Journal of the Pediatrics Association of India

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Hemihypertrophy is not uncommon in pediatrics, a triad of short stature of prenatal onset, skeletal asymmetry, and clinodactyly is characteristic of Russell–Silver syndrome. Association of posterior fossa malformation of Chiari Type 1 with whole length syringomyelia is not reported in literature. We present a case with a combined feature of both syndromes.

Introduction: A large number of Down syndrome (DS) children are born every year in India and are the leading cause of morbidity and mortality in infants. The aim of the present study was to evaluate the possible risk factors in mothers for having DS. Methodology: A total of 217 DS cases were collected, and lymphocyte culturing was performed to confirm aneuploidy. Mothers having DS children (n = 213) with confirmed trisomy 21 and age-matched controls (n = 220) with normal children were collected. Results: Of 217 cases, 213 had confirmed trisomy 21 in children, and free trisomy 21 was observed in 91.71%, followed by mosaics in 3.68% and Robertsonian translocations in 2.30% of the cases. A double aneuploidy with chromosomal constitution 48, XXY,+21 (0.46%) was also seen. The mean maternal age in cases was 27.34 ± 5.2 years, while in controls, it was 27.75 ± 4.9 years. Logistic regression analysis showed that intake of folic acid (P < 0.0001) was associated with reduced risk while decreased parity (P = 0.01), intake of drugs in mothers (P = 0.002), and alcohol intake in fathers (0.032) were significantly associated with an increased risk of a DS child. Nearly 30.62% of the mothers experienced miscarriage before the birth of DS child but was not associated with an increased risk of trisomy 21. Conclusions: DS children were born to mothers younger than 30 years; intake of folic acid significantly reduced the risk, while intake of drugs in mothers and intake of alcohol in fathers significantly increased the risk of a DS child.

Objectives: This study was conducted to observe the incidence of adverse events following immunization (AEFI) in children ≤6 years of age. Material and Methods: An observational study was conducted in the department of pediatrics of our hospital from November 2018 to November 2019. A total of 20,414 children who attended the well-baby clinic for immunization over a period of one year were enrolled and observed for adverse events. Parents of the children were telephonically contacted for the observation of any type of adverse reaction that has followed by the administration of the vaccine. Results: Among 20,414 children, 8246 AEFI were reported during the study period. Majority of the AEFI were reported in the age group <1 week, followed by 6 weeks. Female children (56.7%) had reported more AEFI compared to male children (43.3%) with a ratio of 1.3:1 (F:M). The most common AEFI reported was fever (n = 4195 cases), followed by swelling (n = 2933 cases). Penta + IPV + OPV + Rota (38.2%) was majorly responsible for AEFI, followed by BCG + Hep-B + OPV (35.5%). Most of the AEFI (93.3%) were reported within 1 day of vaccine administration (n = 7691 cases). Conclusion: Our findings revealed that most of the adverse events were observed on day-1 after vaccine administration. Thus, after identifying the vaccines responsible for adverse events and the characteristics of the events, we may continue to consider vaccines as safe biological products. We also recommend that all AEFI should be documented and reported to the Central Drug Standard Control Organization (CDSCO) in real-time regarding vaccine use and awareness of vaccine safety.

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.

Online since 30^thJuly 2020