Background: Sickle cell disease is a common genetic disorder characterised by chronic haemolytic anaemia and vaso-occlusive crisis. Sickle cell anaemia (SCA) has both short-term effects in the form of acute clinical events and long-term repercussions seen with chronic multiorgan involvement. It is associated with significant morbidity and mortality. In India, the disease is largely undocumented. Thus, there is an urgent need to highlight the features of the disease so that locally appropriate models of care may be implemented. Objective: This study aims to evaluate acute clinical events in SCA and to provide data that may help to reduce the rate of morbidity and mortality associated with this disease by early interventions. Materials and methods: A cross-sectional observational study was conducted between November 2020 and May 2022 at Indira Gandhi Government Medical College and Hospital, Nagpur, Central India. The inclusion criteria included previously diagnosed patients of SCA (homozygous sickle cell disease) on high-performance liquid chromatography (HPLC) between the age groups of six months and 12 years, presenting with acute clinical events. The exclusion criteria included patients younger than six months and older than 12 years of age, and all patients with other haemoglobinopathies and sickle cell trait. The study was approved by the Institutional Ethical Committee. All the data was entered into a well-designed Microsoft Office Excel spreadsheet (v 2019, Microsoft, Washington, USA). All the clinical, biochemical, and haematological data were tabulated and analysed. Results: A total of 100 children with sickle cell disease diagnosed by HPLC were enrolled during the study period. About 215 acute clinical events among the 100 cases were recorded, for which they were admitted to the paediatric ward or PICU. The majority (35%, n=35) were seen in the age group of six to nine years (school-going age). About 52% were male and 48% were female (male-to-female ratio= 1.08:1). Pain was the most common symptom. The highest incidence of 36.75% (n=79) was seen with acute painful crises and was the most common indication of hospitalisation, followed by acute febrile illness (AFI) (34.42%, n=74), aplastic crisis (10.23%, n=22), splenic sequestration crisis (9.77%, n=21), hepatobiliary involvement (3.72%, n=8), acute chest syndrome and haemolytic crisis (each 1.86%, n=4), and stroke (1.40%, n=3). In cases of having foetal haemoglobin (HbF) ≥20%, the incidence of acute painful crisis (p=0.0001), hand-foot syndrome (p=0.047), aplastic crisis (p=0.033), splenic sequestration crisis (p=0.039), and AFI (p=0.035) was low as compared to cases having HbF ≤20% which was statistically significant. The incidence of acute painful crisis, hand-foot syndrome, and an aplastic crisis was significantly low in patients receiving hydroxyurea therapy as compared to patients who were not on hydroxyurea. Out of 100 cases, four died during the study period, three died because of splenic sequestration crisis...

Coronavirus Disease 2019 (COVID-19) the disease caused by the novel coronavirus, has led to an unprecedented global pandemic affecting people of all ages. In this case series, all COVID-19 positive neonates (≤28 days of life) born to mothers with Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) infection were selected from tertiary care hospital, in Central India from March 2020 to September 2020. There were 15 neonates affected by SARS-CoV-2 infection. In this case series, authors found that out of 15 neonates, 5 were male and 10 were female. Main symptoms were fever, shortness of breath, poor feeding and others (like-abdomen distension, vomiting) but, often these neonates did not showed other symptoms during stay in designated COVID-19 Neonatal Intensive Care Unit (NICU) with no mortality found in this case series. COVID-19 positive neonates showed a good prognosis, with low rate of severe complications and without any mortality. Treatment was mostly symptomatic or supportive. Most of the neonates tested positive for SARS-CoV-2 were asymptomatic or had mild disease.

Context: Pregnancy induced hypertension (PIH) is one of the important risk factor for preterm delivery. Neutropenia and thrombocytopenia are well recognized neonatal sequelae to maternal hypertension in pregnancy. Preeclampsia-associated neutropenia is a risk factor for an increased incidence of infection in preterm neonates. Methods & material: 87 neonates born to mother with preeclampsia were included with aim to find prevalence of EOS and their haematological profile. Diagnostic work up includes complete blood count, CRP, blood culture and sensitivity (C/S) and other relevant investigations according to cases. Result: Out of 87 neonates, 7 neonates had EOS (8%) with blood culture proven bacterial sepsis, Klebsiella pneumonia (57.14%) was commonest organism isolated followed by E. Coli (28.57%) and Enterococci (14.28%). About 32 (36.76%) mothers had severe hypertension and 55(68.22%) mothers had mild to moderate preeclampsia. About 60(68.79%) neonates were born preterm. 40 (45%) neonates had neutropenia. 38 (43.65%) babies had thrombo-cytopenia. All 7 septic babies had neutropenia and thrombocytopenia. Conclusion: Early onset septicemia is more common in babies born to mother with preeclampsia due to associated Prematurity, Neutropenia and Thrombocytopenia. Hence preventive measures should focus on recognition of these high risk neonates with prompt laboratory screening for sepsis and early institution of empirical antibiotics based on local data.

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Despite numerous efforts, pediatric nutritional anemia remains one of the most serious health issues in developing countries. Severe nutritional anemia is associated with a number of modifiable risk factors, which can be overcome if the risk factors are accurately identified and addressed for different population groups. The purpose of this descriptive study is to focus on severe nutritional anemia in hospitalized children aged 1–5 years in a tertiary care center in Central India. Hospitalized children were enrolled in the study, and demographic, socioeconomic, clinical, and laboratory data, as well as clinical and laboratory images, were reviewed. For defining severe anemia, the World Health Organization cutoff value was used. Out of total 9850 children of 1–5 years of age group admitted in hospital for 2 years, 197 children had severe nutritional anemia, indicated the incidence of 2%. Lower socioeconomic status and malnutrition were significantly correlated to severe nutritional anemia.