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International Journal of Contemporary Pediatrics
Number of Followers: 6  

  This is an Open Access Journal Open Access journal
ISSN (Print) 2349-3283 - ISSN (Online) 2349-3291
Published by Medip Academy Homepage  [12 journals]
  • A clinical study of spectrum of low platelet count to establish etiology,
           diagnosis, complications and prognosis in newborns admitted in Al-Ameen
           medical college hospital NICU, Bijapur, Karnataka, India

    • Authors: Rizwan U. Zama, Naushad Ali N. Malagi, A. N. Thobbi, Salim A. Dhundasi
      Pages: 1451 - 1457
      Abstract: Background: In the newborn low platelet count is a common finding in both preterm and term newborn. It has been estimated that as many as 22% of all new borns admitted to NICU develop low platelet counts. A platelet count of less than 150,000/mL is defined as thrombocytopenia irrespective of the age of the individual.Methods: All the neonates underwent necessary blood investigations like Complete blood counts, (including platelet counts, HB estimation, Red cell indices and PCV), Capsular Polysaccharide - reactive protein. (CRP), Peripheral Smear study, Blood culture, BT, CT, PT, aPPT, Anti-platelet Antibodies.Results: The prevalence of thrombocytopenia in our study was 28%. The proportion of severe thrombocytopenia among the neonatal thrombocytopenia, 11.2% in our study.Conclusions: It can be concluded that thrombocytopenia is very much common in among our NICU admissions. Septicemia is its most important and most common cause.
      PubDate: 2020-06-24
      DOI: 10.18203/2349-3291.ijcp20202569
      Issue No: Vol. 7, No. 7 (2020)
       
  • Nutrition status and outcome in children with acute pancreatitis

    • Authors: Laxmi K. Bharti, Jai Kishun, Basant Kumar
      Pages: 1458 - 1462
      Abstract: Background: AP (Acute Pancreatitis) in children is being more and more diagnosed across the world and developing nation like India. This may be because of multiple factors like better health sector developments, change in dietary and social lifestyle changes due to fast improving economy. There are lots of unknown factors also leading to increase in incidence of AP in children in developing nations like India.Methods: Five-year retrospective data of AP patients admitted Paediatric Gastroenterology department extracted. Data of 63 children collected in five years from 2012 to 2016. Anthropometric data, feeding details, liver function test (LFT) data recorded. Anthropometric data analysed with IAP growth charts. Data entered in excel sheet of window 10. Appropriate statistical data used for analysis of variables.Results: Majority of children of AP were 11-15 years age group. In 63 patients, 28 (44.4%) were undernourished, 23 (36.5%) having normal BMI, 9 (14.3%) were overweight and 3 (4.8%) were obese. Nasojejunal feeding was associated mostly in patients with severe AP. LFT were deranged mostly in cases of severe AP.Conclusions: Overweight, obese and also undernourished children were having more severe AP. Children on nasojejunal feeding (NJ) were mostly having severe AP.
      PubDate: 2020-06-24
      DOI: 10.18203/2349-3291.ijcp20202579
      Issue No: Vol. 7, No. 7 (2020)
       
  • A study of effect of topical anaesthetics on injection pain during
           immunization in infants

    • Authors: Magesh Kumar, V. Venkateshwar
      Pages: 1463 - 1468
      Abstract: Background: Immunization is a necessary aspect of health care of children and injections are there for unavoidable. Many factors affect injection pain during immunization in infants. This study aims to see the effect of use of local anesthetics delivered by various modes for attenuation of vaccine related injection pain in infants and to compare them.Methods: An Open Label Four-Arm Randomized Control Trial of 300 healthy infants of age group 6 weeks to 6 months reported to immunization clinic for immunization with DPT-HiB-Hepatitis B combination vaccine were taken for study. The enrolled subjects were allocated into control group and intervention group (who were applied some form of local anesthesia).Results: Among the four groups of the patients studied we observed a statistical difference in the mean pain scores of the patients recorded at 15 second, 60 second and 5 min after vaccine injection (p value 0.0024 - 0.000). Group A (Infants with topical occlusive LA cream) showed minimum pain scores values at 15 second, 60 second and 5 min after vaccine injection, followed by Group C (Infants with topical LA spray with vapocoolant) whereas Control group (Infants not received any local anaesthesia) and Group B (Infants with topical LA spray without vapocoolant) exhibited the maximum pain scores.Conclusions: Topical occlusive local anesthetic cream and topical LA spray with vapocoolent, were found to be better than topical LA spray without vapocoolant or no topical anesthetic. Use of topical occlusive LA cream led to a lowest pain score. There was no significant difference in the profile of side effects following injection in the four group.
      PubDate: 2020-06-24
      DOI: 10.18203/2349-3291.ijcp20202542
      Issue No: Vol. 7, No. 7 (2020)
       
  • Sociodemographic profile of pediatric poisoning cases

    • Authors: Arpitha B., Adarsh E., Rajanish K. V.
      Pages: 1469 - 1471
      Abstract: Background: Poisoning is one of the commonest cause of emergency hospital admission in children. The accidental poisoning is seen more commonly in toddlers and intentional poisoning is seen in adolescents. Rapid globalization and increased stress has increased the risk of suicidal poisoning. The accidental poisoning can be reduced by proper education to parents and by keeping poisonous substances out of reach of the child.Methods: The study was carried out over 18 months. Sociodemographic profile of pediatric cases was studied in department of  pediatrics at Rajarajeswari medical college and hospital. Descriptive study analysis was done.Results: During 18 month study period, 34 cases were analysed. The incidence was found to be 1.64%. Male:female ratio was found to be 1:1.6. Majority belonged to upper lower class and majority were from urban class.Conclusions: The importance childhood poisoning with its association with socio-demographic factors were studied and intervention were done.
      PubDate: 2020-06-24
      DOI: 10.18203/2349-3291.ijcp20202524
      Issue No: Vol. 7, No. 7 (2020)
       
  • Old dietary cultural practices leading to suboptimal nutritional intake of
           calories in children with acute viral hepatitis

    • Authors: Laxmi Kant Bharti, Neelu .
      Pages: 1472 - 1477
      Abstract: Background: Acute viral hepatitis (AVH) is one of the common infections in developing nation. Hepatotrophic virus causes AVH and most of the time it has self-limiting course. HAV is most common cause of AVH. Suboptimal dietary cultural practices are common in our nation. This study was done to know the impact of suboptimal dietary practices done in AVH.Methods: Observational study conducted with 50 children with AVH. Dietary assessment was done at three point of time.  First During AVH, second, pre illness and then two weeks after nutritional counselling. Data of dietary modification done by parents/caregiver during AVH recorded. History of herbal medicine taken for treatment of AVH enquired.Results: HAV positive was (72%), HEV positivity was in 8 (16%) cases, hepatitis B was positive in 4 (8%) children and dual infection HAV+HEV was detected in 2 (4%) children. Many parents did dietary modification due to AVH and also by some local treating physicians, 18 (36%) patients were also on herbal medication for treatment of AVH. During AVH the mean calorie and protein requirement decreased from 96% to 54% and 92% to 43% respectively. Two weeks after nutritional counseling the mean calorie and protein intake increased from 54% to 88% and 43% to 84% respectively. This change in calorie and protein was statistically significant (p<0.01) Non-vegetarian diet preference was restarted in many of them after nutritional counseling.Conclusions: This observational study revealed that suboptimal dietary cultural practices are prevalent in India. Majority of children were on bland diet and receiving inadequate proteins and calories.
      PubDate: 2020-06-24
      DOI: 10.18203/2349-3291.ijcp20202541
      Issue No: Vol. 7, No. 7 (2020)
       
  • Role of common salt in the treatment of umbilical cord granuloma

    • Authors: Chandra Madhur Sharma, Bindu Aggarwal, Piyush Chaudhary
      Pages: 1478 - 1480
      Abstract: Background: Umbilical granuloma is an overgrowth of granulation tissue following the separation of umbilical cord. Treatment options for this common entity are limited and have side effects such as chemical burns. In this study, we want to highlight the salt application method for treatment of infants with umbilical granuloma.Methods: Thirty six infants were enrolled in present study after institutional ethics committee approval and consent from the parents. After thoroughly explaining the method to all mothers, they are advised to apply a pinch of salt on granuloma twice a day for 3 days .The area of application was cleaned, and common table salt was carefully applied over the lesion. The granuloma was then occluded with surgical adhesive tape for 30 minutes. Cases were followed up after 3 days for assessment of improvement.Results: All thirty six cases responded well to this approach with complete resolution of lesions after 3 days. Small clot like shrunken tissue was found at the site of granuloma, which was easily scraped off during gentle cleansing. No major complication or recurrence was noted in follow-up.Conclusions: The use of common salt in treating umbilical granuloma is simple, cost-effective, curative, and safe. It is easily administered and can be performed by parents at home.
      PubDate: 2020-06-24
      DOI: 10.18203/2349-3291.ijcp20202555
      Issue No: Vol. 7, No. 7 (2020)
       
  • Device closure of patent ductus arteriosus: analysis of cases in a
           Bangladeshi centre

    • Authors: Nurun N. Fatema, Abul K. M. Razzaque
      Pages: 1481 - 1487
      Abstract: Background: Transcatheter closure of Patent ductus arteriosus (PDA) has become the first-choice therapy for closure in patients of any age group.
      Authors reviewed the outcome of device closure in all age groups starting from neonate to adult.Methods: From December 2014 to December 2019, 440 cases underwent transcatheter closure in a catheterization laboratory of a tertiary level cardiac hospital. Selection criteria were isolated PDA or PDA with associated conditions which can be managed in the same setting by an intervention. Exclusion criteria were proven Eisenmenger syndrome. A retrospective review of outcome and complications were recorded from computerized data records.Results: Age of the patient varied from 10 days to 65 years. The median age was 3 years. Most of the patients were female (63%), weight varied from 1.8 kg to 75 kg. the median weight was 7.5 kg. Isolated PDA cases were 74.77 %. Among syndromes, congenital rubella syndrome was common (7.5%), followed by Down Syndrome (6.36%). The narrowest PDA diameter varied for 1.8 mm - 14 mm with a median of 5 mm. Among duct occluders, 8x6 mm CeraTM was the commonest one used in the study population. Complete occlusion was observed in 99.55% of cases.Conclusions: Transcatheter closure of PDA is considered safe and efficacious in all age groups. It is the gold standard now and replaced surgical option in most of the places.
      PubDate: 2020-06-24
      DOI: 10.18203/2349-3291.ijcp20202573
      Issue No: Vol. 7, No. 7 (2020)
       
  • Effect of kangaroo mother care in terms of hospital stay among preterm
           infants in a tertiary health care center

    • Authors: Adarsh E., Bindu Shri D. B., Sahana G.
      Pages: 1488 - 1491
      Abstract: Background: Hypothermia, infections and ineffective breastfeeding are some of the commonest cause of deaths among premature and low birth weight infants. Kangaroo mother care is a well-known intervention to address the issues related to preterm births, such as hypothermia, infection and prolonged hospitalisation.Methods: This study was carried out in a tertiary care centre in Bengaluru on all preterm neonates of birth weight less than 2500 grams with stable hemodynamic conditions over a period of 18 months. Gestational age assessed by the new Ballard's score, within 24 hours of life and anthropometry details of the neonate were recorded at 24 hours of life by the single observer. Kangaroo mother care was given for a minimum of one hour at a stretch per day and the effect on the preterm neonate in terms of hospital stay was assessed.Results: Kangaroo mother care has positive effects on the infants growth, neurodevelopmental outcome, reduction in the morbidities associated with preterm infants, and breastfeeding practices in mothers of preterm neonates.Conclusions: The study promotes awareness of KMC on preterm neonates considering all the benefits and positive effects of KMC on the infant as well as baby, and to the family and nation amongst the health care personnel as well as the society.
      PubDate: 2020-06-24
      DOI: 10.18203/2349-3291.ijcp20202540
      Issue No: Vol. 7, No. 7 (2020)
       
  • Effect of breastfeeding promotions interventions on baby weight at three
           months of age

    • Authors: Krithika S., Adarsh E., Rajanish K. V.
      Pages: 1492 - 1495
      Abstract: Background: Breastfeeding is common in developing countries, but exclusive breastfeeding is rare, and complementary foods are introduced to babies at an early age. Despite the proven risks associated with not exclusively breastfeeding, few mothers exclusively breastfeed their babies for six months as recommended by the World Health Organization. The objective of this study was to determine the effect of breast-feeding promotion interventions on baby weight at three months of age.Methods: A randomized experimental study was conducted for a period of 6 months from February 2019 till July 2019 in a tertiary care hospital. Weight- for-age (WA) indices have been determined for 95 infants from three to four months of age, participating in this study. They included 49 that started received promotion interventions support after delivery (till 2 weeks) and 46 that received routine care (control group). Collected data were analysed using SPSS software ver.11.5.Results: Weight-for-age indices were significantly lower for the early group than the control group (p=0.012). They suggest that the breast-feeding promotion interventions are very important educational tools to ensure healthy weight gain in infants.Conclusions: There is evidence that breastfeeding for at least 6 months, compared with feeding formula, prevents the possibility of atopic dermatitis, cow’s milk allergy and early childhood wheezing. Poorer nutritional status was significantly associated with earlier complementary feeding. The results suggest that exclusive breastfeeding along with promotion of weaning education should be promoted in India.
      PubDate: 2020-06-24
      DOI: 10.18203/2349-3291.ijcp20202517
      Issue No: Vol. 7, No. 7 (2020)
       
  • Preliminary study of the prevalence of hypotrophy and fetal alcohol
           syndrome in Antananarivo, Madagascar

    • Authors: Mbolanirina L. Rakotomahefa Narison, Arthur B. A. Ratsimbazafy, Zo L. Andrianadison, Honore S. Raobijaona
      Pages: 1496 - 1500
      Abstract: Background: Hypotrophy is a major contributor to neonatal mortality and morbidity in underdeveloped countries. In Madagascar, efforts have been made to improve this situation, particularly with regard to prevention and early treatment. This prevention is mainly focused on the search for determining factors. Fetal Alcohol Syndrome (FAS) is not yet mentioned in Madagascar although more than 9% of Tananarivian women drink alcohol. A study was conducted in our department to determine the relationship between maternal alcohol intake and hypotrophy.Methods: The prospective study was carried out in the pediatrics department of the Joseph Raseta Befelatanana University Hospital Centre, on hospitalized hypotrophic newborns (below the 10th percentile) over a period of 3 months from December 1, 2018 to February 31, 2019. In the newborn, authors studied facial features, neurological abnormalities and associated malformations. For the mother, alcohol consumption, pregnancy information was analyzed. The character of FAS could thus be classified.Results: Author counted 21 hypotrophs among the 128 newborns hospitalized during this period. The facial abnormalities observed were: upper lip thickness abnormality (9.5%) and retrognathism (4.7%). Neurological signs described were: difficulty sucking (76.1%), hypotonia (66.6%), restlessness (9.5%), hyper-responsiveness (9.5%), hypertonia (9.5%) and tremor (4.7%). Two organ malformations (9.5%) were seen: cardiac and biliary tract malformations. Only one mother (4.7%) admitted having taken alcohol during pregnancy. Seven cases of familial alcoholism were reported. At the end of this study, we were able to identify only one case of doubtful FAS (4.7%), 2 cases of suspected FAS (9.5%) and 1 case of confirmed FAS (4.7%).Conclusions: This syndrome remains under-diagnosed in Madagascar due to the lack of staff training on FAS and the non-systematization of the search for its signs during systematic visits.
      PubDate: 2020-06-24
      DOI: 10.18203/2349-3291.ijcp20202604
      Issue No: Vol. 7, No. 7 (2020)
       
  • Dipstick urine analysis for detection of renal abnormalities among school
           children

    • Authors: Atindra Mishra, Ruby Thakur
      Pages: 1501 - 1505
      Abstract: Background: Urine analysis by dipstick is a useful tool to identify children with asymptomatic renal diseases.  Dipstick urinalysis screening was conducted in asymptomatic school children to detect prevalence of renal disease.Methods: A cross sectional study was carried out in 862 children of age 6 to 15 years studying in different schools of Birgunj, Nepal between January 2019 to June 2019. First morning mid-stream urine samples were obtained from students and tested by dipstick method. Children with abnormal findings were re-tested after fifteen days.Results: Ninety-six (11.13%) children had urinary abnormalities at the first screening; 8 children had specific urinary abnormalities after second screening. 4 children had urinary tract infection, followed by glomerulonephritis, type 1 diabetes, hydronephrosis and nephrotic syndrome. Urinary abnormalities were more common in females than in males.Conclusions: Asymptomatic urinary abnormalities are detected by urine screening program at school age. Further work-up reveals the specific diagnosis and effective interventions help reduce the renal disease in future.
      PubDate: 2020-06-24
      DOI: 10.18203/2349-3291.ijcp20202605
      Issue No: Vol. 7, No. 7 (2020)
       
  • Comparative study on the effect of oral motor intervention protocols on
           oral motor skills of preterm infants from tertiary care hospital in
           metropolitan city: pilot study

    • Authors: Shailaja S. Jaywant, Jayashri S. Kale
      Pages: 1506 - 1512
      Abstract: Background: Premature infants often have feeding difficulties leading to morbidity or developmental co-morbidities. Premature infant oral motor intervention (PIOMI), has shown the positive effects on feeding progression of the premature infants. PIOMI with the massage technique, may help in improving oral motor activity, weight gain in preterm infants along with better neurobehavioral organization. The study was done to analyse effect of this combined protocol on achieving oral motor control and Neurobehavioral state regulation and evaluate its efficacy against PIOMI.Methods: A total 72 clinically stable infants admitted in premature care unit, fulfilling inclusion criterion were enrolled. They were allocated in control and experimental group. Infants from control group received PIOMI and experimental group received PIOMI with massage therapy (M technique), for 10 minutes each day. Data was collected for oral motor abilities, behavioural assessment, weight and day of achieving full feeds.Results: Gestational age at full feeds was 33.65 weeks and 32.89 weeks in control and experimental groups respectively with ‘p’ value 0.002. The number of days of full feed in experimental group was 3.7 days earlier (p=0.04). Infants from experimental group showed higher oral motor score and more weight gain with significant difference The behavioral regulation in infants of both the groups improved after 8 day.Conclusions: PIOMI with M technique was well tolerated by preterm infants. The modified protocol has resulted in achieving early oral feeds and reducing hospital stay. It has also shown the benefit of behavioural regulation along with better oral motor control.
      PubDate: 2020-06-24
      DOI: 10.18203/2349-3291.ijcp20202606
      Issue No: Vol. 7, No. 7 (2020)
       
  • Prevalence and antibiotic susceptibility pattern of pathogens in children
           with urinary tract infection in a tertiary care hospital

    • Authors: Madhu G. N., Anjum Aara C. A., Shajna Mahamud
      Pages: 1513 - 1518
      Abstract: Background: The changing pattern of antimicrobial susceptibility of bacterial pathogens causing acute UTI is a growing problem. Hence, the knowledge of the local pattern of urinary pathogens and their susceptibility to various antimicrobials is of atmost importance for selection of the appropriate empiric therapy for children with acute UTI.Methods: This retrospective cross-sectional study was conducted in 208 children of 1-18 years age group with suspected UTI infection who were admitted in KIMS hospital, Bangalore from January to December 2018. The data of all samples were collected from medical record.Results: Overall 208 children between 1-18 years with suspected UTI were screened. Out of which 48 were culture positive, with a prevalence of 23%. Culture positive UTI was predominantly found in males in 1-5 years age group as against female predominance in 6-18 years age group. E. coli (45.83%) was the commonest organism isolated in our study, followed by Enterococcus (31.25%), Klebsiella (16.67%), Proteus (4.17%) and Acinetobacter (4.17%).  Antibiotics with highest sensitivity to E-coli are Amikacin (91%) and Gentamicin (77%). Klebsiella is most sensitive to Gentamicin (87.5%) and piperacillin (75%). Enterococcus has highest sensitivity to Vancomycin (67%) and Linezolid (60%).Conclusions: It requires regular monitoring to determine the current status of resistance against antimicrobial agents.  The use of antimicrobials must be restricted in order to decline the resistance and we suggest that empirical antibiotic selection should be based on the knowledge of local pattern of bacterial organisms and their susceptibility to various antimicrobials rather than on universal guidelines.
      PubDate: 2020-06-24
      DOI: 10.18203/2349-3291.ijcp20202607
      Issue No: Vol. 7, No. 7 (2020)
       
  • Prevalence of thyroid dysfunction in neonatal population

    • Authors: Gunjanpreet Kaur, Sunita Arora, Kamalpreet Singh, Mandeep Singh, Arshpreet Kaur
      Pages: 1519 - 1523
      Abstract: Background: The objectives of this study was to study the prevalence of thyroid disorders in high risk neonatal populations and to study association of maternal thyroid dysfunction with neonatal thyroid problems and outcome.Methods: This was an observational study, conducted in NICU at Sri Guru Ram Das Institute of Medical Sciences and Research, Amritsar. The study included neonates born to mothers with thyroid disorder or with clinical features suggestive of thyroid dysfunction. Neonates with history of maternal thyroid dysfunction were screened at 72 to 96 hrs of postnatal age. Those with TSH >10 mIU/L or free T4 <1.1 ng /ml were followed up after two weeks. The neonates with clinical features suggestive of thyroid dysfunction were screened at presentation and those with abnormal thyroid profile were followed up after two weeks. Results obtained were statistically analyzed using SPSS 17.0 software.Results: Out of 260 neonates screened, 208 neonates were born to mothers with hypothyroidism, 6 neonates had increased levels of TSH during first week which normalised on follow up during third week. One neonate born to hyperthyroid mother, showed increased TSH levels during first week and 2nd week which declined to normal level on follow up at 3rd week. Out of 51 neonates with clinical features suggestive of thyroid dysfunction, born to euthyroid mothers, 3 neonates had increased levels of TSH on presentation which normalised on further follow up. Thus, majority of high risk neonates at birth show transient hypothyroidism.Conclusions: None of the neonate was labelled as hypothyroid, all the 10 neonates showed transient hyperthyrotropinemia.
      PubDate: 2020-06-24
      DOI: 10.18203/2349-3291.ijcp20202608
      Issue No: Vol. 7, No. 7 (2020)
       
  • Renal manifestations of sickle cell disease in children

    • Authors: Milind B. Kamble, Vidhya S. Totewad
      Pages: 1524 - 1529
      Abstract: Background: Sickle cell disease prevalence is more in central part of India. This study tries to find extent of renal involvement, risk factors and screening tests in sickle cell disease.Methods: Study was Cross sectional observational study. Demographic and clinical findings were recorded. Renal function tests like serum creatinine, blood urea nitrogen, eGFR were studied. Presence of microalbuminuria was checkeed. Ultrasonography abdomen was done to see the texture and corticomedullary differentiation of kidney.Results: Total 143 patients were studied. Out of which, 117 homozygous (SS type), 26 heterozygous (AS type). Majority belonged to school going age group (i.e. 5 to 10 year age group) with male preponderance in homozygous state. Microalbuminuria was more common in crisis state (61.84% in SS pattern and 83.33% in AS pattern) as compared to steady state in both SS and AS pattern patients. Dipstic method detected more proteinuria than heat coagulation suggesting dipstick method superior to heat coagulation test. Low eGFR was common in patients with SS pattern as compared to patients with AS pattern and was significantly associated with microalbuminuria in both steady state and crisis state. Abnormal USG was seen 3.44% in patients with SS pattern. Renal involvement started below 5 years of age and then increases with age, homozygous childrens in crisis state are affected more.Conclusions: Renal involvement is common in sickle cell anemia i.e it is seen in 50% of the patients. Increasing age, male sex and homozygous state were risk factors. Simple test like dipstic method and heat coagulation test can be used as screening test to detect microalbumiburia, with dipstic method being superior. Presence of microalbuminuria can detect early renal involvement in sickle cell disease. This will help in early diagnosis and management of such patients which avoids further renal complications and thus prevents mortality and morbidity.
      PubDate: 2020-06-24
      DOI: 10.18203/2349-3291.ijcp20202609
      Issue No: Vol. 7, No. 7 (2020)
       
  • Clinical spectrum of enteric fever in children admitted to a tertiary care
           hospital

    • Authors: Jawad Nazir Wani, Abdus Sami Bhat, Saleem Yusuf, Umer Amin Qureshi
      Pages: 1530 - 1533
      Abstract: Background: Enteric fever is a common public health problem with variable clinical presentation. The aim of study was to study the clinical spectrum of enteric fever in children.Methods: This was a prospective study conducted over period of one year from January 2019 to January 2020 in the Department of Paediatrics at Govt Medical College Srinagar. It included all patients in the age group of 1-18 years who were clinically suspected to have enteric fever and had either a positive blood culture for Salmonella or a positive Widal test.Results: This study included total of 76 patients out of which 36 were males and 40 were females. The most common presenting symptoms were fever anorexia, vomiting, diarrohea, abdominal pain, headache and constipation. The most common signs were coated tongue, toxic look, hepatomegaly, splenomeagly, pallor, jaundice and abdominal distension. Complications were seen in in 8 (10.5%) patients. Myocarditis was seen in 3 patients. Encephalopathy and hepatitis was seen in 2 patients each. Pneumonia was seen in 1 patient. Majority of patients had normal white blood cell count (4000-11000/cumm). Leukopenia (<4000/cumm) was seen in 10% patients and leukocytosis (>11000/cumm) was seen in 15% patients. Thrombocytopenia was seen in 9% patients. Blood culture was positive in 36 (47.36%) patients. Salmonella typhi was seen in 33 patients whereas Salmonella paratyphi A was seen in 3 patients. All culture positive cases were sensitive to ceftriaxone, cefixime and azithromycin. Ciprofloxacin resistance was seen in 11 (14.4%) patients.Conclusions: Enteric fever is a common public health problem with fever as most common presenting symptom. Culture yield can be increased in enteric fever by drawing blood culture prior to administration of antibiotics. Ceftriaxone is highly efficacious as monotherapy in enteric fever.
      PubDate: 2020-06-24
      DOI: 10.18203/2349-3291.ijcp20202610
      Issue No: Vol. 7, No. 7 (2020)
       
  • Forecasting the possibility of neonatal early onset sepsis based on
           perinatal risk factors

    • Authors: Kiran C. Pankaj, Sristi Ganguly, Manas R. Upadhyay
      Pages: 1534 - 1539
      Abstract: Background: Neonatal sepsis remains a leading cause of neonatal mortality and morbidity, diagnosis of which remains difficult due to variable presentations. With the increasing threat of antimicrobial resistance, it is important to identify perinatal risk factors which are associated with higher incidence of definite sepsis, to initiate empirical antibiotics, while awaiting blood culture reports.Methods: This was hospital based cross-sectional study done in SVPPGIP, Cuttack, Odisha during January 2019 to April 2019, enrolling all neonates  ≥37 weeks gestation and aged less than 72 hours, with suspected early onset sepsis. Neonates with TORCH infections, congenital anomalies, syndromic baby or with surgical conditions were excluded. After obtaining informed consent, blood culture was sent for all and their perinatal risk factors noted. Blood culture positive newborns were considered to have definite sepsis. Data was analysed with Chi-square test and percentages, using SPSS 18.Results: Among the 200 cases, incidence of definite sepsis was 26%. The most common risk factor was low birth weight and birth asphyxia. Majority (67%) had single or lesser risk factor and number of risk factors was significantly associated with definite sepsis. A significant association was seen between blood culture positivity with low birth weight (p=0.003), foul smelling liquor (p= 0.025), birth asphyxia (p 0.018) and premature rupture of membranes (p= 0.016). The combination of maternal fever and unclean vaginal examination was also significantly associated with the same.Conclusions: Protocols for initiating empiric antibiotics need to be formulated, taking into account the significant risk factors, in resource limited settings, to avoid resource and time wastage.
      PubDate: 2020-06-24
      DOI: 10.18203/2349-3291.ijcp20202611
      Issue No: Vol. 7, No. 7 (2020)
       
  • A comparative study in the outcome between the two fixed doses of
           polyvalent anti snake venom, 10 vials versus 20 vials, with mechanical
           ventilation in children with severe neurotoxic snake envenomation

    • Authors: Shekar V., Chapay Soren, K. Venkataramana Reddy, Lakshmi Aparnadevi V. V., Sai Kumar
      Pages: 1540 - 1543
      Abstract: Background: Every year about 50,000, people die of snake bites in India. Anti-snake venom and mechanical ventilation is mainstay of treatment in cases with severe neurotoxic envenomation. ASV is costly and scarce resource. There is lack of universal consensus towards the optimal dose of ASV in management protocol for children with severe neurotoxic snake envenomation. Objective was to compare the difference in outcome between two fixed doses of ASV, 10vials versus 20 vials, in children with severe neurotoxic snake envenomationMethods: This comparative observational study was carried out for a period of 3 years in Department of Pediatrics of SVS Medical College, Mahabubnagar, Telangana, India. Children with history of snake bite and clinical evidence of neuroparalysis were included. In addition to the mechanical ventilation and other supportive measures, every alternate patient was administered with 10vials (low dose) and 20 vials (high dose) of ASV over 1 hour. Outcome was compared between the two groups.Results: Of the 62 patients, 32 were in each group. The median time to extubation was 41 hours and 39.5 hours and mean duration of the hospital stay was 4.6 days and 4.5 days among the low dose and high dose groups, respectively. There were three deaths, one from low dose group and two from high dose group.Conclusions: There was no significant difference in outcome between the 10 vials vs 20 vials of ASV in addition to mechanical ventilation in treatment of children with severe neurotoxic snake envenomation. So, 10 vials of ASV can be utilized to reduce the cost of treatment.
      PubDate: 2020-06-24
      DOI: 10.18203/2349-3291.ijcp20202612
      Issue No: Vol. 7, No. 7 (2020)
       
  • Association of vitamin D deficiency and bone mass with liver and heart
           iron overload in transfusion dependent thalassemia

    • Authors: Anjali Verma, Alok Khanna, Babita Jangra, Sanjiv Nanda, Surender Verma
      Pages: 1544 - 1548
      Abstract: Background: Transfusion dependent thalassemia patients are reported to have Vitamin D insufficiency/deficiency in many countries. Vitamin D hydroxylation occurs in the liver; whether liver iron overload interferes with this step has not been addressed till date. This study helps to establish an association between liver iron concentration (LIC) and heart iron concentration (MIC) with vitamin D levels and Bone Mass Density in these patients.Methods: A cross sectional study was done by including transfusion dependent Thalassemia patients (TM) if they had an assessment of Liver and cardiac iron done by T2*MRI and bone mineral density by DEXA. Clinical data regarding age, gender, type of iron chelation therapy and laboratory data of S. ferritin and Vitamin D was collected. Data was assessed using appropriate statistical methods.Results: Among 40 TM patients were taken and mean age was 17.6 years. Vitamin D deficiency was identified in 26(65%). 20 out of them had an LIC>7mg/g DW and 6 had MIC>1.65mg/g DW. There was a significant association between LIC>7mg/g and vitamin D level<20 ng/ml and a significant inverse correlation between LIC and vitamin D, suggesting that liver iron overload may indeed affect vitamin D metabolism. Osteopenia was present in 32.5% and osteoporosis was present in 27.5 % of all TM patients. Reduced Bone Mass Density was also found to be linked with iron over load.Conclusions: Regular monitoring of vitamin D levels and supplementation is required in patients with severe liver and heart iron load. More studies are needed to confirm these results.
      PubDate: 2020-06-24
      DOI: 10.18203/2349-3291.ijcp20202613
      Issue No: Vol. 7, No. 7 (2020)
       
  • Diagnosis of malaria by the optimal method in children with routine
           microscopy and its comparison

    • Authors: Shaik Ateal Saheb
      Pages: 1549 - 1553
      Abstract: Background: The term malaria (meaning bad air of the marsh and swampland) first originated in the 17th century. Malaria is one of the most serious medical conditions, Malaria causes symptoms which usually include fever, fatigue, vomiting, and headaches. It may cause yellow skin, seizures, coma, or death in extreme cases. The population of tribal areas of Andhra Pradesh, Tamilnadu, Karnataka, Chhattisgarh, Gujarat, Bihar, Orissa, Northeastern states are contributing 50% of cases of Plasmodium falciparum.Methods: All the clinically suspected cases of Malaria, ‘The optiMAL’ test was done at the bedside and simultaneously thick and thin smears are prepared and sent for microscopic examination. Study was carried out at Narayana Medical College, Nellore, Andhra Pradesh, India. The total number of patients in our study was 150. 1-14 years of age were included in the present study after applying the inclusion and exclusion criteria.Results: The ‘OptiMAL’test method had excellent sensitivity and specificity (100%) for detecting plasmodium vivax, very good sensitivity, and specificity (98.57%, 100%) for detecting plasmodium falciparum. The optimal test had a positive predictive value of 100%, the negative predictive value of 98.61% with p-value <0.001.Conclusions: Our study has shown that the 'OptiMAL' test is an easy and successful diagnostic test that can be performed at the bedside for malaria diagnosis. This is very similar to traditional microscopy and do not need highly qualified workers to conduct experiments or interpret.
      PubDate: 2020-06-24
      DOI: 10.18203/2349-3291.ijcp20202614
      Issue No: Vol. 7, No. 7 (2020)
       
  • An observational study to determine the status of serum and RBC folate in
           drug resistant epileptic children at a tertiary care centre in Western
           Rajasthan, India

    • Authors: Bindu Deopa, Bhawna Chaudhary, Ashish Gupta
      Pages: 1554 - 1557
      Abstract: Background: Drug resistant epilepsies constitute about 10-20% of childhood epilepsies and treated with higher doses and multiple AEDs. AEDs increases folate metabolism by enzyme induction thus causes deficiency of folic acid.Objective was to evaluate the effect on serum and RBC folate in children having drug resistant epilepsy.Methods: In a prospective observational study 83 drug resistant epileptic children of age 6months to 180 months fulfilled the inclusion criteria enrolled in study, from Oct 2014 to Nov 2016 for a period of two years. Serum and RBC folate levels were done in these children. Epileptic children already receiving folic acid supplementation/treatment were excluded from the study. Children with serum folate level <5ng/ml and RBC folate <280ng/ml was considered as folate deficiency.Results: Total 83 children had drug resistant epilepsy (defined by ILAE). Mean age of children with drug resistant epilepsy was 71.39±49.76 months. 71.08 % were male and 28.91% were female. Mean serum folate in these children was 7.75±2.77 ng/ml and RBC folate 381.63±164.54 ng/ml which was significantly lower as compared to healthy children or epileptic not receiving AEDs. 14.45 % children in drug resistant epilepsy had serum folate <5ng/ml while 20.89% were found to be RBC folate deficient (RBC level <280ng/ml).Conclusions: Antiepileptic drugs are associated with lower blood folate status which deteriorates further with increasing number and doses of AEDs in drug resistant patients. Therefore blood folate monitoring should be done in all children on AEDs on regular intervals and should be considered in the etiologic differentials of drug resistant epilepsy. 
      PubDate: 2020-06-24
      DOI: 10.18203/2349-3291.ijcp20202615
      Issue No: Vol. 7, No. 7 (2020)
       
  • Study the current scenario of hand foot mouth disease an Indian
           prospective

    • Authors: Ravi Sahota, Navpreet Kaur, Gurpal Singh, Nisha Upadhyay
      Pages: 1558 - 1560
      Abstract: Background: The hand-foot-mouth disease (HFMD) is an acute communicable disease, mostly affecting children under 5 years of age and caused by human enterovirus 71 (EV-A71) and coxsackievirus A16 (CV-A16). The usual incubation period is 3 to 7 days. Early symptoms are likely to be fever often followed by a sore throat followed by loss of appetite and general malaise. Aim and objectives was to study the trend of hand foot and mouth disease in a private hospital in Uttarakhand over 5 successive years.Methods: This cross-sectional study was carried among 297 cases of HFMD newborn screened at pediatrics department of Sahota Super-specialty hospital, Kashipur, Uttarakhand during year 2015 to 2019 after ethical clearance of institutional ethical committee. Diagnosis is coded with ICD-10. SPSS version 20 was used to calculate frequencies and percentiles.Results: Almost 29 cases of HMFD were picked in 2015, 32 cases in 2016, 43 cases in 2017, 81 cases in 2018, 112 in 2019. Fever observed in 86% cases. Neurological complications were observed in 9 (3%) cases, pneumonitis in 14 (4.7%) cases, cardiomyopathy observed in 3 (<1%) case. One death was reported.Conclusions: It is vital to screen patients with HFMD for these abnormal clinical presentations, allowing timely initiation of appropriate interventions to reduce the mortality. Increased awareness about vaccination in a developing nation like India and vaccination program at the grass root levels have eradicated certain lethal diseases.
      PubDate: 2020-06-24
      DOI: 10.18203/2349-3291.ijcp20202616
      Issue No: Vol. 7, No. 7 (2020)
       
  • Study of correlation between social determinants on mental health status
           of adolescent school students of Patna, Bihar, India

    • Authors: Anil Kumar Tiwari, Anil Kumar Jaiswal
      Pages: 1561 - 1565
      Abstract: Background: The status of mental well-being is a function of emotional well-being, psychological well-being and social well-being, and includes aspects like cognitive and social skills, emotional capacity, empathy, ability to cope with adverse events, and capability to function within a society. Various studies have found strong correlations between a person’s immediate surroundings to how they perceive their well-being as well as their actual status of mental health. On one hand, social determinants affect the causation, severity and outcome of mental well-being, on the other hand the state of mental well-being affects the social determinants by affecting personal freedom, ability to make healthy life choices etc. This makes the study of social determinants of mental health very significant.Methods: A cross-sectional, exploratory study of qualitative nature was undertaken in Patna among School going students between the ages 13-17. A self-administered peer reviewed questionnaire was used for data collection.Results: Of 400 participants 19% have features of depression and other mental health problems. Females were more affected. Students of low socioeconomic group (41.6%) and of single parent family (40%) were affected.Conclusions: Mental health problems are very common in adolescent school students. Active steps must be taken to increase awareness about depression among teachers and parents. Early intervention can help prevent worsening of depression and its impact on life.
      PubDate: 2020-06-24
      DOI: 10.18203/2349-3291.ijcp20202617
      Issue No: Vol. 7, No. 7 (2020)
       
  • Blood pressure distribution in relation with age, anthropometric
           measurements and socio economic status among school children of Warangal
           city, Telangana, India

    • Authors: Mohd Sirazuddin, Najma Farheen, Shirisha Navley
      Pages: 1566 - 1572
      Abstract: Background: Hypertension is the one major global burden disease, causes 7.5 million deaths i.e.12.8%. Coronary Heart Disease Prevails 3-4% rural and 8-10% of urban population under 20 year’s age in India. Two fold rise in rural & six fold rise in urban areas since four decades. Environmental and Genetic factors i.e. Sex, BSA, obesity, family history of hypertension, dietary habits, physical activity, stress, race, ethnicity and socio economic status influence on children and adolescent. Many studies have established normal standards of BP for the children of different ages and races in their countries. Indian children cannot be adopted due to differences in ethnic, socio-economic, dietetic, environmental and emotional factors.Methods: A cross sectional study done with 2422 children of 5 to 16 years age school children, selected from 13 Schools (Government and Private) of Urban and Rural areas of Warangal.Results: A linear increase in mean BP with age, sex, weight, height, social status and locality. DBP has strong negative correlation with sex. i.e. female have high DBP and children of lower class and rural area has high DBP. 54 children <85th and 95th percentile and 5 children >95th percentile has comparatively high mean BP, 27 children with history of Hypertension in parents are >85th and 95th percentiles. Positive correlation with BMI in both sexes studied. A multivariate regression study confers positive strong correlation of Mean SBP and DBP with anthropometry.Conclusions: Observed similar results of SBP and DBP in both sexes, linear Increase in mean SBP and DBP with increasing age, weight, height and BMI. Family history of hypertension and high SES had direct correlation to SBP and DBP; class I SES has higher Mean SBP than class III SES.
      PubDate: 2020-06-24
      DOI: 10.18203/2349-3291.ijcp20202618
      Issue No: Vol. 7, No. 7 (2020)
       
  • Prevalance of anemia in children with acute lower respiratory tract
           

    • Authors: Rajakumar N. Marol, Rohitkumar R. Marol, Renuka R. Marol
      Pages: 1573 - 1577
      Abstract: Background: Anemia and ALRI are quite common in infants and toddlers in developing countries. ALRI is a leading cause of mortality in children below 5 years of age and it is important to prevent risk factors for development of ALRI. Present study was conducted to know the prevalence of anemia in children between 6 m to 23 m with ALRI and the relation between ALRI and anemia.Methods: This is a prospective case control study, conducted at Level 2 hospital situated in   backward district over a period of 1 year. Two hundred cases who had ALRI as per WHO criteria and 200 controls  were taken as the study group. Children were divided in to 3 different age groups. Haemoglobin level was estimated in all.Anemia was defined and classified according to WHO criteria.Results: Out of total 200 children both in cases and controls, 128 (64%) were males and 72 (36%) were females. Overall 190 (95%) of cases and 187 (93.5%) of controls had anemia. The prevalence of anemia was uniform in both sexes and all age groups. Children in the age group 6m -11m were more likely to develop ALRI.Conclusions: Prevalance of anemia in children between 6 m to 23 m with ALRI and without ALRI was 93.5% and 95% respectively.
      Authors cannot declare with affirmation that there was no association between Hb levels and ALRI as prevalence of anemia was very high in control group. Screening all children for anemia and taking proper intervention measures is necessary while treating for other ailments like ALRI.
      PubDate: 2020-06-24
      DOI: 10.18203/2349-3291.ijcp20202619
      Issue No: Vol. 7, No. 7 (2020)
       
  • Risk factors responsible for lower respiratory tract infections in
           children aged under five: a hospital based study

    • Authors: Samrita Seth, Sristi Ganguly, Saroj K. Satpathy
      Pages: 1578 - 1583
      Abstract: Background: Lower respiratory tract infections (LRTI) contribute significantly in terms of hospital admission and mortality. Along with attempts to improve treatment modalities, it is imperative to identify risk factors that will aid in prevention of these infections.Methods: This was a case-control study done in tertiary care hospital, Cuttack, enrolling inpatients between 2 months to 5 years with symptoms suggestive of LRTI as cases. Those with tuberculosis, aspiration pneumonia, asthma and nosocomial infections were excluded. After obtaining consent, questionnaire was administered to parents, regarding their socio-demographic and other relevant details. Data analysis was done using statistical software Epi Info™, version 6 and association of each variable with LRTI assessed with chi-square test.Results: A total of 314 children were enrolled in the study, with 158 being cases. The case-fatality rate was 23% and 53.8% suffered from complications, the most common being respiratory failure. A significant association was seen between LRTI and social variables namely maternal literacy(p-value<0.005), socioeconomic status (p-value<0.001) and number of children (p-value<0.001), housing pattern (p-value<0.001), fuel used at home (p-value=0.003), ventilation adequacy (p-value=0.004), presence of separate kitchen at home (p-value=0.0009) and presence of overcrowding (p-value<0.001) and individual factors improper breastfeeding(p-value<0.005) and weaning(p-value=0.03), malnutrition (p-value<0.001), vitamin A deficiency(p-value=0.03) and history of respiratory infection in mother (p-value=0.025) or siblings(p-value=0.048).Conclusions: The burden of lower respiratory tract infections can be substantially reduced by prevention using the identification of risk factors such as housing patterns, education of parents and improved nutrition of the children, and measures to combat the same, at each level.
      PubDate: 2020-06-24
      DOI: 10.18203/2349-3291.ijcp20202620
      Issue No: Vol. 7, No. 7 (2020)
       
  • A study of relationship between maternal serum vitamin D levels during
           peripartum period and neonatal birth weight

    • Authors: Gurpreet K. Dhillon, Sunil K. Rai, Harpreet S. Dhillon, Shibu Sasidharan
      Pages: 1584 - 1588
      Abstract: Background: An observational study was undertaken to study the relationship between maternal serum vitamin D levels during peripartum period and neonatal birth weight.Methods: This study was done on 569 patients to study the relationship between maternal serum vitamin D levels during peripartum period and neonatal birth weight. The data included was maternal serum samples (taken during peri-partum period) and neonatal birth weight. The primary objective of this project was to assess the vitamin D levels in maternal serum and to study its relationship, if any, with birth weight in the neonates.Results: A total of 569 samples of maternal serum were analyzed for serum 25(OH)D levels out of which 457(80%) mothers were found to have sufficient, 101(18%) insufficient and 11(2%) deficient Vitamin D levels as per US Endocrinological society guidelines. Out of total 569 newborns, 104 (18.27%) were low birth weight (LBW) and 465 (81.27%) were normal birth weight (NBW). Out of total LBW (104), 19(18.27%) were born to vitamin D deficient (VDD) mothers and 85 (81.72%) were born to vitamin D sufficient (VDS) mothers. Out of total NBW(465), 86(18.45%) were born to VDD mothers and 379 (81.17%) were born to VDS mothers. These results were not statistically significant (p=0.76456749).Conclusions: Maternal 25(OH)-vitamin D status during late pregnancy did not have any statistically significant effect on the neonatal birth weight.
      PubDate: 2020-06-24
      DOI: 10.18203/2349-3291.ijcp20202621
      Issue No: Vol. 7, No. 7 (2020)
       
  • Vitamin D deficiency among hospitalized infants with acute lower
           respiratory tract infection

    • Authors: Kumari Pratima, Shivlok Narayan Ambedkar, Jagannath Mohapatra
      Pages: 1589 - 1592
      Abstract: Background: Vitamin D plays important role in immunity and its deficiency might be associated with increased risk of lower respiratory tract infection. This study aimed to determine whether vitamin D deficiency is commoner in infants with acute lower respiratory tract infection as compared to normal infants and to correlate the severity of vitamin D deficiency with severity of ALRTI.Methods: A hospital based prospective case-control study was conducted in a tertiary care hospital. A total of 208 infants (109 cases and 99 controls) older than 7 days to 12 months of age, were enrolled. Cases were selected according to the definition of ALRTI given by WHO (2). Controls were chosen from children attending paediatric outpatients department for immunization or minor short duration aliments. Primary outcome measured as serum 25-hydroxy vitamin D3 (25OHD3) levels and severity of ALRTI was independent variable.Results: Among 109 cases suffering from ALRTI, vitamin D deficiency was present in 65.11%, 92.3%, 88.9% children of ‘pneumonia, severe pneumonia and very severe pneumonia group respectively. It was found that vitamin D deficiency was commoner in cases as compared to controls (80.70 % vs 25.50% ) with OR of 12.40 (95 % CI was 6.13 - 25.38). There was inverse relationship between the severity of ALRTI and Vitamin D levels (p value <0.001 and Pearson correlation coefficient -0.32).Conclusions: Vitamin D levels were significantly lower in ALRI cases as compared to controls and had negative correlation between vitamin D levels and severity of pneumonia.
      PubDate: 2020-06-24
      DOI: 10.18203/2349-3291.ijcp20202622
      Issue No: Vol. 7, No. 7 (2020)
       
  • Vitamin D level as a predictor of pneumonia and asthma in children less
           than 5 years of age

    • Authors: Neha Sharma, Anuj Shamsher Sethi, R. S. Sethi
      Pages: 1593 - 1597
      Abstract: Background: Childhood pneumonia is a global health problem .It the leading cause of death for children under the age of five years. 95% of all pneumonia cases under the age of five occurs in developing countries. Asthma remains the most common chronic disease of childhood in the world. The observation that vitamin D deficiency and asthma share risk factors such as urban residence, obesity and African American ethnicity has generated interest in exploring a link between these two conditions. This study was taken up to assess the role of vitamin D as a predictor of pneumonia and asthma in children less than 5 years of age.Methods: A prospective observational case control study was conducted in MLB Medical college, Jhansi from January 2015 to December 2016 (1 year 11 months). A total of 60 children including 30 asthma cases, 20 pneumonia cases and 10 controls, aged, 6-60 months were enrolled. Controls were healthy children attending outpatient services for immunization.Results: The mean age of the pneumonia patient was 1.5 years, while mean age in asthma patients was 3.1yrs. Ratio of male and female in pneumonia cases was1.5:1, while is asthma ratio was 2:1. In our study 45% pneumonia cases had deficient level of vitamin D (<20ng/ml) and mean level was 11.08±4.68 while 40% of control had deficient level of vitamin D and mean level was 16.04±1.61, p value was 0.0166 and there was significant difference in both the groups. In Asthma cases 53.33% patient had deficient level of vitamin-D and mean level was 10.62±2.908 as compared to 40% control (mean : 16.04±1.62) ‘p’ value was <0.0001 and was highly significant.Conclusions: Our study has illustrated that vitamin-D levels were significantly low in pneumonia and asthma patients as compared to control.
      PubDate: 2020-06-24
      DOI: 10.18203/2349-3291.ijcp20202623
      Issue No: Vol. 7, No. 7 (2020)
       
  • Clinical, epidemiological and laboratory characteristics of children with
           febrile seizures

    • Authors: Poornima Shankar, Shajna Mahamud
      Pages: 1598 - 1605
      Abstract: Background: Febrile seizure is the most common type of seizure disorder that occurs in children aged 6-60 months. Recurrences are common. This study was conducted to evaluate the epidemiology, clinical profile and laboratory parameters of children presenting with febrile seizure in a teaching hospital.Methods: This was a descriptive retrospective study among children presenting with febrile seizure admitted to KIMS, Bengaluru from March (2018-2019). Children between six months to five years were included in the study while patients with prior episodes of afebrile seizures, abnormal neurodevelopment and not meeting the age criteria were excluded. Patient’s demographic and clinical data were collected from the in-patient records and analysed.Results: Among 60 children with febrile seizures were enrolled in our study with highest prevalence in males (58%) and amongst 13-24 months age group (37%). Majority (20%) presented in the monsoon season (June) and in the morning hours (43%). Simple febrile seizures and complex febrile seizures were observed in 60% and 40% respectively. Majority (73%) who developed first episode of seizure were below 24 months ago with mean age of 18.71±11.50 months. 42% had recurrence and was significantly associated with first episode of febrile seizures at age ≤1 year and family history of seizures. Upper respiratory tract infections were the commonest cause of fever. Anaemia and leucocytosis were seen in 72% and 70% cases respectively.Conclusions: Febrile seizure was observed predominantly in children below two years, simple febrile seizure being the commonest. Recurrence was common and significantly associated with the first episode of febrile seizure at the age one year or below and family history. Majority had anaemia which showed that iron deficiency anaemia could be a risk factor. Leucocytosis was present in most which could be either due to underlying infection or due to the stress of seizure itself.
      PubDate: 2020-06-24
      DOI: 10.18203/2349-3291.ijcp20202624
      Issue No: Vol. 7, No. 7 (2020)
       
  • Role of serum sodium levels in recurrence and recurrent episodes of
           febrile seizure

    • Authors: Sara Benny
      Pages: 1606 - 1613
      Abstract: Background: Simple febrile seizures are the common childhood seizures, usually affecting 1 in 20 children between the age group of 6 months to 60 months. Earlier studies have shown an association between low serum sodium as a cause for febrile seizures and its recurrences. The present study was to determine the role of serum sodium in predicting febrile seizure recurrence within 24 hrs and recurrent episodes.Methods: Children aged between 6 months to 60 months with first episode of febrile seizures, admitted to the Paediatric ward of MOSC medical college Kolenchery, were recruited in the study. Inclusion criteria were demographic data, family history, clinical examinations, and laboratory investigations (serum sodium and hemoglobin).Results: Of the total study population of 100 children 33 had recurrences in 24 hours and 16 had recurrent episodes. About 57 children had a family history of febrile seizures, out which 28 children had recurrence of febrile seizure within 24 hours. 26 children had family history of epilepsy, of which only 8 had recurrences in 24 hours and 5 had recurrent episodes. Serum sodium levels of 69 children was above 130 mmol/l and 31 children had sodium level below 130mmol/l. Of 31 children, with low serum sodium levels (<130mmol/l), 29 had recurrence within 24 hours, which was not statistically significant. The sodium levels of 16 children who had recurrent episodes of seizure, was also between 130.1-135mmol/. No significant differences were seen between the serum sodium levels in simple febrile seizures and recurrent episodes.Conclusions: Study showed low serum sodium is not statistically significant to predict a recurrence within 24 hours, but a relative hyponatremia can predispose, a febrile child to occurrence of simple febrile seizure.
      PubDate: 2020-06-24
      DOI: 10.18203/2349-3291.ijcp20202625
      Issue No: Vol. 7, No. 7 (2020)
       
  • Postnatal foot length of newborn: its correlation with gestational
           maturity

    • Authors: Srinivasa S., Anjum Aara C. A., Pavan Kumar Kalla
      Pages: 1614 - 1618
      Abstract: Background: Neonatal death is one of the major contributors (50%) of Under-five child mortality and 70% of the infant mortality. The main causes of neonatal deaths are prematurity and low birth weight (LBW). This study was undertaken to assess newborn foot length and determine its usefulness in identifying LBW/Preterm Babies.Methods: This is a cross sectional hospital based study of 173 newborn babies, done in KIMS Hospital, Bengaluru. All live newborn infants were included in the study. Newborn babies with lower limb congenital anomalies were excluded from the study.Results: Out of 173 newborn, 99 babies were male (57%) and 74 were female (43%). 122 (70.5%) were term and 51(29.5%) were preterm. 48 (38%) were SGA, 120 (69%) were AGA and 5 (3%) were LGA. Their gestational age ranged from 28 to 40 weeks. In this study positive Correlation between foot length and gestational age was found with the “r” value of 0.823. The study also showed a positive correlation between foot length and weight with the “r” value of 0.831.Conclusions: This study has a good correlation of Foot length with gestational maturity and birth weight. Foot length of 7.45cm can be used as a cut- off point for differentiating between term and preterm babies. Derived equation from this study can be used by ASHAs and Anganwadi workers for the estimation of gestational age in resource poor situations and refer the preterm newborns to higher centres for further management as early as possible to prevent long and short term complications of prematurity.
      PubDate: 2020-06-24
      DOI: 10.18203/2349-3291.ijcp20202626
      Issue No: Vol. 7, No. 7 (2020)
       
  • Functional constipation in Bangladeshi children: experience of demography
           and probable risk factors from a tertiary care hospital

    • Authors: Md. Wahiduzzaman Mazumder, Maimuna Sayeed, Md. Benzamin, Mahfuza Chowdhury
      Pages: 1619 - 1623
      Abstract: Background: Constipation is a common problem throughout childhood. It is important to be fully aware of the factors involved in developing constipation in children. There are few published articles on childhood constipation in Bangladesh. In this study, our aim was to evaluate demography and probable/potential risk factors for functional constipation in Bangladeshi children.Methods: The study was carried out among 179 children from May 2018 to June 2019 in the department of Pediatric Gastroenterology and Nutrition, Bangabandhu Sheikh Mujib Medical University (BSMMU) both indoor and outdoor basis. Children with constipation who fulfilled the ROME III criteria were evaluated for demography and probable/potential risk factors of constipation.Results: A total of 179 subjects were included in the final analysis. Among them, 54.75% were boys and 45.25% were girls. Constipation was found more in the age group above 5 years (56.42%), then in 2 to 5 years age group (33.52%) and lower in below 2 years of age (10.6%). Constipation was more among children living in urban area (55.3%) than in rural area (44.69%). Constipation was the presenting complaint in 76.54% subjects, other complaints were abdominal pain (47.49%), anorexia (24.02%), vomiting (19.56%). Diet low in fiber (72.63%) was found as the most common potential risk factor, other factors were ingestion of cow’s milk (32.96%), not having regular meals with parents (19.55%), consumption of junk foods (28.49%). Staying with grandparents (16.76%), living in hostel or madrasa / residential religious institute (5.03%), long period of academic activity, [homework (10.61%) / tutor and coaching (7.26%)], unhygienic toilet in school (6.14%) were also found to be probable associated factors in this study.Conclusions: Functional constipation was found more in boy’s and above five year age group. Low dietary fiber, consumption of cow’s milk and junk food, unwillingness to use toilets in school, long time in academic activity, were found to be potential underlying risk factors of constipation.
      PubDate: 2020-06-24
      DOI: 10.18203/2349-3291.ijcp20202627
      Issue No: Vol. 7, No. 7 (2020)
       
  • Anti NMDA receptor encephalitis: a potentially treatable encephalitis

    • Authors: Archana K. M., Sushma Save, Koppikar Rahul Gautam
      Pages: 1624 - 1626
      Abstract: Anti NMDA receptor encephalitis is autoimmune encephalitis where antibodies are directed against NMDA receptor subunit. It represents a new category of immune-mediated disorder that is often paraneoplastic, presenting with neuropsychiatric symptoms, which is treatable and can be diagnosed serologically affecting both children and adults. Patient can have variable clinical presentation ranging from prodromal illness, neuropsychiatric symptoms, seizures, autonomic instability, hyperkinesias, catatonia, hypoventilation and with or without an associated teratoma. A positive serum or CSF sample screening for antibodies to the NMDA receptor subunit is confirmative. Supportive findings include CSF study, EEG and MRI Brain. The first-line therapies includes IVIG, corticosteroids or plasma exchange. Second line immunotherapy is rituximab or cyclophosphamide or both. Given the high mortality rate (up to 25%), the likelihood of presentation across the age range and the potential for treatment, a high index of suspicion is warranted by clinicians.
      Authors report a case of a 5 year old child with anti NMDA receptor encephalitis who responded well to IVIG therapy.
      PubDate: 2020-06-24
      DOI: 10.18203/2349-3291.ijcp20202628
      Issue No: Vol. 7, No. 7 (2020)
       
  • Popliteal pterygium syndrome: case report from rural India

    • Authors: Vasav D. Desai, Gayatri S. Desai, Nirav Raulji
      Pages: 1627 - 1630
      Abstract: The popliteal pterygium syndrome is a congenital malformation that includes orofacial, musculoskeletal and genitourinary anomalies. It is also known as faciogenitopopliteal syndrome. It is autosomal dominant disorder. It has highly variable expressivity and incomplete penetrance. The incidence of the popliteal pterygium syndrome is 1/300000, which makes it an extremely rare condition. The most striking characteristic of this syndrome is popliteal pterygium, which consists of a net of connective tissue spreading from the ischial tuberosity to the calcaneus.In this study, authors present the case of a 1 day old male patient with cleft upper lip, cleft palate, bifid scrotum, popliteal pterygium and congenital talipes equinovarus (CTEV). 
      PubDate: 2020-06-24
      DOI: 10.18203/2349-3291.ijcp20202629
      Issue No: Vol. 7, No. 7 (2020)
       
  • Calcinosis cutis in a neonate with transient hypoparathyroidism

    • Authors: Sitikantha Nayak, Baikuntha Narayan Mishra, Ranjit Kumar Joshi, Prabin Prakash Pahi
      Pages: 1631 - 1633
      Abstract: Calcinosis cutis is a condition, where there is deposition of calcium salts in skin and subcutaneous tissue, seen often in the middle to elderly aged population and is rare in neonates and infants. There are many aetiological factors, but in neonates and infants it is mostly seen as complication of extravasation of intravenous calcium infusion or trauma. For uncomplicated cases supportive treatment has been advocated.
      Authors describe a case presented with calcinosis cutis, who was treated for transient hypoparathyroidism in neonatal period.
      PubDate: 2020-06-24
      DOI: 10.18203/2349-3291.ijcp20202630
      Issue No: Vol. 7, No. 7 (2020)
       
  • Hypothalamic hamartoma presenting as central precocious puberty: a rare
           case report

    • Authors: Priyanka Sharma, Nishant Acharya, Trilok C. Guleria
      Pages: 1634 - 1637
      Abstract: Precocious puberty is defined as children attaining puberty more than 2.5 to 3 standard deviations (SD) earlier than the median age, or before the age of eight years in girls and nine years in boys. Hypothalamic hamartoma (HH) are rare, non progressive tumor like malformation. Precocious puberty due to HH occurs particularly at early ages, even 2 or 3 years. Treatment options for isolated CPP due to HH include GnRH analogs agonists continuously stimulates pituitary gonadotrophs, which further help in decreasing and desensitizing the release of LH, and to a lesser extent, FSH till the time puberty naturally set in. We present a case of precocious puberty due to hypothalamic hamartoma in 3 years old girl. Treated with GnRH analog lupirode and responded well to treatment with cessation of menstruation and reduction in breast size.
      PubDate: 2020-06-24
      DOI: 10.18203/2349-3291.ijcp20202631
      Issue No: Vol. 7, No. 7 (2020)
       
  • Dapsone induced DRESS syndrome: a rare fatal complication

    • Authors: Komalatha Choppari, Soma Santosh Kumar, Mamatha Pakala
      Pages: 1638 - 1640
      Abstract: DRESS syndrome is a serious life threatening condition characterized by skin eruption, haematological abnormalities and multi organ involvement that can be fatal if unrecognized especially in patients with liver failure. Diagnosis may be difficult because it is rarely seen in children and it can mimic many different conditions. Author report a case of 12 year old female presented to this emergency department with moderate grade fever, skin rash and jaundice following dapsone ingestion. She was evaluated and was diagnosed as DRESS syndrome and successfully treated with steroids.
      PubDate: 2020-06-24
      DOI: 10.18203/2349-3291.ijcp20202632
      Issue No: Vol. 7, No. 7 (2020)
       
  • Neonatal hypercalcemia associated with extensive subcutaneous fat
           necrosis: a case report

    • Authors: Mahmoud M. Osman, Suzan Abdel Hamid, Hussein M. Kira, Adel Abdelsalam Alatar, Enas M. Elsabagh
      Pages: 1641 - 1644
      Abstract: Subcutaneous fat necrosis (SCFN) of the newborn is rare self-limited fat tissue inflammation that usually occurs in term or post-term newborns exposed to perinatal stress factors, such as perinatal asphyxia, meconium aspiration, neonatal sepsis, and therapeutic hypothermia. SCFN usually appears in the first few weeks of life and has a benign course with spontaneous resolution. Monitoring for complications, in particular the potentially life-threatening hypercalcemia, is crucial. In this report, we describe a male infant with extensive SCFN and neonatal hypercalcemia that went through a prolonged course.
      PubDate: 2020-06-24
      DOI: 10.18203/2349-3291.ijcp20202633
      Issue No: Vol. 7, No. 7 (2020)
       
  • Secondary haemophagocytic lymphohistiocytosis in a child with brucellosis

    • Authors: Ajay Mohan Varahala, Ranjeet Malava, Sravanthi Veldandi, Santosh Avinash Boppidi, Varsha Kolachena, Udaya Rani G. Rani G., Divya Nalamalapu, Rhaj Kumar E. P., Raviteja Moturi, Aparna Alladi
      Pages: 1645 - 1647
      Abstract: Human brucellosis is a zoonotic infection, mostly caused by B. melitensis and usually presents as an acute febrile illness. Once considered rare in children, it is now recognized that brucellosis can affect persons of all ages, especially in areas where B. melitensis is the predominant species. Complications may affect any organ system. On the other hand Secondary Hemophagocytic lymphohistiocytosis (SHLH) can occur due to systemic infections, immunodeficiency, and underlying malignancies. (SHLH) is histologically characterized by excessive proliferation and activation of histiocytes or macrophages. Brucellosis associated with SHLH should be suspected whenever there is a prolonged fever along with hepatosplenomegaly and pancytopenia.
      PubDate: 2020-06-24
      DOI: 10.18203/2349-3291.ijcp20202634
      Issue No: Vol. 7, No. 7 (2020)
       
  • Disc battery in the pediatric oesophagus

    • Authors: Manish Mubjal, Nitika Tuli, Porshia Rishi, Harjinder Singh, Shubham Munjal
      Pages: 1648 - 1650
      Abstract: The wide usage of disc batteries in toys, in the late seventies presented a new problem. In the form of accidental lodgements in the pediatric aerodigestive tract. The physico-chemical nature of the disc battery necessitates an early removal, so as to avoid a fatal outcome if missed and retained for a long duration. Management of one such case is reported with radiographic documentation.
      PubDate: 2020-06-24
      DOI: 10.18203/2349-3291.ijcp20202635
      Issue No: Vol. 7, No. 7 (2020)
       
  • Tuberculosis: a great masquerader

    • Authors: Rajeshwari N., Savitha A.
      Pages: 1651 - 1654
      Abstract: Central nervous system tuberculosis caused by Mycobacterium tuberculosis is the most severe form of tuberculosis, accounting for 1% of all TB cases. Intracranial tuberculosis can present as Tuberculous meningitis, Tuberculous encephalopathy, Tuberculous vasculitis, CNS tuberculomas and Tuberculous brain abscess. Here authors present a case of a 10-year-old girl who presented with insidious onset of early morning vomiting, excessive sleepiness with classical neuroimaging findings of intracranial tuberculosis.
      Authors emphasise that intracranial tuberculoma should be considered in the differential diagnosis of any intracranial space-occupying lesion with or without pulmonary involvement.
      PubDate: 2020-06-24
      DOI: 10.18203/2349-3291.ijcp20202636
      Issue No: Vol. 7, No. 7 (2020)
       
  • Exploring the iceberg of gluten

    • Authors: Bhupendra Chaudhary, Ansh Chaudhary
      Pages: 1655 - 1656
      Abstract: Gluten, a protein present in wheat, rice or barley shares the reputation of common etiological agent for childhood disease ‘Coeliac Disease’ (CD) and adult ‘Non-Coeliac Gluten Sensitivity’ (NCGS).
      PubDate: 2020-06-24
      DOI: 10.18203/2349-3291.ijcp20202516
      Issue No: Vol. 7, No. 7 (2020)
       
  • Utility of brain natriuretic peptide in the neonatal pathologies

    • Authors: Shriprasad R. Deshpande
      Pages: 1657 - 1658
      Abstract: This is with reference to the recently published article titled ‘N-terminal pro brain natriuretic peptide as a marker of myocardial dysfunction in newborns with perinatal asphyxia’ by Drs. Kariyappa et al.
      PubDate: 2020-06-24
      DOI: 10.18203/2349-3291.ijcp20202637
      Issue No: Vol. 7, No. 7 (2020)
       
 
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