Pediatric Education and Research

Takayasu arteritis is an inflammatory disease of large  and medium-sized arteries, with a predilection for the aorta and its branches. Advanced lesions demonstrate a panarteritis with intimal proliferation.Lesions produced by the inflammatory process can be stenotic, occlusive, or aneurysmal. All aneurysmal lesions may have areas of arterial narrowing. Patients with aortitis syndrome exhibit various ocular changes.Cataract has seldom described as the initial manifestation of Takayasu arteritis. Here we are presenting  case of 14 year old female patient with arteritis which developed bilateral immature cataract before the initiation of steroid treatment.

Background: The magnitude of overweight and obesity has been on the increasing trend among Indian children that range to 9 to 27.5% and 1 to 12.9% respectively. Enhanced obesity in adolescents induces morbidities like hypertension, respiratory dieses, diabetes mellitus, orthopedic disorders, heart diseases and cardiovascular risks and elevated serum lipid concentrations especially of VLDL and high LDL-C. Objective: The study focused on cardiovascular disease risk factors to determine the prevalence of cardiovascular disease risk factors (pre-hypertension/hypertension, borderline-high/high LDL-C, low HDL-C, and pre-diabetes/diabetes) by weight status (normal weight, overweight, obese) and their trends among Indian adolescents aged between 12-19 yrs. Methodology: A school based cross sectional study was carried out in Raichur involving 200 students. Study subjects were selected by systemic random sampling method. With the help of preselected pro forma data regarding our study parameters were collected. The study was undertaken in the month of July and August. After getting detailed information and consent by the guardians of students, the blood sample was collected and sent to biochemistry department for analysis of lipid profile. Results: Out of 200 subjects, 24% each were from 12 to 13 and 14 to 15 years age group and 26% each from 16 to 17 and 18 to 19 years age group. Majority i.e. 56% was males and 44% were females. Distribution of study population according to BMI where 78% were normal, 10% were obese and 12% were overweight. Prevalence of hypertension was observed in 6% population where almost 11.5 % were from 18-19 years age group. Prevalence of diastolic hypertension was 2.5% and seen in males (3.6%). Diastolic hypertension seen in 2.5% and majority i.e. 3.8% were from 18-19 yrs age group. High level of triglycerides was observed in 2% of subjects which belongs from 18-19 yrs age. Comparison between male and female with respect to various study parameters revealed that mean age & mean LDL difference was observed statistically significant (<0.05) whereas in other variables the mean difference was not proved to be significant (>0.05). Conclusion: With this study we would like to place a take home message that the overweight and obesity is highly prevalent among adolescents. Among the overweight and obese it found that in few dyslipidemia and hypertension has already set in. hence we would suggest the late adolescents is the best time identify the adolescents with obesity and other risk factors and to adopt necessary life style modifications.

Background: The mercury sphygmomanometer has been the gold standard used for obtaining blood pressure (BP). However, due to environmental concerns and more use of automated BP devices, an alternative to using the standard mercury sphygmomanometer to measure BP. Aim: The aim of this study is to determine the reliability of Automatic Blood Pressure Monitor (ABPM) for measuring the blood pressure in children. Methods: One thousand children were enrolled in this study. Those who were critically ill and those who did not give consent were excluded .The accuracy of Omron HEM–7121 BP readings was compared with that of mercury BP device readings. All children rested for 5 min prior to the first BP reading. Each children had four BP measurements recorded sequentially i.e. two valid systolic readings, and two valid diastolic readings by both methods. Results: BP taken with the automated (OMRAN) device was systolic 104.71±6.75 and diastolic was 67.90±6.89. Compared to systolic 107.82±7.49, and mean diastolic of 69.61±7.21 measured by manual mercury sphygmomanometer BP readings (P < 0.001). The comparison of the manual versus the automated readings showed a high coefficient of correlation (r2) for systolic BP (r2 =0.86) and diastolic BP (r2 = 0.89) readings. Comparison of mean differences between automated and manual measures showed the automated machine consistently under-read both systolic and diastolic blood pressures. Linear regression analysis showed that the automated systolic BP and is a significant predictor (b = 0.864P < 0.001) of manual systolic BP. Similarly, automated diastolic BP was also a significant predictor (b = 0.806, P < 0.001) of manual diastolic BP. Conclusions: This study concludes that the automated blood pressure device is reliable and accurate for measuring the BP in children. So, conventional manual BP readings can be replaced by readings taken using a validated, automated BP recorder in population surveys.