Haemoglobinopathy in Andhra Pradesh

Summary Children presenting with pallor, hepatosplenomegaly and other features suggestive of haemolytic disease were investigated for the presence of abnormal haemoglobins. In this effort, 67 cases of thalassaemia major, 118 of, thalassaemia minor, 9 of thalassaemia haemoglobin E disease, 8 of sickle cell anaemia and 98 parents with, the thalassaemia minor trait were detected. None of the cases had migrated from or had ancestors from West Bengal or East Bengal. From the Niloufer Hospital for Women and Children, and the Department of Pediatrics, Osmania Medical College, Hyderabad.     

Infant feeding practices among tribal communities of Andhra Pradesh

Some of the major obstacles to the practice of breast feeding among tribal communities are ignorance and taboos concerning food and feeding. 100 nursing mothers in 12 tribal villages were observed in a study of infant feeding practices. Information about the existing feeding practices was collected; in addition, the study researched attitudes and values concerning the topic of infant feeding. 95% of the women breast fed their babies. Many of the mothers (42%) understood that supplementary foods could be given by the end of the 1st year. Although breast feeding practice was high, the majority of the women (83%) did not believe that it was necessary to make changes in their diets or work styles during the lactating period. 66% of the women did not comprehend how lactation performance could decrease. Only 17% of the mothers took good care during the period of lactation. Education programs should be designed to encourage a unique work and dietary routine for mothers who are breast feeding.     

Current status of iodine nutriture and iodine content of salt in Andhra Pradesh

A cross sectional survey was conducted in the year 2001, to establish the current status of iodine nutriture and level of salt iodisation in the state of Andhra Pradesh, India. All the 23 districts were included. The data was collected in each district through school approach. A total of 3706 salt samples and 1952 casual urine samples were collected. Nearly 45% of the population was found to be consuming iodised salt. All the districts had adequate iodine nutriture except Rangareddy and Cuddapah. The districts which were earlier found endemic to iodine deficiency namely Srikakulam, Vizianagaram, Visakhapatnam, Godavari, Khammam, Adilabad and Warrangal were found with adequate iodine nutriture as reflected by median UIE level of more than 100 microg/L. The study revealed success of salt iodisation program in the state.     

Maternal autonomy is inversely related to child stunting in Andhra Pradesh, India

Child stunting, an outcome of chronic undernutrition, contributes to poor quality of life, morbidity and mortality. In South Asia, the low status of women is thought to be one of the primary determinants of undernutrition across the lifespan. Low female status can result in compromised health outcomes for women, which in turn are related to lower infant birthweight and may affect the quality of infant care and nutrition. Maternal autonomy (defined as a woman's personal power in the household and her ability to influence and change her environment) is likely an important factor influencing child care and ultimately infant and child health outcomes. To examine the relationship between maternal autonomy and child stunting in Andhra Pradesh, India, we analysed data from National Family Health Survey (NFHS)-2. We used cross-sectional demographic, health and anthropometric information for mothers and their oldest child <36 months ( n  = 821) from NFHS-2. The main explanatory variables of autonomy are presented by four dimensions – decision making, permission to travel, attitude towards domestic violence and financial autonomy – constructed using seven binary variables. Logistic regression models were used to test associations between indicators of female autonomy and the risk of having a stunted child. Women with higher autonomy {indicated by access to money [odds ratio (OR) = 0.731; 95% confidence interval (CI) 0.546, 0.981] and freedom to choose to go to the market [OR = 0.593; 95% CI 0.376, 0.933]} were significantly less likely to have a stunted child, after controlling for household socio-economic status and mother's education. In this south Indian state, two dimensions of female autonomy have an independent effect on child growth, suggesting the need for interventions that increase women's financial and physical autonomy.     

Survival of Children Living with Human Immunodeficiency Virus on Antiretroviral Therapy in Andhra Pradesh,India

Objectives

To assess the survival probability and associated factors among children living with human immunodeficiency virus (CLHIV) receiving antiretroviral therapy (ART) in India.

Methods

The data on 5874 children (55% boys) from one of the high HIV burden states of India from the cohort were analyzed. Data were extracted from the computerized management information system of the National AIDS Control Organization (NACO). Children were eligible for inclusion if they had started ART during 2007-2013, and had at least one potential follow-up. Kaplan Meier survival and Cox proportional hazards models were used to measure survival probability.

Results

The baseline median (IQR) CD4 count at the start of antiretroviral therapy was 244 (153, 398). Overall, the mortality was 30 per 1000 child years; 39 in the <5 year age group and 25 in 5-9 year age group. Mortality was highest among infants (86 per 1000 child years). Those with CD4 count ≥200 were six times more likely to die (adjusted HR: 6.3, 95% CI 3.5, 11.4) as compared to those with a CD4 count of ≥350/mm³.

Conclusion

Mortality rates among CLHIV is significantly higher among children less than five years when the CD4 count at the start of ART is above 200. Additionally, lower CD4 count, HIV clinical staging IV, and lack of functional status seems to be associated with high mortality in children who are on ART.

     

Torsade de pointes associated with encephalitis

Torsade de pointes is a polymorphic ventricular tachycardia. Causes of torsade de pointes are well described. Although intracranial disease can produce dramatic electrocardiographic (ECG) changes, we are not aware of previous cases with torsade de pointes and encephalitis. We report a case with encephalitis who developed torsade de pointes, and was treated with temporary ventricular pacing and magnesium infusion.     

Myopericarditis associated with central European tick-borne encephalitis

The case of an 11-year-old child with acute myopericarditis associated with central European tick-borne encephalitis is presented. Cardiac involvement was demonstrated by pericardial effusion, elevated serum concentration of troponin-I and cardiac arrhythmia. Co-infections with enteroviruses, Borrelia burgdorferi or the agent of human granulocytic ehrlichiosis were excluded. Recovery was uneventful. Conclusion Central European tick-borne encephalitis can be complicated by cardiac involvement. Received: 16 February 2000 and in revised form: 10 May 2000 / Accepted: 11 May 2000     

Influenza B infection associated with encephalitis: treatment with oseltamivir

Encephalitis associated with acute influenza infection is unusual in nonepidemic years. A case of a 10-year-old child with influenza B encephalitis and profound weakness who was treated with oseltamivir is presented. This case illustrates several of the unusual findings associated with influenza infections and the result of treatment of influenza B encephalitis with oseltamivir.     

Rasmussen's syndrome associated with chronic brain stem encephalitis.

We report a 3-year-old boy with a clinical picture of Rasmussen's encephalitis who had clinical, radiological and pathological evidence of brain stem involvement resulting in death. In addition, there were unexpected neuropathological findings of severe bilateral mesial temporal sclerosis. We discuss the novel finding of brain stem involvement in this condition and the association with mesial temporal sclerosis.     

抗N-甲基-D-天冬氨酸受体脑炎相关细胞因子的研究进展

抗N-甲基-D-天冬氨酸受体(N-methyl-D-aspartate receptor,NMDAR)脑炎为一类中枢神经系统自身免疫炎症性疾病,目前对其免疫机制知之甚少。脑脊液中除抗NMDAR抗体检测外,缺乏与疾病相关标志物,导致部分患者延误诊治。为此,近年针对细胞因子的研究不断增加,旨在评价其是否可作为新型生物标志物对疾病进行评估并协助诊治。现有研究表明部分细胞因子与抗NMDAR脑炎疾病进程可能相关,故该文就抗NMDAR脑炎相关细胞因子研究进展进行综述。