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International Journal of Contemporary Pediatrics
Number of Followers: 8  

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ISSN (Print) 2349-3283 - ISSN (Online) 2349-3291
Published by Medip Academy Homepage  [12 journals]
  • Caregiver knowledge, attitude and practices about early child development
           in Telangana, India: a cross-sectional study

    • Authors: Leena Gaikwad, Zenia Taluja, Nanda Kishore Kannuri, Samiksha Singh
      Pages: 1940 - 1951
      Abstract: Background: Early childhood development (ECD) refers to the age-appropriate language, cognitive and socio-emotional growth in early years of life. For the very young, 0-3 years of age, parents and caregivers are the main source of stimulus and care. Poor socio-economic conditions may contribute to suboptimal parenting.Methods: We assessed caregivers’ knowledge, attitude and practice (KAP) regarding ECD in underprivileged regions of Telangana, South-India, using a structured survey, and qualitative interviews of frontline workers (FLWs).Results: A large proportion of caregivers had appropriate knowledge and practices regarding nutrition and health: colostrum (>80%), breastfeeding (>94%), growth monitoring (>90%), immunization (99%), and health-seeking for the child (98%). Regarding early stimulation, caregivers knew and believed that reading (91%), playing (94%), storytelling and singing (79%) make the child intelligent; but were unaware that these activities should be initiated before 3 years of age, thus their practice of the same was also low. They expressed their love and affection (99%) well for the child, spent time (46%) and talked to the child (59%), but were not aware this contributes to cognitive and emotional development of the child. Major challenges in effective ECD care as per FLWs included parental attitude, mothers’ agricultural work routine and language barrier.Conclusion: We observed gaps in age-appropriate early stimulation and responsive care. Several good practices are rooted in tradition, but caregivers were not completely aware of the contribution of these practices to their child’s development. Qualitative interviews with FLW show the need of culturally relevant interventions to empower caregivers regarding ECD.
      PubDate: 2020-09-21
      DOI: 10.18203/2349-3291.ijcp20204025
      Issue No: Vol. 7, No. 10 (2020)
  • Evaluation of risk factors for perinatal asphyxia in a tertiary care
           hospital in Bangalore: an observational prospective study

    • Authors: Somashekhar Chikkanna, Kavya S., Saravanan P., Nagaraj M. V.
      Pages: 1952 - 1956
      Abstract: Background: Perinatal asphyxia is an insult to fetus or newborn due to lack of oxygen (hypoxia) or lack of perfusion (ischemia) to various organs of sufficient magnitude and duration. Prenatal asphyxia is one of the major causes of early neonatal mortality in India. Our goal was to evaluate risk factors of perinatal asphyxia.Methods: Observational prospective study on 100 babies delivered in our hospital consecutively and requiring resuscitation were included.Results: The mean age of mothers was 23.5 years. 54% neonates were born to primiparous mothers. Anaemia was widely prevalent in the mothers of neonates requiring resuscitation. The major maternal risk factors for newborns requiring resuscitation were pregnancy-induced hypertension (PIH) (46%), oligohydramnios (41%), polyhydramnios (30%) and meconium stained liquor (28%). The fetal factors associated with resuscitation of newborns were intrauterine growth restriction (IUGR) (30%), prematurity (25%), meconium aspiration syndrome (MAS) (20%), and neonatal seizures (36%). Mortality was highest in hypoxic ischemic encephalopathy (HIE) stage 3 with 11%.Conclusions: The most common maternal risk factors for newborns requiring resuscitation was PIH followed by oligohydramnios, polyhydramnios and meconium stained liquor. IUGR was the most common fetal risk factor followed by, prematurity, MAS and neonatal seizures.
      PubDate: 2020-09-21
      DOI: 10.18203/2349-3291.ijcp20204026
      Issue No: Vol. 7, No. 10 (2020)
  • Correlation between early magnetic resonance imaging brain abnormalities
           in term infants with perinatal asphyxia and neuro developmental outcome at
           one year

    • Authors: Arun Puliyasserimana Satheesan, Ashwini R. Chinnappa, Guruprasad Goudar, Chaitali Raghoji
      Pages: 1957 - 1961
      Abstract: Background: Hypoxic ischemic encephalopathy is an important cause of permanent brain damage in neonates with perinatal asphyxia. Magnetic resonance imaging (MRI) is valuable in predicting prognosis following HIE.Methods: Prospective observational cohort study was conducted in tertiary level referral hospital in term infants born with perinatal asphyxia. MRI brain was done between 5 to 14 days of age. Anthropometry and neurological examinations were recorded at birth, discharge and follow-up. Denver developmental screening test II was performed at follow up.Results: Out of 174 neonates born with PA, enrolled 64 underwent MRI brain. Out of these 14% had stage I, 70% stage II and 16 % stage III HIE as per Sarnat staging. At follow up, abnormalities in tone were noted in 36% infants, which included spastic quadriplegia in 34% and atonic cerebral palsy in 2%. DDST II was normal in 32 and suspect in 18 (36%) infants; with global developmental delay in 14 (28%) and predominantly motor development delay in 4 (8%). Abnormal lesions were seen in the corpus callosum in 34 (68%), posterior limb of internal capsule in 14 (28%), basal ganglia in 11 (22%), watershed region in 6 (12%), thalamus in 4 (8%) and corticospinal tract in 1 (2%) infants were associated with statistical significant poor neurodevelopment outcome p<0.05. Diffusion weighted MRI showed abnormalities in the posterior limb of internal capsule (PLIC) in 27 (54%), BG in 8 (16%) and thalamus in 2 (4%) infants was associated with statistically significant poor neurodevelopmental outcome (NDO) (p<0.05).Conclusions: Lesion in BG, thalamic region and PLIC in conventional MRI and abnormality in DW imaging in PLIC and BG were found to correlate with poor NDO at one year of life.
      PubDate: 2020-09-21
      DOI: 10.18203/2349-3291.ijcp20204002
      Issue No: Vol. 7, No. 10 (2020)
  • An observational study on clinical and bacteriological profile of
           new-borns with early onset sepsis

    • Authors: Mobin George Tharu, Rati Santhakumar, V. C. Manoj
      Pages: 1962 - 1967
      Abstract: Background: Neonatal sepsis related mortality is preventable with timely recognition, rational antimicrobial therapy and aggressive supportive care. The objective of this study was to study the maternal and neonatal risk factors in new-borns with early onset sepsis and to ascertain commonest pathogen responsible.Methods: This study was done in the neonatal intensive care unit tertiary care hospital, Thrissur. Data collected after clinical examination and from the records of new-borns diagnosed with early onset sepsis were analyzed. All neonates suspected to have sepsis had a septic screen to corroborate the diagnosis. Blood culture was performed in all cases of suspected sepsis prior to starting antibiotics. The risk factors for sepsis, both maternal and neonatal were analysed. Their clinical features and bacteriological profile were studied. Data analysis was done using their mean±standard deviation (SD), percentage analysis, chi-square test or fischer’s test.Results: Fifty newborns with diagnosed early onset sepsis (EOS) were studied. Results suggest that maternal screening is prudent, interventions like vaginal examination were causative of sepsis than meconium stained liquor or prolonged rupture of membranes. A coincidental finding suggests that sepsis is more common in males and term babies. Blood culture showed predominant pathogen to be Klebsiella.Conclusions: Among the maternal factors, increased frequency of vaginal examination was most prevalent in the study group. Prematurity and asphyxia were not strong pre-runners for sepsis. EOS cases presenting with respiratory distress were 50%. Fever and tachycardia were the next common clinical features. The cases yielded blood culture positive were 20% and Klebsiella pneumonia (40%) was the commonest organism isolated. 
      PubDate: 2020-09-21
      DOI: 10.18203/2349-3291.ijcp20203975
      Issue No: Vol. 7, No. 10 (2020)
  • Clinical profile of congenital hypothyroidism identified through new-born
           screening: a retrospective observational study

    • Authors: Sudhakar Palanisamy, Ramesh Srinivasan
      Pages: 1968 - 1972
      Abstract: Background: Congenital hypothyroidism is one of the most common preventable causes of mental retardation. The incidence and etiology of congenital hypothyroidism varies significantly across the globe.Methods: In this retrospective observational study we aimed to find out the incidence and etiology of congenital hypothyroidism identified by neonatal screening program. We included all neonates who had their thyroid stimulating hormone screening done in a tertiary care hospital of South India between January 2014 and June 2020 and were diagnosed as a case of congenital hypothyroidism. The growth patterns, clinical features, thyroxine dose requirement during follow-up were also studied.Results: There were 23 babies diagnosed with congenital hypothyroidism during the study period. The incidence rate was 1 in 917 live births for inborn babies, and dyshormogenesis (60%) was the most common etiology. Two babies had clinical features associated with congenital hypothyroidism. None of the babies had clinical features of congenital hypothyroidism during follow-up and their growth & development were normal for age. Babies who required dose increments of thyroxine supplement turned out to be permanent congenital hypothyroidism. Conclusion: Incidence of congenital hypothyroidism was high in our population. Dyshormogenesis was the most common etiology. Majority of congenital hypothyroidism babies were asymptomatic at diagnosis, so screening is a vital tool for early diagnosis. Babies who required thyroxine dose increment with age tend to be permanent congenital hypothyroidism.
      PubDate: 2020-09-21
      DOI: 10.18203/2349-3291.ijcp20203974
      Issue No: Vol. 7, No. 10 (2020)
  • Outcome of neonatal jaundice in term neonates with ABO incompatibility at
           tertiary level center

    • Authors: Amit Kumar Thakur, Mohammad Ashfaque Ansari, Atindra Mishra, Saroj Kumar Jha
      Pages: 1973 - 1977
      Abstract: Background: Neonatal jaundice is extremely common as almost every new-born develops an unconjugated serum bilirubin level of more than 1.8 mg/dl during the first seven days of life. ABO incompatibility is associated in about 20% of all pregnancies but manifestations of ABO haemolytic disease of new-born occurs in <10% of these cases. True incidence of ABO incompatibility, particularly in developing countries like Nepal, is not understood sufficiently. Furthermore, the confirmation of severe ABO incompatibility cannot be made accurately using only a single test. Hence, this study was done to know the outcome of jaundice in ABO incompatibility patients.Methods: This was a descriptive cross-sectional study done at Department of Paediatrics, between August 2018 to July 2019. All term neonates born to ‘O’ positive mother, with blood group A or B positive, and fulfilling the selection criteria were included in the study. Sample size was calculated to be 114 with confidence level at 95% and prevalence of ABO haemolytic disease as 11.4% with margin of error 5%.Results: Severe ABO incompatibility as evident by presence of jaundice within 24 hours of life, a positive result on direct coomb’s test and haemolytic picture on peripheral blood smear was observed in 12% of the total enrolled 200 neonates. Modalities of treatment showed significant relation with severe ABO incompatibility indicating increased need for double volume exchange transfusion in neonates with severe ABO incompatibility.Conclusions: Phototherapy was found to be effective in the management of most of the cases of neonatal jaundice in term ABO incompatible neonates but some cases, requiring exchange transfusion can occur, mostly in presence of positive result on direct Coomb’s test.
      PubDate: 2020-09-21
      DOI: 10.18203/2349-3291.ijcp20203969
      Issue No: Vol. 7, No. 10 (2020)
  • Immunization status of children aged 1-5 years attending tertiary care
           center and reasons for partial or non-immunization

    • Authors: Babitha Rexlin G., Suresh Placode Manikandan
      Pages: 1978 - 1983
      Abstract: Background: Immunization is a reliable evidence-based approach to eradicate deadly infectious diseases. National family health survey (NHFS4) data reveals that immunization after 1 year of age dropped in Kanyakumari district, Tamil Nadu, India.  Methods: Our aim was to determine immunization status and reasons for partial or non-immunization of children aged 1 to 5 years in Kanyakumari district from April 2019 to March 2020. It’s a prospective and descriptive hospital-based study. Here 613 children were split-up in three categories based on ministry of health and family welfare (MOHFW) guidelines as fully, partially or unimmunized. The samples were analysed with IBM. SPSS statistics software 23.0 Version.Results: Of the 613 children 5 were excluded from the study due to contraindications to immunizations. Of the 608 children 529 (87%) were fully immunized, 79(13%) were partially immunized and none were unimmunized. Among partially immunized, 2 parents lacked information (2.5%), 26 parents lacked motivation (32.9%), 45 parents faced obstacles (57%) and 6 parents had other reasons (7.6%). 2 parents who lacked information were migrant laborers, illiterates and the children were home delivered. In the partial immunization, chi-square and regression analysis revealed that for female gender the p-value was 0.001, OR 2.084 with 95% confidence interval (CI) (1.347 to 3.226), for parental education the p-value was 0.0005, OR 1.561 with 95% CI (1.034 to 2.335) and for home delivery the p value was 0.0005, OR 1.564 with 95% CI (1.006 to 2.432).  Conclusions: The study determines that factors associated with partial immunization are female children, illiterate/less educated parents and home delivery.  
      PubDate: 2020-09-21
      DOI: 10.18203/2349-3291.ijcp20204038
      Issue No: Vol. 7, No. 10 (2020)
  • A study of risk factors and their correlation with severity of retinopathy
           of prematurity: a prospective study

    • Authors: Bhuvaneshwari C. Yelameli, Ramesh V. Neelannavar, Kiruthika Das
      Pages: 1984 - 1990
      Abstract: Background: Recent advances in neonatal care in the last decade and improved survival rates have resulted in an apparent increase in the incidence of retinopathy of prematurity (ROP), which is the most important cause of preventable blindness in infants. This study was done to identify the risk factors which predispose to ROP and to assess its correlation with severity of ROP.Methods: A total of 140 neonates with gestational age ≤34 weeks, birth weight ≤2000 grams who were admitted at NICU, S. N. Medical College and HSK Hospital, Bagalkot from December 2018 to May 2019 were considered. Babies were assessed and recorded for the risk factors of ROP in a predesigned proforma. ROP screening was performed using wide-field digital imaging on a retcam shuttle (Clarity MSI, USA).Results: A total of 140 babies were examined, and an overall incidence of ROP was 52 (37.1%). 17 (32.7%) had stage 3, 3 (5.8%) had stage 4, and 1 (1.9%) had stage 5. Among the 52 babies with ROP, 19 (51.3%) underwent laser photoablation. Risk factors like gestational age, birth weight, maternal risk factors, apnea, intrauterine growth restriction (IUGR), hypoglycaemia, respiratory distress syndrome (RDS), sepsis, coronary heart disease (CHD), blood transfusion and oxygen requirement duration were significantly associated with ROP. Delay in the establishment of feeds has been associated with ROP (p<0.001).Conclusions: Screening should be intensified in the presence of risk factors which can reduce the incidence of severe stages of ROP as highlighted by this study.
      PubDate: 2020-09-21
      DOI: 10.18203/2349-3291.ijcp20204039
      Issue No: Vol. 7, No. 10 (2020)
  • Study on biochemical and radiological profile in children clinically
           diagnosed as tubercular meningoencephalitis: a prospective study from a
           tertiary care centre in Rajasthan

    • Authors: Suresh Goyal, Shashibala ., Anuradha Sanadhya, Juhi Mehrotra
      Pages: 1991 - 1995
      Abstract: Background: Objective of the current study was to assess biochemical profile and neuroimaging findings in children diagnosed with neurotuberculosis in a tertiary care centre in Southern Rajasthan, India.Methods: A prospective randomized controlled trial was conducted in Department of Pediatrics, tertiary care centre in Southern Rajasthan, India from July 2017 to June 2018. Total 110 children of age group of 6 months to 18 years with the diagnosis of tubercular meningoencephalitis (TBME) on the basis of clinical evaluation, cerebrospinal fluid (CSF) examination and neuroimaging were included in the study.Results: Among 110 children included in the study, CSF lymphocytic pleocytosis was seen in all. Majority of children (56.36%) cell counts were in the range of 101-500 cells/µl and mean CSF cell count was 198.09±177.86 per µl. CSF protein ranges from 100 to 400 mg/dl in 68.2% children and 19 children had CSF protein >400 mg/dl with mean of 230.98±167.73 mg/dl. In majority of patients (40%) CSF glucose level was in range of 20-40 mg/dl and in 31.82% children CSF glucose was <20 mg/dl. Mean CSF sugar level was 33.86±18.22 mg/dl. None of them demonstrated acid fast bacillus (AFB) on Ziehl-Neelsen staining of CSF sample. Chest radiographic abnormality was found in 41.82% cases. Mantoux test was positive in 16.36% (18) children admitted with TBME. Common abnormalities noted on neuroimaging were: Communicating hydrocephalus (77.27%), meningeal enhancement (40%), infarction (27.27%), cerebral oedema (11.82%) and 9.09% has tuberculoma on neuroimaging. CSF and gastric aspirate were examined by cartridge based nuleic acid amplification test (CBNAAT) for Mycobacterium Tuberculosis (MTB), among them 5 (4.55%) children had positive in CSF and 16 (14.55%) had gastric aspirate positive for MTB by CBNAAT.Conclusions: Clinical, biochemical and radiological parameters is sufficient enough to diagnose TBME in children.
      PubDate: 2020-09-21
      DOI: 10.18203/2349-3291.ijcp20204040
      Issue No: Vol. 7, No. 10 (2020)
  • Extended sick neonatal score in prediction of mortality of neonates
           transported to tertiary healthcare centre and its comparison with sick
           neonatal score and temperature, oxygenation, perfusion and blood sugar

    • Authors: Bela H. Shah, Dhara Gosai, Anurag S. Pikle
      Pages: 1996 - 1999
      Abstract: Background: India contributes up to 25% of neonatal mortality worldwide. Most of the times, the patient deteriorates in-transit from periphery to tertiary healthcare facility. There is a need for reliable scoring system in analysis of neonates transferred to tertiary healthcare centers in prediction of in-hospital mortality. The aim of the research was to evaluate the efficiency of extended sick neonatal score in ‘in-hospital’ mortality prediction of neonates referred to tertiary healthcare institutes and to compare it with that of other scoring systems like sick neonatal score and temperature, oxygenation, perfusion and blood sugar (TOPS) score.Methods: The research was a retrospective observational study. All extra-mural neonates admitted over a period of one month at neonatal intensive care unit (NICU) of our tertiary healthcare centre were considered after informed consent and the required parameters for scoring were assessed. Data was collected according to a pre-formed proforma.Results: Over a period of one month, 145 neonates attended on arrival were analyzed according to the mentioned systems. Various cohorts were considered. Of the systems analyzed, extended sick neonatal score had the highest sensitivity and specificity, regardless of the cohort.Conclusions: Extended sick neonatal score was more efficient than sick neonatal score and TOPS score in mortality prediction of sick neonates.
      PubDate: 2020-09-21
      DOI: 10.18203/2349-3291.ijcp20204041
      Issue No: Vol. 7, No. 10 (2020)
  • Conventional audiometric screening for detection of drug induced hearing
           loss in thalassemics: a pilot study

    • Authors: Vikram Bharadwaj, Manish Munjal, Parth Chopra, Shubham Munjal, Sivjot Binepal, Hemant Chopra, Praveen Sobti
      Pages: 2000 - 2004
      Abstract: Background: Drug induced hearing impairment is likely in subjects undergoing multiple blood transfusions which necessitates timely detection and rehabilitation, especially in the pediatric age group.Methods: A total 30 thalassemic patients undergoing regular iron chelation therapy with Desferrioxamine and Deferasirox were included in this prospective study. Follow up studies were conducted after 12 months of chelation therapy i.e. after 1 year thus spanning a total duration of 1 years.Results: The most common age group was 4-8 years (46%) followed by 8-12 years (20%). Male patients outnumbered female patients in the ratio of 2.75:1 constituting 73% of study population oral Deferasirox (80%) followed Desferrioxamine (13.3%) and a combination therapy (6.6%). The distribution shows shift of pure tone average in higher thresholds with continuation of therapy.Conclusion: Despite Desferrioxamine doses usually felt to be low risk for ototoxicity (less than 40 mg/kg/day), found a high rate of ototoxicity in our patients using pure tone audiometry (23%).
      PubDate: 2020-09-21
      DOI: 10.18203/2349-3291.ijcp20204042
      Issue No: Vol. 7, No. 10 (2020)
  • Anemia in relation to severity of retinopathy of prematurity in preterm
           babies born in tertiary care centre in South India

    • Authors: Hrishikesh S. Pai, Rojo Joy, Varghese Cherian, Preethy Peter
      Pages: 2005 - 2009
      Abstract: Background: Retinopathy of prematurity (ROP) is a vaso proliferative disorder of retina among preterm infants. Significant cause of blindness in children with increased survival of premature infants with improved neonatal care. Potential risk factors for development of ROP include low gestational age, low birth weight, bronchopulmonary dysplasia, sepsis, acidosis, oxygen therapy. Anemia as a cause for retinopathy of prematurity has been postulated but there are very few studies addressed the effect of anemia on incidence and severity of ROP. The objective of this study was to determine the effect of anemia on incidence and severity of retinopathy of prematurity and to determine other factors associated with development of retinopathy of prematurity.Methods: Retrospective descriptive study of 120 babies born premature less than 34 weeks for the development of Retinopathy of prematurity and its severity and for associated conditions. All babies screened for retinopathy of prematurity at 3 weeks of age and further followed up for progression of ROP. Factors analysed included hemoglobin levels at 3 weeks of life, number of blood transfusions, days on ventilator, gestational age, birth weight, duration of oxygen requirement, bronchopulmonary dysplasia for the development of retinopathy of prematurity. Findings described in simple descriptive manner.Results: Anemia and increased requirement for blood transfusion are associated with higher incidence and severity of ROP. Low gestational age, birth weight, prolonged oxygen requirement, intraventricular hemorrhage (IVH), sepsis are other risk factors.Conclusions: It is significant to screen preterm babies for ROP and to anticipate in the background of these risk factors. Minimise oxygen duration and blood loss for sampling to prevent anemia and reduce transfusions.
      PubDate: 2020-09-21
      DOI: 10.18203/2349-3291.ijcp20204043
      Issue No: Vol. 7, No. 10 (2020)
  • Spectrum of prenatally diagnosed neural tube defects at a tertiary
           referral hospital in North India: a retrospective cohort study

    • Authors: Nisha Malik, Savita Rani Singhal, Smiti Nanda, Daya Sirohiwal, Pushpa Dahiya, Anita Bharti
      Pages: 2010 - 2014
      Abstract: Background: Neural tube defects, although largely preventable, constitute an important cause of neonatal mortality and morbidity. The study aimed to identify incidence rate, demographic profile, risk factors, and pregnancy outcomes of women with prenatally diagnosed NTDs.Methods: This retrospective cohort study reviewed the case records of all antenatal women admitted in labour ward of Pt. B.D Sharma postgraduate institute of medical sciences, Rohtak, India with the prenatal diagnosis of NTDs on ultrasound from August 2018 to January 2020. The sociodemographic details, risk factors, obstetric history and pregnancy outcomes were noted. The mean, standard deviation and range values were calculated for normally distributed data. Categorical data were presented as frequency and percentage values.Results: From a total of 21,187 births, 90 had neural tube defects, making an incidence rate of 4.3 per 1000 births. Out of the 86 included cases of NTDs, 46.5% (n=40) had anencephaly, 45.3% (n=39) spina bifida, 5.8% (n=5) encephalocele and 2.3% (n=2) had mixed defects. Majority (69.7%, n=60) of the women were multigravida with a mean age of 24.9±4.2 years. Preconceptional folic acid intake was found in merely 2.3% (n=2) cases and during first trimester of pregnancy in 39.5% (n=40) cases. About 61.6% (n=53) cases who presented at ≤20 weeks gestation underwent pregnancy termination while 38.3% (n=33) had vaginal delivery, of which majority (90.7%) were still births.Conclusions: NTDs are one of the commonest preventable congenital anomalies. Ensuring periconceptional folate supplementation to women-either by food fortification, dietary modification and public awareness is urgently required.
      PubDate: 2020-09-21
      DOI: 10.18203/2349-3291.ijcp20204044
      Issue No: Vol. 7, No. 10 (2020)
  • A cross sectional survey in paediatricians pertaining to management of
           functional gastrointestinal disorders in infants: Indian perspectives

    • Authors: Shrish Bhatnagar, Roshan R. Mane, Irfan A. Shaikh, Ganesh Kadhe
      Pages: 2015 - 2020
      Abstract: Background: Functional gastrointestinal disorders (FGIDs) in infants and toddlers possess extensive burden to the parents and healthcare professionals. Guidelines addressing the practices in diagnosis and management of FGIDs in infants in Indian subcontinent is unavailable. Hence this study assessed current knowledge, attitude and practice of pediatricians in diagnosis and treatment of FGIDs.Methods: A cross-sectional survey based on a structured questionnaire assessed pediatrician’s knowledge about prevalence and profile of most common GI disorders in pediatric age groups (birth to 12 months), association of FGIDs with different feeding practices, impact of FGID on quality of life, various management options and physician preferred method of treatment.Results: Colic was rated as the most common GI disorder, followed by gassiness/fussiness, regurgitation and constipation. About 59% pediatricians come across FGIDs more in formula-fed infants compared to breastfed infants (4.2%) and 93.9% pediatricians affirm that FGIDs affect quality of life. Approximately 91% pediatricians believed reassurance and education was the best management option, which was also reported as the preferred mode of management by about 89% pediatricians, whereas pharmacological therapies were the least preferred (1.6%). For breastfed infants suffering with regurgitation, colic or constipation, majority pediatricians opted for switching to 100% whey partially hydrolysed protein formula; sequentially followed by use of pre/probiotics and switch to extensively hydrolyzed protein formula.Conclusions: Parental education and reassurance offer an ideal mode of management of FGIDs. Partially hydrolysed protein formula may be considered one of the best management options irrespective of the FGID condition in infants who are breastfeed.
      PubDate: 2020-09-21
      DOI: 10.18203/2349-3291.ijcp20204045
      Issue No: Vol. 7, No. 10 (2020)
  • Delayed onset of breastfeeding: what is stopping us'

    • Authors: Ketan Gadhavi, Ruta Deo
      Pages: 2021 - 2025
      Abstract: Background: Breastfeeding is the best meal for a new born child. Various initiatives are in place for early initiation of breastfeeding. The effectiveness of these interventions is put to question when a large number of neonates fail to receive breast milk soon after birth. This study analyses the parameters likely to affect the time of onset of breastfeeding and evaluate the scope for interventions. It is important to assess the factors affecting initiation of breastfeeding, determine the relationship of these factors with the time of initiation and to analyse if counselling by health care workers has any benefit on outcome.Methods: This is a hospital based cross sectional observational study in 200 lactating mothers from a pre-designed questionnaire. Main outcome measure- early onset (<1 hour of birth) of breastfeeding.Results: Only 55% neonates included in this study were breastfed within the first 30 minutes. Positive influence for early initiation of breastfeeding was found with non primi mothers aged more than 26 years, with secondary or higher education, who had vaginal birth with institutional delivery. Early oral intake of mother with professional women living in joint family started early breastfeeding. Use of pre lacteal feeds delayed the onset of breastfeeding. Infants fed earlier were males, weight >2.2 kg. Women counselled by health care workers fed their babies earlier.  Conclusions: This study surmises that pre lacteal feeds should be discouraged and active health care workers’ participation should be encouraged for early breastfeeding. Breastfeeding should be initiated as soon as possible for healthy neonatal outcome.
      PubDate: 2020-09-21
      DOI: 10.18203/2349-3291.ijcp20204046
      Issue No: Vol. 7, No. 10 (2020)
  • Profile and pattern of infants with mothers having lactation failure

    • Authors: Sonia Bhatt, Arti Dhingra, Rajesh Kashyap
      Pages: 2026 - 2029
      Abstract: Background: Breastfeeding mothers face various kinds of problems to breastfeeding. Literature on the frequency and outcome of perceived breast milk insufficiency in mothers of hospitalized neonates in India is patchy and scanty.Methods:  Neonates weighing 1000 grams or more, and their mothers willing to breastfeed formed the study population. Relevant history was taken and clinical examination was performed along with anthropometry of the baby at the time of enrolment in the study. Mothers of neonates were also interviewed. Breast milk was also analyzed for sodium level by ion selective electrophoresis. Weight, head circumference and height were measured at each visit.Results: Of total 285 mothers, 188 mothers (65.9%) said that their milk formation was not sufficient and remaining 97 mothers said that their milk formation was sufficient to fulfil the needs of newborn. Breast milk sodium level was >16 mmol/L in 142 (75.5%) mothers in the crisis group as compared to 21 (21.6%) in the non crisis group. Babies in the crisis group weighed significantly less at admission as well as discharge. The proportion of sick babies, use of bottles/pacifiers and pre lacteal feeds was significantly higher in the crisis group. The velocity of growth of neonates after discharge in both the groups was comparable.Conclusions: Lactation failure was more common among those mothers who were involved in delayed initiation of breastfeeding. Structured counselling sessions with reinforcement on lactation support were proved to be useful to mitigate the situation.
      PubDate: 2020-09-21
      DOI: 10.18203/2349-3291.ijcp20204047
      Issue No: Vol. 7, No. 10 (2020)
  • Vitamin D deficiency in children with asthma

    • Authors: Kasim Resivi Ullerithody, Rajalakshmi Harihara Iyer, Kinattinkara Ramachandran Subharaman
      Pages: 2030 - 2036
      Abstract: Background: Asthma is one of the most common chronic respiratory diseases worldwide. Its exact cause remains unknown. Vitamin D has been implicated as a critical regulator of immunity and found to be associated with several immune mediated diseases. Recently there has been increasing interest in the possible link between vitamin D and asthma. Hence, we planned this study to assess the existence of any correlation between asthma and vitamin D levels in India.Methods: Fifty consecutive cases of clinically diagnosed asthma attending asthma clinic and those admitted in IMCH Calicut, Kerala, India were included in the study and administered detailed questionnaire. Routine physical examination and investigation as per the protocol in asthma clinic were done. Blood was drawn for 25 hydroxy cholecalciferol and serum analyzed by Roche Elecsys chemiluminescence assay. Controls were selected only after all fifty cases were selected. Vitamin D levels were assayed in the same manner as in patients with asthma. Vitamin D levels were then analyzed with other parameters and variables. Statistical analysis was performed using SPSS software, version 16.Results: Prevalence of vitamin D deficiency is high in study population. The difference in vitamin D levels between cases and controls is significant.Conclusions: More studies need to be done to ascertain the relationship between asthma and vitamin D in developing countries like India.
      PubDate: 2020-09-21
      DOI: 10.18203/2349-3291.ijcp20204048
      Issue No: Vol. 7, No. 10 (2020)
  • Predictors of mortality in neonatal septicemia in a tertiary care centre

    • Authors: Dhara Gosai, Bela H. Shah, Jyothi S.
      Pages: 2037 - 2040
      Abstract: Background: Neonatal septicemia continues to be a major cause of mortality and morbidity in new-borns all over the world. Aim and objectives of the study were determining the risk factors for mortality in neonatal septicemia.Methods: A retrospective observational study of the demographics, clinical features and laboratory parameters of 100 neonates admitted in NICU of a tertiary care hospital from September 2019 to March 2020.Results: 67% of neonates delivered outside centre and 33% of neonates delivered at centre were found to have sepsis exclusively based on culture positivity. A significant association was found between very low birth rate (VLBW) (p value<0.001), prematurity (p value<0.01) and high neonatal mortality. Among the different clinical presentations of neonatal sepsis, lethargy (p value<0.02), apnea (p value<0.01) and hypothermia (p value<0.02) were found to be frequently associated with neonatal mortality. Further, C-reactive protein (CRP) positivity (p value<0.003), hyperglycaemia (p value<0.0009) and thrombocytopenia (p value<0.0009) were also associated with high neonatal mortality. Gram positive bacteria were frequently isolated from blood cultures of deceased neonates, Coagulase negative staphylococci (CoNS) (36.1%), being the commonest bacteria followed by B. subtilis (11.1%), Klebsiella spp. (11.1%) and Acinetobacter spp. (8.3%).Conclusion: Demographic factors like VLBW, prematurity, outborn deliveries, clinical and laboratory parameters like lethargy, apnea, hypothermia, thrombocytopenia and hyperglycemia are strong predictors of mortality in neonatal.
      PubDate: 2020-09-21
      DOI: 10.18203/2349-3291.ijcp20204049
      Issue No: Vol. 7, No. 10 (2020)
  • Erosive potential of three different commonly used pediatric syrups on
           deciduous teeth enamel: an in vitro study

    • Authors: Neha Thilak, Sundeep K. Hedge, Sham S. Bhat
      Pages: 2041 - 2047
      Abstract: Background: The aim of the study is to compare the erosive potential of three different commonly used pediatric syrups on deciduous teeth enamel. The objectives of the study were to assess the endogeneous pH and titratable acidity of mefenamic acid syrup (meftal P), cetrizine syrup (alerid) and multivitamin syrup (zincovit) and to evaluate the microhardness of the enamel after successive immersion cycles in each of the syrups.Methods: 40 non carious deciduous teeth were included for the study The samples were then randomly allocated into 4 groups (10 in each group): Group A- mefenemic acid syrup (meftal P), Group B- cetrizine syrup (alerid), group C- multivitamin syrup (zincovit) and group D- control (distilled water). The samples were then subjected to the immersion cycles in the syrups. Assessment of enamel surface microhardness was done using Vickers hardness tester at 7th day and 14th day. The pH and titrable acidity of the syrups were also assessed. One way analysis of variance (ANOVA) and post hoc tests were used for the statistical analysis.Results: Out of the test groups, group C showed the lowest pH of around 4.2 and exhibited the largest titrable acidity (22.8 ml) compared with 21 ml in group A and 15.5 ml in group B. At the end of 14th day, group A had microhardness of about 293.43.84±6.34, group B had 299.930±6.85, group C had 313.380±6.23 and group D had 334.190±5.51.Conclusions: All the pediatric liquid medications assessed in the study, meftal P, alerid and zincovit showed acidic pH, high titrable acidities and all the syrups showed loss of microhardness after exposure to the syrups for 14 days. Loss of microhardness was highest for meftal P followed by alerid and least for zincovit.
      PubDate: 2020-09-21
      DOI: 10.18203/2349-3291.ijcp20204050
      Issue No: Vol. 7, No. 10 (2020)
  • Characteristic of COVID-19 infection in pediatric patients: early findings
           from a tertiary care center, Nagercoil, Tamil Nadu, India

    • Authors: Babitha Rexlin G., Suresh P. M.
      Pages: 2048 - 2053
      Abstract: Background: The planet faces a new challenge with COVID-19 disease caused by novel SARS-CoV2. Pediatric COVID-19 is considered to be mild. Methods: The study aim was to describe the clinical presentation, diagnostic findings and outcome of a cohort of paediatric patients according to Ministry of health and family welfare (MOHFW) criteria, at KKGMCH a tertiary care facility in Kanyakumari district. It’s a retrospective chart review including data of children aged 0 to 12 years with COVID-19 from 20 March to 19 July 2020. Results: Of the 137 children with COVID-19, 17 (12.45%) were infants, 65 (35%) were 1-5 years and 72 (52.55%) were 6-12 years. Age didn’t have influence on acquiring the illness as p value is 0.125. Age had no influence on severity too as p value is 0.28. 46.7% were female and 53.3% were male. There was an apparent male preponderance with (OR 1.63, 95% CI 1.00 to 2.21) but a non-significant p value of 0.54. of the 34 (24.8%) mild symptomatic, 22 (64.7%) were males and 12 (35.2%) were females. The p value is 0.086 stating gender non-influential on severity. 129 (94.1%) children had contact history. The contacts were parents or close relatives. No child with comorbidity presented during this period. Most common clinical features were fever (8.76%), cough (6.6%), rhinorrhoea (2.2%), vomiting (2.9%) and diarrhoea (1.5%). Children never progressed to severe respiratory illness requiring intensive care as per MOHFW criteria. 1 (0.7%) presented with focal consolidation in chest x-ray. All 137 (100%) children got cured.Conclusion: Study concludes pediatric COVID-19 is a mild disease without mortality at beginning of pandemic in Kanyakumari district. Factors like age and gender neither influenced the occurrence of the disease nor the severity.
      PubDate: 2020-09-21
      DOI: 10.18203/2349-3291.ijcp20204051
      Issue No: Vol. 7, No. 10 (2020)
  • Congenital rubella syndrome: a case report

    • Authors: Mahmoud M. Osman, Meryat T. Zakaria, Mutassem F. Alnofal, Sulafa A. Hamdoun, Mohammed S. Alissa
      Pages: 2054 - 2057
      Abstract: Currently, rubella virus infections are very rare in many countries, and may not be recognized promptly.  However, congenital rubella syndrome still appears, often in infants of mothers coming from countries with suboptimal vaccination programs. We describe a case of CRS in a full-term baby girl born to a foreign mother who documented perinatal antibodies against rubella. The baby had the classical abnormalities seen in infants with CRS include congenital cardiac and ocular anomalies. The diagnosis was confirmed by positive rubella serology in both infant and mother. Vaccination is the only known prophylactic measure for congenital rubella syndrome.
      PubDate: 2020-09-21
      DOI: 10.18203/2349-3291.ijcp20204052
      Issue No: Vol. 7, No. 10 (2020)
  • Pseudothrombocytopenia: early recognition avoids unnecessary intervention

    • Authors: Rajeshwari Narayanan, Prahada Jagannathan, Kala Kandhasamy
      Pages: 2058 - 2060
      Abstract: Ethylenediaminetetraacetic acid dependent pseudothrombocytopenia (EDTA-PTCP) is the phenomenon of a spurious low platelet count due to EDTA induced aggregation of platelets. Failure to identify this can lead to unwarranted diagnostic testing, platelet transfusions and deferring emergency surgeries. An adolescent girl child was referred for acute febrile illness with thrombocytopenia. Peripheral smear examination of EDTA sample revealed platelet clumping. WBC and platelet histograms also supported the same. Repeat platelet counts in sodium citrate and heparin confirmed EDTA-PTCP.
      PubDate: 2020-09-21
      DOI: 10.18203/2349-3291.ijcp20203973
      Issue No: Vol. 7, No. 10 (2020)
  • Accidental partial hanging by door curtain causing ischemic encephalopathy
           in a child: a rare case report

    • Authors: Arun Prasad, Lokesh Tiwari, Pradeep Kumar, N. Yankappa
      Pages: 2061 - 2064
      Abstract: Accidental strangulation is an uncommon injury in children, however it may lead to neurological disability or death. Various modes of injuries have been reported in such accidents. Children might get strangulated while playing if they are wrapping any cord or cloth like material around their neck. Caregivers of the children should be aware of the potential sources around and mechanisms of such injuries to avoid such accidents.
      PubDate: 2020-09-21
      DOI: 10.18203/2349-3291.ijcp20204024
      Issue No: Vol. 7, No. 10 (2020)
  • Spontaneous neonatal gastric perforation in a very preterm neonate

    • Authors: Kartheeka M. G., Arvind Shenoi, Nilesh Nikhilesh Rao
      Pages: 2065 - 2067
      Abstract: Gastric perforation in neonates is a rare, serious and life-threatening problem. The precise aetiology is obscure in most cases. By virtue of its high mortality rate, it requires prompt recognition and surgical intervention. We report a case of gastric rupture in a very preterm/very low birth weight neonate with antenatal reversal of flow in umblical artery.
      PubDate: 2020-09-21
      DOI: 10.18203/2349-3291.ijcp20204027
      Issue No: Vol. 7, No. 10 (2020)
  • Joubert’s syndrome: a case report

    • Authors: Kapil S. Bainade, Veeranna A. Kotrashetti, Vijay B. Sonawane, Amit Vatakar, Shuchi R. Bhatarkar
      Pages: 2068 - 2071
      Abstract: Joubert syndrome is an autosomal recessive genetic disorder that affects the area of the brain that controls balance and coordination. This syndrome is difficult to diagnose clinically because of its variable phenotype.  Signs and symptoms commonly include hypotonia abnormal breathing patterns; abnormal eye movements; ataxia; distinctive facial features; and intellectual disability. Various other abnormalities may also be present. This condition is characterized by a specific finding on an magnetic resonance imaging (MRI) called a "molar tooth sign" in which the cerebellar vermis of the brain is absent or underdeveloped and the brain stem is abnormal. The exact diagnosis is often not made for several years after birth.We present a case of Joubert syndrome in a thirteen year old male with developmental delay, ataxia, mild hypotonia, nystagmus and molar tooth sign on MRI. Awareness of the characteristic clinical and radiological findings in Joubert syndrome will help in early diagnosis, appropriate counselling and proper rehabilitation.
      PubDate: 2020-09-21
      DOI: 10.18203/2349-3291.ijcp20204053
      Issue No: Vol. 7, No. 10 (2020)
  • Maple syrup urine disease presenting as severe neonatal metabolic
           encephalopathy: a case report

    • Authors: Rohini Patil, Giridhar S., Umadevi L., Rathinasamy M., Antony J
      Pages: 2072 - 2076
      Abstract: We report a 17 day old boy, who developed progressive encephalopathy, after an apparent period of normalcy. Magnetic resonance imaging showed diffusion restriction in myelinated areas like, a pattern suggestive of maple syrup urine disease. Dried blood spots for tandem mass spectrometry and urine for gas chromatography mass spectrometry confirmed elevation and excretion of branched chain amino acids respectively.  After peritoneal dialysis, baby improved but continued to have residual neurological deficit, in spite of MSUD-specialized diet. Molecular studies confirmed the diagnosis. This report highlights the need for early identification of these infants to optimize neurological outcomes.
      PubDate: 2020-09-21
      DOI: 10.18203/2349-3291.ijcp20204054
      Issue No: Vol. 7, No. 10 (2020)
  • Hereditary spastic paraplegia associated with a rare endoplasmic reticulum
           lipid raft-associated protein 2 mutation

    • Authors: Sai Chandar Dudipala, Naveen Reddy Cheruku, Krishna Chaithanya Battu
      Pages: 2077 - 2079
      Abstract: Hereditary spastic paraplegia (HSP) is a clinically and genetically heterogeneous group of neurological disorders that are characterized by progressive spasticity of the lower extremities. It can present as pure form or complex form. It can be present from infancy to adulthood, but majority in adult population. Childhood onset HSP must be differentiated from common conditions like cerebral palsy, neurodegenerative disorders and metabolic disorders. Many patients with pediatric HSP are mistakenly diagnosed with cerebral palsy. In children with spastic paraplegia in whom no acquired cause identified, HSP should be considered. Here we diagnosed a 6-year-old boy with HSP who presented with progressive spastic paraplegia, intellectual disability, seizures, joint contractures and cataract. His genetic study revealed exonic deletion of endoplasmic reticulum lipid raft-associated protein gene, which is associated with complicated Autosomal recessive HSP 18 (SPG18). HSP 18 was rarely described in literature.
      PubDate: 2020-09-21
      DOI: 10.18203/2349-3291.ijcp20204055
      Issue No: Vol. 7, No. 10 (2020)
  • Giant fetal lymphangioma with non-immune hydrops fetalis

    • Authors: Jerin Monisha Paul, Prabhukumar Sakthigirisamy, Ilangumaran Lakshmanan, Sucindar Mullainathan, Saravanan Sambandam
      Pages: 2080 - 2082
      Abstract: Fetal lymphangioma is one of the rarest congenital malformation occuring in the newborn. We are reporting a giant fetal lymphangioma which may be the largest one so far reported in medical literature and its association with non immune hydrops fetalis. A late preterm 35+3 weeks gestation female neonate with birth weight of 3.8 kg was delivered via emergency caesarean section, for prevention of birth injuries in view of large for gestation. Baby had weak cry at birth. On examination a giant cystic mass extending from right hemithorax to right anterolateral abdominal wall measuring 25×12.5×9 cm was present. Systemic examination revealed respiratory distress and ascites. Neonate was admitted in NICU and started on supportive measures, despite which went into cardio respiratory arrest at second hour of life and revived with Cardiopulmonary resuscitation. Baby had second cardiopulmonary arrest at 9 hours of life and couldn’t be revived. Antenatal ultrasound showed massive ascites, bilateral pleural effusion with cardiomegaly and multiseptated cystic swelling over right chest wall. Based on clinical and antenatal findings we made a diagnosis of Giant fetal lymphangioma with non-immune hydrops fetalis. Giant fetal lymphangioma is an antenatal diagnosis. Its association with non-immune hydrops fetalis is a bad prognostic indicator with high mortality.
      PubDate: 2020-09-21
      DOI: 10.18203/2349-3291.ijcp20204056
      Issue No: Vol. 7, No. 10 (2020)
  • Cutaneous vasculitis in a child with community acquired pneumonia

    • Authors: Sakti Priya M., Pinnaka Subbarao, Ramachandran P., Dinesh Kumar J.
      Pages: 2083 - 2085
      Abstract: Mycoplasma pneumoniae is an important etiological agent in community acquired pneumonia (CAP) in children aged 3 to 15 years. Mycoplasma pneumoniae may present with varied extra pulmonary manifestations. A 5 year old child presented with cough and fever and was initially managed as CAP due to Streptococcus pneumoniae. Child continued to have fever spikes and worsening distress and developed pleural effusion. Mycoplasma immunoglobulin M (IgM) was raised and child was treated with azithromycin. After 10 days of admission, the child developed fissuring of lips and discoloration of extremities. Direct Coombs test, cold agglutination test, antinuclear antibody (ANA) and anticardiolipin antibody were positive.  Suspecting small vessel vasculitis, she was started on enoxaparin and aspirin and improved well. This case of CAP due to Mycoplasma pneumoniae is presented for the rare extrapulmonary manifestation of cutaneous vasculitis.
      PubDate: 2020-09-21
      DOI: 10.18203/2349-3291.ijcp20204057
      Issue No: Vol. 7, No. 10 (2020)
  • Transmission of SARS-CoV-2 infection mother to the newborn

    • Authors: Bonifacio Caballero, Daniel Caballero
      Pages: 2086 - 2089
      Abstract: The emergence of the new corona virus infection that occurred in Wuhan, the capital city of China's Hubei province in December 2019 initially labeled 2019-nCoV and later named SARS-CoV-2, has spread in several countries around the world and subsequently raised concerns about the possibility of vertical transmission from the mother to the fetus, producing its disease named COVID-19. Around 12 articles about pregnant women infected with COVID-19 and their newborns have been published between February 10 and April 4, 2020. So far, there are few reports on newborns. There is currently evidence of vertical transmission from pregnant women with COVID-19 infection during the third trimester. The results of this report suggest that currently there is evidence of intrauterine infection caused by vertical transmission in women who develop COVID-19 pneumonia and die in late pregnancy. However, most of these newborns have been asymptomatic or mildly symptomatic, but as the outbreak and information are changing rapidly, it is recommended to continue to check for updates.
      PubDate: 2020-09-21
      DOI: 10.18203/2349-3291.ijcp20203970
      Issue No: Vol. 7, No. 10 (2020)
  • Chronological events in neonatal auditory screening - review

    • Authors: Manish Munjal, Vineeta Munjal, Vasu Bansal, Shubham Munjal
      Pages: 2090 - 2094
      Abstract: Neonatal screening for auditory impairment necessitates a meticulous and exhaustive work to detect at an early age this deficit and thereby plan an appropriate rehabilitative modality test, the speech maybe effected.
      PubDate: 2020-09-21
      DOI: 10.18203/2349-3291.ijcp20204058
      Issue No: Vol. 7, No. 10 (2020)
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Heriot-Watt University
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