Indian Journal of Trauma and Emergency Pediatrics

Introduction: Monsoon-related illnesses are major cause of morbidity and mortality in children during rainy season in Mumbai. Outcome of these illnesses largely depend on appropriate and timely care. Experience suggests delayed medical attention is a common problem in study population. Aims & Objectives: Present Study aimed to assess the prevalence, reasons and risk factors for delayed medical attention in children with monsoon-related illnesses as well as the impact on final outcome. Materials & Methods: This cross-sectional observational study included 220 children (1 month-12 years) hospitalized with monsoon-related illnesses in a tertiary hospital during two seasons (June-September) in 2019-2020. “Delayed medical attention” was pre-defined for study purpose as one or more of the following – a) More than 24 hours delay between onset of symptoms and first visit to qualified medical practitioner, or b) More than 72 hours delay between first consultation and referral to hospitalization,) c) More than 24 hours delay after referral and actual hospitalization. Results: Almost three-fourth of the study children (71.8%) received delayed medical attention with maximum delay at the level of first consultation (44.5%) followed by referral (36.5%). Delayed medical attention was more common in cases with initial self-treatment ( p 0.010; OR 38.58 with CI 2.33-638.84), Unqualified first consultations (p 0.003; OR 21.38 with CI95% 2.87-159.18) and Doctor-shopping (p0.0004; 21.38 with 95% CI 2.69 to 30.28). Older children beyond five years had significantly higher risk of delayed attention than under-five children (p 0.033; OR 1.93 with 95% CI 1.05-3.55) as also those with non-specific febrile illnesses (p 0.048, OR 2.29 with CI 95% 1.00 - 5.21). Conclusion: Delayed medical attention is widely prevalent in children with monsoon-illnesses among study population despite easy access to low-cost public health care in the city, largely due to inappropriate help-seeking behaviour. Older children, non-specific febrile illness, self- treatment, unqualified consultations and doctor-shopping are identified as significant risk factors for the delayed care.

Parenthood involves continuous cognitive and emotional labor that extends far beyond visible caregiving tasks. This largely invisible burden, commonly termed the parental mental load, includes planning, anticipating, organizing, monitoring, decision-making, and emotional regulation related to child care and household functioning. Increasing evidence from sociology, neuroscience, psychology, and public health demonstrates that excessive parental mental load is associated with chronic stress, burnout, sleep disturbance, and impaired executive functioning. These parental outcomes, in turn, adversely influence child emotional, behavioral, and developmental health through bidirectional mechanisms. Despite its clinical relevance, parental mental load remains under-recognized within routine healthcare practice and is rarely addressed explicitly within policy or legal discourse. This narrative review synthesizes international and national evidence linking parental mental load with health outcomes and examines how existing human-rights instruments, labor laws, and child-welfare statutes implicitly acknowledge caregiver well-being. The article further highlights implementation gaps, particularly in low- and middle-income countries, and proposes clinical, legal, and systems-level strategies to identify, redistribute, and mitigate cognitive caregiving burden. Explicit recognition of parental mental load is essential for advancing family-centered pediatric care and safeguarding children’s rights to optimal health and development.

Drug abuse among adolescents has emerged as a major global public health concern. Adolescence is a critical developmental period characterized by significant physical, emotional, psychological, and social changes. During this vulnerable phase, experimentation with psychoactive substances may occur due to curiosity, peer pressure, family influences, academic stress, mental health disorders, and easy availability of drugs. Substance abuse during adolescence can adversely affect brain development, academic performance, mental health, social relationships, and long-term health outcomes. Early initiation of drug use is associated with increased risk of addiction, psychiatric disorders, criminal behavior, and premature mortality. This review article discusses the epidemiology, risk factors, commonly abused substances, health consequences, prevention strategies, and management approaches related to adolescent drug abuse.

Trauma remains a leading cause of morbidity and mortality globally, particularly among young adults. Often, the initial response to a traumatic injury determines the patient’s prognosis. This paper reviews the literature regarding the effectiveness of Structured Teaching Programmes (STPs) in enhancing knowledge and practical skills related to trauma care among college students. Through a systematic evaluation of various pedagogical approaches, this review highlights the transition from theoretical understanding to clinical competency. The findings suggest that STPs—utilizing simulation-based learning and modular curricula—significantly improve the proficiency of non-medical college students in providing “first-hour” emergency care.

Cut-throat injuries represent a critical emergency due to the high risk of airway compromise, hemorrhage, and distortion of normal anatomy. Prompt airway management is crucial in preventing hypoxia and mortality. We report a case of a middle-aged male presenting with a deep anterior neck laceration and exposed airway structures. The airway was initially secured using endotracheal intubation under controlled anaesthetic conditions, followed by definitive surgical tracheostomy. Careful planning, maintenance of oxygenation, and coordination between anaesthesia and surgical teams played a crucial role in successful management. This case highlights the importance of a stepwise airway approach in managing complex neck trauma.