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Article ; Online: Unusual case of 'scorbutic proptosis'.

Arora, Shilpa Khanna / Jana, Manisha / Seth, Rachna

BMJ case reports

2024 Volume 17, Issue 1

Abstract: Proptosis is a frequent presenting symptom/sign of many paediatric malignancies. Acute-onset proptosis is an ophthalmic emergency that can endanger vision if not treated promptly. Appropriate treatment must be instituted only after investigating for the ... ...

Abstract	Proptosis is a frequent presenting symptom/sign of many paediatric malignancies. Acute-onset proptosis is an ophthalmic emergency that can endanger vision if not treated promptly. Appropriate treatment must be instituted only after investigating for the underlying aetiology. Here, we report a developmentally delayed boy in middle childhood who presented with recent onset bilateral proptosis. Clinical examination followed by radiological evaluation suggested scurvy to be the underlying cause and vitamin C supplementation led to prompt reversal of proptosis. The relevant literature has been reviewed and presented here to apprise the paediatric oncologists about this rare but easily treatable cause of proptosis.
MeSH term(s)	Male ; Humans ; Child ; Scurvy/diagnosis ; Exophthalmos/etiology ; Exophthalmos/diagnosis ; Vision, Ocular ; Tomography, X-Ray Computed/adverse effects ; Physical Examination
Language	English
Publishing date	2024-01-31
Publishing country	England
Document type	Case Reports ; Journal Article
ISSN	1757-790X
ISSN (online)	1757-790X
DOI	10.1136/bcr-2022-253380
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Article: Axillary Lymph Node in Extra-Ocular Retinoblastoma - Benign or Malignant?

Ravindra, Shubha Gadde / Sagar, Sambit / Arora, Shilpa Khanna / Seth, Rachna / Lomi, Neiwete / Kumar, Rakesh

Indian journal of nuclear medicine : IJNM : the official journal of the Society of Nuclear Medicine, India

2023 Volume 38, Issue 3, Page(s) 305–306

Abstract: A 1-year-old male child presented with whitish discoloration of pupil of the left eye and swelling over the left axilla. A contrast-enhanced magnetic resonance imaging of the brain and orbits performed revealed left eye extra-ocular retinoblastoma. 18F- ... ...

Abstract	A 1-year-old male child presented with whitish discoloration of pupil of the left eye and swelling over the left axilla. A contrast-enhanced magnetic resonance imaging of the brain and orbits performed revealed left eye extra-ocular retinoblastoma. 18F-fluorodeoxyglucose positron emission tomography/computed tomography scan was done in this child as a part of baseline staging of retinoblastoma in an ongoing research project. The scan revealed left eye extra-ocular retinoblastoma along with calcified left axillary level I lymph node.
Language	English
Publishing date	2023-10-10
Publishing country	India
Document type	Journal Article
ZDB-ID	2181722-4
ISSN	0974-0244 ; 0972-3919
ISSN (online)	0974-0244
ISSN	0972-3919
DOI	10.4103/ijnm.ijnm_4_23
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Article ; Online: Intussusception in a child with Acute Lymphoblastic Leukemia: a remarkable presentation with literature review - a case report.

Majumder, Ankur / Misra, Sunayana / Kumar, Vijay / Arora, Shilpa Khanna

Journal of the Egyptian National Cancer Institute

2021 Volume 33, Issue 1, Page(s) 18

Abstract: Background: Gastrointestinal complications are not uncommon in patients of Acute Leukemia. Intussusception as a complication in leukemia, although described, is exceedingly rare. Also, it is usually seen after chemotherapy and not as a part of the ... ...

Abstract	Background: Gastrointestinal complications are not uncommon in patients of Acute Leukemia. Intussusception as a complication in leukemia, although described, is exceedingly rare. Also, it is usually seen after chemotherapy and not as a part of the native disease process. This case report aims to highlight such a rare association which warrants clinical and pathological attention. Case presentation: A 14 year old male presented with an acute abdomen. Initial routine investigations revealed a deranged blood picture. On further examination of bone marrow aspirate, biopsy and detailed immunohistochemical studies a diagnosis of B-Acute Lymphoblastic Leukemia (B-ALL) was made. Concurrent ultrasound of the abdomen to find a cause for severe abdominal pain revealed an Ileo-colic intussusception. The patient was started on steroids; however he succumbed to his illness after two days, before surgery could be attempted. Conclusion: Rare presentations of relatively common diseases are a hurdle for timely and effective medical intervention. Although a rare condition in itself in leukemic patients, the occurrence of Intussusception in this particular patient, especially when no chemotherapy was initiated, is a very rare event. This case report was made to add to the relatively scarce literature available on this particular association. As it is a surgically treatable condition and since delay in diagnosis may lead to poorer prognosis, possibility of co-existence of ALL and intussusception should be borne in mind by all treating physicians and hematopathologists for effective patient care.
MeSH term(s)	Biopsy ; Child ; Humans ; Intussusception/diagnosis ; Intussusception/etiology ; Leukemia, Myeloid, Acute ; Male ; Precursor Cell Lymphoblastic Leukemia-Lymphoma/complications ; Precursor Cell Lymphoblastic Leukemia-Lymphoma/diagnosis ; Precursor Cell Lymphoblastic Leukemia-Lymphoma/drug therapy ; Ultrasonography
Language	English
Publishing date	2021-07-29
Publishing country	England
Document type	Case Reports ; Journal Article ; Review
ZDB-ID	1176790-x
ISSN	2589-0409 ; 1110-0362
ISSN (online)	2589-0409
ISSN	1110-0362
DOI	10.1186/s43046-021-00079-z
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Article: Predictors of severe dengue amongst children as per the revised WHO classification.

Arora, Shilpa Khanna / Nandan, Devki / Sharma, Anu / Benerjee, Pronita / Singh, Dhirendra Pratap

Journal of vector borne diseases

2022 Volume 58, Issue 4, Page(s) 329–334

Abstract: Background & objectives: World Health Organization (WHO) revised its guidelines for classification and management of dengue in 2009. This revised system was found out to have good sensitivity and negative predictive value but poor specificity as well as ...

Abstract	Background & objectives: World Health Organization (WHO) revised its guidelines for classification and management of dengue in 2009. This revised system was found out to have good sensitivity and negative predictive value but poor specificity as well as positive predictive value. Methods: This retrospective study was carried out in a tertiary care hospital of Delhi, India to assess factors predicting the occurrence of severe dengue in children as per the revised classification. A total of 647 suspected dengue cases were admitted in the hospital in the year 2015. Detailed clinical and epidemiological data of 170 patients who were confirmed as dengue either by NS1 antigen test or by serology (Ig M positive) were recorded and statistically analyzed. Results: The number of laboratory-confirmed cases was 170 and included thirty (17.65%) dengue fever (DF), 106 (62.35%) dengue with warning signs (DWS) and 34 (20.0%) severe dengue (SD) patients. Regression analysis revealed that presence of vomiting, altered sensorium, shock, peri-orbital edema, hepatomegaly, splenomegaly, severe anemia, thrombocytopenia, elevated urea and creatinine, decreased total protein and globulin were significantly associated with occurrence of severe disease. Interpretation & conclusion: The addition of clinical features (peri-orbital edema and splenomegaly); and laboratory findings (elevated urea and creatinine, decreased serum protein and globulin) might help improve the sensitivity and specificity of the revised WHO dengue classification in predicting severe dengue.
MeSH term(s)	Child ; Dengue/complications ; Dengue/diagnosis ; Dengue/epidemiology ; Humans ; Retrospective Studies ; Sensitivity and Specificity ; Severe Dengue/complications ; Severe Dengue/diagnosis ; Severe Dengue/epidemiology ; World Health Organization
Language	English
Publishing date	2022-04-05
Publishing country	India
Document type	Journal Article
ZDB-ID	2161218-3
ISSN	0972-9062
ISSN	0972-9062
DOI	10.4103/0972-9062.318312
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Article ; Online: Paediatric orbital ultrasound: Tips and tricks.

Gupta, Amit / Arora, Shilpa Khanna / Seth, Rachna / Kumar, Rakesh / Jana, Manisha

Australasian journal of ultrasound in medicine

2022 Volume 25, Issue 4, Page(s) 200–206

Abstract: Background: The orbital structures are ideally suited for ultrasound examination due to their superficial location and cystic composition of the eye. However, orbital ultrasound remains an underutilised modality due to preference for other cross- ... ...

Abstract	Background: The orbital structures are ideally suited for ultrasound examination due to their superficial location and cystic composition of the eye. However, orbital ultrasound remains an underutilised modality due to preference for other cross-sectional modalities in general practice. Aim: In this article, we review the basic principles, clinical uses and technique of orbital ultrasound in peadiatric patients. Materials and methods: The clinical utility of orbital ultrasound in peadiatric patients is demonstrated using selected cases. Results: Ultrasound is useful in the diagnosis of various posterior segment pathologies, especially in conditions causing opacification of light-conducting media of the eye. It is also beneficial in diagnosing various orbital pathologies, particularly in differentiating solid from cystic lesions. Discussion: The added advantages of its use in children include lack of ionising radiation and reduced requirement of sedation or general anesthesia. Ultrasound is the most practical initial investigation in cases where ophthalmoscopy is limited by opacification of ocular media. The addition of color Doppler on ultrasound can give additional information about the vascularity of the lesion. Conclusion: Use of ultrasound can be streamlined into the workup of various orbital and ocular pathologies either as an initial investigation or as a problem-solving tool in cases with a diagnostic dilemma on other modalities.
Language	English
Publishing date	2022-08-22
Publishing country	Australia
Document type	Journal Article ; Review
ZDB-ID	2843953-3
ISSN	2205-0140 ; 1836-6864
ISSN (online)	2205-0140
ISSN	1836-6864
DOI	10.1002/ajum.12314
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Article: Acute lymphoblastic leukemia presenting as nephromegaly in a child: A rare case report.

Arora, Shilpa Khanna / Swarnim, Swarnim / Hemal, Alok / Bidhuri, Neha

The Turkish journal of pediatrics

2020 Volume 61, Issue 1, Page(s) 97–101

Abstract: Arora SK, Swarnim S, Hemal A, Bidhuri N. Acute lymphoblastic leukemia presenting as nephromegaly in a child: A rare case report. Turk J Pediatr 2019; 61: 97-101. Acute leukemia is the commonest pediatric malignancy with acute lymphoblastic leukemia (ALL) ...

Abstract	Arora SK, Swarnim S, Hemal A, Bidhuri N. Acute lymphoblastic leukemia presenting as nephromegaly in a child: A rare case report. Turk J Pediatr 2019; 61: 97-101. Acute leukemia is the commonest pediatric malignancy with acute lymphoblastic leukemia (ALL) constituting about 75% of all leukemias. ALL commonly presents as fever, bleeding, bone pains, anemia, lymphadenopathy and hepatosplenomegaly. The liver, spleen or lymph nodes are the most common sites of extramedullary involvement in ALL, with renal involvement being relatively uncommon. The usual differential diagnosis of acquired massive bilateral nephromegaly in children includes pyelonephritis, obstructive uropathy, infections such as HIV nephropathy, mucormycosis, glycogen storage diseases, myelofibrosis with extramedullary hematopoiesis, kidney tumors and rarely hematological malignancies like ALL. Here we report a 2 years old child who presented with abdominal distention, low grade fever and constipation. Clinical examination revealed massive bilateral nephromegaly. Preliminary investigations showed severe anemia and slightly elevated WBC counts with presence of reactive changes in lymphocytes along with few atypical cells (9%). Abdominal ultrasonography revealed bilaterally enlarged kidneys which was later confirmed by CT abdomen. He was eventually diagnosed with CALLA positive B cell ALL for which treatment was started in accordance with the International network for cancer treatment and research (INCTR) protocol 02 04. At present, he is on maintenance phase and responding well to the treatment with regression of kidney size to normal on follow up ultrasonogram. Thus, leukemia should be considered in a child presenting with bilateral nephromegaly after exclusion of above mentioned differential diagnosis. Bone marrow aspiration must be done before doing a more invasive investigation like renal biopsy.
MeSH term(s)	Anemia/etiology ; Child, Preschool ; Humans ; Kidney/abnormalities ; Kidney/diagnostic imaging ; Leukocytosis ; Male ; Precursor Cell Lymphoblastic Leukemia-Lymphoma/diagnosis ; Tomography, X-Ray Computed
Language	English
Publishing date	2020-01-16
Publishing country	Turkey
Document type	Case Reports
ZDB-ID	123487-0
ISSN	0041-4301
ISSN	0041-4301
DOI	10.24953/turkjped.2019.01.015
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Article ; Online: Writing Methods: How to Write What You Did?

Arora, Shilpa Khanna / Shah, Dheeraj

Indian pediatrics

2016 Volume 53, Issue 4, Page(s) 335–340

MeSH term(s)	Humans ; Manuscripts as Topic ; Publishing ; Research Design ; Writing
Language	English
Publishing date	2016-04-28
Publishing country	India
Document type	Journal Article
ZDB-ID	402594-5
ISSN	0974-7559 ; 0019-6061
ISSN (online)	0974-7559
ISSN	0019-6061
DOI	10.1007/s13312-016-0847-7
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Article: Pediatric HIV Disclosure in Northern India: Evaluation of Its Prevalence, Perceptions amongst Caregivers, and Its Impact on CLHIV.

Meena, Rajesh / Hemal, Alok / Arora, Shilpa Khanna

AIDS research and treatment

2018 Volume 2018, Page(s) 2840467

Abstract: Background: With improving standards of care of children living with HIV (CLHIV), pediatric HIV related mortality rates are declining. New challenges like HIV status disclosure are emerging which need to be addressed to ensure their smooth transition ... ...

Abstract	Background: With improving standards of care of children living with HIV (CLHIV), pediatric HIV related mortality rates are declining. New challenges like HIV status disclosure are emerging which need to be addressed to ensure their smooth transition into adulthood. Poor disease disclosure rates are observed in CLHIV globally. Aims: This study was done to assess the prevalence of HIV disclosure in North Indian CLHIV, know the perceptions of caregivers regarding disclosure, and evaluate the impact of disclosure on CLHIV. Methods: It was a questionnaire based cross-sectional study carried out amongst 144 caregivers of CLHIV aged 6-16 years attending the pediatric HIV clinic of a tertiary care teaching hospital. Results: Though the majority (93.8%) caregivers felt that it is important to disclose but only 33% of the children were actually disclosed. Eighty five percent felt that disclosure must be done by one of the family members and correspondingly 73% of the disclosed children were actually disclosed by their parents. Forty seven percent believed that the most appropriate age for disclosure is 10-12 years. The mean age at which disclosure was actually done was 11.06 ± 1.62 years. Comparison of the disclosed and undisclosed CLHIV revealed that the disclosed group had significantly higher age, longer duration of taking ART, and higher proportion of paternal orphans. Age of the CLHIV was the only significant factor for disclosure. Several reasons were cited by the caregivers for nondisclosure. The caregivers observed improved drug adherence in 47.9% of the children following disclosure. Conclusions: There is a need to develop region specific pediatric HIV disclosure guidelines keeping in mind the caregivers' perceptions. The guidelines must be age appropriate, systematic, and socioculturally acceptable. The most suitable age for disclosure appears to be 10-12 years. Involvement of caregivers and health care providers in the process is a must.
Language	English
Publishing date	2018-10-24
Publishing country	United States
Document type	Journal Article
ZDB-ID	2573930-X
ISSN	2090-1259 ; 2090-1240
ISSN (online)	2090-1259
ISSN	2090-1240
DOI	10.1155/2018/2840467
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Article ; Online: Psychiatric Problems Amongst Adolescents Living With HIV at a Tertiary Care Centre in India.

Pilania, Renu / Hemal, Alok / Agarwal, Sheetal / Beniwal, Ram Pratap / Arora, Shilpa Khanna

Indian pediatrics

2020 Volume 57, Issue 11, Page(s) 1026–1028

Abstract: Objective: To assess the prevalence of psychiatric problems among adolescents living with HIV (ALHIV).: Methods: Questionnaire-based cross-sectional study conducted at pediatric HIV clinic of a tertiary care hospital. Participants: 101 ALHIV between ... ...

Abstract	Objective: To assess the prevalence of psychiatric problems among adolescents living with HIV (ALHIV). Methods: Questionnaire-based cross-sectional study conducted at pediatric HIV clinic of a tertiary care hospital. Participants: 101 ALHIV between 10-18 years of age. Results: Of the 101 ALHIV, 12 (11.88%) met criteria for psychiatric disorders, of which dysthymi (5,41.6%) and oppositional defiant disorder (6,50%) were the commonest. Father of 7 (58.34%) and mother of 8 (66.6%) screen positive patients were dead as compared to 22 (24.7%) and 13 (14.6%) of screen negative patients (P=0.016 and P=0.0003, respectively). Conclusion: Psychiatric problems are common in ALHIV in the age group more than 15 years.
MeSH term(s)	Adolescent ; Ambulatory Care Facilities ; Child ; Cross-Sectional Studies ; Female ; HIV Infections/complications ; HIV Infections/epidemiology ; Humans ; India/epidemiology ; Tertiary Care Centers
Language	English
Publishing date	2020-08-09
Publishing country	India
Document type	Journal Article
ZDB-ID	402594-5
ISSN	0974-7559 ; 0019-6061
ISSN (online)	0974-7559
ISSN	0019-6061
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Article: Microbiome: Paediatricians' perspective.

Arora, Shilpa Khanna / Dewan, Pooja / Gupta, Piyush

The Indian journal of medical research

2015 Volume 142, Issue 5, Page(s) 515–524

Abstract: Millions of microorganisms inhabit the human body and affect its homeostasis in multiple ways. Alterations in this microbial community have implications for the health and survival of the human hosts. It is believed that these microorganisms should be ... ...

Abstract	Millions of microorganisms inhabit the human body and affect its homeostasis in multiple ways. Alterations in this microbial community have implications for the health and survival of the human hosts. It is believed that these microorganisms should be included as part of the human genome because of their influence on human physiology hence the term "microbiome" is commonly used to refer to these microbes along with their genetic make-up and their environmental interactions. In this article we attempt to provide an insight into this recently discovered vital organ of the human body which is yet to be fully explored. We herein discuss the composition and role of microbiome in human health and disease with a special emphasis in children and culture-independent techniques employed in mapping of the microbiome. Alteration in the gut microbiome has been associated with causation of several paediatric diseases like infantile colic, necrotizing enterocolitis, asthma, atopy, obesity, type -1 diabetes, and autism. Atopic dermatitis and psoriasis have also been associated with changes in the cutaneous microbiome. Respiratory microbial imbalances during infancy have been linked with wheezing and bronchial asthma. Dysbiosis in the regional microbiome has been linked with caries, periodontitis, and chronic rhinosinusitis. The future therapeutic implications of this rapidly evolving area of research are also highlighted.
MeSH term(s)	Biodiversity ; Child ; Humans ; India ; Microbiota ; Pediatrics
Language	English
Publishing date	2015-12-14
Publishing country	India
Document type	Journal Article ; Review
ZDB-ID	390883-5
ISSN	0971-5916 ; 0019-5340
ISSN	0971-5916 ; 0019-5340
DOI	10.4103/0971-5916.171275
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