Soumya Tiwari

Congenital Rickets Presenting as Refractory Respiratory Distress at Birth

Congenital rickets is a very rare entity in the spectrum of metabolic bone disease in children. The authors report an as yet unreported case of congenital rickets presenting with respiratory distress at birth. The radiographs of long bones and wrist showed generalized osteopenia with cupping and fraying of epiphyseal ends in the second week of life. The patient was managed with very high doses of vitamin D which led to clinico-radiological and biochemical improvement. More than being interesting for its extreme rarity, this report assumes importance as it brings forth the possibility of congenital rickets being a differential diagnosis for a newborn with respiratory distress.

Efficacy and safety of a single daily dose of gentamicin in hospitalized Indian children: a quasi-randomized trial

OBJECTIVES To compare the clinical efficacy, pharmacokinetic profiles and safety of once-daily dosing (ODD) and multiple daily dosing (MDD) of gentamicin in hospitalized Indian children. PATIENTS AND METHODS Four hundred children admitted to our hospital were studied prospectively. The patients were randomized to ODD or MDD groups alternately. The primary outcomes were: (i) a good clinical outcome, as defined; and (ii) occurrence of side effects, if any. Clinical efficacy was determined by comparing the proportion of patients with a favourable response between the two groups, while pharmacokinetic profile was assessed by comparing the peak and trough concentrations of the drug in a subgroup of patients. Safety of the two regimens was compared, besides recording any symptoms due to side effects of the drug, with the help of serum creatinine and brainstem-evoked response audiometry (in a subgroup of the patients). RESULTS We found ODD of gentamicin in hospitalized Indian children to be efficacious and safe. A favourable clinical response was achieved in 167 of the 188 patients (89%) in the ODD group and in 161 of the 212 patients (76%) in the MDD group. Similarly, a higher number of patients in the ODD group showed favourable gentamicin peak concentrations as compared with the MDD group (100% versus 87%). The MDD group showed a higher number of trough concentrations in the undesirable range as compared with the ODD group (17% versus 0%). CONCLUSIONS The study supports extended-interval (single daily) dosing in hospitalized Indian children due to its efficacy and safety with the added advantage of needing fewer injections.

Neonaticide in India and the stigma of female gender: report of two cases

Abstract Neonaticide is known to occur across the globe in both developed and developing countries, but has rarely been reported from India. Two similar cases of female neonaticide are presented which were committed by their mothers while in the maternity ward. The social issues and maternal provocation highlighted in this report are different from those reported in world reviews of neonaticide.

Failure to Thrive

Failure to thrive is poor physical growth that results when the nutritional demands of young children are not fulfilled. This diagnosis is made when, on serial growth monitoring, the child’s anthropometric parameters such as weight for age and/or height are found to be significantly below the expected values. A detailed evaluation by the treating physician, taking into account physical and psychosocial factors affecting the child’s health is essential for understanding the factors contributing to failure to thrive. The treatment of this entity requires a multidisciplinary approach, correcting the macro and micronutrient deficiency in the child as well as education of parents regarding age-appropriate feeding recommendation for children. In addition, parents need to be apprised of the possible implications of malnutrition on growth and neurodevelopment of the child. Early childhood being a crucial period for growth and development, an early diagnosis and treatment will result in better outcomes in children with failure to thrive.

Reporting quality of trial abstracts—improved yet suboptimal: A systematic review and meta‐analysis

We conducted a systematic review and meta‐analysis of literature to determine if the publication of the Consolidated Standards of Reporting Trials (CONSORT) abstract guideline in 2008 was followed by change in reporting quality of randomized controlled trial (RCT) abstracts.