Background:There is considerable variation in BCG scar failure rate on available data and correlation between BCG scar and tuberculin conversion remains controversial. Through this study we aimed to determine the scar failure rate and tuberculin conversion in term infants vaccinated with BCG within the first month.Materials and Methods:A prospective cohort study was conducted among 85 consecutive infants weighing >2 kg attending the immunization clinic of a medical college hospital. Fifteen subjects who could not complete the follow up were excluded. Total of 70 cases were analyzed. All babies were administered 0.1 ml of BCG and examined at 3 months (+1 week) for scar. Tuberculin test was done with 5TU PPD. An induration of >5 mm was considered positive. Statistical analysis was done using Microsoft Excel and SPSS-22.Results:Out of the 70 infants, 41 (58.6%) were males. Although majority (72.9%) of infants were vaccinated within 7 days, only 18 (25.7%) received BCG within 48 hours of birth. Sixty-four (91.4%) had a visible scar at 12 weeks post vaccination representing a scar failure rate of 8.6%. Tuberculin test was positive in 50 (71.4%). The mean ± s.d. for scar and tuberculin skin test (TST) reaction size was 4.93 ± 2.01 mm and 6.01 ± 3.22 mm, respectively. The association between scar formation and tuberculin positivity was highly significant (P < 0.001). There was significant correlation between scar size and TST size (r = 0.401, P = 0.001)Conclusions:Less than 10% of infants fail to develop a scar following BCG vaccination. There is good correlation between scar positivity and tuberculin conversion.

Sputum induction in young children is safe and feasible in Indian settings. While the success was limited, bacterial yield was high.

Background: There is dearth of studies on detailed clinical profile and outcome of pediatric septic shock in India. Objective: To describe clinical profile and outcome of septic shock in children. Methods: This retrospective study was conducted from June 2010 to June 2013 in a tertiary care hospital. Case records of children aged 1month to 18 years with diagnosis of septic shock were analyzed. Results: A total of 94(9%) out of 1035 admissions had shock and 53(56.3%) of them had a diagnosis of septic shock. Analysis was done on 43 (M:F, 20:23). The mean age was 3 year (range 1month-14 years). Maximum (48.83%) cases were in infancy. The common presenting symptom was fever (62.79%) followed by altered mental status in 30.23%. Pediatric SIRS criteria was met in 35(81.3%). Most common abnormal lab parameters were elevated liver enzymes (86.04%) followed by anemia (62.79%) and leukocytosis (60.46%). Thrombocytopenia and Coagulopathy was seen in 55.81% and 60.41% respectively. Pneumonia was the commonest etiology (51.1%) followed by cellulitis/abscess in 30.2%. Blood culture was positive in 18.6% and Staphylococcus was the commonest organism. Frequency of MODS was 90.69%. Most (74.41%) cases presented with decompensated shock and 97.67% required inotropes. Majority (88.37%) required mechanical ventilation. The mortality rate was 60.46% and mean duration of PICU was 8.3 days. Anemia, leucopenia, decompensated shock and need for mechanical ventilation were significantly associated with mortality (p<0.05). Conclusion: Septic shock was the most common type of shock encountered in PICU and carries a high mortality. Maximum numbers of patients were below 1year and pneumonia was the commonest underlying cause.

Aims and Objectives:To determine the frequency of cranial ultrasound abnormalities in preterm neonates in the first week of life. To evaluate the association between cranial ultrasound findings and perinatal risk factors in regard to the immediate clinical outcome. Materials and Methods: This Retrospective study was done in NICU in a tertiary hospital. Records of all preterm neonates (<37weeks) admitted to NICU who underwent neuro-sonography between Jan2016 -Jan 2017 were included. Results: Out of 100 preterms, 53% had normal CUS findings while 47% had abnormal finding. Abnormal CUS was significantly associated with gestational age <32weeks (p<0.001) and birth weight <1.5kg (p=0.006). Among the abnormal CUS findings intraventricular hemorrhage was the most common (40.42%) followed by periventricular hyper-echogenicity (21.27%), cystic periventricular leukomalacia (8.51%), parenchymal bleed (8.51%), cysts (8.51%), cerebral edema (6.38%), ventriculomegaly (4.25%) and thalamic injury (2.12%). Neonatal comorbidities associated with abnormal cranial ultrasound were RDS (25.53%), neonatal sepsis (21.27%), birth asphyxia (17.02%), neonatal seizures (8.51%), NEC (6.38%) and others (21.27%). There was significant association between abnormal cranial ultrasound and RDS (p=0.014) and birth asphyxia (p=0.008). Mortality was 36.1% and all had abnormal cranial USG. Intraventricular hemorrhage (76.4%) was the most common cause of death followed by parenchymal bleed (11.7%). Conclusion: There was significant association between abnormal CUS and gestational age and birth weight. Most common abnormality was IVH and it carried the highest mortality. RDS and birth asphyxia had significant association with abnormal ultrasound. Early neurosonography could help in prognosticating immediate outcome and early intervention.

We report 3 atypical rubella cases in a family cluster in India. The index case-patient showed only mild febrile illness, whereas the other 2 patients showed acute encephalitis and died of the disease. We confirmed rubella in the index and third cases using next-generation sequencing and IgM.