In malaria-endemic regions, people often get exposed to various pathogens simultaneously, generating co-infection scenarios. In such scenarios, overlapping symptoms pose serious diagnostic challenges. The delayed diagnosis may lead to an increase in disease severity and catastrophic events. Recent coronavirus disease 2019 (COVID-19) pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has affected various areas globally, including malaria-endemic regions. The Plasmodium and SARS-CoV-2 co-infection and its effect on the health are yet unexplored. We present a case report of a previously healthy, middle-aged individual from the malaria-endemic area who suffered SARS-CoV-2 and Plasmodium falciparum co-infection. The patient developed severe disease indications in the short time period. The patient showed neurological symptoms, altered hematological as well as liver-test parameters, and subsequent death in a narrow time-span. We hereby discuss the various aspects of this case regarding treatment and hematological parameters. Further, we have put forward perspectives related to the mechanism behind severity and neurological symptoms in this fatal parasite-virus co-infection case. In malaria-endemic regions, due to overlapping symptoms, suspected COVID-19 patients should also be monitored for diagnosis of malaria without any delay. The SARS-CoV-2 and Plasmodium co-infection could increase the disease severity in a short time span. In treatment, dexamethasone may not help in severe case having malaria as well as COVID-19 positive status and needs further exploration.

Background: Pain is one of the most misunderstood, under diagnosed and under treated medical problems, particularly in children. If left unaddressed, pain can affect children in ways that will follow them throughout their lives. Nurses play an important role in assessing and managing pain among children during hospitalization. Objective: To evaluate the knowledge, attitude, and practices of pediatric pain management among nursing personnel working in pediatric tertiary care hospital. Materials and Methods: A cross-sectional, self-administered questionnaire-based survey was carried out involving 40 nurses. The questionnaire had 45 items in the domains of personal information, knowledge, and perception toward the pain of pediatric patients, and practices for pain relief. Voluntary participation was ensured and anonymity maintained at all level. Results: The mean age of nurses was 25.53 ± 4.05 years. 90% had a diploma in nursing and 10% were graduates. More than a half (57.5%) of the subjects had experience between 1 and 5 years. The mean score for knowledge was found to be 10.88 ± 2.81 (range 3-16.87%). Most of the participants (87%) thought that children have good pain sensitivity. Only 40% nurses knew about pain scoring system; however, none used pain scoring system in daily practice. None of the nurses were able to answer about the route of administration of morphine for chronic and prolonged pain. Only 44% had shown the correct attitude toward pain in children and 60% participants gave a satisfactory answer regarding practices. Conclusion: Study revealed a deficiency in the knowledge of nurses and their practices regarding pain in children.

To compare the bilirubin levels measured by transcutaneous bilirubinometer and serum samples for the management of jaundice in preterm neonates. MethodsThe study was a prospective comparative observational study conducted in a tertiary care neonatal unit of Odisha from January 2019 to June 2020. All inborn and outborn neonates with a gestational age of 28 0/7 weeks to 36 6/7 weeks with the clinical diagnosis of neonatal jaundice were included in the study. Transcutaneous bilirubin (TcB) was estimated by Dragger jaundice meter JM-105 and simultaneously venous blood and total serum bilirubin levels (TSB) were measured by diazonium method. The comparison between TcB and TSB values was analyzed by direct linear correlation in scatter plot and Bland-Altman plot. ResultsA total of 167 preterm neonates (66, 28-33 6/7 and 111, 34-36 6/7 ), with a mean gestational age 33.55 ±2.36 weeks and a mean birth weight of 1960 ± 613 grams, were analyzed. The mean TSB and TcB levels were 12.99 ± 3.47 mg/dl (min-max 4.9-18.3 mg/dl) and 14.156 ± 4.71 mg/dl (min-max 4-20.1 mg/dL), respectively. The TcB is excellently correlated with TSB with a correlation coefficient of r =0.948, p ≤0.001. The bias difference between TcB and TSB is -1.16 (95% CI: 2.35, -4.6) mg/dl. The correlation coefficients between 28-33 6/7 weeks gestational age groups (r = 0.944) and 34-36 6/7 gestational age (r = 0.950) were similar. ConclusionTcB is well correlated with TSB level in preterm neonates. Hence, TcB can be used for the guidance of management in these neonates.

Background: Febrile seizures are very common in pediatric practice. We need to differentiate between febrile seizures and other seizures due to central nervous system (CNS) infection by various means of investigation. Though approximately 30% of patients with febrile seizure have later epilepsy and the risk is around 20% even if electroencephalogram (EEG), and neuro-imagings are normal. But data regarding this is laking in developing countries like India.Aim: The primary objective of this study is to determine the hospital-based prevalence among various types and etiologies of seizures in children admitted to the pediatric department in a teaching hospital of a developing country, India. Besides, the different types of seizures were correlated with the EEG and neuroimaging findings along with the acute onset of seizures among children. Conclusion:The study concluded that EEG must be the standard modality of test for patients' diagnosis of seizure in children with seizures. CT/MRI scan can give a better supplement to the results but MRI findings are more accurate in cases of complex febrile seizures.