predicted correctly.  Conclusion: Our study concluded that for triage scoring, any child with 2 or more abnormal clinical variables at the time of first contact should be taken as serious that might lead to death.

 Introduction: Early warning signs related to language development may also include: late talking, inadvertently hitting or grabbing instead of communicating verbally, pronunciation problems, slow vocabulary growth, difficulty rhyming words, trouble learning numbers, the alphabet, the days of the week. Methodology: The study was conducted as a cross sectional study of descriptive type from August 2011 – March 2013. Hundred children who studied in two private schools coming under the purview of school health Institute of Child Health and Hospital for Children were recruited into the study. Results: It was observed that children with specific learning disability seem to be more interested in sports channel and cartoon channel, rather than vernacular language channel. It is observed that  66% of the children with specific learning disability have access to extra schooling- which higher than the other two groups. Conclusion: Children with specific learning disability don’t miss breakfast, Children with specific learning disability are punctual and Children with specific learning disability have good attendance.

 Introduction: It is generally observed that at least  20% of the children in a class room get poor marks – they are scholastically backward. Poor marks must be seen as a symptom reflecting a larger underlying problem in children. Methodology: Hundred scholastically backward children who were identified with the help of the class teacher fifty children were selected out of 340 children studying in the first school and the other fifty were selected from amongst the 614 children studying in the second school, based on the sample size required for the study four children studying in the first school were being brought up in a hostel.  Results: A child classified as a slow learner would require extra coaching at school and home. It was also observed that out of the 56 slow learners cause could be attributed for the scholastic cause in only 40. To distinguish the remaining 16 from mixed learning disabilities assessment of  IQ  needs to be done.  Conclusion: Children with scholastic backwardness and  advantageous socioeconomic conditions must be subjected for assessment by GLAD to look for Specific Learning Disability.

 In Maharashtra, stings by the red scorpion are quite common in Kankan area and the dry districts of Ahmednagar and Aurangabad. Scorpion stings are relatively less hazardous in adults, but may lead to serious toxicity in children. Hence, it assumes so much clinical importance in children. Various epidemiological factors play a major role in the incidences of scorpion stings, like the type of house in which the victim resides, as “Kuchha” houses, which provide good hiding places for the scorpions, record more instances of stings.  environmental factor like summer season also play an important role in the epidemiology.

 Background and Objectives: Phototherapy is one of the most common and invasive methods in treatment of unconjugated hyperbilirubinemia of the neonate. Adverse effects of phototherapy include loose stools, skin rash and dehydration. There are very few studies which show the effect of phototherapy on total count and reticulocyte count. So, this study was done to show the effect of phototherapy on total count and reticulocyte count. Subjects and Methods: This is a prospective hospital based comparative study  on 100 eligible neonates admitted in the Neonatal Intensive Care Unit receiving phototherapy at Adichunchanagiri Institute of Medical Sciences and research hospital, a rural tertiary care hospital, B.G.Nagara, Nagamangala Taluk, Karnataka from December 1st 2013- November 30th 2014. Two samples before and after phototherapy, were taken and analysis was done. The results were analysed statistically. Results:   A total of 100 neonates were included in our study of which 55(55%) were males and 45(45%) were females. The mean(+/-SD) total countwas 15463.5+/-163.6 before phototherapy and 15363+/-151.83 after phototherapy.   The mean(+/-SD) reticulocyte count was 3.07+/-0.13% before phototherapy and 2.79+/-0.10%  after phototherapy.  Conclusion: In our study phototherapy has a significant effect on reticulocyte where as there was no significant effect on total count including neutrophils and leucocytes.