Background: Pregnant women and newborns are highly susceptible to Covid-19, manifesting as multisystem inflammatory syndrome-New-born (MISC-N) in many babies born to Covid positive mothers. The relationship between Covid-19 infection during pregnancy and neonatal neurodevelopmental outcome, if any, is unclear necessitating a follow-up study in this aspect. Methods: 16 babies with MIS-N, born to symptomatic Covid antibody positive mothers were enrolled. Demographic profile, treatment details and biochemical parameters were analyzed with neurodevelopmental follow-up. Results: 25% mothers received 2 doses of Covid vaccine; 50% had oligohydramnios and 75% received antenatal steroids. 87.5% were preterm of which 62.5% required surfactant with ventilator support and 75% required ionotropic support. Significant association was found between the antibody level and D-dimer levels with the ferritin and LDH levels of the baby (p < 0.05); gestational age with LDH and D-dimer levels (p < 0.05) and Covid antibody level of the baby vs the duration of ventilator requirement (P-value-0.0009). D-dimer values of babies were positively associated with both maternal antibody and D-dimer levels. Neurodevelopmental follow-up done at 6 months of corrected gestational age showed 37.5% were normal, 37.5% hypertonic and 25% hypotonic. HINE score was below 60 in 62.5%. Development assessment using Bayley-III showed a delay in the motor domain (62.5%), cognitive domain (56.25%) and language domain (62.5%). Conclusion: Neurodevelopmental problems occur in babies born to Covid positive mothers and should be stratified as "high risk".

Nail diseases in children may be congenital or acquired and occurs in 3 to 11% of pediatric population. Twenty nail dystrophy is a nail disorder with a classical presentation, often affecting all twenty nails. It is an idiopathic disorder in childhood but can be associated with other diseases such as lichen planus, alopecia areata, psoriasis, eczema, IgA deficiency, atopic dermatitis, ichthyosis vulgaris and vitiligo. Twenty nail dystrophy is otherwise called trachyonychia. Typically, the condition is bilateral and symmetrical affecting all the nails of hands and feet. It is cosmetically disfiguring and can be source of anxiety for children and parents, which can impact further the quality of life. Twenty nail dystrophy is of two types, based on the clinical presentation namely opaque or shiny trachyonychia. Since this nail disorder is associated with a number of dermatologic diseases, children require long term follow up. We report a case of a 12-year-old boy with a three-year history of twenty nail dystrophy with no relevant family history of skin or nail diseases. The child had isolated nail manifestation without any other dermatologic condition. Twenty nail dystrophy is a self-limiting disease, which is treated conservatively. The aim of this report is to highlight importance of a thorough physical examination to diagnose nail disorders in early stages, which will be helpful to clinicians to distinguish the different nail conditions and associated illness and decide on the correct management. It is important to counsel the family about the benign nature of the disease and good prognosis.

Introduction: Febrile seizure is one of the most common paediatric emergencies encountered in a paediatric practice. There have been studies done with regards to iron deficiency anaemia and family history and chances of a child developing febrile seizure. Many studies state that vitamin D has a role in development of brain and seizure activity. Aim: To find the association between Vitamin D levels and febrile seizures in children and assessing the nutritional status of children with febrile seizures. Materials and Methods: Fifty consecutive children (developmentally normal), between ages of 9-60 months, presenting with febrile seizures to the Paediatric Department, from February 2019 to January 2020, were enrolled. Antenatal history regarding birth order, maternal weight gain, antenatal check-ups, antenatal supplements and medical problems in mother if any, were noted. Birth history, birth weight, breast feeding, complimentary feeding and present diet history were noted. The height and weight were documented. Skin colour was noted based on Fitzpatrick scale. Vitamin D levels were classified as deficient if blood levels were <10 IU; insufficient if between 10-30 IU and sufficient, if the levels were >30 IU. Collected data were analysed and compared using Sigma Plot 13 and Chi-square test was done and a p-value <0.05 was considered as statistically significant. Results: Vitamin D insufficiency was prevalent in 68% of children. The dark skin, reduced time spent outdoors, clothing habits and diet and antenatal factors contribute to this vitamin D insufficiency. A 58% of children had Height for Age Z (HAZ) score less than -1SD and 62% of children had Weight for Age Z (WAZ) score less than -1SD. On correlating the Complete Blood Count (CBC) values with iron deficiency, it was found that 56% of children with febrile seizure had anaemia based on Red-cell Distribution Width (RDW) value >14.5. Febrile seizure was less common in summer (16%). Conclusion: A 68% of children had vitamin D insufficiency. A 56% of children had low iron based on RDW. The nutritional status of children was poor as assessed by HAZ and WAZ scores.

<abstract><sec> <title>Introduction</title> <p>Children with epilepsy are at greater risk of developing psychiatric and behavioural disorders such as attention deficit/hyperactivity disorder (ADHD), conduct disorder, autism spectrum disorder (ASD), as well as affective and aggressive disorders than normal children which may affect the well- being and quality of life of the child.</p> </sec><sec> <title>Aim and Objectives</title> <p>This study aims at identifying behavioural problems in children with epilepsy enabling early diagnosis and intervention. The objectives were to assess the presence and type of behavioural problems in children with epilepsy.</p> </sec><sec> <title>Methods</title> <p>A prospective cross-sectional study was conducted on children who were diagnosed as epilepsy in two age groups of 1.5–5 years and 6–18 years recruited by non-probability convenience sampling. Data regarding seizure semiology, clinical features and treatment were obtained. Children underwent IQ assessment, electroencephalogram and brain neuroimaging. Child Behaviour Check List (CBCL) was administered to parents or primary caregivers after obtaining informed consent. Results were analyzed for presence of behavioural problems using SPSS-23.</p> </sec><sec> <title>Results</title> <p>In the study, out of 50 study subjects, 72% were between 6–18 years. 60% children had generalised seizures, 58% children had epilepsy for &lt;2 years and abnormal EEG was present in 80% children. 6% children had behavioural problems and 4% had borderline presentations. Co-relation of behavioural problems with age was statistically significant with p value 0.027. Behavioural problems identified were aggressiveness and anxiety.</p> </sec><sec> <title>Conclusion</title> <p>Childhood epilepsy is associated with behavioural problems along with other co-morbidities warranting a search during follow-up visits.</p> </sec><sec> <title>Take-home message</title> <p>Early identification and treatment of behavioural problems in children with epilepsy by periodic assessment during follow up visits, careful selection of combination of drugs and appropriate dose can improve the overall outcome in children taking antiepileptic drugs (AEDs) for epilepsy.</p> </sec></abstract>

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