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Screening newborns is recognized as an important health policy. It is cost-effective and is implemented as a national health program in most developed countries. Though births in developing countries contribute to more than half of the total births globally, newborn screening (NBS) is not yet implemented in most developing countries. If not diagnosed and treated timely, some of these infants will contribute to neonatal mortality. In contrast, others will have long-term sequelae like developmental delay, learning disabilities, behavioral abnormalities, and backward academic performance in the future. In addition, the diagnosis, management, and treatment of these conditions also carry a significant financial as well as emotional burden on the family. An NBS program can be the most rational and effective way to prevent such morbidities and mortalities. NBS in developing countries competes with other health issues such as the control of infectious diseases, vaccinations, and poor nutrition. Also, lack of government support, poor economy, inadequate public health education, lack of awareness among health care workers, early discharge from hospital, and many births out of hospital are the significant obstacles in the countries that lack total coverage. It is high time now to change our attitude; our focus should be not only on the reduction of mortality and infectious morbidity but also on reducing disabilities with the introduction of screening for newborns. Integrating NBS with the national healthcare system is crucial for successful implementation in developing countries. Integration should also include a payment scheme to reduce the economic burden on families. In recent years, many developing countries have started implementing pilot projects as a step toward the national program of screening newborns.

Autism spectrum disorder (ASD) is a complex neurodevelopmental condition characterized by deficits in social interaction, communication difficulties, and repetitive behaviors that profoundly impact the lives of affected individuals and their families. This article provides a comprehensive overview of ASD, focusing on screening, diagnosis, and intervention strategies. Early signs of ASD can manifest in infancy, but parents may not recognize them until their child falls behind in meeting social milestones. This delay in recognition is often due to a lack of awareness, societal stigma, and limited knowledge about developmental and behavioral disorders. Globally, ASD prevalence is increasing potentially due to broader diagnostic criteria, increased awareness, and improved screening practices. Screening for ASD is crucial for early identification and intervention. Various tools are available such as the Modified Checklist for Autism in Toddlers (M-CHATs), Trivandrum Autism Behavioral Checklist (TABC), and the Social Communication Questionnaire (SCQ). Diagnosing ASD involves using established criteria such as the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), and specific diagnostic tools like the Autism Diagnostic Observation Schedule (ADOS) and the Indian Scale for the Assessment of Autism (ISAA). Interventions for ASD should be multidisciplinary, involving professionals such as developmental pediatricians, psychologists, psychiatrists, special educators, occupational therapists, physiotherapists, speech therapists, and social workers. Applied behavior analysis (ABA), naturalistic developmental behavioral interventions (NDBIs), and parent-mediated treatment are among the evidence-based approaches. Additionally, speech-language therapy, motor therapy, and sensory integration therapy play vital roles in addressing the diverse needs of individuals with ASD. Medical interventions should be used alongside behavioral and environmental strategies. Early screening, accurate diagnosis, and tailored interventions are essential for improving the lives of individuals with ASD. A multidisciplinary approach and increased awareness are crucial in addressing the growing prevalence of ASD worldwide.

Stevens-Johnson syndrome (SJS) is a dreaded hypersensitivity reaction and a rare immune disorder. We present a Stevens-Johnson syndrome induced by herbal kadha, which may be the first case. A ten-year-old boy presented with massive sloughing, redness, oedematous skin, an oral ulcer, and an inability to feed or drink for two days. The present symptoms started after 12 hours of consuming herbal Kadha, given by a private practitioner in clinics where he was treated for fever. After not responding to earlier treatment, the patient was referred to the present Institute. The patient had a history of seizure disorder and had been on tablet phenytoin for seven months with no history of adverse reactions to it. He was treated in the intensive care unit. Fortunately, he responded to treatment and recovered fully. He received treatment in the form of immunoglobulin and steroids. Phenytoin and herbal kadha were withdrawn, and Clobazam was continued. Natural herbal medicines can develop severe adverse effects. Physicians should remain aware that drug interactions can likely be seen with drugs with a narrow therapeutic index combined with herbal preparations. Clinicians should do more research on the interaction between herbal and prescription medications.

Based on the examination of four distinct cases, this case series offers a thorough investigation of the intricate relationship between dengue fever and hepatitis A infection. Despite their distinct origins, both illnesses manifest overlapping clinical features, posing considerable diagnostic hurdles, particularly in endemic regions. The cases reveal consistent symptoms such as elevated fever, abdominal discomfort, jaundice, and irregular liver function test results, underscoring the intricate nature of an accurate diagnosis. Variations in age distribution and the severity of symptoms underscore the necessity for tailored treatment approaches. Diagnostic challenges stem from the similarity in clinical presentations and shared laboratory abnormalities, necessitating comprehensive serological assessments. Therapeutic strategies entail a multidisciplinary approach addressing both hepatic and systemic manifestations, with supportive measures ensuring favorable clinical outcomes. Despite the complexities involved, timely interventions facilitate gradual symptom amelioration and successful patient recovery. Informing clinical practice and directing public health actions, this case series provides insightful information about the diagnostic and treatment complications associated with co-occurring dengue fever and hepatitis A infection.

This comprehensive review explores the multifaceted role of vitamin D (VD) in critically ill children, examining its implications for clinical outcomes. Although this substance has long been known for its function in maintaining bone health, it is now becoming more widely known for its extensive physiological effects, which include immune system and inflammation regulation. Observational research consistently associates VD levels with outcomes like duration of hospitalization, mortality, and illness severity in critically ill pediatric patients. Mechanistically, it exerts anti-inflammatory and endothelial protective effects while modulating the renin-angiotensin system. Increasing VD levels through supplementation presents promise as a therapeutic strategy; however, further research is necessary to elucidate optimal dosage regimens and safety profiles. This review emphasizes the significance of comprehending the intricate relationship between VD and critical illnesses among pediatric populations.

 Neonatal morbidity and mortality continue to be major public health issues globally, especially for infants admitted to neonatal intensive care units (NICUs). This study aims to investigate the incidence of morbidities among neonates born to high-risk mothers and to evaluate the impact of various maternal risk factors on neonatal morbidity and mortality in the NICU setting.  This prospective observational study was conducted on 1,000 newborns up to 28 days of life, all with maternal risk factors, born in our tertiary care center, and admitted to the NICU.  Most NICU admissions occurred during the 34-36 weeks of gestation, comprising 412 (41.20%) of the total admissions. Additionally, there was a female predominance, with 552 cases, representing 55.20% of the admissions. Most of the NICU patients came from rural background 594 (59.40%) and belonged to socioeconomic status (SES) IV 764 (76.40%). Higher percentages of neonatal morbidities were observed among children of illiterate and primarily educated mothers, amounting to 913 cases (91.30%). After evaluating patients in the NICU, we found that mortality was 172 (17.20%). Mothers with previous bad obstetric histories were at greater risk of poor neonatal outcomes. Cesarean sections were more commonly associated with NICU admissions, accounting for 555 cases (55.50%). The primary risk factors included pregnancy-induced hypertension, previous lower segment cesarean section, fetal distress, and premature rupture of membranes. Significant neonatal morbidities included respiratory distress syndrome (RDS) due to prematurity 79 (45.9%), intrauterine growth retardation 19 (11.0%), meconium aspiration syndrome 16 (9.3%), birth asphyxia, sepsis 29 (16.8%), and congenital anomalies 12 (6.9%). RDS was identified as the leading cause of morbidity.  The present study highlights several critical factors associated with NICU admissions and neonatal morbidities, underscoring the need for targeted interventions to improve neonatal health outcomes.

Autoimmune hepatitis (AIH) is quite rare in children. AIH is classified into two types based on the presence of autoantibodies: type 1 and type 2. The presentation of AIH varies, ranging from asymptomatic to acute or chronic hepatitis and occasionally fulminant liver failure. It can present at any age. In 20% of AIH cases, other autoimmune disorders might be present, such as diabetes mellitus and arthritis. A high index of suspicion is required for the early diagnosis of this condition. Pediatricians should consider the possibility of AIH in patients with jaundice once common causes are ruled out. The diagnosis is done on the basis of the presence of typical autoantibody titer, liver biopsy findings, and response to immunosuppressive medications. Some AIH patients may not respond to immunosuppressive therapy and may need a liver transplant. We present a case of a 12-year-old male child with thalassemia trait who was diagnosed with AIH.

Lymphatic malformations frequently present as benign masses in the neck and clavicle region among infants and young children. Cystic hygroma represents an often-encountered form of lymphatic malformation. This case report details the medical history of a one-year-old girl characterized by a multifaceted medical background, initially exhibiting symptoms of persistent cough, cold, and neck swelling. Further investigations revealed more severe conditions: complex congenital heart defects, including large atrial septal defect (ASD), large ventricular septal defect (VSD), and aorta arising from the right ventricle with cystic hygroma and annular pancreas. The patient underwent various diagnostic tests, including chest X-rays, ultrasound, magnetic resonance imaging (MRI), and computed tomography pulmonary angiogram (CTPA), leading to multidisciplinary treatment involving sclerotherapy for cystic hygroma and supportive therapies. The case underscores the challenges in diagnosing and managing pediatric patients with overlapping conditions and the critical need for continuous follow-up.

Oro-facial-digital syndrome, specifically Mohr syndrome, is an uncommon genetic disorder characterized by predominant oro-facial anomalies and polysyndactyly. While typically associated with autosomal recessive and X-linked dominant inheritance patterns, this case presents an autosomal dominant mode of transmission. This report documents the clinical presentation of three individuals, a 12-year-old male child and two females, 10-year-old and eight-year-old, who have inherited the disorder from their ancestors. The observed features include post-axial polysyndactyly in both upper and lower limbs, with the male child exhibiting additional manifestations of strabismus and knee joint defects. Symptomatic management is pursued due to the absence of complications, with surgical interventions and subsequent cosmetic repairs planned for all three children. Post-surgical physiotherapy is scheduled as part of their comprehensive treatment plan. The prognosis for this disorder is generally favorable, with a complete recovery anticipated and no complications expected.

This case report documents the clinical journey of a 14-year-old female child experiencing bilateral swelling and pain in the mandibular region, suggestive of idiopathic masseter muscle hypertrophy. This condition, although relatively uncommon, can present itself either unilaterally or bilaterally. While cosmetic concerns, often denoted as a \"square face,\" are commonly expressed by patients, additional symptoms like protrusion, bruxism, or trismus may also be present. The patient reported a gradual and asymptomatic bilateral bulging in the mandible angle region, with an explicit complaint of pain. The physical examination revealed bilateral masseter hypertrophy without accompanying local inflammatory changes. Diagnosing this condition necessitates discerning its characteristics, evaluating clinical and radiographic findings, and excluding more severe pathologies like parotid diseases, lymphangioma, and rhabdomyoma. In cases of diagnostic uncertainty, complementary tests are deemed appropriate. Treatment strategies range from conservative measures to surgical interventions. This investigation aims to fulfill its primary objectives by presenting a case study elucidating the intricacies of idiopathic masseter hypertrophy, detailing associated symptoms, and exploring the spectrum of potential treatment options. Through this exploration, we contribute to the evolving understanding and management of this unique condition, especially within the pediatric age group.