Diagnostic Accuracy of Rapid Antibody Detection Test for Scrub Typhus.

OBJECTIVE: To detect the diagnostic accuracy of rapid antibody detection test using IgM immunochromatography for scrub typhus in children. METHODS: This cross-sectional study enrolled children aged 2 months-18 years hospitalized over a period of 18 months with undifferentiated fever of duration five days or more. The blood samples were subjected to serological tests like Weil-Felix, Scrub IgM ELISA, immunofluroscence assay (IFA) and rapid diagnostic test (IgM Immunochromatography). Diagnostic accuracy was measured against IFA as the gold standard. RESULTS: A total of 90 children were included in the study, among which 43 children were positive for gold standard test IFA. Rapid diagnostic test showed sensitivity of 88.3%, specificity of 89.3%, positive predictive value of 88.3% and negative predictive value of 89.3%. The sensitivity, specificity, PPV and NPV of Weil-Felix test was 39.5%, 84.2%, 58.6 and 71.1%, respectively and of IgM ELISA was 93%, 89.3%,88.8% and 93.3%, respectively. CONCLUSION: IgM immunochromatography had good diagnostic accuracy for scrub typhus in children with acute undifferentiated fever.

Effect of Neonatal Factors on the Eruption of Primary Teeth in Children: A Longitudinal Prospective Cohort Study.

Introduction: Eruption of first primary teeth is a normal physiological process. Antenatal nutritional deficiency and prenatal and neonatal factors play an important role in eruption of primary teeth. Neonatal factors, such as gestational age (GA), degree of prematurity, severity of neonatal illness, and birth weight are primarily related to eruption of primary teeth. The relation between neonatal factors and the timing of eruption of primary teeth has not been studied prospectively among Indian preterm infants. Aims: To evaluate the influence of neonatal factors on the eruption of primary teeth in children born preterm. Materials and methods: A prospective longitudinal cohort study design was adopted. A total of 150 subjects were recruited by simple random sampling. Each child was followed up from birth up to 36 months. Intraoral examination was done and the teeth present in each visit were recorded. Data were statistically analyzed and interpreted. Statistical analysis used: Descriptive statistics, t-tests for independent sample, and Pearson's chi-squared tests were applied. Tooth showing statistically significant difference in mean age of eruption between term and preterm categories was studied for the effect of maternal and neonatal characteristics on eruption using multivariate regression analysis. Results: The mandibular central incisor was the first tooth to erupt. Significant determinant of eruption of mandibular incisor in term children was found to be parity, weight for GA, and complementary feeding, whereas for preterm children, significant determinants were parity, birth weight birth length, weight for GA, and complementary feeding. Conclusion: Neonatal factors, such as birth weight, birth length, weight for GA, and introduction of complementary feeding have a strong significant association with the eruption of primary teeth. Clinical significance: The findings of this study will guide in the preventive management of oral health in preterm children. How to cite this article: Indira MD, Nandlal B, Narayanappa D, et al. Effect of Neonatal Factors on the Eruption of Primary Teeth in Children: A Longitudinal Prospective Cohort Study. Int J Clin Pediatr Dent 2023;16(2):321-326.

It is just not short stature.

Russell-Silver syndrome, also called asymmetric dwarf dysgenesis syndrome is an uncommon genetic disorder presenting with low birth weight, failure to thrive and growth retardation (short stature), developmental delay, facial dysmorphism and hemihypertrophy. The estimated incidence is between 1 case in 3,000 to 1 case in 100,000. We are hereby reporting one such case of postnatal growth retardation with facial dysmorphism and several other features of Russell-Silver syndrome and confirmed by genetic analysis.

Indian parents prefer vaccinating their daughters against HPV at older ages.

BACKGROUND: Increasing uptake of human papillomavirus (HPV) vaccine should be a priority in developing countries since they suffer 88% of the world's cervical cancer burden. In many countries studies show that age at vaccination is an important determinate of parental acceptability. This study explores parental preferences on age-to-vaccinate for adolescent school-going girls. MATERIALS AND METHODS: The sample was selected using a two-stage probability proportional to size cluster sampling methodology. Questionnaires were sent home with a random sample of 800 adolescent girls attending 12 schools in Mysore to be completed by parents. Descriptive statistics including frequencies, percentages and proportions were generated for independent variables and bivariate analyses (Chi square test) were used to assess the relationship between independent and appropriate age-to-vaccinate. RESULTS: HPV vaccination acceptability was high at 71%. While 5.3% of parents felt girls should be vaccinated by 10 years or younger; 38.3% said 11-15 years; 14.8% said 16-18 years; 5.8% suggested over 19 years; and 33% didn't know. Only 2.8% of parents would not vaccinate their daughters. CONCLUSIONS: Delaying HPV vaccination until later ages may significantly increase uptake of the HPV vaccine in India.

A Case of Ocular Torticollis.

A 1-year-and-2-month-old male baby was brought to Pediatric out patient department with head tilt to left side, chin rotated to right side with full range of neck movement, right eye hypertropia increased on left gaze, and not associated with any other musculoskeletal abnormalities. Diagnosis of ocular torticollis secondary to right superior oblique muscle palsy was made.

Mutations of TFAP2B in congenital heart disease patients in Mysore, South India.

BACKGROUND & OBJECTIVES: Cardiac malformations in the young constitute a major portion of clinically significant birth defects. Congenital heart disease (CHD) is a common congenital cardiac birth defect, affecting nearly 1 per cent of all live births. Patent ductus arteriosus (PDA) is clinically significant foetal circulation anomaly, second most common form of CHD which constitutes approximately 10 per cent of total CHDs. The study aimed to screen for TFAP2B mutations in CHD patients of Mysore. METHODS: With informed consent, 100 clinically diagnosed CHD patients and 50 healthy controls in Mysore, south India, were recruited for the analysis of screening of mutations. MassARRAY analysis of 5 prominent mutations of TFAP2B was performed. RESULTS: The analysis did not show any of the five mutations of TFAP2B screened by massARRAY in patients and controls, indicating that these mutations were not involved in the manifestation of CHD in the patients at Mysore, south India. INTERPRETATION & CONCLUSIONS: The findings suggest the lack of involvement of known mutations of TFAP2B with syndromic or nonsyndromic CHDs in Mysore patients.

GATA4 specific nonsynonymous single-nucleotide polymorphisms in congenital heart disease patients of Mysore, India.

Congenital heart disease (CHD) is the most common type of birth defect, affecting 1% of all live births. The recent exponential increase in the knowledge of medical genetics has revolutionized the understanding of CHDs during the past few decades. GATA4, a transcription factor, is involved in heart development. There are many contradictory reports on involvement of single-nucleotide polymorphisms (SNPs) of GATA4 in the manifestation of CHD. In view of this, an attempt has been made to analyze the known SNPs of GATA4 in Mysore patients with CHD. Of the 308 CHD patients recruited, 100 were screened for SNPs of GATA4 by MassARRAY, which identified 11 SNPs, of which 6 were found in both CHD cases and controls. The other 5 SNPs, c.278G>C (G93A), c.1207C>A (L403M), c.1232C>T (A411V), c.1295T>C (L432S), and c.1180C>G (P394A), were found only in CHD patients. Secondary structure analysis revealed that mutant proteins with the SNPs G93A, L403M, and L432S showed structural changes in their helix, sheet, and turn. Thus, these findings suggest the involvement of specific SNPs of GATA4 in the manifestation of CHD, reported for the first time in an Indian scenario. However, screening for a larger number of CHD patients would help us to establish genotype-phenotype correlation.

A maiden report on CRELD1 single-nucleotide polymorphism association in congenital heart disease patients of Mysore, South India.

Cardiac malformations contribute greatly to cardiovascular disease in the young, constituting a major portion of clinically significant birth defects. Congenital heart disease (CHD) is a common congenital cardiac birth defect, affecting nearly 1% of all live births. Although significant advances have been made in understanding mechanisms controlling heart formation, the causes of most CHD in humans remain undefined in the vast majority of cases. Of the several genes identified for CHD, CRELD1 is an important cell adhesion molecule crucial in cardiac development, which is known to cause atrioventricular septal defect in Down syndrome and also in sporadic forms of atrioventricular septal defect. With informed consent, 100 clinically diagnosed CHD patients and 50 healthy controls in Mysore, South India, were recruited for single-nucleotide polymorphism (SNP) genotyping. MassARRAY analysis of five prominent SNPs of CRELD1 was performed. The analysis revealed the occurrence of the SNP c.985 C>T of CRELD1 in two of CHD patients and not in controls. This SNP shows a change from arginine to cysteine in the second calcium-binding epidermal growth factor (EGF) domain, leading to change in the ß-sheet in the secondary structure. Therefore, the SNP c.985 C>T of CRELD1 is involved in causing CHD in patients of Mysore, South India.