Introduction: Celiac Disease shares clinical features with malnutrition and may be responsible for malnutrition. The objective of this study was to study clinico-laboratory profile of seropositive Celiac Diseases in Severe Acute Malnutrition. Material & Methods: The present study was a prospective, hospital based, observational study conducted at Malnutrition Treatment Centre (MTC) of tertiary care Pediatric hospital associated with government medical college of southern Rajasthan. The study was conducted over the period of one year from Dec. 2017 to Nov. 2018. Total 110 children with Severe Acute Malnutrition enrolled and screened for Celiac Disease on the basis of celiac serology (tTg-IgA/IgG). Clinico-laboratory findings of celiac seropositive and seronegative patients were recorded and analysed statistically. Results: Celiacsero-positivity was observed in 30 cases (27.28%). Out of these seropositive cases 14 cases (46.66%) were seropositive for both tTg-IgA and IgG, while 9 cases (30%) were positive for only tTg-IgA and rest 7 cases (23.33%) were positive for only tTg-IgG. Most of the seropositive patients (12, 40%) were in age group of 4-5 years of age group. In seropositive cases recurrent blood in stool (54.45%) and recurrent diarrhoea (52.94%) were common clinical features at the time of admission. S. Vit. B12 & Folic Acid were low in all the patients but more seropositive patients showed low levels of S. Folic acid (P value <0.05). Conclusions: Recurrent diarrhoea and blood in stool were common presenting feature on admission in celiac seropositive patients suffering from severe acute malnutrition. Vit. B12 and Folic acid deficiency were also observed as a common finding in seropositive patients.

Very often clinicians are confronted with unconscious patients; the cause being hypoglycaemia. In addition to correction of hypoglycaemia promptly, a search for the cause of hypoglycaemia must be attempted at the earliest with a stepwise approach. Here, the authors present a rare case of recurrent hypoglycaemia where a stepwise approach ultimately led to a diagnosis, but there were various reports which were misleading. The diagnosis was insulinoma which was apparent from the history and presenting features. But, the initial investigations, even though having high sensitivity, were normal, thus leading to a more invasive approach. The patient was ultimately cured by enucleation.

Background: Coronavirus disease 2019 (COVID-19) and the nationwide lockdown have resulted in profound disruptions in health care. Thus, the study was done to assess the barriers faced by caregivers of children with chronic diseases in accessing healthcare services due to the lockdown. Methods: A questionnaire-based telephonic survey was performed after 2 months of nationwide lockdown in children with chronic diseases at a tertiary hospital in India. Barriers faced were recorded and compared with the place of residence and socioeconomic status (SES). Results: A total of 101 children with mean ± standard deviation age of 9.7 ± 3.6 years and median (interquartile range) disease duration of 48 (12, 84) months were included. The majority (84.6%) was on daily therapy and 65.3% reported disrupted treatment. Patients residing away from the capital had greater difficulty in investigations and in transport to the hospital (P < 0.05) compared to those in the capital. Patients from lower SES had more difficulty in procuring medications (64.1% and 35.4%; P = 0.006), transport (62.3% and 29.1%; P = 0.003), and perceived significant effect of COVID-19 on their child (47.2% and 16.7%; P = 0.002) compared to middle SES. Conclusions: Disrupted health-care access during COVID-19 suggests the need for health-care systems to be better equipped to manage patients with chronic illnesses during such pandemics.

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Background: Prescriptions are detailed instructions about a patient’s course of treatment that is provided in writing by a medical professional. Hence, prescription not only manifests the knowledge of medical practitioner but also perspective toward the patient, considering his or her economical and social condition. The study which incorporates components such as availability of drugs, rationality of prescription, cost per prescription, and affordability is called drug utilization study. According to the World Health Organization (WHO), drug utilization is the marketing, distribution, prescribing, and use of medications in society with a focus on the ensuing medical, social, and financial repercussions. To confirm the importance of pharmaceuticals in routine medical practice, it is very helpful and effective to study drug utilization and prescription patterns. These studies have a strong emphasis on many facets of drug use, including prescription, administration, effects, and associated occurrences such as positive or negative drug reactions. Aims and Objectives: This study was aimed to evaluate the prescription pattern of drugs and their utilization in the outdoor patients of dermatology department of a tertiary care hospital in southern Rajasthan. Our objectives were to assess whether the use of drugs is rational or not and to identify different drugs used in various types of dermatological disorders. Materials and Methods: A prospective cross-sectional observation study was conducted over a period of 11 months (May 2020–March 2021) on 400 prescriptions. Patients with severe ailments who were shifted indoor, pregnant women, and patients <18 years were excluded from our study. Data were gathered, recorded, and analyzed using statistics in accordance with a predetermined format. Results: Out of 400 patients included in the study, 64% were males and 36% were female patients. We deduced from this survey that maximum number of patients attending dermatology department were suffering from fungal infection followed by dermatitis. In our study, 508 (41.30%) and 722 (58.69%) of the medicines were delivered topically and orally, respectively. In all patients, topical medications were prescribed to the greatest number of patients. Antihistamines were the medications that were most frequently prescribed in our study, followed by antifungal medications. Tablet levocetirizine is the antihistaminic medicine that is most frequently prescribed, whereas Vitamin E, terbinafine, calcium, and Vitamin D3 are rarely. For a variety of dermatological conditions, the maximum number of patients received three prescription medications. According to the WHO criteria, generic names were prescribed for all of the medications. Conclusion: This drug prescribing and utilization study gives an idea to the prescriber regarding prevalent disease pattern in the area. It also helps to improve quality of prescription and promote rational and cost effective treatment.