Anemia is a condition in which the number of red blood cells, and consequently, their oxygen-carrying capacity is insufficient to meet the body's physiologic needs. The mean hemoglobin level at the time of delivery in full-term normal infants is 16.5 ± 3 gm% in cord blood. After rising in the first 24 h, it then starts falling progressively to reach a nadir of 12.0 ± 1 gm% by 1 year of age. Anemia is one of the leading causes of mortality and morbidity in under-five children, as high incidence has been noted among them. Early screening, diagnosis, and interventions are helpful to prevent the consequences associated with it. Nutritional anemia was diagnosed as the most common cause of anemia in the Indian subcontinent. It is common in infancy and in female children. Malnutrition and splenomegaly were common signs in anemic children. There are wide variations in etiology and clinical features in hospitalized children depending on various factors.

Coronavirus infection, or COVID 19, was originally identified in Wuhan, China, in December 2019, but quickly spread over the world, resulting in a pandemic. Remdesivir, an antiviral agent by inhibiting viral RNA-dependent polymerase enzyme and was earlier used against Ebola, HIV etc, was presumed useful in the quest for a remedy against SARS-CoV-2. Several investigations had shown its promising antiviral properties in vitro and in vivo against severe acute respiratory syndrome due to coronavirus (SARS-CoV-1). Hence, Remdesivir was approved by the US FDA in the second half of 2020, followed by DCGI, for treatment in adults and children with SARS-CoV-2, requiring hospitalisation with moderate to severe symptoms. Pivotal trials (ACTT 1, SIMPLE Severe trial) showed a faster median time to recovery in these patients. However, several studies found no statistically significant difference in time to clinical improvement or mortality between patients who got remdesivir and those who did not. Although it was hailed as a "Miracle medicine" when it was first launched for COVID-19, its limited efficacy may not justify its status as such. The goal of this review is to outline the evidence and clinical studies of remdesivir, as well as its rise and decline as a treatment option.

Objectives: The objectives of the study are to estimate the incidence of respiratory distress (RD) with etiology and associated risk factors in newborns admitted to neonatal intensive care units and to propose adequate management plan for better clinical outcome. Study Design: This was a hospital-based prospective, longitudinal study. Setting: The study was conducted in a tertiary care teaching hospital of Odisha between November 2015 and October 2017. Study Population: A total of 202 newborns, born with RD, constitute the study population. The risk factors are delineated with outcome. Results: Out of 202 newborns with RD, 107 (53%) were males and 95 (47%) were females. Based on birth weight and gestational age, 35% were of very low birth weight (< 2000 grams; VLBW) and 19.8% were of low birth weight (2000 to <2500 grams; LBW). Both these groups accounted for 54.9% of all babies under the study. Pre-terms were 50.5% among VLBW and 9.9% among normal birth weight (NBW) babies. Most common etiology was found to be RD syndrome (RDS, 39.6%). 95% of cases survived while 5% resulted in death. 60% of the death was contributed by RDS and prematurity, while 40% of deaths were seen in term gestation with NBW resulting from birth asphyxia in this study. Although the death ratios in each group of newborns VLBW, LBW, and NBW were almost equal, the etiology of RD and death in the respective groups was different. Conclusion: The study shows an association between mortality and onset of RD. Early onset of RD increases mortality. Antenatal steroid administration has a positive outcome. VLBW and LBW newborns succumb more to RD. The etiology of RD is different in different categories of birth weight. Continuous positive airway pressure is the cornerstone in management of RDS.

Objectives: The present study was sought to determine the spectrum of congenital heart diseases (CHDs) and their correlation with maternal risk factors at a tertiary care hospital situated in sub-urban area. Materials and Methods: This cross-sectional, observational study was conducted from February 2019 to February 2020. A total of 100 children suspected for CHD were screened and 67 confirmed CHD cases were enrolled into the study. Children having cardiomyopathy, rheumatic heart disease, secondary heart disease, and asymptomatic children were excluded from the study. Detailed history of presenting complaints, pregnancy, family history, consanguinity, and socioeconomic status was documented. Chest X-ray, electrocardiogram, and echocardiography were done to arrive at a definitive diagnosis. All the statistical analyses were performed using the SPSS software version 20.0 (IBM Corp, Somers, NY, USA). Results: Majority of the children presented with symptoms in the age group of 1–5 years. Most of the parents of children with CHD were educated up to secondary educational level (34%) followed by illiterate (24%). Economic status of most of the parents was upper lower class (67%). Maternal risk factors were not observed in 60% (n = 40) of the cases. 41.79% of CHD children were born to consanguineously married couple. Maternal stress was present in 40% of the cases. The most common presenting complaint was lower respiratory tract infection (LRTI in 61%). Murmur was seen in 70% (n = 47) of the cases. Majority of the cases (84%) were acyanotic and cyanosis was present in 16% of the cases. Atrial septal defect (ASD) was the most common which constituted 44.6% in acyanotic heart disease while tetralogy of Fallot (TOF) was the most common with 18.1% in cyanotic heart disease. In both cyanotic and acyanotic CHD groups, majority of the cases had no maternal risk factors (45.5% and 62.5%, respectively). Conclusion: The most common types of CHDs in acyanotic and cyanotic CHD groups are ASD and TOF, respectively. Consanguinity, stress during pregnancy, and diabetes mellitus were identified as the major risk factors for CHD. LRTI and shortness of breath were the most common clinical features in children with CHD.

Objectives: To assess the cardiac changes in moderately malnourished (MAM) and severe acute malnutrition (SAM) children. Methodology: A cross-sectional, observational study conducted over a period of 1 year. The study included 150 children, 50 from each group, first being children with SAM, second being MAM children, and third group included normally nourished, age-matched children between 6 and 60 months, admitted in the pediatric ward. Structural and functional echocardiography parameters were compared in these groups. Statistical analysis was conducted using the SPSS software version 20. Results: SAM children showed significant reduction of structural (except left ventricular internal diameter [LVID]) and functional cardiac parameters as compared to other groups. Major anthropometric parameters including body surface area (BSA) were correlated with all structural cardiac parameters; left ventricular mass (LVM) strongly correlated (r = 0.773) but no correlation was found with functional cardiac parameters. Conclusion: Structural (except LVID) and functional cardiac changes were significantly reduced with malnourishment. We had also concluded BSA of children strongly correlated with structural cardiac parameters such as LVM and interventricular septum thickness with specific age and sex.

Introduction: Diarrhoea is the second most common cause of deaths among children less than 5 years of age (15%) and half of the cases occur from 6 to 12 months of age. Deaths among hospitalised children, are mostly among the malnurished, demanding urgent diagnostic, therapeutic and nutritional intervention. Aim: To sensitise practicing pediatricians about such double dangers as high index of suspicion helps in early diagnosis and prompt intervention. Case: Eight month old baby presented with acute gastroenteritis (AGE) for 2 days. Exclusively breast-ded upto 6 monts of age. The child was treated with WHO recommended standard of care for AD such as oral rehydration solution (ORS), Zinc and usual complimentary feeds, including formula milk which the baby was on for last 2 months. Did show some initial improvemnt but worsened by week end; with large explossive stools, abdominal distension and perianal excoriation. Managed as secondary lactose intolerance post-viral AGE. Cow's milk protein allergy (CMPA) was thought unlikely in absence of any history of diarrhoea despite top feeds. Continued Zinc and complimentary feeding, but replaced formula milk with soy based feed. Th baby improved over next 4 days, started gaining weight and was discharged. Conclusion: Formula-fed infants with secondary lactose intolerance, when changed to lactose-free diet, may have early resolution of diarrhea and less scope of treatment failure. Being cheaper, Soy is considered a better alternative for short-term use in selected cases in developing countries as ours.

Recurrent abdominal pain (RAP) is a frequent complain in general pediatric practice, and it is really challenging to a treating physician. Many pediatricians often label such case as functional abdominal pain. Sometimes, the symptoms are vague and investigations fail to catch appropriate pathology. We report a slow-growing pancreatic tumor as RAP.