Cerebrospinal fluid levels of procalcitonin, lactate, and lactate-ratio are reliable markers to diagnose bacterial meningitis in blood-contaminated cerebrospinal fluid.

Background: Anemia is said to be present when the hemoglobin level is more than two standard deviations below the mean for the child’s age and sex. Anemia is the most common global nutritional disorder and may lead to psychomotor retardation, low intelligence, decreased learning capability, weakening of immune system and predisposes to serious infections in children. Methods: The study was an observational study. Physical signs of severe anemia were looked in patients attending outpatient department or admitted in hospital. Children with hemoglobin levels <7 gm/dl and in the age group 6 months to 6 years were recruited in study. Results: The study included 192 patients with a male, female ratio of around 1:1. The mean age of the study subjects was 2.2±1.6 years. Most of the patients around 54% belonged to age group of 6 months to 1½ years. Fever was most common presentation in 86 cases (44.77%), followed by diarrhea and easy fatigability in 38 (19.79%) and 21 (10.93%) patients respectively. A total of 76.56% of patients were having nutritional and 23.44% non-nutritional causes. Iron deficiency anemia is most common etiology 115 (59.90%) with 14 patients having celiac disease, 19 cases (9.90%) were diagnosed as megaloblastic anemia, 13 cases (6.77%) were diagnosed as dual deficiency anemia, 30 cases (15.63%) were diagnosed as hemolytic anemia. Conclusions: Nutritional anemia is major cause of anemia in children. Celiac disease, trichuriasis, cow milk protein allergy should be ruled out in iron deficiency anemia patients.

Background: Mumps is a self-limiting viral disease in children which usually resolve within 10 days. It is characterized by fever, constitutional symptoms and swelling of the parotid gland(s) and may lead to serious complications. The most common complication is orchitis, followed by meningitis. Less common complications include pancreatitis, encephalitis, deafness, mastitis, oophoritis, and facial Bell palsy. Methods: This is a hospital-based Prospective observational study where children age ≤18 years who presented with mumps were studied for immunization status, clinical course, complications and outcome. Results: Fever was the most common presentation followed by parotid involvement. The mean duration of illness was 9±2 days. Constitutional symptoms like headache, myalgia or fatigue were seen in 90 patients (60%). The most common complication seen was orchitis and tonsilitis, 4 cases (2.7%) each followed by pancreatitis (2%), febrile seizures (2%) and meningitis (2%). The least common was myocarditis (0.7%). Only 10 (6.7%) of the patients were hospitalized and none died. All the patients were cured within 2 weeks and without any sequels.  The average loss of school days (school absentee) were 8 days. These complications were seen only in non- immunized patients. Conclusions: The benefits of vaccination against mumps in addition to rubella and measles would be a logical public health intervention that would have a significant clinical and economic benefits and to prevent complications of mumps.

Background: Anemia is one of the leading causes of mortality and morbidity in children. The etiology of anemia is multifactorial including nutritional anemia, hemolytic anemia, aplastic anemia, storage disorders, hematological malignancies, anemia secondary to some chronic diseases. Methods: The study is an observational study. Physical signs of severe anemia were looked in patients attending outpatient department or admitted in hospital. Children with hemoglobin levels <7 g/dl and in the age group 6 months to 6 years were recruited in study. The aim is to look for non-nutritional etiology of severe anemia in children in Kashmir. Results: Out of 192 children, 97 (50.52%) females and 95 (49.48%) males, with a male, female ratio of around 1:1. A total of 147 (76.56%) children in our study were having nutritional and 45 (23.44%) were having non nutritional causes. Among non-nutritional anemia 30 cases were hemolytic anemia, 11 hypoplastic anemia, 3 leukemia and 1 patient were diagnosed as Osteopetrosis. Conclusions: Though nutritional deficiency anemias are predominant; it may not always be the case. Hemolytic anemia and leukemias should be ruled out while evaluating a patient of severe anemia and pancytopenia. Bone marrow failure syndrome, storage disorders should be ruled out in patients with skeletal anomalies.

Background: Diarrhoea remains one of the major causes of death among infants significantly in Asia, Africa and Latin America. The major contributing factors for higher incidence and mortality rates are improper sanitation, unsafe drinking water, physiological conditions like malnutrition, weak immune system.Rotavirus is the major causative agent of diarrhoea in young children in developed and undeveloped countries. Electrolyte abnormalities is the leading causes of morbidity and mortality in younger children with acute gastroenteritis and increased mortality is seen in malnourished children. The common abnormalities associated with acute gastroenteritis are hyponatremia and hypokalaemia. The average duration of hospital stay is 2.5 days.Methods: This is a descriptive cross-sectional study which studied 173 patients of acute gastroenteritis which have been admitted to the CMC, Tehran in 1 year. (June 2021-May2022).Results: In this study 173 patients were studied. 101 patients (58.4%) were infants, 55 patients (31.8%) were preschool children and 17 patients (9.8%) were older children. 70 patients (40.5%) were females and 103 patients (59.5%) were males. The most common electrolyte abnormality that was encountered in this study is hyponatremia (51.4%) >hypokalaemia (11.6%) >hypernatremia (6.9%) >hyperkalaemia (1.2%).Conclusions: The order of electrolyte abnormalities seen: Hyponatremia (51.4%), hypokalaemia (11.6%), hypernatremia (6.9%), hyperkalaemia (1.2%). Duration of hospitalisation is 1 day for majority of the patients and is high for patients with hyponatremia.