Asian Journal of Pediatric Practice
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No Patient can be Denied Treatment Due to Financial Constraints
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Lichen Planus-like Eruption Resulting from a Jellyfish Sting
Get PDFIntroduction: Contact with a jellyfish can cause a wide variety of conditions, ranging from cutaneous eruption to fatal cardiovascular and respiratory collapse. Cutaneous features can be both acute and chronic. We report a case of persistent lichen planus-like eruption in a young boy after a jellyfish sting, a hitherto unreported occurrence. Case presentation: A 15-year-old boy presented with multiple lichen planus-like violaceous papules over the lower part of his left thigh on the anterior aspect and also over the patellar region. He had a history of a jellyfish sting over his lower limbs incurred while bathing in the sea 4 weeks prior to presentation. Histopathology revealed a predominantly perivascular mononuclear cell infiltrate immediately beneath the dermoepidermal junction underneath the hyperplastic epidermis. The lesions significantly subsided with topical corticosteroid application. Conclusion: This case report demonstrates a new variant of chronic cutaneous change following a jellyfish sting. We report it because of its uniqueness and we believe that physicians should be aware of the possibility of an aquatic animal-induced disease when dealing with lesions with lichen planus-like morphology. 
Detection of Congenital Heart Disease by Fetal Echocardiography and Its Correlation with Karyotype
Get PDFBackground: Congenital heart diseases (CHDs) account for a third of all major congenital abnormalities in children; nearly 1,80,000 children are born with heart defect each year in India. Approximately, 10% of present infant mortality in India may be attributed to CHD alone. Such high mortality is due to laying less emphasis on its prenatal diagnosis by fetal echocardiography. This study was done with objectives to find out the incidence of CHD in high risk cases and its correlation with karyotype and also evaluating the diagnostic accuracy of fetal echocardiography. Methods: Fetal echocardiography was performed in 142 high risk cases who attended antenatal clinic of Institute of Medical Sciences (IMS), Banaras Hindu University (BHU), Varanasi between July 2014 to June 2016 with maternal/fetal risk for CHD (maternal diabetes mellitus, collagen disorders, teratogen exposure, maternal TORCH infection, in vitro fertilization [IVF] conceived pregnancy, familial history of CHD, abnormal four-chamber view, monochorionic twins). Results: The incidence of major CHD was 28/1,000 live births and 56/1,000 live births for minor CHD in high risk group. Ventricular septal defect (16.6%) and hypoplastic left heart syndrome (16.6%) were the most common CHD detected. Family history of CHD increases the risk significantly. Fetal echocardiography was 75% (46.77-91.11, 95% confidence interval [CI]) sensitive and 94.5% (89.22-97.35, 95% CI) specific, with 92.91% (87.44-96.1, 95% CI) diagnostic accuracy. It was seen that 16.6% cases of CHD had aneuploidy detected on karyotyping (trisomy 21 and trisomy 18). Conclusion: Fetal echocardiography is highly sensitive and specific, when done by an experienced operator. Prenatal diagnosis of CHD and planned delivery in a cardiac facility had satisfactory immediate outcomes
Impact of Real-time Assessment on the Training of Trainers for the Introduction of Rotavirus Vaccine in India
Get PDFBackground and aim: The introduction of rotavirus vaccine (RVV) in the universal immunization program of India is a big feat as it became the first nation in the World Health Organization (WHO) Southeast Asia region to do so. The involvement of huge numbers of frontline workers in introducing new vaccines in India and the underlined deficits in skills and knowledge require efficient capacity building programs. In view of this, limited research is available on the effectiveness of capacitybuilding interventions for healthcare workers. There is a dearth of studies from India measuring the “on-spot” impact of immunization trainings on healthcare workers. This study aims to assess the effectiveness of training in RVV introduction in enhancing the knowledge of the participants. Methods: The study was conducted among the participants attending two training workshops for the introduction of RVV: a state workshop in Pune and a regional workshop in Guwahati. The participants who attended the workshops and participated in both the pre- and post-test were included in the study. Real-time data was collected via Google forms pre- and post-training sessions. Results: In both workshops, a comparison of pre- and post-test scores of all questions taken together showed a significant increase in the knowledge level of theparticipants (p < 0.05). In Guwahati, the knowledge of the participants regarding doses of RVV, inadequate dosing, vaccine vial monitor (VVM), open vial policy, operationalization of RVV and monetary incentive increased significantly. In Pune, the knowledge of the participants regarding doses of RVV, bundling approach, schedule and dose, storage temperature for RVV, VVM, open vial policy, vaccine delivery and operationalization of RVV increased significantly after the training. Conclusion: A pre-planned and well-designed knowledge assessment tool can be used to understand the impact of training workshops in enhancing the knowledge and practical skills of the participants prior to the introduction of a new vaccine. 
Flow Cytometer: The Need of Modern Hematology Laboratory
Get PDFIndeed, laboratory diagnosis is rapidly changing from what it was in the past to the present. Nowadays, flow cytometer (FCM) has become a novel introduction to the modern diagnostic technique, mainly in the field of hematology. In case of acute leukemia, peripheral blood, bone marrow examination, cytochemistry and immunohistochemistry for differentiation of myeloid or lymphoid lineage is required, which is feasible by flow cytometry. It has dramatically improved the diagnostic efficiency and reduced the duration of sampling along with better diagnostic outcomes as well as provided efficient therapeutic monitoring of any drug or drug regimen. It has also opened some more sensitive therapeutic plans, like monitoring “Minimal residual disease (MRD)”, which is not possible without FCM. Detection of MRD has led to improved overall survival of patients. It has also opened up huge opportunities for research, which has become an important part of academic curriculum nowadays. Considering the importance and absolute necessity for better outcomes in hematology, the knowledge of basic principle of FCM becomes indispensable. Here, we try to elucidate the elementary components of this technique and also highlight its uses. 
Retinoblastoma: A Curse to Childhood
Get PDFRetinoblastoma is a cancer of the retina, the innermost layer of the eye that receives the light and images necessary for vision. About 300 children are diagnosed with retinoblastoma each year, making it the most common eye cancer in children under the age of 5. Every year, thousands of babies and children in low- and middle-income countries lose their sight and their lives to a treatable childhood eye cancer called retinoblastoma; usually because it was not recognized and treated in time. 
Management of Diabetic End-stage Renal Disease: Role of Hemodialysis
Get PDFDiabetes mellitus is now the most common cause of end-stage renal disease (ESRD) all across the globe, including India. In view of the alarming rise in numbers, renal failure due to type 2 diabetes has been termed a “medical catastrophe of worldwide dimensions". When a patient develops uremic symptoms he needs renal replacement therapy. The renal replacement therapies available for all patients with ESRD are: hemodialysis, chronic ambulatory peritoneal dialysis (CAPD) and renal transplantation. Kidney transplantation is the best option for patients with diabetic ESRD. The 5-year survival of transplant patients of 75-85% is far superior to the 5-year survival rate of around 25% on dialysis. 
HCFI Round Table Expert Zoom Meeting on “Are People Adopting COVID-appropriate Behavior During Unlocking and School Reopening”
Get PDFHCFI Round Table Expert Zoom Meeting on “Are People Adopting COVID-appropriate Behavior During Unlocking and School Reopening