Background: Growth retardation and anemia are manifestations of pediatric HIV infection and are independent risk factors for death among infected children. We sought to describe nutritional status, anemia burden and HIV disease correlates among infected children in India.Methods: We analyzed retrospective data from 248 HIVinfected children aged 1-12 years attending four outpatient clinics in South India (2004)(2005)(2006). Standard WHO definitions were used for anemia, HIV staging and growth parameters. A subsection of children with prospective haemoglobin assessments were also included in the analysis. Statistical analysis included chi square, t test, and univariate analyses Results: The overall prevalence of anemia was 62.5%, and 8.1% had severe anemia (Hb < 7 gm/dl). The proportion of underweight and stunted children in the population was 55.3% and 46.2% respectively. Poor growth (WAZ, HAZ < -2) was significantly associated with anemia and advanced HIV disease status (p < 0.005). Risk factors for anemia included advanced HIV stage (OR = 5.2; CI 2.9-11.2; p < 0.005) and severe immunodeficiency (OR = 4.5; CI 2.01-10.0; p < 0.005). Anemia was independently associated with pulmonary tuberculosis; hemoglobin in those with and without tuberculosis was 8.9 and 10.2 g/dl respectively (p < 0.005). Anemia was not significantly associated with age, gender, multivitamins, cotrimoxazole, presence of ART, or ART type (zidovudine versus stavudine). Among 45 anemic children with available prospective data who received at least 6 months of ART along with nutritional supplements, subsequent mean hemoglobin improved significantly by 1.5 gm/dl (CI 0.8-2.3, p < 0.005)Conclusions: The high prevalence and strong interrelationship of growth retardation and anemia among HIV-infected children in India underscores the need for incorporating targeted nutritional interventions during national scale up of care, support and treatment among children.

Urinary tract infections (UTIs) are a common, potentially serious, and often occult bacterial infections of childhood. UTI is more frequent in females than males at all ages with the exception of the neonatal period. Urinary tract infections imply invasion of urinary tract by pathogens which may involve the upper or lower urinary tract depending on the infection in kidney, bladder and urethra. OBJECTIVES: To determine the incidence of UTI in febrile children below 5years of age and to know the aetiological profile of UTI among the same group of children with fever. METHODS: This cross sectional observational study included all febrile children from one month to 5years of age, admitted in Pediatric ward in MGM Medical College, Kishanganj, Bihar. RESULTS: Overall incidence rate of UTI in the present study was 6% with maximum incidence in children <2years of age. Among culture positive cases majority (50%) grew E. coli. DMSA revealed renal cortical scarring in 42. 85% cases following UTI. CONCLUSION: From the present study it can be concluded that UTI is a common bacterial infection in infant and children. Rapid evaluation and treatment of UTI is important to prevent renal parenchymal damage and renal scarring or renal failure.

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ABSTRACT:A prospective and descriptive clinical study was done to study etiological factors of birth asphyxia and its outcome. Total 150 newborn babies were included in this study and 1190 normal babies were taken as control to study etiological factors for birth asphyxia. Data analysis was done by Z test, chi square test, univariate and ultivariate logistic regression analysis of risk factors. In this study statistically significant association between severity of perinatal asphyxia and severity of HIE was seen. In this study, significant proportion of neonates develop HIE following asphyxia insult. The identification of HIE following perinatal hypoxic insult is important because of the predictive significance for future motor and cognitive deficits. KEYWORDS: Birth asphyxia, HIE, predictive significance. INTRODUCTION:Perinatal asphyxia, neonatal asphyxia or birth asphyxia is a medical condition resulting from deprivation of oxygen to a newborn infant that lasts long enough during the process to cause physical harm, usually to the brain. Hypoxic damage can occur to most of the infants organs (Heart, lungs, liver, gut, kidney), but brain damage is of most concern and perhaps the least likely to completely heal. (1) Birth asphyxia is one of the major causes of early neonatal mortality in India. Among the institutional births, incidence is 5% and accounts for 24.3% of neonatal deaths. (2) The greatest risk of adverse outcome is seen in newborn infants with fetal acidosis (pH <5), a five minute apgar score of 0-3, hypoxic ischemic encephalopathy (HIE) or multi organ malfunctions. (3) Sarnat and Sarnat described their HIE grading in 21 infants in 1976 (4) in a study relating electroen-cephalographic findings to the clinical conditions of infants. Later on this classification was modified by Levene based on clinical observation. HIE was classified as mild HIE (Stage I) in which the infant was hyper alert with normal muscle tone, reflexes were normal and seizures were absent. Moderate HIE (Grade II) presented with an infant being lethargic, decreased muscle tone, weak or absent reflexes and seizures were present. In severe HIE (Grade III) the level of consciousness was very much depressed (Stuporose) with flaccid muscle tone, absent reflexes and seizures were either too frequent or difficult to control.The common worry of health professional and parents is the permanent brain damage that birth asphyxia can cause and the common aim is to reduce the number of newborns affected. Improving women's' health and health care will reduce the risk factors and decrease the number of newborns needing resuscitation.Nevertheless, there is one single intervention for dealing ith asphyxia when it occursResuscitation. Therefore, every birth attendant must be both skilled and equipped to resuscitate newborns that don't start breathing spontaneously.So, appropriate and effective resuscitation at birth is a cornerstone of optimal neonatal care. The new guidelines provide for a uniform, systematic and action oriented approach to the neo...

Background: Hepatitis B virus (HBV) infection is a global health problem. Over two billion people have been infected with hepatitis B virus globally, of whom over 350 million are chronic carriers. Vertical (mother to child) and horizontal early childhood transmission are the main routes of HBV transmission and are responsible for most chronic infections. The aim of this study was to study the role played by different modes of transmission of HBV and to study the burden of hepatitis B in pediatric age group.Methods: All children below 12 years of age, admitted for jaundice, of both sexes, during one year study period were included. 50 patients (control) who were not suffering from jaundice or known liver disease were also included.Results: Prevalence of HBsAg positivity among jaundiced children was 15.24%. There was increase in HBsAg positivity with increase in the age signifying role of horizontal mode of transmission in Hepatitis B virus infection.Conclusions: HBV infection is an important health problem in paediatric age group. Horizontal mode of transmission plays important role in the spread of HBV infection among children.