Clinical Features and Adverse Prognostic Indicators in Datura Poisoning in Children.

We describe the clinical features and adverse prognostic indicators of Datura intoxication in 47 children. 15 (31.9%) children required intensive care and 1 (2.1%) died. Time elapsed >3.15 hour between ingestion and starting treatment [RR (95% CI): 9.4 (3.1-28.3)], age <9.5 year [RR (95% CI): 3.5 (1.5-8.0)], and seizure [RR (95% CI): 2.8 (1.4-5.8)] were the most important adverse prognostic features.

Drug Repurposing: Hydroxyurea Therapy Improves the Transfusion-Free Interval in HbE/Beta-Thalassemia-Major Patients with the XmnI Polymorphism.

Aims: HbE/ß-thalassemia is the most prevalent form of severe ß-thalassemia in Asian countries. Hydroxyurea (HU) is the most common drug used for the management of sickle-cell anemia but not thalassemia. In this study, we aimed to assess clinical HU response among the Bengali HbE/ß-thalassemia patients with respect to the XmnI γGglobin polymorphism and elucidate the association between this polymorphism and HU response efficacy. Materials and Methods: We enrolled 49 transfusion-dependent patients with HbE/ß-thalassemia. Fetal hemoglobin levels were measured using high-performance liquid chromatography and complete blood counts were determined pre- and post-HU therapy. Polymerase chain reaction-restriction fragment length polymorphism analyses were performed for genotyping the XmnI γGglobin polymorphism. Results: A total of 30 (61.22%) patients were found to be responders, whereas the remaining 19 (38.78%) were nonresponders. We found 33 patients with the heterozygous (C/T) and three with the homozygous mutant (T/T) genotype status. We obtained a statistically significant correlation (p < 0.001) between the XmnI polymorphism genotype and transfusion-free interval. Patients with the XmnI polymorphism were found to be good responders for HU therapy and showed increased hemoglobin levels. Conclusions: Our findings indicate that HU is a potential drug candidate for thalassemia management, particularly for HbE/ß-thalassemia. These results hold implications in repurposing HU as an effective and efficient therapy for HbE/ß-thalassemia.

Predictors of Renal Complications in Children With Hematotoxic Snakebite.

OBJECTIVE: To study the predictors of renal complications following hematotoxic snakebite in children. METHODS: This comparative study was conducted in the pediatric ward of a tertiary-care centre among 364 consecutively children admitted with hematotoxic snakebite between January 2016 and December 2017. Clinical and laboratory indicators were compared between children who developed acute kidney injury and those who did not. RESULTS: Acute kidney injury was seen in 139 children (38.2%), majority being stage 2 (55, 39.5%). 59 children (16.2%) developed permanent renal damage and 16 (4.4%) died due to envenomation. Acute tubular necrosis was the most common (25, 39.1%) histopathological change. CONCLUSIONS: Receiving anti-snake venom more than one hour after bite was the most significant adverse prognostic indicator, both for renal complications and mortality.

A study on the prevalence and correlates of nicotine dependence among adolescents of Burdwan Town, West Bengal.

CONTEXT: Tobacco will cause one billion deaths in the 21st century. The use of tobacco causes dependence both psychological and physical. AIMS: To find out the level of nicotine dependence and it correlates among adolescents. SETTINGS AND DESIGN: A community-based, cross-sectional, observational study was conducted in the Burdwan town, West Bengal, among 1354 adolescent tobacco users. MATERIALS AND METHODS: Data were collected by direct interview using a pretested, predesigned, semistructured schedule containing the Fagerström Test for Nicotine Dependence (FTND) questionnaire. STATISTICAL ANALYSIS: Pearson's Chi-square test, Student's unpaired t-test, one-way analysis of variance, Pearson's product-moment correlation coefficient, and multivariable linear regression were used. All the statistical analyses were performed using SPSS version 19.0. RESULTS: The mean FTND score was significantly higher among adolescents aged >15 years, males, Hindu, tobacco users from joint family, who belonged to lower socioeconomic status, who started using tobacco at the age of 10-12 years, using tobacco for ≥5 years, who were not married, were illiterate, working, and not aware of the injurious effect of tobacco to health. CONCLUSIONS: A suitable individualized approach should be used for those who want to quit tobacco depending on their FTND score.

A study on association of iron deficiency with attention deficit hyperactivity disorder in a tertiary care center.

BACKGROUND: Iron is important for brain development and cognitive function. Iron deficiency may cause alteration of neurotransmitters and may be manifested by different central nervous system disorders including attention deficit hyperactivity disorder (ADHD). AIMS: As studies are scarce in the Indian context, we had undertaken this study to find out the association between iron deficiency and ADHD. SETTINGS AND DESIGN: Hospital-based cross-sectional study. MATERIALS AND METHODS: Hematological parameters indicating iron status (hemoglobin [Hb], ferritin, Iron, total iron binding capacity [TIBC], mean corpuscular volume [MCV], and mean corpuscular Hb [MCH]) were measured among 119 ADHD patients selected by complete enumeration method and 119 controls. STATISTICAL ANALYSIS: Shapiro-Wilk test, Mann-Whitney U-test, Spearman's correlation, and binary logistic regression were used. P < 0.01 was taken as statistically significant. RESULTS: Hb, iron, ferritin, MCV, and MCH were lower among cases and negatively correlated to ADHD, while reverse is true for TIBC and ADHD. Iron deficiency anemia makes one 3.82 times more prone for ADHD. CONCLUSION: Iron deficiency was associated with ADHD.

Cardiofaciocutaneous Syndrome: Case Report of a Rare Disorder.

Cardiofaciocutaneous syndrome or CFC syndrome is a rare genetic disorder first described in 1986. It is one of the RASopathies involving multiple organs particularly the heart, skin and face affecting males and females equally. The phenotypic features overlap with 2 other conditions, the Noonan and Costello syndrome. We report on a 22-month-old boy with CFC syndrome presenting with typical craniofacial appearance, heart defects, ectodermal abnormalities, growth failure and developmental delay. Estimated population of affected individuals worldwide is a few hundreds.

Neonatal Brain Abscess due to Extended-Spectrum Beta-Lactamase Producing Klebsiella pneumoniae.

Klebsiella pneumoniae (K. pneumoniae) causing brain abscess in newborn infants is rare. Presented herein, is a 27-day-old male neonate who developed two frontal lobe abscesses in association with K. pneumoniae sepsis and meningitis. Antibiotic susceptibility testing utilizing the double-disk synergy method (Cefotaxime and Amoxycillin-Clavulanate) confirmed the extended spectrum beta-lactamase (ESBL) production by the isolate. He was treated simultaneously with antibiotics (Meropenem and Amikacin) and abscess aspiration through the anterior fontanelle, with less than satisfactory outcome. ESBL producing K. pneumoniae brain abscess in neonates is extremely rare in the English literature. Emperical carbapenems and aminoglycoside coverage in neonates with K. pneumoniae sepsis and brain abscess, especially in areas with high rate of ESBL producing bacteria may be warranted.

Lissencephaly--not an uncommon cause of intractable seizure in children: report of 3 cases.

Lissencephaly or azyria, a rare disorder characterised by the absence of cerebral convolutions and poorly formed sylvlan fissures giving the appearance of a foetal brain with smooth cerebral surface, thickened cortical mantle and microscopic appearance ofincomplete neuronal migration. It is to consider lissencephaly in the diagnosis of developmental delay with seizure disorder as many patients may be diagnosed as cerebral palsy. Several lissencephaly syndrome have been described, Here three cases of lissencephaly with developmental delay and Intractable seizures are reported.

Congenital lobar emphysema: a case report.

Congenital lobar emphysema is a rare variety of congenital malformation of lung characterized by over distension of a lobe of a lung due to partial obstruction of the bronchus. We are reporting a neonate admitted in the pediatric emergency ward with the respiratory distress since 16th day of life.Investigation revealed the overexpansion of the left upper lobe with mediastinal herniation, shifting of the mediastinum to the opposite side and collapse of the ipsilateral lower lobe. The baby was treated with conservative treatment and the condition of the baby was improved.

Autism and mental retardation with convulsion in tuberous sclerosis: a case report.

A 6-year-old male child born of a non-consanguineous marriage admitted in the pediatrics emergency ward with the history of recurrent attacks of convulsion since 4 month of age. He was also suffering from frequent vomiting. Examination revealed that the child had characteristics features of angiofibromas on the face with butterfly distribution, hyperpigmented patches on forehead, hypopigmented macules on trunk, prominent subependymal and cortical tubers. The child was diagnosed as tuberous sclerosis. Association of autistic behaviors and severe degree of mental retardation are noteworthy in this child indicating the need of counseling as early as possible along with behavioral and educational strategies for mental retardation from early age with other symptomatic management.