Online ISSN: 2515-8260

Keywords : pediatric

Role of Pegylated Interferon and Ribavarin in Chronic Hepatitis C in childhood cancer survivors less than 12 years

Dr. Gitika Pant, Dr Nishant Verma, Dr Shreshtha Ghosh

European Journal of Molecular & Clinical Medicine, 2023, Volume 10, Issue 4, Pages 1229-1234

Chronic hepatitis C (CHC) may be seen in cancer survivors due to frequent blood component therapy and parenteral exposures during treatment. Considering the long term adverse effects of CHC, the study was carried to evaluate the response of combination therapy (Pegylated Interferon and Ribavirin) in cancer survivors affected with CHC as direct acting antivirals have still not been approved for children below 12 years age.
Methods: This was a retrospective study carried in cancer survivors below 12 years, who had CHC. They were treated with combination of Pegylated interferon alpha2b 60mcg/m2/week and ribavirin 15mg/kg/day for 24 or 48 weeks for Genotypes 3 and 1 respectively. Rapid viral response (RVR) and sustained viral response (SVR) were evaluated by PCR at 4 weeks of starting therapy and after 24 weeks of completing therapy. Data on coinfection with Hepatitis B was also evaluated.
Results: Of the 32 patients, 21 were leukemia/lymphoma survivors and 11 were survivors of solid tumours. Genotype 1 was seen in 22/32(69%) and Genotype 3 in 10/32(31%). Hepatitis B co-infection was present in 6 (18.7%) patients. RVR (100% vs 45.5%) and SVR (100% vs 62%) were significantly higher for Genotype 3 as compared to Genotype 1. SVR for HCV was not significantly different in those with HBV coinfection as compared to those without.
Conclusion: Pegylated IFN and ribavirin combination therapy is a successful modality for treating CHC in age group <12 years in childhood cancer survivors where long term morbidities due to Hepatotropic viruses affect the quality of life.

Evaluation of Anemia in Dependent Age Groups of Society (Pediatric and Geriatric population) - A Hospital Based Cross Sectional Study

Shalini Singh,Surya prakash, Neeraj Kumar Singh

European Journal of Molecular & Clinical Medicine, 2023, Volume 10, Issue 3, Pages 627-636

Anemia is a major public health concern globally and in India despite numerous health programme organized across the country for decades the national prevalence rates of anemia are reaching new heights as is evident from the national family health survey (NFHS 5).
World Health Organization (WHO), defines anemia as having hemoglobin (Hb) levels lower than 12.0 and 13.0 g/dL in females and males, respectively. The “Dependent Population” defined as People, below 15 years of age group and 65 years and above.  Thus, in age group below 15 years and above 65 years, it is indeed necessary to identify anemia, stratify the type and its severity and search for etiology accordingly. 
Aim: To evaluate etiology, morphological types and grading patters of anemia in pediatrics and geriatric patients. 
Material and methods: The present study was two-months hospital based prospective study of all diagnosed cases of anemia to access the etiology, morphological type and associated grading pattern of anemias in pediatric and geriatric age group from September 2022 to October 2022, which included 56 cases. 
Result: During a period of 02 months, out of the 56 patients, 20 belonged to the pediatric age group (upto 15 years) and 36 belonged to the geriatric age group (65 years and above) were evaluated for anemia. Male to female ratio, out of 20 pediatric patients, was of 3:1. Majority of our patients (55 %) belonged to age group of 06-10 years. Similarly, out of 36 geriatric patients, 17 patients were female (47.3%) and 19 patients were male (52.7%) with male to female ratio of 1.1:1.  Majority of our patients (77.78 %) belonged to age group of 65-75 years. Clinically, majority of pediatric patients presented with nutritional deficiency (30%) and majority of geriatric patients presented with generalized weakness and fatigue (20%). Majority of pediatric age group showed moderate degree of anemia (50%) and in geriatric age group for 36 blood samples were evaluated out of which majority of them showed moderate degree of anemia (47.2%) and severe (47.2%) equally. Morphologically out of 20 blood samples of pediatric age group displayed Microcytic anemia (50 %) with most common etiology being, iron deficiency anemia was observed in 06 cases (30%) with serum ferritin levels below 15 ng/ml and out of 36 geriatric patients’ anemia of chronic disease was observed in 13 cases (36.11%) with most common, etiology being, renal disorder.
Conclusion: Anemia remains a major health concern in both dependent age groups. Early detection of anemia and definite characterization for the underlying etiology should be taken in consideration for the overall improvement in the quality of life in both dependent age groups. 

Recent Advances In Dental Caries Diagnosis: A Review

Gaurav Aggarwal; Artika Gupta; Sunil Malhan; Ravneet Kaushal; Arvind Arora .

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 8, Pages 2074-2080

Dental caries, a progressive bacterial damage to teeth, is one of the most commondiseases that affects 95% of the population and is still a major cause of tooth loss.Recent years have seen an increase in research activity surrounding diagnostic methods, particularly in the assessment of early caries lesions. The use of technologies as adjunct to clinical visual examination for caries diagnosis will facilitate preventive care in dentistry to lower treatment cost as well as reduce the cost and time for testing potential anticaries agents. In recent years, the early diagnosis of dental caries has gained importance as conservative dentistry is kept in the forefront. Especially in pediatric patients, the dentist should focus on the early detection of dental caries and minimally invasive treatment options. The conventional caries detection methods often fail to detect initial enamel lesions that have not progressed to cavitation. For this reason, various new techniques have been developed aiding early detection of caries. The aim of this review is to give general information about recent caries detection methods and to mention their benefits when used in conjunction with conventional methods.

MRI Evaluation of Seizures in Pediatric Age Group Patients in a Tertiary Teaching Hospital

Mandepudi Geethika, K.Venkataramana Reddy, Subhashreddy Doni , Sandeep Madineni, MohdMohsin Khan, SamaVarsha, Kyatham Madhulatha

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 7, Pages 4030-4042

Background: Seizures are a very common presentation in the emergency department. Seizures are characterised by involuntary impairments in motor, sensory, or autonomic functioning. They are brought on by abnormal, excessive neuronal activity that is triggered by paroxysmal electrical discharges from the brain. In children, seizure disorders are a prominent contributor to both morbidity and mortality. Mortality rates in neonates range from 21 to 24 percent, while morbidity rates range from 25 to 35 percent.
Material and Methods: The current study was a prospective hospital-based investigation carried out in the Radiology Division of S.V.S. Medical College and Hospital in Mahabubnagar, Telangana, India. The investigation was conducted between September 2019 and August 2022 in the department of Radiodiagnosis. 148 people made up the sample. Siemens Magnetom Area's 1.5 T MRI equipment was used to capture every image.


Dr.Divyarani M N , Dr.Sreelakshmi K , Dr.Dayananda , Dr Ramya BS

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 4, Pages 3045-3051

Background :COVID 19caused by severe acute respiratory syndrome corona virus2(SARS Cov2) involves respiratory and other systems. Patient with Covid 19 presents with wide range of hematological and coagulation abnormalities. Hemostatic abnormalities in Covid 19 are related with disease progression, severity and mortality. The objective of our study is to evaluate the role of hematological and coagulation parameters in determination of Covid 19 severity.Materials and methods: Total 70 cases were enrolled in the study, conducted in department of pathology at Bangalore Medical college and research institute, Bangalore. Hematological and coagulation parameters were compared with mild, moderate, severe and critical. Appropriate statistical analysis is applied.Result: Parameters like WBC, Neutrophils, HCT,NLR were higher in patients with severe disease when compared to mild and moderate cases.PT, D-Dimer did not show statistically significant association with severity of disease.Conclusion: The study concluded that leukocytosis, neutrophilia,elevated NLR are associated with severity of the disease

A prospective comparative study of functional and radiological outcome in percutaneous trans-olecranon fossa four cortex purchase lateral pinning versus cross-pinning in displaced supracondylar fractures of humerus in children

Somashekara S.A, Deepak H.R, Sunkappa S.R Somashekar Doddabhadre Gowda, Manoj Gidaganti

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 2, Pages 871-879

Traditional treatment with closed reduction and application of plaster slab or cast is
inappropriate in the case of displaced supracondylar fractures of humerus as this method may
potentially lead to malunion & subsequent elbow deformity, as it is difficult to obtain
satisfactory reduction and to maintain the reduction due to distraction forces acting at the
elbow. Our study involved 40 children who had sustained displaced supracondylar fractures
(Gartland-Type III) who were treated in the Department of Orthopaedic at a Tertiary care
trauma center, between November 2018 to May 2020. 55% of our cases were in the age group
5-10 years, 60% were male & 40% female.
80% (n=32) of the cases had history of fall on outstretched hand, followed by 3% with fall on
flexed hand which is in concordance with the most common mode of injury established by
many studies. 70% of the cases had fracture of left supracondylar humerus as compared to
30% on the right side. 30 out 40 cases had postero-medial displacement of distal fragment &
remaining 10 cases had postero-lateral displacement.

Assessment and evaluation of hearing, tinnitus, and vertigo in children with endocrine disorders

Dr Rajveer Basu, Dr Preeti Lahari, Kiran Lahari, Dr Jugvendra Lahari .

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 4, Pages 1805-1811

Background: Metabolic and endocrine disorders are related to a significant proportion of
mortality and morbidity seen in the child population globally. The disorders and associated
comorbidities affecting various body organs including inner ear functions include diabetes
mellitus, growth hormone deficiency, childhood obesity, precocious puberty, etc.
Aims: The present clinical trial was carried out to assess high-frequency hearing,
associated tinnitus and vertigo in children with endocrine disorders including growth
hormone deficiency, precocious puberty, type 1 diabetes mellitus, obesity and idiopathic
short stature.
Materials and Methods: 120 subjects having a growth hormone deficiency, precocious
puberty, type 1 diabetes mellitus, obesity and/or idiopathic short stature, and 32 healthy
children were evaluated with a complete otolaryngologic examination followed by
otoscopic ear examination, tympanometry, vertigo, and tinnitus. The collected data were
subjected to statistical evaluation and results were formulated.
Results: PTA˃20dB was seen in 2.5% (n=3) subjects, HFA ˃20dB was seen in 5% (n=6),
PTA and HFA ˃20dB in 5% (n=6) subjects (p= 1.000, 0.465, and 1.000). 18.6% (n=19) had
tinnitus, and 8.82% (n=9) had vertigo. Presence of vertigo and tinnitus in study subjects
with ISS seen in 22.7% (p=0.04). Vertigo with PTA and HFA value ˃20dB was seen in
3.84% (n=1) subject with GHD, 5.88% (n=2) with Type1 DM, 4% (n=1) with obesity, and
3.06% (n=3) subjects in whole experimental group.
Conclusion: Within its limitations, the present study concludes that endocrine diseases
manifested in childhood can lead to alterations in the inner ear with poorly understood
aetiology. However, the study suggests a balance examination and thorough hearing
examination be done in all children visiting endocrinology clinics to detect and treat any
associated abnormality at an early stage.

Seizure Due To Electrolyte Imbalance In Pediatric

Nurul Hidayah; Huldani .; Fauziah .; M Naufal Risyad

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 8, Pages 4664-4668

Seizures are symptoms that are temporary and sudden as a result of abnormal electrical
activity in the brain. Seizures can be caused by various conditions, for example, epilepsy,
fever, hypoglycemia, hypoxia, hypotension, brain tumors, meningitis, electrolyte
imbalance, and drug overdose. Severe and acute electrolyte disturbances cause
neurological deficits such as seizures, which may be the sole presenting
symptom. Electrolytes are compounds in a solution that dissociate into particles with a
positive (cation) or negative (anion) charge. Most of the metabolic processes require and
are affected by electrolytes. Electrolyte imbalances are common in clinical practice and the
diagnosis is confirmed by laboratory tests. Seizures are common in patients with
hyponatremia, hypocalcemia, and hypomagnesia. Tonic-clonic seizures or other types can
be found due to these electrolyte disturbances. Hypo or hyperkalemia can also cause
seizures, but it is very rare. These electrolyte disturbances can trigger epileptic areas in the
brain. Central nervous system disorders due to electrolyte imbalance are reversible.
However, if this is not treated immediately it will cause permanent brain damage


Mohammed Meyassr Melybari, Khulood Nader Felemban, Emran Hasan Fallatah, Hesham Abdullah Ganim, Sultan Hymid Al-Hazmi, Moawad Ayed Allihyani, Manal Salmi Alsadi Saeed Hassan Abdullah ALqurashi, Afraa Mohmad Bassuoni, Ayman Salem Ajyeeb, Sameer Mohammad Ali Albishri

European Journal of Molecular & Clinical Medicine, 2019, Volume 6, Issue 1, Pages 492-500

Antibiotics are the most commonly used drug group in hospitalized patients and primary health clinics as they are all over the world. Inappropriate or unnecessary use of antibiotics leads to adverse effects related with antibiotics, occurrence of resistant microorganisms, and increased therapeutic cost. With the Budgeting Application Instruction, which entered into force in 2003 for controlling antibiotic use, approval of an infectious disease specialist (IDS) was required for use of some differences in antibiotic knowledge and attitudes between parents of Medicaid-insured. It is unknown whether understanding has improved and whether previously identified differences persist.Efforts to reduce antibiotic misuse and overuse are necessary to curb additional increases in antibiotic resistance in developed and developing countries also in KSA saw increases in antibiotic use for children during the last 2 decades, no educational campaigns for patients and professionals, and introduction of new vaccines. ​
Aim of the study: To assessment of prevalence of antibiotic use for pediatric acute viral gastroenteritis attending the primary health clinics in Makah city in Saudi Arabia 2019.
Method: This is a cross-sectional study, thirty questions of children years of age who had suffered from acute gastroenteritis during the March to June, 2019 was conducted attending the primary health care centers in Makkah, Saudi Arabia. our total participants were (80).
Results:Oral antibiotics were preferred by 45.0% followed by intravenous route (30.0%), and intramuscular route in 8.75%. Antibiotics less than week were prescribed in about 43.0%. Duration from 7-14 days was recorded by 20%. Long-term antibiotics were prescribed by 3.0%. Questioning about the seasonal break out of viral gastroenteritis as stated by study individuals.
Conclusion: must be Antibiotic use based on consultation with an infectious diseases specialist decreased inappropriate antibiotic use. Acute gastroenteritis is a major source of morbidity and mortality among young children in developed and developing countries. Enter pathogenic viruses are regarded as particularly relevant causative agents.