Understanding the Perspectives of Paediatric Physicians on Physiotherapy in Paediatric Rehabilitation in Chennai, India: A Qualitative Approach.

OBJECTIVES: Children with disabilities may exhibit a multitude of symptoms, and treatment requires a multidisciplinary approach for a satisfactory outcome. Lack of awareness among physicians, lack of referral, and lack of inter-sectoral coordination have hindered paediatric practice in Tamil Nadu, a state in India with a striking childhood disability rate that warrants a timely interdisciplinary approach. However, the perspectives of paediatricians on paediatric physiotherapy are unknown. The aim of the study was to investigate the perspectives of practicing paediatric physicians in Chennai on the role of physiotherapy in paediatrics. METHODS: For an in-depth exploration, qualitative semi-structured interviews were conducted in person with 10 paediatricians. Audio from the sessions was recorded and transcribed, and data saturation was achieved through iterative analysis. RESULTS: A grounded theory analysis of the results yielded 5 domains under which the perspectives and expectations of the physicians were described, along with the barriers experienced by patients' parents as explained by their paediatrician. The responses highlighted deficits in awareness, structural support, accessibility and direct communication between physicians and physiotherapists. CONCLUSIONS: Paediatric physicians have different opinions, and some ignorance persists concerning paediatric physiotherapy. This study warrants a proper structure of the paediatric rehabilitation unit and regular interdisciplinary meetings and focus group discussions to increase access for parents and improve patient outcomes.

Lipemic Serum in a Child With New-Onset Type 1 Diabetes Mellitus Presenting With Diabetic Ketoacidosis: A Case Report.

Diabetic ketoacidosis (DKA) was observed in a 12-year-old female child recently diagnosed with type 1 diabetes mellitus. A rise in triglyceride (TG) levels accompanied this. High TG levels were suspected due to the lipemic appearance of the serum. Acute pancreatitis and lipemia retinalis are potential complications for hypertriglyceridemia patients. Treating the DKA and insulin deficiency reverted the TG levels to normal without using lipid-lowering agents.

Effect of Light-Emitting Diode Phototherapy on Serum Calcium Levels in Neonates With Jaundice.

BACKGROUND: To assess the change in serum total calcium levels during light-emitting diode phototherapy treatment for jaundice in term neonates. METHODS: A prospective observational study was done on 104 term neonates with hyperbilirubinemia in a tertiary care center to investigate the effects of phototherapy using a light-emitting diode device. The total serum bilirubin along with total calcium levels was measured at the start and at the end of phototherapy. Additionally, all the newborns enrolled in the study were evaluated for hypocalcaemia-related symptoms such as jitteriness, irritability/excitability, lethargy, and convulsions. RESULTS: A significant lowering of posttreatment total calcium level compared to that of pretreatment level (p<0.001) was found in our study. Hypocalcemia (serum calcium <8 mg/dL in term neonates) was found in 12.5% of the study subjects. CONCLUSIONS: In the treatment of neonatal jaundice, similar to conventional blue and white light phototherapy, light-emitting diode phototherapy also has hypocalcemia as an adverse effect. We recommend monitoring these babies for hypocalcemia during light-emitting diode phototherapy.