Pediatric Education and Research

Children with dengue fever presenting to the Basaveshwar Teaching And General Hospital and Sangmeshwar Teaching and General Hospital Attached to M.R. Medical College, Gulbarga, during the months of January 2011 to December 2012, were prospectively followed up for clinical profile and outcome. Commonest clinical features were fever, vomiting, bleeding, body pain and Hepatomegaly. Elevated liver enzymes and low platelet counts were common laboratory findings in dengue. Hepatomegaly and thrombocytopenia were more common in DHF and DSS group. Retro-orbital pain was slightly more in DHF and DSS groups and there was a tendency for DSS to present at an earlier age. 

This article aimed to provide a special perspective on role of pediatric journals in evidence-based pediatrics and child health through a preliminary search of PubMed for articles that analyzed pediatric journals. There were studies on analyses of pediatric subspecialty-specific journals such as orthopedics, surgery, dentistry, dermatology, and nursing. The various pediatric journals analyzed for their contribution to evidence-based pediatrics and child health were Journal of Pediatric Orthopaedics-A (JPO-A), Journal of Pediatric Orthopaedics-B (JPO-B) and Journal of Children’s Orthopaedics (JCO); Journal of Pediatric Surgery, Pediatric Surgery International and European Journal of Pediatric Surgery; six pediatric dentistry journals; four pediatric nursing journals; Journal of Pediatric Psychology, Journal of Clinical Child and Adolescent Psychology, Journal of Abnormal Child Psychology, and Child development. The topics researched in analyses of pediatric journals were levels of evidence, citation analysis, traumatic dental injuries, instructions to authors and editorial policies, referencing accuracy, and reporting rates of demographic, methodological and ethical information, and methodological standards  

Background: The Omental fibrous hamartoma is a very rare lesion, mainly seen in children characterised by single/multiple, Omental/mesenteric large solid mass, which may be confused with malignant neoplasm.Microscopically these are composed of fibroblast in bundles separated by myxomatous stroma. Lesion has benign clinical course without recurrence.Case Presentation: We present a 3 yrs old male child with history of complaints of abdominal lump since 2 yrs, which was increasing progressively in size over period of time. No history of nausea, vomiting, fever etc. Contrast enhanced computed tomography (CECT) revealed large well-demarcated heterogeneously hyperdense lesion in right hypochondriac, right lumbar and umbilical region displacing bowel loops on either side without penetration & showing minimal enhancement on contrast study. Histological examination of entire mass confirmed the diagnosis of OMENTAL FIBROUS MYXOID HAMARTOMA. No evidence of recurrence noted during follow up period of 2 yrs.Conclusion: Fibrous hamartoma of omentum is a very rare lesion and its aggressive appearance needs to differentiate from malignancy. The clinical picture of our case also led to high suspicion of malignancy.However by consideration of histological findings we could achieve the correct diagnosis. 

Coeliac disease is an immune-mediated enteropathy caused by a permanent sensitivity to gluten in genetically susceptible individuals. It occurs in children and adolescents with gastrointestinal symptoms,dermatitis herpetiformis, dental enamel defects, osteoporosis, short stature, delayed puberty and persistent iron deficiency anaemia and in asymptomatic individuals with type 1 diabetes, Down syndrome, Turner syndrome, Williams syndrome, selective immunoglobulin (Ig)A deficiency and first degree relatives of individuals with coeliac disease. The Coeliac Disease Guideline Committee of the North American Society for Paediatric Gastroenterology, Hepatology and Nutrition has formulated a clinical practice guideline for the diagnosis and treatment of paediatric coeliac disease based on an integration of a systematic review of the medical literature combined with expert opinion.The Committee examined the indications for testing, the value of serological tests, human leukocyte antigen (HLA) typing and histopathology and the treatment and monitoring of children with coeliac disease. It is ecommended that children and adolescents with symptoms of coeliac disease or an increased risk for coeliac disease have a blood test for antibody to tissue transglutaminase (TTG), that those with an elevated TTG be referred to a paediatric gastroenterologist for an intestinal biopsy and that those with the characteristics of coeliac disease on intestinal histopathology be treated with a strict gluten-free diet (GFD).

Extra-uterine malnutrition is common in preterm very low birth weight (VLBW) newborns in spite of fortification with available human milk fortifiers. Hypothesizing that increasing the volume of feed would be safe and will lead to better postnatal weight gain we randomized 96 babies with birth weight less than 1500 gm after reaching the full feeds (i.e.150 ml/kg/day), to continue feeds at 150 ml/kg/day (standard volume) or to increase to 200 ml/kg/day (high volume) of expressed breast milk or preterm formula feed. Expressed breast milk was fortified with available fortifier. There was significantly higher daily weight gain in high volume group as compared to standard volume group. Appropriate for gestational age (AGA) babies showed significantly higher weight gain as compared to small for gestational age (SGA) babies, both in high and standard volume group. Incidence of feed intolerance did not differ significantly between two feeding groups. High volume feeds at 200 ml/kg/day was safe and resulted in better daily weight gain than standard volume feeds i.e.150 ml/kg/day in preterm very low birth weight babies  

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