Disordered eating behaviors, body dissatisfaction and their determinants in Indian adolescents: A cross-sectional observational study.

Objective: Although the prevalence of disordered eating is maximum in high-income countries, the most significant rise occurred in East Asia and South Asia over the last three decades. Body dissatisfaction and disordered eating behaviors (DEBs) are more common than full-blown eating disorders. The cognitive distortion leading to these manifestations mainly occurs during adolescence and early adulthood. In this study, we assess the burden of DEBs in a cohort of Indian adolescents and determine their correlation with body dissatisfaction, calorie intake, and clinicosocial determinants. Methods: The study was conducted from November 2016 to November 2020 and enrolled 180 adolescents of 10-18 years attending the outpatient department of a tertiary-care hospital. Subjects were screened for DEBs, using a 15-item Screening Questionnaire for Eating Distress Syndromes, and for body dissatisfaction, using Photographic-Figure-Rating-Scale. Clinicosocial interviews, dietary and anthropometric evaluation, and psychiatric screening using a Mini-International Neuropsychiatric Interview (MINI-KIDS screen) were conducted. Results: DEB was present in 17.2% of adolescents, while 81.1% had body dissatisfaction and 32.2% had some psychiatric symptoms. The prevalence of DEBs in females was much higher than in males (OR = 7.89, 95%CI: 2.25-27.75, P = 0.001). More males (84.1%) reported body dissatisfaction than females (76.7%) [χ² =9.2, P = 0.010]. However, while females wished to lose weight, males desired weight gain, as measured by body dissatisfaction score (t = 2.9, P = 0.004). Apart from sex, other factors found significant in predicting DEBs in multivariate analysis were education, body dissatisfaction, BMI, and the number of siblings. Conclusion: We conclude that, unlike overt eating disorders, DEBs are common in Indian adolescents. The development of DEBs is influenced by gender, education, body dissatisfaction, BMI, and the number of siblings.

The 5th Edition of the World Health Organization (WHO) Classification of Hematolymphoid Tumors: What's New in Pediatrics?

The World Health Organization (WHO) has revised the classification of hematolymphoid tumors (WHO-HAEM5) in August 2022 to incorporate certain recent changes in understanding of disease biology. This article highlights the important changes, with particular reference to those most relevant to children.

Efficacy and safety of vemurafenib in Langerhans cell histiocytosis (LCH): A systematic review and meta-analysis.

Almost half of the patients with Langerhans cell histiocytosis (LCH) are refractory to primary induction chemotherapy or undergo reactivation. The ideal treatment modality for refractory/relapsed LCH is yet not evidenced. This review aimed to determine the efficacy and safety of vemurafenib (a BRAF pathway inhibitor) in LCH, particularly the refractory/relapsed cases. The literature search was conducted using PubMed, Embase, CENTRAL, and abstracts published in the SIOP meetings. Studies that described the outcome of patients of LCH being treated with vemurafenib, alone or in combination, were included. A total of 416 studies were screened, and after applying exclusion criteria, 22 studies (n = 107) were included in the final analysis. The first-line therapy was prednisolone plus vinblastine for most patients (n = 92, 86%), and vemurafenib was started upfront in 3 patients (3%). The median time to first clinical response with vemurafenib was one week. The median time to best response was 5.25 months. Out of 107 patients, 62 patients (58%) had ultimately no active disease (NAD) while 39 (36%) had active disease better (ADB), making the overall response rate (ORR) of 101/107, ie, 94.4% (CI 0.88; 0.98). The main adverse effects of vemurafenib were rash or photosensitivity (47%) and other cutaneous adverse events (15%). Vemurafenib is highly efficacious and safe in the treatment of refractory LCH; however, the timing of its commencement and duration of therapy is yet to be established. Larger prospective collaborative trials are needed to answer the appropriate treatment duration and effective maintenance therapy approach.

Autoimmune Encephalitis as a Rare Paraneoplastic Syndrome in Adrenocortical Carcinoma.

Paraneoplastic neurologic syndromes (PNSs) are rare in pediatrics and are understood to be consequences of cross-reactivity against various neuroendocrine antigens expressed on cancer cells. Here, we report a case of autoimmune encephalitis, a type of PNS associated with a case of adrenocortical carcinoma (ACC), that had a clinical response to immunosuppressive therapy. ACC is a rare tumor with controversial tissue of origin but expresses various neuroendocrine antigens that could be the possible mechanism for this rare yet interesting association.