BackgroundThalassemia Major is a preventable genetic disorder characterized by abnormal hemoglobin synthesis and lifelong blood transfusions. The children suffering from Thalassemia Major have poor quality of life. This study was conducted to assess the factors influencing quality of life of these children and how it can be improved.MethodsA descriptive cross sectional study was conducted in 2014 at Thalassemia Day Care Centre of a tertiary level children’s hospital in Delhi, to assess quality of life of children suffering from Thalassemia Major. A total of 241 eligible children (age 2–18 years) were enrolled in the study. Socio demographic and clinical characteristics were collected from interview and existing medical records. The PedsQL 4.0 generic core scale was used for assessing the quality of life of the children.ResultsThe mean age of children was 8.69 ± 4.98 years. Two-thirds (63.5%) were boys. The total mean QoL score of the children was 82.0 ± 14.4. The quality of life scores were better for boys as compared to girls. The most affected domain was the emotional domain which showed statistically significant (p = 0.025) difference between boys and girls. The total QoL scores were significantly affected by the current age of the child (p = 0.000) and presence of co-morbidity (p = 0.026). Children not on any form of iron chelation therapy (p = 0.003) and fewer hospital visits (p = 0.044) had better QoL scores.ConclusionsFactors improving the quality of life were control of iron overload and adverse effects of ICTs, management of co morbidities and fewer hospital visits.
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. Results A total of 2919 children with suspected severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) illness were tested for novel COVID-19 virus in the flu emergency ( n = 1744), severe acute respiratory infection (SARI) ward ( n = 825), and non-COVID area ( n = 350) of the hospital. 8.73% (255/2919) children tested positive for SARS-CoV-2 infection. Of the 255 positive cases, 144 (56.47%) were managed on an outpatient basis and 100 (59 boys) required admission in COVID ward. The mortality rate of patients with SARS-CoV-2 was 11.4% (29/255). Majority of children admitted with COVID-19 had severe to critical illness due to the presence of malnutrition and underlying comorbidities. Conclusions Children of all age groups were susceptible to COVID-19 illness with a slight male preponderance. Amongst infected, two-third were asymptomatic or had mild symptoms that required outpatient management and home isolation. The adverse outcomes were more commonly seen in infants and children > 10 y of age with malnutrition and comorbid illness. Supplementary Information The online version contains supplementary material available at 10.1007/s12098-021-03822-5.
Aim The SARS‐CoV‐2 pandemic is characterised by multiple reports of paediatric multisystem inflammatory disease or multisystem inflammatory syndrome in children (MIS‐C) with Kawasaki disease‐like features often complicated by myocarditis, shock and macrophage activation syndrome. Certain clinical and laboratory markers may be used to identify high risk cases. Methods All sequentially admitted patients hospitalised between April 2020 and October 2020, who met the WHO case definition for MIS‐C were included. Data included patient demographic information, presenting symptoms, organ dysfunction and laboratory parameters. SARS‐CoV‐2 infection was diagnosed by nasopharyngeal swab real‐time reverse transcription‐polymerase chain reaction and/or rapid antibody test for SARS‐CoV‐2 as recommended. The clinical and laboratory criteria were compared in the survival and non‐survival groups. Results A total of 29 patients with MIS‐C were treated during the study period. There were 21 survivors and 8 non‐survivors. The non‐survivors had more neurocognitive and respiratory symptoms along with increased incidence of myocarditis compared with survivors. The serum levels of CPK‐MB, D‐dimer, ferritin and triglyceride were significantly raised in non‐survivors as compared to survivors. Conclusion The non‐survivor group had higher CPK and greater proportion of children with troponin‐T elevation indicating higher incidence of myocardial injury and necrosis. The D‐dimer, ferritin and triglyceride were also higher in the mortality group, indicating the greater extent of inflammatory damage in this group.
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