Indian Journal of Child Health <p align="justify"><strong>Indian Journal of Child Health (IJCH)</strong> is a monthly, peer-reviewed, international journal, published by <strong>Atharva Scientific Publications,</strong>&nbsp;Bhopal, India. <strong>IJCH</strong> is both online and print, open access journal and it allows free access to its contents and permits authors to self-archive the final accepted version of their articles. The journal publishes articles covering various aspects of child health including basic research and clinical investigations in different fields of pediatrics covering perinatal and neonatal to adolescent age group.</p> Atharva Scientific Publications en-US Indian Journal of Child Health 2349-6118 Assessing the performance of vision screening performed by trained teachers in school children <p><strong>Background:</strong> The World Health Organization report states that visually impaired individuals around the world are as high as<br>285 million. <strong>Aim:</strong> This study aims to assess the validity of teacher-based vision screening in primary schoolchildren (aged 6–7 years),<br>implemented post-training. <strong>Methods:</strong> The study was conducted between November 2014 and February 2015 in Aydin province<br>of Turkey and it was planned in different phases; invitation of teachers for participation in the study, implementation of teacher<br>training program for the screening of refractive error, strabismus and color blindness, and testing the teachers’ performance. To<br>evaluate the validity of the proposed teacher-based visual screening, the assessment results of the teachers were compared with the<br>ophthalmologist’s diagnosis which was regarded as the gold standard. Results were expressed in terms of sensitivity, specificity,<br>and positive and negative predictive values.<strong> Results:</strong> Eight teachers who successfully completed the training and participated in the<br>student’s screening process, had teaching experience ranging from 5 to 15 years. The false positive error and false negative error<br>rates were about 3% and 7%, respectively. Further, quantification yielded sensitivity of 84%, specificity of 94%, positive predictive<br>value of 91%, and negative predictive value of 88%. <strong>Conclusions:</strong> Teachers with adequate training can accurately and reliably<br>detect the refractive error, strabismus, and color blindness in schoolchildren.</p> Nukhet Kirag Mehmet Bilgen ##submission.copyrightStatement## 2019-01-19 2019-01-19 709 712 Assessment of fetal nutrition status at birth using the clinical assessment of nutritional status score <p><strong>Introduction:</strong> Assessment of fetal malnutrition (FM) among neonates has been a major concern to health personnel due to the potentially serious sequelae of malnutrition on multiple organ systems. There is a dearth of research in the use of a clinical assessment of nutritional (CAN) status score as a method of assessing FM in term newborns regarding the Indian context. <strong>Objective:</strong> This study was conducted to assess the FM by CAN score and to verify the validity of CAN score in relation to other anthropometric variables. <strong>Materials and Methods:</strong> A hospital-based observational study was carried out at a tertiary care hospital, Chamarajanagar, for a period of 3 months from March 2018 to May 2018. All liveborn, singleton term infants &gt;37 weeks of gestation were included in the study. All measurements were carried out between 24 and 48 h of newborn age and data were collected using a structured questionnaire. <strong>Results:</strong> In this study, out of 250 neonates included, 52.8% of newborns were female and 47.2% were males. Total 8% of the study population was low birth weight, and 92% had normal birth weight. The CAN score of &lt;25 was found in 21.2% while the rest of 78.8% of cases had CAN score of &gt;25. CAN score had a sensitivity of 90%, specificity of 84.78%, and diagnostic accuracy of 85.2%. <strong>Conclusion:</strong> CAN score, a simple clinical index for identifying FM, is a good indicator than other anthropometric methods of determining intrauterine growth restriction like ponderal index.</p> Lakshmi Lakkappa Suguna Somasundara ##submission.copyrightStatement## 2019-01-19 2019-01-19 713 716 A study of neonatal hyperbilirubinemia from a tertiary care hospital in Northern India <p><strong>Objective:</strong> The objective of this study was to analyze the incidence of pathological jaundice, average time of presentation, mean duration<br>of phototherapy, and need for exchange transfusion with appropriate medical management. <strong>Methods:</strong> Thus, retrospective study was<br>conducted at neonatal intensive care unit of a tertiary care hospital from August 2017 to August 2018. All live births who were diagnosed<br>with neonatal hyperbilirubinemia and requiring treatment were included in the study. Exclusion criteria included any baby with conjugated<br>serum bilirubin &gt;20% of total serum bilirubin or &gt;2 mg/dl or neonate with any congenital malformation. <strong>Results:</strong> Nearly 5% of total<br>babies delivered developed neonatal jaundice requiring treatment. The most common causes isolated were ABO incompatibility followed<br>by Rh incompatibility. Almost 46% of babies were not found to have any cause. The most likely etiology concluded in this group was<br>breastfeeding jaundice. <strong>Conclusion:</strong> Breastfeeding jaundice should be considered as one of the common causes of pathological jaundice<br>making lactational counseling during antenatal and postnatal period an essential component of management and prevention of pathological<br>jaundice. Early detection and timely intervention with lesser invasive treatment modalities such as intravenous immunoglobulin<br>G, hydration, and phototherapy should be attempted aggressively to avoid need for high-risk procedures like exchange transfusion.</p> Nidhi Bedi Chandra Mohan Kumar Shweta Singh ##submission.copyrightStatement## 2019-01-19 2019-01-19 717 719 Role of imaging in neonatal Chikungunya encephalitis acquired by vertical transmission <p><strong>Background:</strong> Chikungunya is a viral infection which usually manifests as fever, rash, and arthralgia. Neurological complications are rare but are increasingly been seen in children and adults in endemic countries like India. Vertical transmission is seen in neonates with mothers who have been infected with the virus in the antenatal period. <strong>Objective:</strong> The objective of the study was to identify the essential role of imaging in the workup of these neonates, especially magnetic resonance imaging (MRI). <strong>Methods:</strong> A retrospective descriptive analysis of 10 neonates presenting with hypoactivity, maculopapular rash, and fever progressing to generalized seizures, and apnea suggestive of encephalitis was done. Chikungunya was confirmed by serum IgM CHICK enzyme-linked immune sorbent assay. Imaging evaluation included neurosonogram, computed tomography, and MRI with diffusion-weighted sequence with follow-up imaging at 1–3 months. <strong>Results:</strong> All the neonates had encephalopathy (100%) with or without seizures and perioral rashes. Cerebrospinal fluid showed mononuclear pleocytosis, raised protein or hypoglycorrhachia in 75% cases. Bacterial markers including cultures were negative. MRI showed features of viral encephalitis involving frontoparietal subcortical and deep white matter and corpus callosum with restricted diffusion. Neurocognitive outcomes in these neonates revealed neurodevelopmental delays for which follow-up MRI imaging was important, revealing reversal in diffusion changes, cystic encephalomalacia, and diffuse cerebral atrophy. <strong>Conclusion:</strong> In countries like India, experiencing annual outbreaks of Chikungunya infections radiologists must be familiar with the neuroimaging features and its possible sequelae.</p> Namrita Sachdev Yashvant Singh Shivani Gupta ##submission.copyrightStatement## 2018-12-21 2018-12-21 720 723 Behavioral problems in children with steroid-sensitive nephrotic syndrome: An ignored aspect! <p><strong>Background:</strong> Nephrotic syndrome (NS) is a common chronic renal disorder in children. Oral glucocorticoids are required in<br>high doses for prolonged periods adding to various comorbidities including psychosocial issues and behavioral problems.<br><strong>Objectives:</strong> This study was done to analyze the behavioral profile of children with steroid-sensitive NS (SSNS), also its association<br>with other factors such as mothers’ education, socioeconomic status, and age distribution. <strong>Materials and Methods:</strong> This was a<br>questionnaire (child behavior checklist)-based cross-sectional study conducted at a tertiary care center. Children from 6 to 15 years<br>with diagnosis of SSNS for the duration of 1 year or more were included in the study. Cases were divided into two groups: Infrequent<br>and frequent relapsing NS (IFRNS)/steroid-dependent NS (SDNS). Equal number of children in 6–15 years age group attending<br>outpatient clinic was taken as controls. <strong>Results:</strong> Children with SSNS (n=161) had behavioral problems in significant percentage<br>(39.13%) compared to the control group (8.75%). It was observed more in boys (73.02%) who had more hyperactive, aggressive<br>behavior, and externalizing problems. Internalizing problems (anxious/depressed, withdrawn/depressed, and somatic complaints)<br>were significantly more in the study group (17.39%) as compared to none in the control group. Children with FRNS/SDNS course<br>had more significant problems compared to relapse IFRNS group. Age distribution, socioeconomic status, and mother’s education<br>had no significant effect on its occurrence. <strong>Conclusion:</strong> Significant behavioral problems are observed in children with SSNS and<br>are related to the type of SSNS.</p> Prakash Chand Thakur Shobha Sharma Kuldip Kumar ##submission.copyrightStatement## 2019-01-19 2019-01-19 724 730 To study the impact of unilateral breast massage on milk volume among postnatal mothers - A quasi-experimental study <p><strong>Background:</strong> Breast massage is known to increase the volume of breast milk. This is known to occur through stimulation of oxytocin and prolactin. None of the studies have been done which looked at the local effects of breast massage. <strong>Objective:</strong> The objective was to study the impact of unilateral breast massage on breast milk output among postnatal mothers. <strong>Materials and Methods:</strong> This quasi-experimental study was conducted in a tertiary health-care hospital, Telangana. Postnatal mothers who approached the center’s milk bank for expressing breast milk were included in the study. The enrolled mothers were shown video of breast massage and also demonstrated the technique of breast massage using breast module by the lactational counsellors of the milk bank, at the hospital in Hyderabad. All the mothers were asked to do massage to the left breast for 10 min and later were asked to express breast milk separately from both breast using electrical hospital grade breast pump. The volume of milk produced from both the breasts was recorded separately at the third session. <strong>Results:</strong> A total of 42 postnatal mothers were enrolled in the study. The median volume of breast milk expressed from the left breast after breast massage was 22.5 ml (10,30) and the median volume of breast milk expressed from the right breast without breast massage was 15 ml (10,25). The volume of breast milk produced from the side of breast massage was significantly higher when compared to unmassaged side with p&lt;0.001. <strong>Conclusion:</strong> Breast massage increases the volume of breast milk production. If this increase in breast milk production is due to oxytocin and prolactin, then breast massage on one side should have its effect equally on both the breasts. However, in our study, the volume of milk produced on the massaged side was significantly higher than the unmassaged side. Hence, apart from oxytocin and prolactin, there may be some other local factors responsible for increased milk secretion which requires further research.</p> Santhosh Kumar Kraleti Swapna Lingaldinna Sravani Kalvala Sadiqua Anjum Himabindu Singh ##submission.copyrightStatement## 2019-01-19 2019-01-19 731 734 Percutaneous cystolithotripsy in children and its outcome: A single center experience <p><strong>Background:</strong> Pediatric bladder stone disease is very common in certain regions of India. Traditionally, pediatric surgeons have been managing this by open surgeries. <strong>Aim:</strong> The aim of the study was to manage vesical calculus in children by percutaneous cystolithotripsy (PCCL).<strong> Materials and Methods:</strong> All the children up to 18 years of age suffering from vesical calculus were operated by PCCL. Cystoscopy performed first to assess the stone burden. 18 Fr angiocath needle was used to puncture the bladder under vision and 0.035 guide wire was passed. Tract was dilated using single-step screw dilator; a 20 French Amplatz sheath was passed over the screw dilator and nephroscope was introduced. Lithotripsy was done using pneumatic lithotripter. Per urethral Foley catheter was placed and suprapubic puncture site was suture closed. <strong>Results:</strong> A total of 74 patients were operated in the past 3 years with an age range was 1–18 years with female preponderance. Complete clearance was achieved in all patients while the average duration of surgery was 30 min with range of 15–50 min. All the patients were operated under regional anesthesia and were discharged the next day. Among the study population, three patients had superficial wound infections at the puncture site which was managed conservatively. <strong>Conclusion:</strong> PCCL is a good option for managing vesical calculus in children. It has minimal morbidity and very small scar as compared to open cystolithotomy. Even in recurrent stones, it can be effectively performed, and in fact, it is easy to learn and reproducible.</p> Milind P Joshi Kakad Ruturaj Chaudhari Pankaj Zade Priti S Gavai Mahendra S Verma Ashwinikumar ##submission.copyrightStatement## 2018-12-21 2018-12-21 735 738 Staphylococcal scalded skin syndrome in a very low birth weight preterm infant <p>Staphylococcal scalded skin syndrome (SSSS) is an exfoliative dermatitis produced by the toxins of some strains of staphylococci, predominantly phage Group 2, strains 71 and 55. It has been reported mostly in children under 5 years of age with few cases only reported in very preterm infants. The disease can be life threatening in very low birth weight preterm babies. We are reporting one such case to emphasize the importance for clinicians to not only recognize the clinical manifestations of SSSS but also the need to closely monitor infants, especially VLBW infants with SSSS for bacterial sepsis and other complications.</p> Saleenas S PMC Nair Jemila James Anand N ##submission.copyrightStatement## 2019-01-19 2019-01-19 739 740 Herpes simplex virus encephalitis in an 8 years old with normal cerebrospinal fluid and negative herpes simplex virus polymerase chain reaction - A clinical and radiological diagnosis <p>Herpes simplex encephalitis is known to cause significant morbidity and mortality both in children and adults. Polymerase chain reaction (PCR) for herpes simplex virus (HSV) in cerebrospinal fluid (CSF) is the diagnostic modality accepted worldwide. However, a negative CSF HSV PCR result should always be interpreted in the context of the timing of specimen collection and also considering the clinical picture. We report a case of HSV encephalitis in an 8-year-old male child whose initial CSF picture was normal and CSF for HSV PCR was also negative. However, the magnetic resonance imaging brain findings and clinical profile along with a marked response to acyclovir therapy started very early in the course of illness left little doubts about the diagnosis.</p> Parminder Singh Divya Gupta ##submission.copyrightStatement## 2019-01-19 2019-01-19 741 743