Background: Asthma is a chronic inflammatory condition of the airways resulting in increased airway reactivity to a variety of stimuli like allergens, irritants, viruses and exercise. There is a strong association between the exposure of allergens and development of asthmatic symptoms. A hypersensitivity reaction initiated by immunologic mechanisms mediated by Immunoglobulin E (IgE) antibodies occurs in allergic asthma. IgE and eosinophils play an important role in the inflammatory process resulting in bronchial hyperresponsiveness. The aim of this study was to evaluate serum total IgE levels and Absolute Eosinophil Count (AEC) as markers of disease activity and study their association with the severity of bronchial asthma in children.Methods: A prospective study was conducted in the paediatric department of a tertiary care hospital in Ahmedabad, Gujarat, India from July 2017 to December 2018. Children between 4-14 years of age diagnosed as having bronchial asthma were included in the study. Serum total IgE levels and absolute eosinophil count were done in all the study participants and their correlation with the severity of asthma was assessed.Results: Of the total 109 patients of asthma, 44(40.4%) had intermittent asthma, 30(27.5%) mild persistent, 25(22.9%) moderate persistent and 10(9.2%) severe persistent asthma. Serum total IgE levels were raised above the normal limits for age in 94(86.2%) patients and increased AEC was found in 61(56 %) patients. Both serum total IgE levels and AEC increased significantly (p<0.0001) with increasing severity of asthma.Conclusions: Serum total IgE levels and AEC can be used to predict the severity of asthma in children.

Background: Hypernatremia is known to occur in exclusively breastfed neonates in the first few days of life, and its clinical presentation is usually nonspecific. Early identification and prompt treatment of this condition are necessary to prevent morbidity and mortality. Objective: The objective of the study was to evaluate the clinical features, causative factors, complications, and outcome of hypernatremia in exclusively breastfed term newborns. Materials and Methods: A prospective study of exclusively breastfed healthy term neonates with hypernatremia (serum sodium ?150 mg/dl) was carried out from March 2016 to February 2017. The presenting symptoms, clinical signs, birth and feeding history, and laboratory investigations of the subjects were noted and analyzed. Results: Hypernatremia was noted in 35 (1.6%) of the total term neonates. The condition was more common in babies delivered by cesarean section (34.3%), firstborn neonates (74.3%), and during the summer months (74.3%). Mean age of presentation was 4.06±1.43 days. The most common findings were weight loss ?7 % from the birth weight (74.3%), feeding problems (71.4%), and decreased frequency of urine (60%). Serum sodium levels ranged from 150.5 to 187 mEq/dl. Acute kidney injury was noted in 4 (11.4%) cases. All the patients were discharged, and there was no mortality. Conclusion: Hypernatremia is a common condition in exclusively breastfed neonates. It occurs due to inadequate intake of breast milk by the neonate and is exaggerated in hot environment. Daily weighing of the neonates and monitoring the frequency of urine are important for early detection. Addressing feeding problems early is a simple yet effective measure to prevent this condition.

Background: Hypothyroidism is a common endocrinal cause of growth retardation in children. Following adequate treatment with thyroxine, growth resumes at an accelerated rate which is known as catch-up growth. There are few observational studies from India on the growth parameters following treatment with thyroxine in children with hypothyroidism.Methods: A retrospective study was done in children aged 2-10 years who were newly diagnosed cases of primary hypothyroidism [Total serum Thyroxine (T4) levels <5 µg/dl and serum Thyroid Stimulating Hormone (TSH) levels ˃15 µU/ml] and treated with oral thyroxine to attain euthyroid state. Height measured before starting treatment and at the time of follow up visits was noted, the Height Standard Deviation Scores (HSDS) were calculated. The effect of thyroxine on linear growth was studied.Results: There were 23 children who were diagnosed as having primary hypothyroidism of whom 16(69.6%) were females and 7(30.4%) were males. The mean age of the children studied was 7.3±2.3 years. The mean dose of thyroxine required to maintain euthyroid status was 4.6±2.2 µg/kg/day. Mean duration of follow up was 13.7±2.4 months. The initial HSDS was - 2.31±0.9 which improved to a final value of - 1.7±0.76 (ΔHSDS0.61, p value <0.0001). Mean height velocity was 8.1 cms/year.Conclusions: Following adequate thyroxine replacement therapy catch-up growth occurs and increased growth velocity leads to partial regain of height deficit in the first couple of years of treatment.

Background: Anemia is a major nutritional problem in India. Anemia in infancy and early childhood affects growth and development and is associated with increased morbidity and mortality. The aim of this study was to determine the prevalence, severity and types of anemia and study the risk factors for anemia in hospitalised infants. Methods: A prospective study was conducted at a tertiary care hospital in Western India from July 2016 to December 2017. Complete hemogram of all hospitalised infants between 6-12 months of age was done and those with haemoglobin levels<11g/dl were considered anemic. Results: Out of 206 hospitalised infants,131(63.6%) had anemia. Male: female ratio was1.3:1. The most common illness for which they were admitted was respiratory tract infections.35.1% of the anemic infants had low birth weight, 19.1% were born prematurely and 59.5% had a history of maternal anemia. Only 42% were exclusively breast fed till 6 months of age and improper complementary feeding practices was observed in 61.8% of infants. Mild, moderate and severe anemia was seen in 41.2%, 50.4% and 8.4% infants respectively. The most common type of anemia was microcytic hypochromic anemia (67.2%). Conclusion: Anemia is a major problem in infants with a high prevalence. Most infants have mild to moderate anemia and the most common type is microcytic hypochromic anemia most likely due to iron deficiency. Preterm gestation, absence of exclusive breastfeeding, consumption of cow's milk, improper complementary feeding practices and presence of maternal anemia were the risk factors found to be associated with development of anemia in the present study.