VIMS Health Science Journal

Socio-Demographic Risk Factors Associated with Severe Acute Malnutrition In Children

Dr. Niraj Lakhmawar — 2025-01-06

Background: Severe Acute Malnutrition (SAM) remains a significant public health concern in India, particularly in Maharashtra, where malnutrition contributes to high child mortality rates. SAM is associated with delayed growth, impaired cognitive development, and increased susceptibility to infections. Despite government initiatives, its prevalence continues to rise, necessitating a deeper understanding of its socio-demographic and environmental determinants. Objective: This study aims to investigate socio-demographic, maternal, environmental, and nutritional risk factors associated with SAM among children aged 6–59 months in Maharashtra and to inform targeted interventions to reduce malnutrition prevalence. Methodology: A cross-sectional observational study was conducted on 100 children diagnosed with SAM, using WHO diagnostic criteria. Data were collected through structured questionnaires and medical record reviews. Variables analyzed included socio-demographic characteristics, maternal and child healthcare factors, environmental conditions, and nutritional practices. Results: The highest prevalence of SAM was observed in children aged 13–24 months (40%), coinciding with weaning and dietary transitions, followed by 6–12 months (30%). Male children (55%) were more affected than females (45%). A significant association was noted with higher birth order, as children with birth order greater than two comprised 50% of cases. Low birth weight (<2.5 kg) was present in 60% of SAM cases, emphasizing the importance of maternal and neonatal health. Poor maternal healthcare was a critical contributor, with 60% of mothers lacking antepartum care and 70% lacking postnatal care. Maternal education played a pivotal role; 55% of affected children had illiterate mothers. Socioeconomic disparities were evident, as 70% of SAM cases occurred in lower socioeconomic classes. Conclusion: This study highlights the multifaceted determinants of SAM in Maharashtra, underscoring the need for interventions targeting vulnerable age groups, maternal education, and healthcare accessibility.

Study of Clinical profile of Bronchiolitis at a Rural based Tertiary Care Hospital

Dr. Vivek Karad — 2025-01-06

Acute bronchiolitis is a common self-limiting lower respiratory tract infection primarily affecting infants and young children, with Respiratory Syncytial Virus (RSV) as the leading causative agent. Despite its significant burden on healthcare systems, data on clinical profiles in resource-limited settings are limited. Objectives: To study the clinical, radiological, and haematological profiles of bronchiolitis in children aged 2 months to 5 years presenting to a tertiary care hospital in Maharashtra. Methodology: A prospective observational study was conducted on children aged 2 months to 5 years diagnosed with bronchiolitis. Data on demographic characteristics, clinical features, radiological findings, and haematological parameters were collected and analysed. Results: The study included 100 children, with a mean age of 1 year. The highest incidence (50%) was observed in infants aged 2–6 months. A slight male predominance (55%) was noted. Fever and cough were present in all cases (100%), followed by wheezing (80%), difficulty breathing (70%), nasal congestion (70%), and cyanosis (10%). Radiological findings revealed hyperinflation in 70% of cases, peribronchial thickening in 40%, and patchy infiltrates in 30%. Haematological analysis showed a mean hemoglobin level of 10.5 ± 1.2 g/dL, total leukocyte counts of 11,000 ± 4,000 cells/?L, neutrophil percentage of 35 ± 25%, and lymphocyte percentage of 55 ± 10%. Lymphocytosis was observed in 60% of cases, leucocytosis in 40%, and elevated CRP levels in 30%. Conclusion: Bronchiolitis predominantly affects infants under 1 year, with a slight male predominance. Fever, cough, and wheezing are the most common clinical features. Early diagnosis and management are crucial to reducing complications.

Impact of Hypothermia on Respiratory Distress In Neonates

Dr. Aishwarya Puranik — 2025-01-06

Neonatal hypothermia is a global concern linked to increased morbidity and mortality, particularly in developing countries. Defined by the WHO as a body temperature below 36.5°C, hypothermia is a preventable condition that can lead to severe complications, including respiratory distress syndrome (RDS). Objective: To assess the association between hypothermia and respiratory distress syndrome (RDS) in neonates, evaluate the prevalence of hypothermia, and analyze its impact on RDS severity. Methodology: This prospective observational study was conducted over one year in the NICU of a tertiary care center. Neonates with gestational ages between 24 and 42 weeks and diagnosed with hypothermia (body temperature <36.5°C) were included. Statistical analysis was focused on the association between hypothermia and RDS severity. Results: Out of 100 neonates, 55% were male, and 60% were born to primiparous mothers. Hypothermia was present in 50% of neonates, and RDS was observed in 55%. Among neonates with hypothermia, 40% experienced severe RDS, while no severe RDS was observed in non-hypothermic neonates (p < 0.01). Hypothermic neonates also showed lower mean oxygen saturation (85%) compared to normothermic neonates (97%), with improvement after rewarming. The association between hypothermia and RDS severity was statistically significant. Conclusion: Hypothermia significantly impacts the severity of respiratory distress syndrome in neonates, emphasizing the need for early detection and proper thermal management in NICUs. Addressing hypothermia can reduce RDS severity and improve neonatal outcomes.

An Approach to Joint Pain in Paediatric Patients: A Comprehensive Review

Dr. Neha Khadke — 2025-01-06

Joint pain in paediatric patients is a common but diagnostically challenging issue, with causes ranging from benign self-limiting conditions to serious diseases that may result in long-term disability. This review addresses a structured diagnostic approach to joint pain in children, covering infectious, inflammatory, traumatic, and neoplastic causes. Key diagnoses include septic arthritis, juvenile idiopathic arthritis (JIA), Lyme arthritis, and malignancies such as leukaemia and osteosarcoma. A detailed history and physical examination are essential for identifying underlying conditions, distinguishing benign causes from emergencies. Infectious causes require urgent consideration, especially septic arthritis, which risks rapid joint destruction. Inflammatory conditions like JIA are common chronic arthritides in children and need timely referral for rheumatologic assessment. Malignancies and traumatic causes also warrant careful attention to avoid delayed diagnosis. Laboratory investigations—including complete blood counts, inflammatory markers (ESR and CRP), and autoantibodies (ANA and RF)—help support diagnoses. Imaging studies, particularly radiography, ultrasound, and MRI, are pivotal for assessing trauma, inflammation, and marrow involvement. Targeted approaches for specific conditions, such as joint aspiration in septic arthritis and serological testing for Lyme arthritis, are discussed. Advances in biomarkers, imaging, and biologic therapies—especially TNF inhibitors and interleukin blockers—are highlighted as emerging tools in diagnosing and managing paediatric joint pain, offering promising avenues for early diagnosis and personalised care.

Telemedicine in Paediatric Health Care

Akshita Kansal — 2025-01-06

Technology-enabled telemedicine is improving children's health worldwide. This article documents how paediatricians are using telemedicine to provide inpatient and outpatient care, patient and physician education, and research. It discusses the value of telemedicine in responding to crises and disasters and providing access to paediatric care to underserved and isolated communities. Legal issues, inadequate payment for services, cost and sustainability of technology, and lack of national technology infrastructure are some of the barriers to the development of telemedicine.

Paediatric Ependymoma- A Rare Case Report

Dr. Rishab Singh Deo — 2025-01-06

Ependymomas are rare central nervous system (CNS) tumours originating from ependymal cells lining the ventricles and spinal cord. This case report details a unique presentation of a sellar ependymoma in a 2-year-old male presenting with acute symptoms, including inability to walk and vomiting. Magnetic resonance imaging (MRI) revealed a large sellar and suprasellar mass causing hydrocephalus. The patient underwent a parieto-occipital craniotomy with complete tumour excision and placement of a ventriculoperitoneal shunt to manage hydrocephalus.

Mohr Syndrome- A Rare Case Report

Dr. Akshita Kansal — 2025-01-06

An orofaciodigital syndromes (OFDS) is a rare genetic disorder with diverse collection of abnormalities, mainly affecting the face, oral cavity and digits. Orofacial digital syndrome type II, also called the “Mohr syndrome” is a very rare subtype of OFDS. We report a case of 1-year-old male child presented to Paediatric outpatient department with complaints of syndactyly along with polydactyly associated with characteristic features of OFDS type II. Considering the overlapping clinical features, it is important to establish a correct diagnosis by distinguishing appropriate features.