From the desk of editor-in-chief

Respected members of IAP Karnataka,

Greetings from Karnataka Pediatric Journal!

With immense pleasure, I am presenting the second issue of the flagship journal of IAP Karnataka. I am happy to receive the positive feedback for the journal from our mentors and members. The editorial board will strive to continue and maintain the standard of the journal. With the support from our esteemed members, I am sure the journal will get indexed soon.

The present issue has very interesting articles. In the review articles on skin prick testing and food allergy, the authors have described the mechanisms, diagnosis, and management of these allergies in children. Pediatricians are increasingly be encountering various allergic conditions such as atopic dermatitis, food allergies, allergic rhinitis, and asthma in their day-to-day practice. Accurate diagnosis of allergies depends very much on a detailed history supported by the judicious use of allergy tests. The history should focus first on confirming the diagnosis of allergy and then identifying the potential allergen. Investigations should be guided by the history and performed judiciously.

As the focus has been shifted to the prevention of infections in keeping the environment more sterile and minimalist interaction between human, animals, and microbiota, it has seen the surge of allergic diseases in the past 3 decades. There has been an increased emergence of food allergies in the past two decades with awareness of common foods causing food allergy. At present, the research focus is on treatment and any measures which can help in prevention of food allergies. Early use of broad-spectrum antibiotics in the 1^st year of life and cesarean section will disturb normal healthy microbiota development in gut resulting in dysbiosis and predilection of allergies. Advice for unnecessary avoidance of foods must be given with discretion to parents, bearing in mind, that this can cause micronutrient deficiency in children, if done without proper scientific reason.

The first few hours and days of a newborn’s life are a critical window for establishing lactation and providing mothers with the support they need to breastfeed successfully. Baby-friendly hospital initiative, since 1991, has helped to motivate facilities providing maternity and newborn services worldwide to better support breastfeeding. The author has described various steps of successful breastfeeding in simple language.

Renal tubular acidosis is a common inherited tubulopathy in children. Proximal renal tubular acidosis, usually secondary to a systemic metabolic disease, is characterized by a generalized dysfunction of the proximal tubule resulting in Fanconi syndrome. In addition to supportive therapy, specific treatment for the underlying etiology and regular monitoring of growth and laboratory parameters are of utmost importance.

Polycystic ovarian syndrome (PCOS) is the most common female endocrinopathy. Clinical features of PCOS are usually evident in adolescence. PCOS may clinically manifest for the 1^st time in adolescence. Hyperandrogenemia and oligoanovulation are the two essential criteria for the diagnosis of PCOS. It has long-term effects on cardiovascular, endocrinal, reproductive, and metabolic health. Early management of PCOS mitigates its long-term effects on health. Therapeutic lifestyle management and psychological counseling form the main stay of treatment in adolescence. Diagnosis of PCOS in adolescence is revisited and confirmed in adulthood. Management of PCOS is multidisciplinary and requires long-term regular follow-up in adolescence and adulthood. This has been discussed by the author in detail which will definitely benefit the pediatricians in the management of such adolescents.

Monitoring of lung functions is mandatory for diagnosis and further management of asthmatic patients. Spirometry, the widely available investigation, is the gold standard test used for mapping pulmonary dynamicity. It has got its own limitations in the form of operational difficulties in children, the elderly, and in those with neuromuscular or behavioral issues. In the current era of COVID-19 pandemic, the utility of spirometry has been further restricted to selected cohort only, due to potential risk of viral transmission during the procedure. There are certain distinct advantages of oscillometry over spirometry. People with neuromuscular weakness, cognitive limitations, and the elderly can easily perform it with only minor understanding and effort. Oscillometry is more sensitive than spirometry in detecting peripheral airway diseases. Less aerosol generation during the normal tidal breath is another advantage of oscillometry, over spirometry needing forceful efforts, which makes it more suitable for use in viral pandemic situations for monitoring patients with both asthma and pneumonia.

Although much is spoken about breaking bad news by medical professionals, there is very little information on parents’ perspective of this experience. Study of the parents’ satisfaction with the experience of receiving the diagnosis of Down syndrome (DS) for their child has been evaluated in this original article. Children studying in special schools with DS were identified and a retrospective study of their parents’ experience on receiving their child’s diagnosis was done using a semi-structured questionnaire. Factors associated with satisfaction and avoidance of factors causing dissatisfaction will help improve the perception of these parents toward the condition.

The original article on perinatal outcome of hypertensive disorders of pregnancy (HDP) assessed the incidence of HDP and its correlation with perinatal outcomes. HDP are multisystem diseases, which may complicate 5–10% of all pregnancies and are leading causes of maternal and perinatal mortality and morbidity worldwide. This study has shown useful insights into incidence of hypertensive disorders of pregnancy and perinatal outcomes in comparison to normal pregnancy.

There are three interesting case reports on congenital eyelid imbrication syndrome, subaponeurotic fluid collection, and neonatal Group B streptococcal osteomyelitis and suppurative arthritis which the readers will find it very interesting. I thank the editorial board members, authors, and reviewers for their support in bringing out this issue.