Introduction: Thalassemias are inherited blood disorders characterized by abnormal hemoglobin production. There are two main types, alpha thalassemia, and beta-thalassemia. Beta Thalassemia Major (also called Cooley's Anemia) is a serious illness. Symptoms appear in the first two years of life and include paleness of the skin, poor appetite, irritability, and failure to grow. There is absent or decreased production of normal hemoglobin, resulting in microcytic anemia of varying degrees. The thalassemias have a distribution concomitant with areas where P. falciparum malaria is common. The alpha thalassemias are concentrated in Southeast Asia, Malaysia, and southern China. The beta thalassemias are seen primarily in the areas surrounding the Mediterranean Sea, Africa, and Southeast Asia. Proper treatment includes routine blood transfusions and other therapies which can lead to iron overload and contraction of infections such as HIV, HCV, and HBV shortening the life span of patients. On the other hand, inadequate transfusions may lead to severe anemia and debility. Material and Methods: This retrospective record-based cross-sectional study was conducted in S.N. Medical College, Agra. Results: In our tertiary center, we have 103 registered patients of thalassemia, in which 44 are females and 59 are males. Out of the 103 thalassemia cases, 95 (92.2%) belonged to beta-thalassemia major, 4(3.8%) of betathalassemia intermediate, and 1 (0.9%) of beta-thalassemia minor category. Fever was the most common presenting symptom. Pallor and hepatomegaly were the most common signs among cases. Conclusion: Hemoglobinopathies are the commonest hereditary disorders in India and pose a major health problem. The data on the prevalence of β-thalassemias and other hemoglobinopathies in different caste/ethnic groups of India is scarce.

Background: Worldwide community-acquired pneumonia (CAP) is the major cause of high mortality among under five children in India. After introduction of Pneumococcal and H. influenzae vaccination there is paucity of data regarding etiological profile of pneumonia. Aims and Objective: To evaluate the Clinico- epidemiological profile and etiology of community acquired pneumonia in children. Materials and Methods: We enrolled children aged 3-59 months with CAP (based on WHO criteria of tachypnea with cough or breathing difficulty) over 18 months and recorded presenting symptoms, clinical signs and chest radiography. We performed blood and nasopharyngeal swab (NPS) bacterial culture simultaneously to detect etiological agent of community acquired pneumonia in children. Results: Out of 150 cases of CAP, 90 % of caeses had cough and fever and nearly 80-90% cases had tachypnea and crackles on examination. Radiological findings suggestive of pneumonia was seen in 86% cases . Most common organism isolated was S aureus in both NPS culture (18.7 %) and blood culture (14.7 %). Other common organisms detected in NPS culture were S pneumoniae (6%), E Coli (4.7%), Klebsiella (4.7%), CONS (3.3%), and Pseudomonas (2.7%). In blood culture the common organism detected after S aureus was E coli (5.3%), S pneumoniae (3.3%), Klebsiella (3.3%), CONS( 3.8%), and Pseudomonas (2.5%). Conclusions: We observed that S aureus was the predominant etiological organism isolated in both blood and nasopharyngeal swab bacterial culture in patients suffering from community-acquired pneumonia.

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Introduction:In India, Dengue epidemics are becoming more frequent. The majority of dengue virus infection are self limiting, but complications may cause substantial morbidity and mortality. Methods: In this retrospective study, medical records were reviewed and analyzed. Patients were classified into dengue with and without warning sign and severe dengue (DHF/DSS). Objectives: To assess clinical profile of dengue infection in children less than 18 years of age and to evaluate outcome of dengue fever admitted from June to December 2018, in Department of Pediatrics, Sarojini Naidu Medical College, Agra. Results: A total of 50 dengue positive patients were classified into dengue with or without warning signs 42(84%) and 8 (16%) severe dengue cases. The most commonly involved children were male between 5-10 yr (36%) of age group followed by 1-5 yr (34%). Most common clinical manifestation was fever observed in 96% cases followed by rash (66%), pain abdomen (52%) and vomiting in 26% cases.46% cases of dengue had warning signs. Most common clinical and radiological findings were ascites seen in 24% cases followed by pleural effusion. Elevation of Aspartate Transaminase (SGOT) in 82% and thrombocytopenia was seen in 60% cases. Conclusion: High grade fever, vomiting, abdominal pain and skin rash with normal or low platelet count were varying clinical presentation. Early clinical suspicion and diagnosis with prompt management accompanied by preventive measures can prevent morbidity and the mortality associated with dengue.

Background: Under-five and infant mortality constitutes a major health problem in India. To combat this high mortality, IMCI strategy aiming at holistic and integrated approach to child health and development was developed by WHO. This study is a comparative study conducted at Emergency and Outpatient Department of Pediatrics FHMC Tundla and SNMC Agra. Total of 200 young infants (0-2months) were taken. Detailed history and examination was done for all enrolled young infants according to IMNCI and for enrolled infants diagnosis and treatment was made in the Pediatric Department and was considered as Gold Standard. Results: Out of total 200 young infants, 117 were 0-7 days of age and rest 83 were 7-59 days of age. Of these 109 infants were admitted, and 91 infants were sent home after initial management. There was no mismatch in diagnosis of 48% infants, while partial mismatch in 38.5% infants, over diagnosis in 10.5% and under diagnosis was present in 3% infants of 0-2 months of age. Conclusion: This study had good diagnostic agreement and only 3% of infants were underdiagnosed.