Krishna Kumar Yadav

The current status of community-acquired pneumonia management and prevention in children under 5 years of age in India: a review

India has the highest number of global deaths of children under 5 years of age. In the year 2015, it was reported that there were 5.9 million deaths of children under 5 years of age globally, of which 1.2 million (20%) occurred in India alone. Currently, India has an under 5 mortality rate of 48 per 1000 live births. Community-acquired pneumonia contributes to about one sixth of this mortality. Fast breathing is the key symptom of community-acquired pneumonia. The World Health Organization recently categorized community-acquired pneumonia in children under 5 years of age into two, pneumonia, and severe pneumonia. Fast breathing with or without chest in-drawing is categorized as pneumonia and fast breathing with any of danger signs as severe pneumonia. Because effective vaccines against two of the common organisms causing community-acquired pneumonia, namely Streptococcus pneumoniae and Haemophilus influenzae type b, are available, there should be urgent and phased introduction into the Indian Universal Immunization Programme. Several preventable risk factors of community-acquired pneumonia such as lack of exclusive breast feeding for first 6 months of life, inappropriate complimentary feeding, iron deficiency anemia, malnutrition, and indoor air pollution should be adequately addressed. The community should be aware about the signs and symptoms of community-acquired pneumonia and its danger signs so that delay in qualified care seeking can be avoided. To achieve the sustainable development goal of ⩽25 under five deaths per 1000 live births by 2030, a multipronged approach is the need of the hour.

Assessment of the acceptance and effectiveness of peer-assisted learning in pediatrics

Background: Peer-assisted learning (PAL) is the development of knowledge and skill through active help and support of equals. However, this has not been tested in medical education in India. Objectives: To assess the effectiveness of PAL on improvement in cognitive assessment scores and its acceptance among undergraduate medical students in one public teaching medical university in North India. Methodology: After approval from the Institutional Ethics Committee, three PAL sessions, 1 per week, each on specific topic, were conducted using small group discussion methodology with a faculty contact and student leader and 4–6 peer-learners, in 9th semester MBBS students. A pretest with multiple choice questions (MCQs) was followed by distribution of learning objectives and list of resource material. PAL session was conducted after 72 h, followed by posttest by MCQs and then focus group discussion (FGD) on students’ experiences. Results: Of the 26 students enrolled, three PAL sessions was completed by 22 (84.6%) students. The correlation coefficient between pre- and post-test scores was 0.48 (P < 0.0001), with a 24.2% improvement in posttest scores. In the nine FGDs most said that PALs helped in the better preparation of the topic, clarifying doubts, lessened examination anxiety, improved communication skills, and increased self-confidence. Conclusion: PAL was well accepted, and it improved assessment scores. Therefore, it can be adopted for teaching selected topics across all subjects of MBBS course.

Fluid and electrolyte therapy in surgical neonates II-Actual estimation.

SummaryFluid and electrolyte therapy plays a major role in the successful outcome of neonatal surgery. Where hyperalimentation is not available and long term fluid therapy is required, repeated infusion with plasma, albumin and 10 per cent dextrose has proved helpful for restoration of serum proteins and energy.

Interleukin 1 receptor antagonist (IL1RA) gene polymorphism and levels associated with adverse outcome in severe community-acquired pneumonia in children: A hospital-based study in India

High morbidity and mortality due to community‐acquired pneumonia (CAP) is seen in children under 5 years of age in India. Besides identified risk factors for CAP, there may be a phenotype‐genotype association with cytokines, resulting in enhanced inflammatory response resulting in the adverse outcome (AO), namely complications and death.