Fall in Vitamin D Levels during Hospitalization in Children

Plasma levels of 25-hydroxyvitamin D [25(OH)D] were measured by competitive Electrochemiluminescence Immunoassay (ECLIA) in 92 children (67 boys, 25 girls) aged 3 months to 12 years at admission to hospital (timepoint 1, T1) and at discharge (timepoint 2, T2). There was a significant fall in the mean 25(OH)D from T1 (71.87 ± 27.25 nmol/L) to T2 (49.03 ± 22.25 nmol/L) (mean change = 22.84 nmol/L, P value = 0.0004). Proportion of patients having VDD (levels <50 nmol/L) at admission (25%, 23/92) increased significantly at the time of discharge (51.09%, 47/92) (P=0.0004). There was a trend towards longer duration of hospital stay, requirement of ventilation and inotropes, development of healthcare-associated infection, and mortality in vitamin D deficient as compared to nondeficient patients though the difference was statistically insignificant. In conclusion, vitamin D levels fall significantly and should be monitored during hospital stay in children. Large clinical studies are needed to prospectively evaluate the effect of vitamin D supplementation in vitamin D deficient hospitalized children on various disease outcome parameters

Evaluation of cartridge-based nucleic acid amplification test for diagnosis of tuberculosis in children in various body fluids

Introduction: The paucibacillary nature presents a major challenge in the diagnosis of tuberculosis (TB) in children. The utilization of cartridge-based nucleic acid amplification test (CBNAAT) for the diagnosis of TB presents itself with added advantages such as detection to resistance to rifampicin and short turnaround time. Objectives: The aim of the study is to evaluate the diagnostic yield of CBNAAT in various body fluids and to compare with BACTEC-MGIT 960 and acid-fast bacilli (AFB) microscopy in children with suspected TB and to see the prevalence of rifampicin resistance in the study population using CBNAAT. Materials and Methods: This cross-sectional study included participants &lt;14 years with suspected TB. Gastric aspirate samples obtained from pulmonary TB cases and body fluid specimens obtained from extrapulmonary TB cases were processed for the detection of Mycobacterium tuberculosis (MTB) using CBNAAT, BACTEC-MGIT 960, and AFB microscopy. The results obtained using CBNAAT were compared to other laboratory tests using an appropriate statistical method. Results: Fifty patients diagnosed with TB (34 pulmonary, 10 pleural effusion, and 6 abdominal) were included in the study, and clinical fluid specimens obtained from study participants were processed for the detection of MTB. Out of 34 gastric aspirate samples, 28 (82%) were positive by CBNAAT which was statistically higher than BACTEC-MGIT 960 (P &lt; 0.05). Among extrapulmonary TB cases, only 2 pleural fluid specimens were positive by CBNAAT, whereas BACTEC-MGIT 960 and AFB microscopy could not detect MTB. Out of 34, 4 (11.76%) patients with newly diagnosed pulmonary TB were found to be rifampicin resistant using CBNAAT. Conclusions: CBNAAT showed promising results as a diagnostic tool in detecting MTB and rifampicin resistance in pulmonary TB using gastric aspirate. It, however, did not show good results in children with extrapulmonary TB in the clinical fluid specimen. The present study also showed the presence of high rifampicin resistance in treatment naïve pulmonary TB patients

Episodes of prolonged “trance-like state” in an infant with hypothalamic hamartoma

Hypothalamic hamartoma (HH) is one of the most common causes of central precocious puberty (CPP) in first few years of life. It can present with either seizures or CPP, although both manifestations coexist in the majority of the children. Gelastic seizures (GS), or laughing spells, are usually the first type of seizures seen in patients with HH. Although a wide variety of seizure types are known to occur in children with HH, GS are most common and consistent seizure type. The clinical presentation of HH may vary with the size and position of the mass, although large tumours typically present with both CPP and seizures. Although CPP can be managed with medical therapy, seizures can be very difficult to treat, even with multiple antiepileptic drugs. Noninvasive gamma knife surgery has been used with some success for the treatment of refractory epilepsy. We present a case of HH with very early onset seizures and CPP. The patient had an atypical form of seizures described by the parents as a "trance-like state" in which the patient had prolonged episodes of unresponsiveness lasting for hours with normal feedings during the episodes. GS occurred late in the course and were refractory to various combinations of antiepileptic drugs. A brain magnetic resonance imaging showed a large sessile HH (>20 mm). Later in the course of the disease, the patient experienced cognitive and behavioural problems. The patient underwent gamma knife surgery at nearly 5 years of age and experienced a modest response in seizure frequency. This case highlights the presentation of HH as a previously unreported seizure morphology described as a prolonged "trance-like state.

Feasibility and acceptability of professional continuous glucose monitoring system in children with Type 1 diabetes mellitus: An observational study

Context: Professional continuous glucose monitoring (P-CGM) has been approved for use in adults and adolescents with type 1 diabetes mellitus (T1DM). There is dearth of data on its use and feasibility in children 70% was seen in 31 (73.8%) children. Common adverse events were local redness in 11 (26.2%), local irritation in 16 (38.1%) and parental anxiety in 12 (28.5%) children. Conclusions: There were no significant adverse effects noticed with Professional CGM (using iPro™2) and is feasible and acceptable to children (2–10 years) with T1DM as well as their caregivers

Utilization of Terminalia chebula Retz. fruits pericarp as a source of natural dye for textile applications

Terminalia chebula Retz. (Hindi-Harra), Family-Combretaceae, Trade name-Myrobalan, fruits pericarp powder was taken for the utilization as a dye. The dried fruits constitute one of the most important vegetable tanning materials and have been used in India for a long time. This paper describes the isolation of dye from its fruit pericarp (36.24 %) which can impart fast shades on silk, wool and cotton using alum, copper sulphate, ferrous sulphate, potassium dichromate and stannous chloride as mordants with varying degree of colorfastness to washing (4-5), light (4-5), crocking (4-5) and perspiration (4-5). The fruit pericarp may thus find its use for the isolation of dye and is an excellent value addition of the available raw material

<span style="font-size:11.0pt;mso-bidi-font-size: 10.0pt;font-family:"Times New Roman","serif";mso-fareast-font-family:"Times New Roman"; mso-ansi-language:EN-GB;mso-fareast-language:EN-US;mso-bidi-language:AR-SA" lang="EN-GB">Utilization of <i style="mso-bidi-font-style:normal">Terminalia chebula </i>Retz. fruits pericarp as a source of natural dye for textile applications</span>

114-121<span style="font-size:11.0pt; mso-bidi-font-size:10.0pt;font-family:" times="" new="" roman","serif";mso-fareast-font-family:="" "times="" roman";mso-ansi-language:en-gb;mso-fareast-language:en-us;="" mso-bidi-language:ar-sa"="" lang="EN-GB">Terminalia chebula Retz. (Hindi-Harra), Family-Combretaceae, Trade name-Myrobalan, fruits pericarp powder was taken for the utilization as a dye. The dried fruits constitute one of the most important vegetable tanning materials and have been used in India for a long time. This paper describes the isolation of dye from its fruit pericarp (36.24 %) which can impart fast shades on silk, wool and cotton using alum, copper sulphate, ferrous sulphate, potassium dichromate and stannous chloride as mordants with varying degree of colorfastness to washing (4-5), light (4-5), crocking (4-5) and perspiration (4-5). The fruit pericarp may thus find its use for the isolation of dye and is an excellent value addition of the available raw material.</span