Background: Fever of unknown origin is one of the leading etiologies for morbidity and mortality among children worldwide and their spectrum keeps changing constantly from time to time. The objective of this study was to study the clinical profile and etiological spectrum of fever beyond 2 weeks duration in children aged 2 months to 12 years admitted in a tertiary care hospital. Methods: A prospective observational study, done in tertiary care centre over six month period (May 2016 to October 2016). Children aged 2 months to 12 years presenting with fever beyond 2 weeks duration fulfilling the inclusion criteria were included in the study and evaluated further. Initial investigations include complete blood count including peripheral smear for MP/malignancy, urine routine, chest X-ray, mantoux, CRP, blood and urine cultures were done followed by specific serology tests and further relevant investigations. The etiological outcomes were mainly analysed. Results: The etiological outcomes of the study were classified into 5 groups as infections, malignancies, connective tissue disorder, miscellaneous and undiagnosed. Among the study population, infection emerged as the major etiological outcome constituting 69.1% followed by malignancies (16.7%), connective tissue disorder (5%), miscellaneous (5.8%) and undiagnosed (3.4%). Conclusions: Infections, especially enteric fever still remains the leading etiology of fever beyond 2 weeks duration or FUO in children aged 2months to 12 years. Irrational usage of antibiotics has been highlighted in general practice which needs to be amended by periodic discussions and epidemiological surveys to prevent the emergence of drug resistance.

Background: Acute Renal Failure (ARF) is one of the common causes of morbidity and mortality in children. With the availability of increasing knowledge and awareness, dialysis facilities and excellent supportive treatment, the overall outcome is changing. This study is undertaken to find out the outcome of ARF in children.Methods: This prospective cross-sectional study was done in Institute of Child Health and Hospital for Children, (ICH and HC) Egmore, Chennai from February 2014 to January 2016. Children with elevated blood urea (>40 mgs/dl) and serum creatinine (>1 mg/dl) were included and evaluated for etiology, treatment modality and outcome and other co-morbid features. Data was analysed on SPSS 20.0. P value of <0.05 was considered significant.Results: A total of 105 children (65 boys, 40 girls) from newborn period to 12 years were examined. The common age of presentation of ARF is 1-4 years with a male preponderance and acute glomerulonephritis were found to be commonest cause. There was no statistically significant difference in mortality in relation to age group (P 0.98). There was a statistically significant difference in mortality in relation to duration of oliguria (P 0.02), Serum creatinine levels (P 0.03). The role of other biochemical values like serum potassium (P 0.14), serum bicarbonate (P 0.59) were not found statistically significant. Peritoneal dialysis in general improves survival, but it is not statistically significant (P 0.33). Systemic complications associated with ARF increases mortality and it is statistically significant (Chi- square value = 9.13, P = 0.003).Conclusions: ARF in children is due to transient disorders and early referral to major centres even with 1-2 days oliguria and early treatment will improve the prognosis. Peritoneal dialysis in severe ARF with associated complications really helped the children.

Objective: To eliminate iodine deficiency disorders (IDD) in children, the Indian government implemented a universal salt iodization program more than 3 decades ago. Recently, it was identified that excess iodine intake could lead to autoimmune thyroiditis in children. We aimed to measure the level of iodine excretion as well as thyroid profiles as an option to identify autoimmune thyroiditis in school-going children. Materials and Methods: A total of 111 children between the ages of 6 and 12 years were subjected to a blood test to measure free thyroxine, thyroid-stimulating hormone, anti-thyroglobulin, and anti-thyroperoxidase levels. The children were categorized into control and case groups based on the clinical outcome. Biochemical analysis, thyroid gland assessment, fine-needle aspiration cytology (FNAC), and ultrasound sonography were performed. Urinary iodine excretion (UIE) level was measured by the Sandell-Kolthoff reaction method. Results: Approximately 90% of the study population was identified with a higher level of iodine in urine. A positive correlation was observed between the UIE, anti-TPO, and anti-TGO titers among the cases. Out of 61 cases, 21 children showed overt hypothyroidism (34.43%) and the remaining were identified with subclinical thyroid symptoms (65.57%). FNAC confirmed autoimmune thyroiditis in 43 children within the case group. Conclusion: Excess iodine intake may trigger thyroid autoimmunity in children. Children who are having higher levels of anti-thyroid antibodies are at risk of developing thyroid dysfunction if they consume more than the required iodine for metabolism. High levels of iodine in the urine of control children indicate that the IDD program in our nation is running successfully.