PURPOSE: We aimed to study the pattern of liver-injury in children with dengue fever (DF) and validate serum aminotransferase ≥1,000 IU/L as a marker of severe DF. METHODS: Children admitted with DF were included. DF was defined by presence of clinical criteria and positive serological or antigen tests in absence of other etiology. DF severity was graded as dengue without or with warning signs and severe dengue. Liver-injury was defined as alanine aminotransferase (ALT) more than twice the upper limit of normal (boys, 30 IU/L; girls, 21 IU/L). RESULTS: Of 372 children with DF, 144 (38.7%) had liver-injury. Risk of liver-injury and aminotransferase levels increased with DF severity (p < 0.001). Recommended ALT and aspartate aminotransferase (AST) cut-off at ≥1,000 IU/L had sensitivity 4.8% (5/105), specificity 99.3% (265/267) for detection of severe DF. In children with ALT and AST < 1,000 IU/L (n=365), the area under receiver operating curves for prediction for severe DF, were 0.651 (95% confidence interval [CI], 0.588–0.714; p < 0.001) for ALT and 0.647 (95% CI, 0.582–0.712; p < 0.001) for AST. Serum ALT at 376 IU/L and AST at 635 IU/L had sensitivity and specificity comparable to ≥1,000 IU/L for defining severe DF. CONCLUSION: Liver-injury is common in DF. The ALT and AST levels increase with DF severity. ALT and AST levels of ≥1,000 IU/L could be lowered to 376 IU/L and 635 IU/L respectively for defining severe DF.
Alanine Transaminase ; Arboviruses ; Aspartate Aminotransferases ; Child* ; Dengue ; Female ; Fever* ; Humans ; Sensitivity and Specificity ; Severe Dengue* ; Transaminases*

Objectives: The coronavirus disease 2019 (COVID-19) pandemic is a public health emergency posing unprecedented challenges for health authorities. Social media may serve as an effective platform to disseminate health-related information. This study aimed to assess the extent of social media use, its impact on preventive behavior, and negative health effects such as cyberchondria and information overload. Methods: A cross-sectional observational study was conducted between June 10, 2020 and August 9, 2020 among people visiting the outpatient department of the authors’ institution, and participants were also recruited during field visits for an awareness drive. Questions were developed on preventive behavior, and the Short Cyberchondria Scale and instruments dealing with information overload and perceived vulnerability were used. Results: The study recruited 767 participants with a mean age of about 45 years. Most of the participants (>90%) engaged in preventive behaviors, which were influenced by the extent of information received through social media platforms (β=3.297; p<0.001) and awareness of infection when a family member tested positive (β=29.082; p<0.001) or a neighbor tested positive (β=27.964; p<0.001). The majority (63.0%) of individuals often searched for COVID-19 related news on social media platforms. The mean±standard deviation scores for cyberchondria and information overload were 9.09±4.05 and 8.69±2.56, respectively. Significant and moderately strong correlations were found between cyberchondria, information overload, and perceived vulnerability to COVID-19. Conclusions This study provides evidence that the use of social media as an information- seeking platform altered preventive behavior. However, excessive and misleading information resulted in cyberchondria and information overload.

The outward angulation of elbow with supinated forearm is cubitus varus deformity. This deformity is often seen as sequelae of malunited supracondylar fracture of humerus in paediatric age group of 5e8 years. The deformity is usually non-progressive, but in cases of physeal injury or congenital bony bar formation in the medial condyle of humerus, the deformity is progressive and can be grotesque in appearance. Various types of osteotomies are defined for standard non-progressive cubitus varus deformity, while multiple surgeries are required for progressive deformity until skeletal maturity. In this study we described a novel surgical approach and osteotomy of distal humerus in a 5 years old boy having grotesque progressive cubitus varus deformity, achieving good surgical outcome.
Child, Preschool ; Elbow Joint ; injuries ; Fractures, Malunited ; complications ; Humans ; Humeral Fractures ; complications ; Humerus ; surgery ; Joint Deformities, Acquired ; surgery ; Magnetic Resonance Imaging ; Male ; Osteotomy ; methods

Background: This study assessed anticipatory dental anxiety levels among 8- to 12-year-old children based on subjective and physiological measures and their correlation. The variations in anxiety based on sex, age, temperament, and academic performance were evaluated. Methods: An observational study was conducted in 60 children recruited from the waiting room over a 6-month period. The operator recorded subjective anxiety in the children using a novel visual facial anxiety scale. The operator also noted the demographic details and child’s temperament using the nine dimensions of the Thomas and Chess criteria, and graded children as “easy,” “slow to warm-up,” and “difficult.” The academic performance of the children was graded (parental ratings) on a five-point Likert scale. Physiological variables (heartrate [HR], oxygen saturation[SpO2 ], and blood pressure [BP]) were recorded by another evaluator. The correlation between anxiety levels and physiological variables was also assessed. The effects of age, sex, temperament, and academic performance on anxiety were evaluated. Results: The study included 60 children aged 8–12 years, including 36 boys and 24 girls. Seventy percent of children had mild to moderate levels of pre-extraction anxiety, while 30% of children demonstrated high anxiety.A significant positive correlation was noted between anxiety levels and HR (rs = 0.477, P < 0.001*) and systolic BP (rs = 0.294, P < 0.05), while a significant but inverse correlation was observed with SpO2 (rs = −0.40, P < 0.05). Anxiety did not influence diastolic BP. Children with difficult temperament and poor academic performance had significantly higher anxiety. Conclusion A high percentage (70%) of children aged 8–12 years had mild to moderate anxiety prior to the extraction procedure. Increased HR, systolic BP, and reduced SpO2 were significantly associated with high levels of anticipatory dental anxiety. Pre-extraction anxiety was significantly related to the temperament and scholastic performance.

Background: Dental treatment is challenging for children experiencing pain and anxiety. Effective administration of local anesthesia (LA) is crucial for most pediatric dentistry treatments. Eye Movement Desensitization and Reprocessing (EMDR) therapy has emerged primarily to manage post-traumatic stress disorder (PTSD) and a wide variety of anxiety- and pain-related conditions. However, the use of this therapy to manage pain in pediatric dentistry has not yet been reported. This study aimed to assess the trends in pain in pediatric dental patients with and without EMDR therapy during LA and extraction. The need for analgesic consumption within 24 h post extraction and the overall dental experience were also evaluated. Methods: Sixty children aged 8-12 years participated in a randomized controlled clinical trial with the goal of extracting the primary mandibular first or second molar on the right or left side and were stratified into: group I: EMDR therapy; group II: Tender Love and Care. Pain was measured at three different time intervals. An unpaired t-test was performed for intergroup comparison of continuous data, and the repeated measures ANOVA was applied for intergroup comparison between the groups. Results: Pain was significantly lower in group I (pain after topical LA gel application, P = 0.229; pain after LA administration, P = 0.036; pain after extraction, P < 0.001). The need for analgesic consumption was lower in this group (P = 0.072), and the overall dental experience was rated better (P < 0.0001). Conclusion Research has shown that EMDR therapy effectively reduces pain in children, making it a recommended practice for pediatric dentists trained in this technique.

Background: Dental treatment is challenging for children experiencing pain and anxiety. Effective administration of local anesthesia (LA) is crucial for most pediatric dentistry treatments. Eye Movement Desensitization and Reprocessing (EMDR) therapy has emerged primarily to manage post-traumatic stress disorder (PTSD) and a wide variety of anxiety- and pain-related conditions. However, the use of this therapy to manage pain in pediatric dentistry has not yet been reported. This study aimed to assess the trends in pain in pediatric dental patients with and without EMDR therapy during LA and extraction. The need for analgesic consumption within 24 h post extraction and the overall dental experience were also evaluated. Methods: Sixty children aged 8-12 years participated in a randomized controlled clinical trial with the goal of extracting the primary mandibular first or second molar on the right or left side and were stratified into: group I: EMDR therapy; group II: Tender Love and Care. Pain was measured at three different time intervals. An unpaired t-test was performed for intergroup comparison of continuous data, and the repeated measures ANOVA was applied for intergroup comparison between the groups. Results: Pain was significantly lower in group I (pain after topical LA gel application, P = 0.229; pain after LA administration, P = 0.036; pain after extraction, P < 0.001). The need for analgesic consumption was lower in this group (P = 0.072), and the overall dental experience was rated better (P < 0.0001). Conclusion Research has shown that EMDR therapy effectively reduces pain in children, making it a recommended practice for pediatric dentists trained in this technique.

Background: Dental treatment is challenging for children experiencing pain and anxiety. Effective administration of local anesthesia (LA) is crucial for most pediatric dentistry treatments. Eye Movement Desensitization and Reprocessing (EMDR) therapy has emerged primarily to manage post-traumatic stress disorder (PTSD) and a wide variety of anxiety- and pain-related conditions. However, the use of this therapy to manage pain in pediatric dentistry has not yet been reported. This study aimed to assess the trends in pain in pediatric dental patients with and without EMDR therapy during LA and extraction. The need for analgesic consumption within 24 h post extraction and the overall dental experience were also evaluated. Methods: Sixty children aged 8-12 years participated in a randomized controlled clinical trial with the goal of extracting the primary mandibular first or second molar on the right or left side and were stratified into: group I: EMDR therapy; group II: Tender Love and Care. Pain was measured at three different time intervals. An unpaired t-test was performed for intergroup comparison of continuous data, and the repeated measures ANOVA was applied for intergroup comparison between the groups. Results: Pain was significantly lower in group I (pain after topical LA gel application, P = 0.229; pain after LA administration, P = 0.036; pain after extraction, P < 0.001). The need for analgesic consumption was lower in this group (P = 0.072), and the overall dental experience was rated better (P < 0.0001). Conclusion Research has shown that EMDR therapy effectively reduces pain in children, making it a recommended practice for pediatric dentists trained in this technique.

Background: Dental treatment is challenging for children experiencing pain and anxiety. Effective administration of local anesthesia (LA) is crucial for most pediatric dentistry treatments. Eye Movement Desensitization and Reprocessing (EMDR) therapy has emerged primarily to manage post-traumatic stress disorder (PTSD) and a wide variety of anxiety- and pain-related conditions. However, the use of this therapy to manage pain in pediatric dentistry has not yet been reported. This study aimed to assess the trends in pain in pediatric dental patients with and without EMDR therapy during LA and extraction. The need for analgesic consumption within 24 h post extraction and the overall dental experience were also evaluated. Methods: Sixty children aged 8-12 years participated in a randomized controlled clinical trial with the goal of extracting the primary mandibular first or second molar on the right or left side and were stratified into: group I: EMDR therapy; group II: Tender Love and Care. Pain was measured at three different time intervals. An unpaired t-test was performed for intergroup comparison of continuous data, and the repeated measures ANOVA was applied for intergroup comparison between the groups. Results: Pain was significantly lower in group I (pain after topical LA gel application, P = 0.229; pain after LA administration, P = 0.036; pain after extraction, P < 0.001). The need for analgesic consumption was lower in this group (P = 0.072), and the overall dental experience was rated better (P < 0.0001). Conclusion Research has shown that EMDR therapy effectively reduces pain in children, making it a recommended practice for pediatric dentists trained in this technique.