Pediatric Education and Research

The thymus is a T-cell producing lymphoid organ in the anterior mediastinum that plays a role in the development of the immune system, particular the maturation of T-cells. It typically has a retrosternal location and hence can mimic retrosternal pathology. In Infants presenting with repeated respiratory tract infection, after ruling out other system involvement, Higher imaging techniques must be utilized to differentiate physiological from pathological lesions so as to clinch diagnosis and implement relevant intervention. This rare case in a 7-month infant shows how a left upper zone persistent shadow, a rare X-ray findings of left thymus is misdiagnosed as persistent pneumonia or pulmonary sequestration and how imaging helps in avoiding unnecessary treatment.

Keywords: T-cell; Lesions; Immune system; Pneumonia.

With the use of non invasive nasal devices to augment ventilation in neonates complications of parotitis or arthritis may occur. If bacterial than it should be considered as nosocomial or HAI hospital acquired infection. A 16-day male neonate was admitted with swelling on right side of face and excessive crying for 2 days, and restricted movement of right shoulder. Pus came out from parotid duct opening and grew staph Methicillinresistant Staphylococcus aureus (MRSA) sensitive to vancomycin; he also needed surgical drainage of swelling. Stringent and monitored aseptic precautions and oral toilet will prevent such cases.

Keywords: Neonatal; Parotitis; Shoulder arthritis; Nasal prong; Orogastric tube; Sialadenitis.

Introduction: Correlation of Single breath count (SBC) with Peak expiratory flow rate (PEFR) in pediatric age group is not a widely studied topic. SBC can be a reliable potential alternative to PEFR, the latter being effort dependent and thus difficult to measure in the said age group. One minute count (OMC) is a new concept that has been used in the study at our institute. OMC is the maximum number count in 1 minute by the subject and it can be an effective alternative in children who can't count rapidly and efficiently in a single breath. Aims and objectives: To study correlation of Peak expiratory flow rate (PEFR) with Single breath count (SBC) and One minute count (OMC) in healthy asymptomatic children of third and fourth standards from a school in Mumbai. Materials and Method: PEFR readings were obtained using a Peak flowmeter, while SBC and OMC were done manually. Subjects were first given a demonstration using a Peak flow meter and the readings were then recorded by trained personnel. For SBC and OMC readings, the subjects were shown a video demonstrating the procedure and then readings were taken. Best of 3 readings was considered for all 3 parameters. Correlation of PEFR with SBC and OMC was done with help of Pearson's correlation coefficient. Linear regression analysis of the data was also done. Results: Mean age of the study group was 8 years. Mean height was 1.18 meters. Boys were 50.9 of the total. SBC was easy to perform. By Pearson's correlation, all 3 parameters were strongly correlated, with p – value at 0.01. On linear regression, all 3 tests had co-linear outcome. They are comparable. The drawback of the study was, it was subject dependent; depending on how rapidly and efficiently the child can count. A video demonstration of the proper procedure helped us overcome the problem. Conclusion: SBC can be an equally effective screening tool for pediatric respiratory functions in healthy children; as reliable as Peak flowmetry. OMC can be an effective alternative in cases where SBC can't be performed. Further studies in asthmatic children are warranted to learn its implications in disease state.

Keywords: PEFR; SBC; One minute count; Asthma manuscript.

Background: Postoperative sore throat is common after general anesthesia. The incidence in pediatric anesthesia is variable, and the etiology unclear. Establishing risk factors would enable prevention and could improve quality of care. Aims: We performed a prospective single center cohort study aiming to establish the incidence of postoperative sore throat in children undergoing GA with an endotracheal tube (ETT) or laryngeal mask airway (LMA). Secondary aims were to identify independent risk factors for sore throat and the incidence of other postoperative complications including stridor, laryngospasm, nausea and vomiting. Methods: Between November 2018 and April 2019, perioperative data were collected from children aged 5–16 years undergoing general plastic, urology, renal and orthopedic surgery. Patients completed all postoperative questionnaire within 24 hours of surgery. Results: We screened 256 children for inclusion at a tertiary pediatric hospital in the United Kingdom. One hundred and ninety-seven patients were included in the final analysis. The frequency of postoperative sore throat was 35.8%. Stridor occurred in 1.7%, laryngospasm 1% postoperative vomiting in 4.0%. Nausea, vomiting, thirst and pain were associated with a sore throat. Over 50% of children with an endotracheal tube cuff pressure <20 cm H 2O had a postoperative sore throat.

Keywords: Incidence; Sore Throat; Endotracheal Tube; Laryngeal Mask Airway

Introduction: Accidental bleach ingestion is frequent in children. The cause and types of this accidental ingestion vary in different parts of the world depending upon the factors such as demography, socioeconomic status, education, local belief and customs. Objectives: Retrospective analysis of sociodemographic profile and outcome of cases of bleaching powder poisoning in children. Material and methods: It was a retrospective study. All children admitted to pediatric ward of SBHGMC, Dhule with history of ingestion of bleaching powder between January 2013 and June 2018 was analyzed. Result: Forty-one children were admitted with bleaching powder poisoning. Male preponderance (61%) was noted. Most of the patients from 2 to 4 years group. Muslim's children were 96% and all were from lower socioeconomic group. Conclusion: Toddlers are more vulnerable to accidental bleaching powder poisoning mainly because of ignorance on the part of parents to use and handle it properly for their work, easy accessibility for the kids playing around. No serious complication like esophageal burn or death occurred in this series of study.

Keywords: Bleaching power; Children 2 to 4 years.’ Lower socioeconomic.

Background: Breastfeeding is one of the important aspects of a woman’s life. Asymmetry/small size of the breast(s) has important psychological consequences on the mother about her capacity of milk production and ability to breastfeed her baby. Objectives: To find out the size of the breasts among lactating Indian women in the first postpartum week. Method: The study was conducted over 6 months in tertiary care hospital in Delhi involving 451 consecutive consenting mothers (18–40 years) within the first postpartum week. The breast and nipple size were estimated by anthropometry (Capraro and Dewhurst technique). Results: Mean breast unit was 565.22 cm2 and mean areolar unit was 43.18 ± 21.88 cm2. Mean breast unit and mean areolar units were similar on both sides. These were neither significantly different among various maternal age groups nor according to parity. Both breast and areolar units did not differ significantly with frequency of breastfeeding. The mean nipple length had significant positive correlation with the parity but there was no significant difference between the length of the right and left nipple. Conclusion: The size of right and left sides of breasts (as estimated by measurement of Breast Unit) was not significantly different in mothers of different ages, parity and frequency of breastfeeding in the first postpartum week. However, nipple length was found to be longer in multiparous breastfeeding mothers. The mothers having lowest range of ‘Breast Unit’ 255 cm2 also reported normal lactation output, a very encouraging finding implying that mothers with small breasts are also capable of producing enough milk for their infants.

Keywords: Breast; Breast size; Lactation; Breastfeeding counseling.