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Climate change is already impacting children's health in a variety of ways. Indian children are among the most severely affected; they are experiencing respiratory illnesses from air pollution, heat-related illnesses, malnutrition, vector- and water-borne diseases; and mental health problems such as post-traumatic stress disorder from weather disasters. There is a need to increase awareness and capacity building among paediatricians for understanding the impact of climate change on the health of children and educating parents about preventive measures. Detailed environmental history taking will help to identify risk factors. To address climate change issues, professional paediatric associations should increase their advocacy with government agencies. It is essential to ask policymakers to immediately reduce greenhouse gas emissions. Reducing the burning of coal and other fossil fuels and moving to renewable energy sources such as solar and wind will reduce India's carbon emissions and decrease environmental illness among children. The pediatricians of India should declare that climate change is a child health emergency.

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Adolescent Medicine addresses the health care of adolescents, young adults, and their families. Adolescent psychology constitutes an important part. The COVID-19 pandemic has given insight into adolescent needs, bringing the focus on prevention rather than mere correction. One needs to factor in the unique aspects of adolescence, their need to impress peers and gain acceptance, and their unique information processing, not calculating trade-offs between risk and reward the way adults might, in a linear, rational, logical, and verbal manner. The article focuses on the need for collaborative training among the various stakeholders in Child and Adolescent Mental Health.

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Behaviour disorders are common in children. Various studies in children and Adolescents in India have found that 6% to 30% of study participants had one or other behaviour This calls for emphasis on integration of behavioral health (IBH) in the training programs for medical undergraduates and postgraduates in paediatrics. This article examines the current medical training programs for IBH of children and adolescents in curriculum of these programs in India. Pediatrics residency programs are described. The impact of Indian culture on IBH issues is also discussed. Ideas for integrating behavioral health in Medical education in India are given.

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While the marketing and sale of electronic cigarettes (e-cigarettes) in India is forbidden since September, 2019, vaping represents a significant risk to the health and safety of Indian adolescents. Though the prevalence of youth e-cigarette use in India remains unknown, pediatricians are often brought to provide care to youth who vape. In this commentary, background information on e-cigarettes including a review of the different types of vaping devices and of the substances contained in e-cigarette liquids is provided. The short- and long-term health risks associated with vaping, including risks for the developing brain, acute lung injuries and long-term mental health effects, and a practical approach for clinical management of e-cigarette use for Indian pediatricians is presented. Public health measures to prevent and reduce youth vaping and a review of current Indian laws and policies around e-cigarette use are also mentioned.

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Chicken-pox is one more newer vaccine in our armamentarium against infectious diseases. Due to its extremely contagious nature, varicella is experienced by almost every child or young adult in the world. Each year from 1990 to 1994, prior to availability of varicella vaccine, about 4 million cases of varicella occurred in the United States. Of these cases approximately 10,000 required hospitalization and 100 died. Although varicella is not commonly perceived as an important public health problem, the socioeconomic consequences in industrialized countries of a disease that affects practically every child and causes the carrier absence from work should not be underestimated. The varicella vaccines available in the market are safe and effective. A recent cost-benefit analysis in USA showed that routine chicken-pox vaccination is likely to save five times the investment. Even when only direct costs were considered, benefits almost balanced the costs. At present similar studies from developing countries are not available. The public health impact of varicella and zoster may be increasing in regions with high endemic rates of HIV infection. Varicella vaccine may be used either at an individual level to protect susceptible adolescents and adults, or at a population level, to cover all children as part of a national immunization programme. Vaccination of adolescents and adults will protect at-risk individuals, but will not have a significant impact on the epidemiology of the disease on a population basis. On the other hand, extensive use as a routine vaccine in children will have a significant impact on the epidemiology of the disease. If sustained high coverage can be achieved, the disease may virtually disappear. If only partial coverage can be obtained, the epidemiology may shift, leading to an increase in the number of cases in older children and adults. Hence, routine childhood varicella immunization programmes should emphasize high, sustained coverage. At present, this vaccine will have a lower priority in the National Immunization Schedule that does not have MMR and typhoid, which have a greater socioeconomic impact. Hence, at the present time WHO does not recommend the inclusion of varicella vaccination into the routine immunization programmes of developing countries.

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