Background: Gestational diabetes mellitus (GDM) is defined as glucose intolerance of variable degree with onset or first recognition during pregnancy. It is the most common medical complication of pregnancy and its prevalence varies from 1-20%. GDM normally occurs in the second and third trimesters of pregnancy and is associated with several maternal and fetal complications which can cause significant morbidity and mortality.Objectives: To describe the neonatal outcomes of infants born to mothers with GDM. Method: This case-control study was conducted on a sample of 240, divided into two groups: a GDM group (n=120) and a non-GDM group (control group, n=120). Mothers and babies were recruited at the well-baby clinics in the Galle district representing six Medical Officer of Health (MOH) areas. Data were collected using medical and health records, clinic cards and an interviewer-administered questionnaire.Results: Infants of the GDM group had a higher mean birth weight (3049.50 ± 520.91g) compared to the non-GDM group (2868.13±380.73g) (p=0.002). Mean birth length was also higher in the GDM group (50.98 ± 3.12cm) than n the non-GDM group (50.20 ± 2.44cm) (p=0.031). Ponderal index and head circumference showed no significant differences. GDM group had significantly more macrosomia cases (6 vs. zero, p=0.013). Gestational age was significantly lower in the GDM group (265.61 ± 11.12 days) than in the non-GDM group (269.05 ± 10.69 days) (p=0.015). Significantly more pre-term deliveries were observed in the GDM group (17 vs. 7, p=0.031). No significant association was found between GDM and mode of delivery (X2=2.453, p=0.117). The GDM group had significantly more episiotomies (X2=19.902, p=<0.001). Neonatal jaundice (19 vs. 6, p=0.006), heart murmurs (13 vs.1, p=<0.001) and atrial septal defect (ASD) / ventricular septal defect (VSD) (10 vs 0, p=0.001) were significantly higher in the GDM group. Complication or infections in the first three months were not significantly different between the two groups (p=0.098).Conclusions: GDM was significantly associated with higher birth weights and higher birth lengths in infants, along with an increased risk of preterm deliveries. GDM was significantly linked to adverse neonatal outcomes, including macrosomia, neonatal jaundice, heart murmurs, and ASD/VSD.
Introduction: Urinary tract infection (UTI) is a leading bacterial infection in childhood. The prevalence varies according to gender and age. Children with anomalies are more susceptible to UTI.Objectives: To describe the clinical characteristics and associated renal anomalies in children with culture-positive UTIs in a single centre.Method: A cross-sectional study was conducted among children aged 0–14 years referred for specialized nephrology care. UTI was defined as symptomatic, culture-positive with ≥10⁵ colony forming units (CFU) in midstream urine or any CFU in suprapubic aspiration. Children with learning disabilities, neuropsychiatric disorders, or unreliable parental history were excluded.Results: Of 166 patients, 111 (66.9%) were male. The mean age was 6.84±3.91 years, with a mean birthweight of 2.8±0.5 kg. For 57 (34.3%), it was the first UTI episode, with up to 10 episodes reported. Common symptoms included fever (75.3%, n=125), excessive crying (46.4%, n=77), poor stream (33.7%, n=56), frequency and intermittency (both occurred in 33.7% (n=56), dysuria (32.5%, n=54), backache and flank pain (4.2%, n=7). Predisposing factors included constipation (31.9%, n=53), phimosis (12.7%, n=21), and poor hygiene (2.4%, n=4). Ultrasound was performed in 149 (89.8%), with 35 (21.1%) showing no abnormalities and 91 (54.8%) revealing upper tract pathology. Micturating cystourethrogram (MCUG) and diethylene triamine penta-acetate (DTPA) scans were conducted in 45.8% and 49.4% of cases, respectively.Conclusions: In this single centre study, in 166 children, aged 0–14 years with culture-positive UTI, there were 66.9% males. Mean age was 6.84±3.91 years. Common symptoms were fever, excessive crying, poor stream, frequency, intermittency, backache and flank pain. Predisposing factors included constipation, phimosis and poor hygiene. Ultrasound scan, performed in 1149 children, showed abnormalities in 91(61.1%).
Introduction: Paediatric cancer is a leading cause of death in children and adolescents after common causes like malnutrition and infection. The field of paediatric oncology has developed significantly over the past few decades resulting in improved 5-year survival of all paediatric cancers to 75-80%.Objectives: To assess the clinical profile, short-term outcomes and survival of paediatric cancer patients treated at our state-run tertiary care cancer institute in Jabalpur, Madhya Pradesh, India.Method: This observational study was conducted for 2 years in the Paediatric Haemato-Oncology ward at State Cancer Institute, Jabalpur, Madhya Pradesh, India. After obtaining written informed consent, 234 children diagnosed with malignancies were enrolled in the study. Inclusion criteria were children aged 0 to <18 years diagnosed with malignancy. Data were recorded and entered in Excel sheet. Analysis was done focusing on the distribution of malignancies by age, gender and tumour type. All patients received chemotherapy, radiotherapy or surgery based on the type of malignancy. The study outcomes were categorized as remission, relapse or death.Results: Out of a total of 234 children, 152 (65 %) were males. Most common age of presentation was 0-5 years (39%). Common malignancies in decreasing order of frequency in our study population were leukaemia, lymphoma, renal tumours, soft tissue sarcoma, bone tumour, retinoblastoma, central nervous system tumours and germ cell tumours. Haematological malignancies constituted the highest frequency in our study population i.e., 154 (66%) children were diagnosed with leukaemia. Bone marrow transplant (BMT) was done in 3 children in our BMT unit. Fever (70%), pallor (44%), decreased appetite (60%), and bleeding spots (40%) were the common presenting symptoms. Outcome analysis indicated that 170 (72.6%) patients were alive at the end of the study, 25 (10.6%) had abandoned treatment and 24 (10.5%) had succumbed to the disease. The total number of relapsed cases was 15 (6.4%).Conclusions: Common malignancies were leukaemia, lymphoma, renal tumours, soft tissue sarcoma, bone tumour, retinoblastoma, central nervous system tumours and germ cell tumours. Haematological malignancies constituted 66% in our study population. Fever, pallor, decreased appetite, and bleeding spots were the common presenting symptoms. There were 10.5% deaths and 6.4% relapses.
Introduction: Neonates commonly experience physiological weight loss in the first few days of life. A weight loss >10% of birth weight is considered excessive and is associated with increased risks of morbidity and mortality.Objectives: To evaluate the factors influencing weight loss among exclusively breastfed newborns during their first week of life.Method: A case-control study was conducted at the Colombo North Teaching Hospital, Ragama, in 2025. The study enrolled exclusively breastfed newborns aged 2-7 days, born at or after 34 weeks of gestation with a birth weight of at least 1500g. Cases were defined as newborns with a weight loss >10%, while controls were those with a weight loss <7%. Data were collected through maternal interviews and medical record review.Results: The study included 65 cases and 65 controls. The mean weight loss was 10.5±0.5% for cases and 4.8±1.0% for controls. A significantly higher proportion of mothers in the case group were primiparous (83.1% vs. 67.1%, p<0.05), had fewer than 6 antenatal clinic visits (63.1% vs. 21.5%, p<0.001), lacked antenatal breastfeeding counselling (69.2% vs. 38.5%, p<0.01), and delivered via caesarean section (49.2% vs. 32.3%, p<0.05) compared to control group. Other factors that were significantly associated with excessive newborn weight loss included prematurity (<37 weeks) (p<0.05), maternal cracked nipples (p<0.01), and maternal breast engorgement (p<0.001). Furthermore, newborns with excessive weight loss had a significantly higher incidence of jaundice requiring phototherapy, dehydration fever, and hypoglycaemia. Conclusions: Primiparous mothers, mothers with less than 6 antenatal clinic visits, mothers who lacked antenatal breastfeeding counselling, mothers who delivered via caesarean section, prematurity, maternal cracked nipples and maternal breast engorgement were significantly associated with excessive newborn weight loss.
Introduction: Autism spectrum disorder (ASD) is diagnosed with impairment in social interactions and communication along with the presence of restricted repetitive behaviour (RRB). These stereotypies can have a significant impact on the quality of life (QoL) of both the affected children and caregivers.Objectives: To characterize RRBs in children with ASD according to the four DSM-5 Section B domains. Specific objectives were to quantify the frequency and severity of RRB, to examine its associations with clinician-rated ASD severity and attention difficulties and to assess its relationships with the functioning of the child health-related QoL, social communication, and parental perceptions regarding the child’s condition and the impact on daily life.Method: A descriptive cross-sectional study was conducted over 6 months at Teaching Hospital Kurunegala. Children diagnosed with ASD and aged 2-17 years were included. Statistical analysis was done using SPSS-25; tests for associations were done via t-test and Pearson’s correlation; significance was set at p-value of 0.05.Results: The study included 94 children with a mean age of 6.62 years and 74.5% were males. The most frequently observed RRB was pacing or moving around repetitively. Mean PedsQL score was 64.55. Moss attention rating scale (MARS) had a mean score of 64.00; 81.1% believed that doctors could help improve their child’s condition. No significant correlation was found between RRB and any component of PedsQL. Physical functioning was significantly associated with social functioning, emotional functioning, and school functioning. Social communication severity score was significantly associated with physical functioning, emotional functioning, and social functioning.Conclusions: The most frequently observed RRB was pacing or moving around repetitively. No significant correlation was found between RRB and any component of PedsQL. Physical functioning was significantly associated with social functioning, emotional functioning, and school functioning. Social communication severity score was significantly associated with physical functioning, emotional functioning, and social functioning.
Background: Paediatric traumatic brain injury (TBI) is a leading cause of death and long-term disability in children worldwide.Objectives: To assess the clinical and aetiological profile of children admitted with TBI to a tertiary care centre and to study the outcome of the childrenMethod: This descriptive hospital-based study was conducted at a tertiary care centre from December 2023 to July 2024. All children admitted with TBI were included. Clinical and demographic data, imaging findings, management strategies, and outcomes were analysed using descriptive statistics.Results: Fifty-five children were enrolled; 63.6% were boys; 43.6% were aged <5 years; 41.8% were due to road traffic accidents, 32.7% to falls from height and 25.4% to self-falls. At admission, 27.2% had mild, 43.6% moderate, and 29.1% severe TBI. Imaging revealed craniofacial fractures in 60% and cerebral oedema in 56.3%. Seizures occurred in 30.9% children; 36.3% required ventilation, and 14.5% underwent tracheostomy. Mortality was 16.3%; 40% of survivors had persistent neurological sequelae at discharge.Conclusions: Paediatric TBI affected children <5 years old in 43.6% cases. There was male predominance. The common causes were road traffic accidents, falls from height and self-falls. Common imaging findings were craniofacial fractures and cerebral oedema. Seizures occurred in 31% of children and 36% required ventilation, Mortality was 16.3%.
Introduction: Bacterial meningitis involves inflammation of the meninges due to bacterial infection. Despite improved outcomes globally through immunization and intensive care, it remains a significant cause of morbidity and mortality in Indian children due to poor vaccine coverage, antibiotic resistance, and delayed treatment. Understanding its epidemiology and management is essential for better outcomes.Objectives: To study prevalence, clinical profile, lab profile and outcome in acute bacterial meningitis for children aged 1 month to <18 years. Method: A retrospective study (May 2019–May 2024) included children admitted with acute bacterial meningitis. Fifty-eight children were selected as per inclusion criteria. Data were collected in the form of history as well as clinical examination, laboratory data, radiological investigation, treatment, complications, and clinical outcome at discharge and post-meningitis sequalae at follow-up and analysed.Results: Fifty-eight paediatric cases of acute bacterial meningitis were studied; 53.5% children were >5 years, with a male: female ratio of 1.6:1. Common symptoms included fever (91.3%), altered sensorium (57.1%), and headache (46.6%). Cerebrospinal fluid (CSF) pleocytosis, hypoglycorrhachia, and elevated protein were seen in 57%, 34.5%, and 41.4% cases respectively. CSF culture positivity was 17.5%, with Streptococcus pneumoniae being the most common organism. Imaging abnormalities included meningeal enhancement and hydrocephalus. At discharge, 32.8% had sequelae. CSF neutrophil % significantly predicted sequelae (p=0.013), while C-reactive protein and erythrocyte sedimentation rate did not. Risk factors included concurrent infections (32.7%), sinusitis, pneumonia, congenital anomalies, and immunodeficiency.Conclusions: Streptococcus pneumoniae was the most common organism. At discharge, 32.8% had sequelae. CSF neutrophil % significantly predicted sequelae. Risk factors included concurrent infections, sinusitis, pneumonia, congenital anomalies, and immunodeficiency.
