Emerging Role of the Ketogenic Dietary Therapies beyond Epilepsy in Child Neurology.

Ketogenic dietary therapies (KDTs) have been in use for refractory paediatric epilepsy for a century now. Over time, KDTs themselves have undergone various modifications to improve tolerability and clinical feasibility, including the Modified Atkins diet (MAD), medium chain triglyceride (MCT) diet and the low glycaemic index treatment (LGIT). Animal and observational studies indicate numerous benefits of KDTs in paediatric neurological conditions apart from their evident benefits in childhood intractable epilepsy, including neurodevelopmental disorders such as autism spectrum disorder, rarer neurogenetic conditions such as Rett syndrome, Fragile X syndrome and Kabuki syndrome, neurodegenerative conditions such as Pelizaeus-Merzbacher disease, and other conditions such as stroke and migraine.

Utility of the END-IT Score to Predict the outcome of Childhood Status Epilepticus: A Retrospective Cohort Study.

Introduction: Scoring systems to predict outcomes in pediatric status epilepticus (SE) are limited. We sought to assess usefulness of the END-IT score in pediatric SE.

Methodology: We conducted a retrospective study at a tertiary hospital in New Delhi, India.

Clinical Profile of COVID-19 Illness in Children-Experience from a Tertiary Care Hospital.

Objective: To detail clinical profile and outcome in children infected with SARS-CoV-2.

Methods: This retrospective study was undertaken at a tertiary care pediatric teaching hospital in Northern India. The data on clinical characteristics and outcome of children (< 18 y) with COVID-19 illness from April 2020-October 2020 were reviewed and analyzed.

Multilocus disease-causing genomic variations for Mendelian disorders: role of systematic phenotyping and implications on genetic counselling.

Multilocus disease-causing genomic variations (MGVs) and multiple genetic diagnoses (MGDs) are increasingly being recognised in individuals and families with Mendelian disorders. This can be mainly attributed to the widespread use of genomic tests for the evaluation of these disorders. We conducted a retrospective study of families evaluated over the last 6 years at our centre to identify families with MGVs and MGDs.

Point Prevalence of Peripheral Neuropathy in Children and Adolescents with Type 1 Diabetes Mellitus.

Objective: To assess the point prevalence of peripheral neuropathy (PN) in children with type 1 diabetes mellitus (T1DM) and to determine their predictors.

Methods: In this cross-sectional study, children aged 8-18 y with T1DM on insulin therapy for > 2 y and free from acute complications were enrolled. All participants were evaluated for symptoms of PN with diabetic neuropathy symptom (DNS) score and underwent a detailed neurological examination.

Inherited Manganese Disorders and the Brain: What Neurologists Need to Know.

Although acquired manganese neurotoxicity has been widely reported since its first description in 1837 and is popularly referred to as "manganism," inherited disorders of manganese homeostasis have received the first genetic signature as recently as 2012. These disorders, predominantly described in children and adolescents, involve mutations in three manganese transporter genes, i.e.

Pubertal Development and its Determinants in Adolescents With Transfusion-Dependent Thalassemia.

Objectives: To assess pubertal development and its determinants in adolescents with transfusion-dependent thalassemia (TDT).

Methods: In this cross-sectional study from a tertiary teaching hospital in Delhi, records of adolescents aged 17-19 years with TDT on regular transfusion at thalassemia day-care centre were reviewed. Pubertal development and its determinants were assessed.

Respiratory Care in Children with COVID-19.

The novel coronavirus disease 2019 (COVID-19) pandemic caused by severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) is causing significant morbidity and mortality worldwide. The common presentations in children include involvement of respiratory system leading to pneumonia and acute respiratory distress syndrome, as well as multiorgan dysfunction syndrome and multisystem inflammatory syndrome in children (MIS-C). Pediatric COVID-19 is a milder disease as compared with the adults.

Development and Evaluation of a Working Memory Intervention Kit in Children with Epilepsy in Low-Resource Settings.

Objectives: In this pilot study, the authors developed and evaluated a working memory intervention (WMI) using a combination of mobile phone-based application and an activity booklet, among children with idiopathic generalized epilepsy.

Methods: Pre- and post-intervention cognitive evaluation at 8 wk included: subtests comprising working memory index from Wechsler Intelligence Scale-IV, color cancellation task for sustained attention, and parent's rating from the Conners' ADHD/DSM-IV Scales of the Conners' Rating Scales-Revised.

Results: Fourteen children completed the intervention; one was lost to follow-up.

Maintaining human milk bank services throughout the COVID-19 pandemic: A global response.

If maternal milk is unavailable, the World Health Organization recommends that the first alternative should be pasteurised donor human milk (DHM). Human milk banks (HMBs) screen and recruit milk donors, and DHM principally feeds very low birth weight babies, reducing the risk of complications and supporting maternal breastfeeding where used alongside optimal lactation support. The COVID-19 pandemic has presented a range of challenges to HMBs worldwide.

What Is New in the Management of Childhood Tuberculosis in 2020?

The Government of India has developed a National Strategic Plan for tuberculosis (TB) elimination by 2025, five years ahead of the global target set by the World Health Organization (WHO). For achieving these targets there has been a paradigm shift in the diagnostic and treatment strategies of TB at all ages. This update summarizes the specific changes in pediatric TB management in light of the guidelines developed by National Tuberculosis Elimination Program and Indian of Academy of Pediatrics.

Neurological Deterioration in Three Siblings: Exploring the Spectrum of Argininemia.

Argininemia or hyperargininemia is a urea cycle disorder caused by deficiency of the enzyme arginase 1. It is inherited in an autosomal recessive fashion. It commonly leads to spastic diplegia in childhood, but other important features include cognitive deterioration and epilepsy.

Novel insights into the histology of jejunoileal atresia and its therapeutic implications.

Aim: To study the histology of resected specimens of jejunoileal atresia (JIA) and to explore its probable therapeutic implications.

Methods: Biopsies were taken from the resected specimens of 32 patients of JIA. Sections were taken at the atretic ends and successively at every 5 cm in resected proximal bowel.

Management of Infants with Congenital Adrenal Hyperplasia.

Treatment of congenital adrenal hyperplasia (CAH) requires lifelong replacement of glucocorticoids with regular follow up to manage associated morbidities. The current review focuses on follow-up and management of infants diagnosed with classical CAH pertinent to Indian context. Early initiation of oral hydrocortisone in divided doses is recommended after diagnosis in newborn period, infancy and childhood.

Impact of Using Different Growth References on Interpretation of Anthropometric Parameters of Children Aged 8-15 Years.

Objective: To compare the effect of the application of three growth references (Agarwal, 1992; Indian Academy of Paediatrics (IAP), 2015; and World Health Organisation (WHO), 2007) on interpretation of anthropometric parameters in schoolchildren.

Setting: Cross-sectional school-based study.

Participants: Children 8-15 years studying in one government school and one private school of Delhi.

The Profile of Donors to a Human Milk Bank in a Developing Nation.

Donor human milk plays a vital part in the care of sick neonates. There is paucity of literature on the profile of human milk donors of low- and middle-income countries (LMICs). This retrospective observational study evaluated the demographic profile of 1,553 donors of a human milk bank of a tertiary care center from a LMIC over a period of 21 months.

Newborn Screening and Diagnosis of Infants with Congenital Adrenal Hyperplasia.

Congenital adrenal hyperplasia (CAH) is an autosomal recessive endocrine disorder which can manifest after birth with ambiguous genitalia and salt-wasting crisis. However, genital ambiguity is not seen in male babies and may be mild in female babies, leading to a missed diagnosis of classical CAH at birth. In this review, we provide a standard operating protocol for routine newborn screening for CAH in Indian settings.

Incidence of vincristine induced neurotoxicity in children with acute lymphoblastic leukemia and its correlation with nutritional deficiencies.

Injection vincristine is an important component of therapy for acute lymphoblastic leukemia (ALL). An important adverse effect of vincristine is neurotoxicity. The incidence of this adverse effect is well studied.

Cerebral Palsy in North Indian Children: Clinico-etiological Profile and Comorbidities.

Aims And Objectives: Cerebral palsy (CP) is a common motor disability in children. This study aimed at elaborating various comorbidities and etiologies and also at correlating motor disability with other disabilities.

Material And Methods: This hospital-based study was conducted in the outpatient department of a tertiary care hospital in Delhi on 160 children with CP in the age group 2-15 years.

Surgical Surprise during Posterior Sagittal Anorectoplasy: A Rectal Duplication.

An 8-month-old boy with anorectal malformation (ARM) was incidentally found to have double rectal pouches during posterior sagittal anorectoplasty. The distal blind-ending pouch was excised, and the larger proximal pouch was tapered and anorectoplasty performed. The excised pouch was confirmed as rectal duplication cyst.