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   Table of Contents - Current issue
Coverpage
November-December 2021
Volume 11 | Issue 6
Page Nos. 257-305

Online since Friday, December 31, 2021

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EDITORIALS  

Post-COVID Psychiatry practice p. 257
Anita Mahajan
DOI:10.4103/cmrp.cmrp_118_21  
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Influence of COVID-19 pandemic on health due to home confinement p. 259
Purvy Garg, Pratibha Singh
DOI:10.4103/cmrp.cmrp_41_21  
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ORIGINAL ARTICLES Top

Clinical and laboratory profile of children with primary immunodeficiency - Perspective from a developing country p. 262
Sushma Krishna, Ranjini Srinivasan, Anand Prakash, Sagar Bhattad, CK Indumathi
DOI:10.4103/cmrp.cmrp_74_21  
Aim: The aim of the study was to describe the clinical and laboratory features of children diagnosed with primary immunodeficiency from India. Background: Primary immunodeficiency disorders (PIDs) are a diverse group of conditions with heterogeneous presentation. Materials and Methods: A retrospective chart review of clinical and laboratory data of 40 children with primary immunodeficiency between 1 month and 18 years of age was carried out. A diagnosis of primary immunodeficiency was made based on the standard criteria. Results: Among the 40 children reviewed, males were more affected than females (1.8:1). Seventy per cent of the patients had onset of symptoms before 1 year of age. Recurrent fever (50%) was the most common presentation. Various infections included pneumonia (45%), gastrointestinal infections (18%), oral thrush (15%), recurrent otitis media (7.5%) and recurrent skin infections (5%). Non-infective complications included neurological manifestations such as developmental delay and seizures (10%), growth failure (38%) and cytopenia. Patients were categorised into combined humoral and cellular immunodeficiency (30%), predominant antibody deficiencies (12%), diseases of immune dysregulation (32%), congenital deficiencies in phagocytes (10%) and deficiencies in innate and intrinsic immunity (15%). A genetic confirmation of the immunodeficiency could be obtained only in half of all patients (49%). Conclusions: Children with PIDs can present with typical manifestations such as recurrent life-threatening infections or may have more unusual presentations such as cytopenia or unexplained growth failure.
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Trends of malnutrition from 1947-2021 among under-five children in India p. 269
Shivani Rohatgi, Sukhneet Suri, Praveen Kumar
DOI:10.4103/cmrp.cmrp_43_21  
Context: Malnutrition is a silent emergency and a leading cause of morbidity and mortality amongst children under 5 years of age. There are intra and inter-generational consequences of malnutrition. Aim: To study the trends of prevalence of malnutrition among under-five children in India since its independence. Subjects and Methods: The trends in malnutrition indicators from 1947 to 2021 in India through 40 studies out of 186 descriptive, cross-sectional and epidemiological studies, reports, etc., from the national and international electronic databases were reviewed and analysed. Results: Indicators of malnutrition have changed over the years. There is the paucity of data on child malnutrition from 1947 to 1972. Until the 1980s, the data were represented in the proportion of under-five children falling below a specified percent of the median as per weight-for-age. From 1980 to 2021, the data on the nutrition status of children under five are available as prevalence based on weight-for-age, height-for-age and weight-for-height. Overall, not much progress can be observed towards achieving sustainable development goals (SDGs) targets for underweight, stunting and wasting since 2005. Conclusions: The past seven decades have witnessed upward as well as downward trends during various periods of time in the prevalence of undernutrition. However, there has always been an upward trend in the prevalence of over-nutrition. To achieve SDG-2 by 2030, i.e., to reduce and maintain wasting by 5%, stunting by 40% and no further increase in childhood obesity, there is a need to strengthen the existing strategies and focus on the most vulnerable and critical age groups.
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REVIEW ARTICLE Top

Tolerability of Sarilumab – An anti-interleukin-6 receptor monoclonal antibody is controversial for the management of COVID-19 p. 280
Justin Jacob Abraham, I Jerlin Michelle, SA Shevaani, Kiran Kumar Rathinam, Muhasaparur Ganesan Rajanandh, Vijayakumar Thangavel Mahalingam
DOI:10.4103/cmrp.cmrp_71_21  
The emerging upsurge of severe acute respiratory syndrome coronavirus 2 (SARS CoV-2) has resulted in a global pandemic which originated in Wuhan city, China. The complicated virology of SARS CoV-2 makes it difficult to evaluate the therapeutic management for this infection. Drug repurposing is been considered in the management of novel coronavirus. Sarilumab, a monoclonal antibody, is being considered in the management of SARS CoV-2 infection, because it binds to both membrane-bound and soluble human interleukin 6 (IL-6) Ra, thereby blocking both IL-6 canonical and trans-signalling pathways. In this study, we tried to evaluate the reasons why Sarilumab is a not suitable option for treating novel coronavirus.
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CASE REPORTS Top

Gastric Fibromatosis: A case report and review of literature from a Tertiary Cancer Center p. 284
Amr Abouzid, Mahmoud M Saleh, Gehad A Saleh, Amany Hassan, Omar Hamdy
DOI:10.4103/cmrp.cmrp_1_21  
Gastrointestinal fibromatosis is a rare mesenchymal tumor. It has local invasive behaviour with low-metastatic potential. We present a 36-year-old female patient presented to Oncology Center, Mansoura University, Egypt, with accidentally discovered gastric mass by abdominal computed tomography (CT). The mass was adherent to the posterior wall of the gastric fundus, the tail of pancreas and encasing the splenic artery. The patient underwent partial gastrectomy, distal pancreatectomy and splenectomy. Pathological examination of the specimen showed bland spindle cell proliferation, with oval nuclei, scanty eosinophilic cytoplasm. There was no detected mitosis or necrosis or haemorrhage. Immunohistochemistry of tumor cells was positive with β-catenin and SMA, while Desmin, CD117, DOG-1 and S-100 were negative. The patient did not receive any adjuvant therapy. The patient underwent strict periodic follow-up every 3 months with abdominal CT for 6 months after surgery.
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Early diagnosis of Wiskott-Aldrich syndrome in the neonatal period and successful haematopoietic stem cell transplant in infancy p. 288
Abdul Rauf, Rakesh Kumar Pilania, KM Abdul Latheef, Revathi Raj, Amit Rawat
DOI:10.4103/cmrp.cmrp_81_21  
Wiskott-Aldrich syndrome (WAS) is a rare X-linked inborn error of immunity characterised by triad of eczema, microthrombocytopenia and recurrent infections. We herein report a case, where a male new-born with thrombocytopenia and no other symptoms was suspected of WAS in view of the significant family history of two previous sibling deaths. The diagnosis was confirmed by flowcytometry for WAS protein expression. He was initially managed with intravenous immunoglobulin replacement, regular cotrimoxazole prophylaxis, emollients and topical steroids for eczema (which child developed from the third month). The child underwent haematopoietic stem cell transplant (HSCT) at 8 months of age successfully and has remained asymptomatic at 5 years of follow-up. Early diagnosis of inborn error of immunity is extremely important for the prevention of complications and successful treatment including HSCT.
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CLINICOPATHOLOGICAL CONFERENCE Top

A 65-year-old woman with fever and renal failure p. 291
Tanvi Batra, Atul Kakar, Atul Gogia, Sonia Badwal
DOI:10.4103/cmrp.cmrp_113_21  
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SHORT COMMUNICATIONS Top

How COVID lifted up the spirits! p. 295
Kanika Chandra
DOI:10.4103/cmrp.cmrp_108_21  
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Impact of lockdown on patients other than COVID-19 in India p. 298
Avadhesh Kumar Yadav
DOI:10.4103/cmrp.cmrp_20_21  
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Drones for fighting COVID-19 Pandemic p. 303
Raju Vaishya, Karthikeyan P Iyengar, Ibrahim Haleem Khan, Mohd Javaid
DOI:10.4103/cmrp.cmrp_85_20  
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CORRIGENDUM Top

Corrigendum: Outbreak of Middle East respiratory syndrome coronavirus, Saudi Arabian experience p. 305

DOI:10.4103/2352-0817.334585  
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