Identification of Novel Biomarkers Using Serum and Urinary Proteomics for Early Detection of Hypoxic Ischemic Encephalopathy.

Hypoxic-ischemic encephalopathy (HIE) is a severe birth complication affecting neonates. Around 40-60% of affected neonates die by two years of age or have severe disabilities and neurodevelopmental delays. The early assessments of brain injury using traditional clinical and biochemical indicators do not always align with its severity and recovery. This delays identifying neonates who may benefit from adjuvant therapeutic strategies and monitoring therapy response. Our aim was to identify specific proteins using proteomic approach to predict the severity of neonatal asphyxia so that its outcome can also be prevented. To achieve this goal a case-control study was conducted on 38 neonates, and serum and urine samples were collected within 24 h of life. Clinical findings, biochemical parameters, and outcomes of the neonates were recorded. A tandem mass spectrometry-based quantitative proteomics approach was used to identify proteins in the serum and urine of HIE neonates. Bioinformatics analyses were performed to assess the potential features and competence of the identified differentially expressed proteins. This resulted in identification of 51 differentially expressed proteins which were found common to both serum and urine proteomic data. Some of the promising biomarkers found were APOD, ORM1, SOD1, and FABP1. These proteins were associated with the pathways like Amyloid fiber formation, diseases of programmed cell death, detoxification of reactive oxygen species, and neurodegenerative diseases. This study will pave the way for identifying the biomarkers (proteins) that can screen neonates for brain injury and monitor the disease progression, which may reduce mortality and neurodevelopmental impairment. Supplementary Information: The online version contains supplementary material available at 10.1007/s12291-023-01143-2.

Effectiveness of nutritional awareness in child diet among mothers of under five in anganwadi in Mysuru: A quasi-experimental study.

Background: Children are the most important assets to any country; their physical, mental, and emotional developments are crucial for future as they become citizens. Mothers' knowledge on nutrition for kids plays a vital role in the health of the children. Regular interventions as counseling or discussions with the mothers will be an effective tool to counter under nutrition, malnutrition, and also micronutrient deficiencies. Our objective was to assess the effectiveness of nutritional awareness in child diet among the mothers of under five in anganwadis in Mysuru with pre- and post-awareness. Materials and Methods: It is a quasi-experimental study for a duration of 3 months. The sample size was 35, with convenient sampling, and the data were collected using a semi-structured, validated questionnaire from mothers whose children are enrolled in anganwadis. The data were analyzed using mean, Chi-square/Fischer test using SPSS version 22. Results: The mean score before and after awareness was 6.26 ± 0.701, and the post score was 6.83 ± 0.618. There was a significant association between birth order of the child enrolled and the post-awareness grades. There was also a statistical significance between mean scores of pre- and post-awareness. Conclusion: We can conclude from the above study that regular and objectified communication with the mothers is an effective strategy for the improvement of their awareness regarding child nutrition.

Relationship between the cost of illness and quality of life among adolescents with type 1 diabetes-a mixed method study.

Type 1 diabetes mellitus (T1DM) is a major problem worldwide that affects the quality of life, well-being of patients and their families. This study aimed to determine the relationship between the cost of illness and quality of life among patients with T1DM. A concurrent, parallel, mixed-method study of 113 adolescents with T1DM registered in public and private hospitals in the Mysore district was conducted by obtaining data related to the cost of illness and quality of life using a validated Diabetes-Specific Quality of Life (DSQoL) questionnaire. Thematic analysis was used to identify the themes. There was a significant association amonghealth insurance status, treatment facility type, catastrophic health expenditure (CHE), and cost of illness. The CHE proportion was32.7%. Financial sources for treatment were met primarily by borrowing money with interest (58 patients, 51.3%), followed by individualincome (40 patients, 35.3%), contributions from friends and relatives (10 patients, 8.8%), and selling of assets (5 patients, 4.4%). The monthly health expenditures of approximately 22 (19.46%) households were greater than their monthly incomes. There was a positive correlation (rvalue of 0.979) between the cost of treatment and the DSQoL score, and this correlation was statistically significant, with a p value < 0.001. The higher theDSQoL score was, the worse the quality of life and the worse the well-being of T1DM patients. Three themes were identified: the impact of financial cost on family coping, the impact of financial cost on seeking care and the emotional burden of financial cost. There was a statistically significant positive correlation between the cost of treatment and the DSQoLscore. Adolescents with T1DM who had greatertreatment costs had worseDSQoL, and significantly lower health expenses were observed among adolescentswho had health insurance. Cost of illness acts as a barrier to treatment and placesa burden on patients and their families.

Usage of Cartridge Based Nucleic Acid Amplification Test (CB-NAAT/GeneXpert) test as diagnostic modality for pediatric tuberculosis; case series from Mangalore, South India.

BACKGROUND: Diagnosis of Tuberculosis in children is challenging. Hereby we report a case series of 4 patients where Cartridge Based Nucleic Acid Amplification Test (CB NAAT) helped us in early diagnosis. CASE CHARACTERISTICS: Case 1 was a 14-year old girl who was on anti-tuberculous therapy (ATT) for 2 months without any improvement; sputum CBNAAT detected multi-drug resistant tuberculosis (MDR-TB). Case 2 was a 9-year old boy with history and examination findings suggestive of meningitis; CB-NAAT of the cerebrospinal fluid (CSF) was positive. Case 3 was a 1-year old child having fever, cough of 1 month duration with Mantoux positive. CB-NAAT of gastric lavage was positive. Case 4 was a 3- month old child who presented with severe respiratory distress of 11 days duration. Chest x-ray showed miliary mottling; CB-NAAT of gastric lavage was positive. CONCLUSION: CB-NAAT testing was very useful in making an early and definitive diagnosis of tuberculosis, including MDR-TB.

Levosimendan. A promising future drug for refractory cardiac failure in children?

Intravenous positive inotropic agents play an important role in treating acute decompensation of patients with heart failure due to left ventricular systolic dysfunction. Levosimendan is a new positive inotropic agent having ATP-dependent potassium-channel opening, and calcium-sensitizing effects, which increases cardiac contractility and performance along with vasodilatatory action without increasing myocardial oxygen demand. We report a case of a 12-year-old girl with viral myocarditis, dilated cardiomyopathy, biventricular failure with severe left ventricular dysfunction, refractory to standard management, and who was successfully improved with levosimendan.

Clinical profile of dengue among children according to revised WHO classification: analysis of a 2012 outbreak from Southern India.

OBJECTIVE: To study the clinical profile of dengue fever and its outcome in children with application of revised WHO classification and to identify risk factors for severe dengue. METHODS: This study was a prospective observational study of children diagnosed with dengue from July 2012 through February 2013 at a tertiary care hospital in Bangalore, Karnataka (South India). RESULTS: Eighty one children including 55(67.9 %) boys and 26(32.1 %) girls were diagnosed with dengue. Mean age of presentation was 8 y. Vomiting (60.5 %), pain abdomen (32 %), headache (30.9 %), myalgia (23.5 %) and bleeding manifestations (16 %) were the common presenting complaints. Facial puffiness (63 %), hepatomegaly (51.9 %), ascites (48.1 %), pleural effusion (39.5 %) and petechiae (14.8 %) were noted during examination. Dengue NS1 antigen, IgM, IgG were positive in 66.7 %, 29.6 % and 18.5 % of cases respectively. Investigations showed hemoconcentration in 72.8 %, leucopenia (34.5 %), thrombocytopenia (82.7 %), abnormal liver function test (LFT) (33.3 %). USG abdomen was suggestive of dengue in 66.7 % and gall bladder edema was noted in 53.1 %. Two patients died out of the total 81 patients with mortality rate of 2.5 %. Number of cases classified as Dengue without warning signs (D), Dengue with warning signs (DW) and Severe Dengue (SD) were 48.1 %, 27.2 % and 24.7 % respectively. CONCLUSIONS: Children between 5 and 15 y were most affected by dengue fever. Pain abdomen and vomiting were most common presenting symptoms. Ascites, plerural effusion, hepatomegaly, gall bladder wall thickening and abnormal LFT were found significantly high in severe dengue cases.