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Publisher: Medip Academy   (Total: 12 journals)   [Sort by number of followers]

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Intl. J. of Advances in Medicine     Open Access   (Followers: 2)
Intl. J. of Basic & Clinical Pharmacology     Open Access   (Followers: 3)
Intl. J. of Clinical Trials     Open Access   (Followers: 2)
Intl. J. of Community Medicine and Public Health     Open Access   (Followers: 5)
Intl. J. of Contemporary Pediatrics     Open Access   (Followers: 4)
Intl. J. of Otorhinolaryngology and Head and Neck Surgery     Open Access  
Intl. J. of Reproduction, Contraception, Obstetrics and Gynecology     Open Access   (Followers: 12)
Intl. J. of Research in Dermatology     Open Access   (Followers: 1)
Intl. J. of Research in Medical Sciences     Open Access   (Followers: 5)
Intl. J. of Research in Orthopaedics     Open Access  
Intl. J. of Scientific Reports     Open Access   (Followers: 2)
Intl. Surgery J.     Open Access   (Followers: 1)
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International Journal of Contemporary Pediatrics
Number of Followers: 4  

  This is an Open Access Journal Open Access journal
ISSN (Print) 2349-3283 - ISSN (Online) 2349-3291
Published by Medip Academy Homepage  [12 journals]
  • Primary antiphospholipid syndrome in children: experience from two
           tertiary centres in South India

    • Authors: Mahesh Janarthanan, Dhaarani Jayaraman, Julius Scott, M. S. Latha, Saravanan Margabandhu, Chitra Sundaramoorthy, S. Srinivas
      Pages: 243 - 247
      Abstract: Background: Antiphospholipid syndrome (APS) is a systemic autoimmune disorder characterized by the presence of episodes of vascular thrombosis, recurrent fetal loss and other clinical features in the presence of antiphospholipid antibodies. The aim of the study was to analyze the clinical manifestations and immunologic profile of children presenting with APS.Methods:
      Authors did a retrospective case record study of patients admitted with thrombotic events between September 2013 and August 2018 and identified patients with positive antiphospholipid antibodies. Children who had clinical features of active lupus were not included.Results: The clinical and immunologic profile of 7 pediatric patients presenting with APS over 5 years from 2013 to 2018 were analysed. Symptoms secondary to vascular thrombosis were limb swelling, stroke, gangrene of toes and Budd Chiari syndrome.Conclusions:APS though rare should be considered in the differential diagnosis of children presenting with thrombotic events. They need long term anticoagulants to prevent further episodes. 
      PubDate: 2019-02-23
      DOI: 10.18203/2349-3291.ijcp20190070
      Issue No: Vol. 6, No. 2 (2019)
       
  • Prediction of neonatal hyperbilirubinemia using umbilical cord blood
           bilirubin

    • Authors: Kiran Haridas, Rajendra Shinde, Gangadhar Belavadi
      Pages: 248 - 252
      Abstract: Background: Neonatal hyperbilirubinemia is a common problem among newborns.  Neonatal hyperbilirubinemia has a potential complication of kernicterus which is still seen in many newborns. In present study authors used umbilical cord blood bilirubin to predict the development of significant hyperbilirubinemia in the early neonatal period. The objective of this study is to evaluate the correlation between concentration of bilirubin in the cord blood and occurrence of hyperbilirubinemia in term newborns.Methods: In this prospective study authors included 500 term healthy consecutively born babies whose umbilical cord blood was collected and were followed up for first 7 days for the appearance of jaundice. The clinical assessment of jaundice was done by Kramer rule. The data was analyzed by using SPSS 17 statistical software.Results: Study found that umbilical cord blood bilirubin was 90% sensitive and 87% specific with a PPV of 75% and NPV of 92% in predicting significant neonatal hyperbilirubinemia.Conclusions: The study conducted clearly points that the use of cord blood bilirubin for identifying newborns at risk of hyperbilirubinemia helps in early detection and treatment of jaundice. There by preventing the potential complication kernicterus. This method is economical and socially acceptable. Hence cord blood bilirubin should be done on all healthy term newborns.
      PubDate: 2019-02-23
      DOI: 10.18203/2349-3291.ijcp20190676
      Issue No: Vol. 6, No. 2 (2019)
       
  • Usefulness of fine needle aspiration cytology in diagnosis of causes of
           lymphadenopathy in children

    • Authors: Chandra Sekhar Kondapalli, Goutham Mandali
      Pages: 253 - 259
      Abstract: Background: The present study was conducted to study the causes of lymphadenopathy, associated clinical findings, usefulness of FNAC in diagnosis of various causes of lymphadenopathy as lymph node biopsy is a difficult and invasive procedure in children attending pediatric department.Methods: A study was done at Katuri medical college and hospital. A total of 50 patients with lymphadenopathy including both local and generalized were studied for a period of 2 years by taking proper history, through physical examination both generalized and systemic and all the patients were subjected for relevant investigations for establishment of diagnosis which is essential for institution of proper treatment. A prospective study consisting 50 patients with lymphadenopathy (<12year) is undertaken to find the incidence of various causes of lymphadenopathy in the affected patients for 2 year.Results: It was observed that 10, 17 and 23 children were having lymphadenopathy in the age groups of 0-3-year, 4-8 year and 9-12 year respectively. Majority of patients were having lymphadenopathy only after 4 year of age, male 28 and female 22. The major symptoms in order of incidence were palpable swelling, fever, cough, weight loss, loss of appetite and sore throat. Duration of lymphadenopathy of less than 1 month was seen in 25 cases ,1-6 months 24 cases and more than 6 months in 1 case. Enlargement of lymph nodes in cervical region, was the major finding in these patients. 47 cases were having local lymphadenopathy mainly in the cervical region and 3 cases were having generalized lymphadenopathy. 80% of the patients were having firm lymph nodes, remaining 20% of the patients were having soft lymphadenopathy. 36 patients were having mobile lymph nodes while 14 patients were having matted lymph nodes. Tenderness was observed in 21 cases against absence of tenderness in 29 cases. Analysis of the FNAC results revealed positive for tuberculosis in 11 cases reactive hyperplasia in 26 cases, granulomatous changes seen in 4 cases and suppurative lymphadenitis in 6 cases.Conclusions: In developing countries like India whenever a patient attends the Department of Paediatrics with lymphadenopathy it is always be prudent to exclude tuberculosis, which is quite prevalent. FNAC is helpful in those with benign conditions like reactive hyperplasia to rule out underlying serious systemic diseases and reassuring the parents.
      PubDate: 2019-02-23
      DOI: 10.18203/2349-3291.ijcp20190035
      Issue No: Vol. 6, No. 2 (2019)
       
  • Nutritional status assessment by anthropometry in children with chronic
           liver disease aged 6 months to 12 years

    • Authors: P. Sudhakar, P. V. Dhaarani Giri
      Pages: 260 - 263
      Abstract: Background: In spite of distinctive improvements in nutritional therapy, malnutrition and growth retardation remained as challenging significances of chronic liver disease (CLD) in children. The present study was done to evaluate the severity and frequency of malnutrition using anthropometry in CLD children.Methods: The study included 50 children with CLD attending the OPD of Institute of Child Health and Hospital for Children, Egmore, Chennai during the period from April 2016 to September 2016. Physical growth and nutritional status in the patients were evaluated using anthropometric parameters and Z-scores.Results: The incidence of malnutrition in the children using height for age was found to be 90%, weight for age- 84%, BMI for age- 40%, MAC for age- 88%, TST for age- 88%. SGA showed 96% malnutrition. Weight for age and body mass index were influenced by this fluid retention (P=0.002 and P=0.007 respectively). Whereas height for age, MAC and TST were not influenced by fluid retention (P=0.321, P=0.371 and P=0.031 respectively).Conclusions: Assessment of nutritional status in CLD children can be easily diagnosed by anthropometric measurements. Early diagnosis of malnutrition will decrease the related morbidity and mortality in children.
      PubDate: 2019-02-23
      DOI: 10.18203/2349-3291.ijcp20190082
      Issue No: Vol. 6, No. 2 (2019)
       
  • Prevalence and outcome of retinopathy of prematurity in preterm infants,
           with low birth weight at KMCH, Tamil Nadu, India

    • Authors: R. Nikhil, K. Rajendran, Bala Krishnan
      Pages: 264 - 268
      Abstract: Background: Premature infants have avascular or incompletely vascularized retina at birth and ROP evolves over 4-5 weeks after birth. The aim of this study is to know the prevalence of retinopathy of prematurity in preterm infants, with birth weight ≤ 1500 grams and/or gestational age ≤32 weeks in a tertiary care center.Methods: The study was conducted in Kovai Medical Centre and Hospital Coimbatore in 2016. The sample size is 95 babies. All preterm infants admitted with a birth weight of ≤1500 grams and/or ≤ 32 weeks of gestation and baby those at risk of ROP.Results: 95 babies have enrolled during the study period of which 78 babies fulfilled the inclusion criteria and completed this prospective study.12 babies could not complete the follow-up protocol and 5 babies died before full vascularization of the retina. 78 babies who fulfilled the inclusion criteria were screened and 15 babies were found to have ROP. The prevalence of ROP in this study is 19.2%.Conclusions: Among the preventable causes of blindness in children, ROP figures very high on the agenda. Low birth weight and gestational age were found to be the most important risk factors for the development of ROP.
      PubDate: 2019-02-23
      DOI: 10.18203/2349-3291.ijcp20185519
      Issue No: Vol. 6, No. 2 (2019)
       
  • A prospective study on cardiac changes (electrocardiographic, enzymatic
           and echocardiographic) in birth asphyxiated neonates admitted in tertiary
           care centre

    • Authors: A. Muhammed Shadique, Madhivanan Sailavasan
      Pages: 269 - 274
      Abstract: Background: Reduced myocardial performance and cardiac output following perinatal asphyxia may significantly complicate perinatal management and may contribute to increased end-organ damage and mortality. Hence the present study was done with the aim to assess the usefulness of echocardiography, electrocardiography (ECG), and cardiac enzymes in evaluating myocardial damage in perinatal asphyxia neonates and to assess their correlation with different stages of hypoxic-ischemic encephalopathy (HIE) and outcome.Methods: The study was conducted in the NICU, Department of Pediatrics, Government Chengalpattu Medical college hospital between August 2017 and August 2018 using 70 birth asphyxiated term babies. The asphyxiated babies were resuscitated as per NRP guidelines and were stratified into HIE stages as per Levene system of classification and were managed as per clinical condition. ECG grading, echo changes were noted. Creatinine kinase-MB (CKMB) levels were measured and documented after 12 hours of life among these babies and were analysed.Results: Of 70 cases, 36 (51.4%) had mild, 26 (37.1%) moderate and 8 (11.4%) severe HIE. Abnormal ECG was observed in 63 cases. Raised CKMB levels were found in 67 (95.7%) and abnormal echo findings were noted in 46 (65.7%) babies. ECG, echo changes and CKMB levels showed increasing abnormalities with increasing severity of HIE (p=0.000, 0.030 and 0.001 respectively). 8 babies in present study expired.Conclusions: Cardiac abnormalities among asphyxiated neonates requires high index of suspicion. ECG abnormalities, echo changes, elevated CK-MB levels in babies with HIE can help us identify neonates at risk of complications and guide in timely intervention that can prevent mortality of these babies and help us achieve better neurological outcome in these babies.
      PubDate: 2019-02-23
      DOI: 10.18203/2349-3291.ijcp20190547
      Issue No: Vol. 6, No. 2 (2019)
       
  • A study of prevalence and pattern of congenital heart disease at Sopore,
           Kashmir, North India

    • Authors: Suhail Naik, Mohd. Irshad, Aliya Kachroo, Mudasir Ahmad
      Pages: 275 - 279
      Abstract: Background: Early detection of congenital heart disease is of paramount importance to improve the quality of life of children and prevent morbidity and mortality. Congenital heart disease (CHD) is one of the major causes of mortality and morbidity in the pediatric population of both the developing and developed countries. Present aim was to study the prevalence, age and sex wise distribution, and clinical spectrum of congenital heart disease (CHD) at Sopore, Kashmir, North India.Methods: Around 39829 children in the age group 0 months to 18 years were screened for Defects at birth, Diseases in children, Deficiency conditions and Developmental Delays including Disabilities over the period of 18 months under RBSK. Clinical examination, echocardiography and color Doppler were used as diagnostic tools.Results: A prevalence of 5.3 per 1000 population was observed. VSD (ventricular septal defect) was the commonest lesion (30.1%), followed by PDA (patent ductus arteriosus) in 21.6 % and ASD (atrial septal defect) in 20.2%. Tetralogy of Fallot was the commonest cyanotic heart disease (8.0%). Maximum numbers of children with heart disease were diagnosed in the age group 6 weeks to 6 years.Conclusions: For better estimation of prevalence of congenital heart diseases, more elaborate community-based studies are needed. Such community based studies can be easily done by collecting and analyzing data collected from screening programs like RBSK. Such community based screening programs helps in detecting silent cardiac ailments, their prevalence and pattern, and early therapeutic intervention. A few prevalence studies have been carried out piecemeal in different locations of India; and more such studies can be easily done by collecting and analyzing data collected under RBSK screening program.
      PubDate: 2019-02-23
      DOI: 10.18203/2349-3291.ijcp20190226
      Issue No: Vol. 6, No. 2 (2019)
       
  • Convulsive status epilepticus in children: clinical profile and outcome in
           a tertiary care hospital

    • Authors: Madhu P. K., Krithika R.
      Pages: 280 - 287
      Abstract: Background: The outcome of status epilepticus (SE) depends on various determinants such as age, type and duration of SE, etiology, management and associated comorbidities. This study was undertaken to describe the clinical profile and outcome of children with convulsive status epilepticus presenting to pediatric intensive care unit (PICU).Methods: Eighty-seven children between the age group 1 month to 12 years who at presentation or during the PICU stay had convulsive status epilepticus (CSE) were included in the study. Clinical profile, etiological spectrum and outcome at the end of hospital stay were analysed.Results: Median age of CSE was 4 years and 55 (63.2%) were below 5 years of age.  Acute symptomatic etiology of CSE was a significant risk factor (p= 0.03) for refractory status epilepticus (RSE) which was seen in 31 patients (39%). Acute symptomatic etiology was the cause of CSE in 46 (59.2%) children. Remote symptomatic (26.4%), cryptogenic (18.4%) and progressive (2.3%) were other etiologies. Neuro-infection (29.8%) and febrile seizures (11.5%) were the most common acute symptomatic causes. Mortality and morbidity occurred in 23 (26.4%) and 8 (9.2%) patients respectively. Remaining 56 (64.6%) returned to baseline condition at the end of hospital stay. Longer duration (p= 0.03) and acute symptomatic etiology (p=0.049) were significant risk factors for mortality.Conclusions: Most common causes of CSE in children are acute symptomatic. Longer duration of status is associated with higher mortality. Hence, termination of seizure activity at the earliest, prudent management of respiratory or circulatory impairments in these children and improving the overall health care to prevent neuro-infections are important steps to improve outcome.
      PubDate: 2019-02-23
      DOI: 10.18203/2349-3291.ijcp20190093
      Issue No: Vol. 6, No. 2 (2019)
       
  • Study of prevalence of vitamin D deficiency in nephrotic syndrome

    • Authors: Shivanand Illalu, Velagala Swetha Venkatareddy, Sudhindrashayana R. Fattepur
      Pages: 288 - 294
      Abstract: Background: Patients with nephrotic syndrome (NS) lose 25-hydroxyvitamin D in the urine and can have low blood levels of this metabolite. Corticosteroid therapy on long term basis can cause osteoporosis and affects the bone mineral content (BMC) and bone mineral density (BMD) in children. Hence this study was undertaken to study the prevalence of Vitamin D deficiency in children with Nephrotic syndrome.Methods: It is a time bound prospective hospital based observational study done at Department of Paediatrics, KIMS Hospital, Hubli. A detailed history and clinical examination including anthropometry was taken for cases of Nephrotic syndrome admitted to the hospital. 5ml venous blood was collected and sent for estimation of calcium (Ca), phosphorus (P), Alkaline phosphatase (ALP) and 25(OH) Vitamin D levels.Results: Mean age of onset of nephrotic syndrome was 4.6 years and median age at study entry was 7 years. Male to female ratio was 1.4:1. Vitamin D deficiency was present in 16(47.05%) children and insufficiency was present in 11(32.35%) children with nephrotic syndrome. Wasting was present in 11.76% and stunting was present in 50% of the children with nephrotic syndrome. There was no statistically significant difference of vitamin D levels with respect to sex and age group. Frequent relapsers had low levels of vitamin D levels as compared to 1st episode and infrequent relapsers. There was moderately significant positive correlation between serum calcium and vitamin D levels and negative correlation between phosphate levels and vitamin D levels.Conclusions: Vitamin D deficiency is common in children with nephrotic syndrome even after the remission of proteinuria.
      PubDate: 2019-02-23
      DOI: 10.18203/2349-3291.ijcp20190502
      Issue No: Vol. 6, No. 2 (2019)
       
  • Incidence of rotaviral and adenoviral diarrhoea amongst children under 5
           year of age in a tertiary care centre

    • Authors: Jaishree Ambhore, Minhajuddin Ahmed
      Pages: 295 - 298
      Abstract: Background: Rotavirus and Adenovirus is considered to be an important cause of diarrhoea in under five children and the data is very scarce due to decrease testing. This study was done to estimate the incidence, clinical profile and laboratory features among under five children with diarrhoea.Methods: A prospective interventional study was conducted in Chirayu Medical College, Bhopal on children aged between 6 months - 5 years hospitalized with acute non-bloody diarrhea with 30 children in each group.Results: Total 328 children were included in the study out of which 216 were males and 112 were females with a male:female ratio 1.9:1. 92(28%) patients were positive for rotavirus out of which 64(19.5%) were males and 28(8.5%) were females in present study.Conclusions: Rotavirus infection is one of the common etiological agents responsible for diarrohea. Rotavirus infection results in disease burden with morbidity and mortality in children and vaccination is the only control measure to decrease the incidence and mortality in children.
      PubDate: 2019-02-23
      DOI: 10.18203/2349-3291.ijcp20190094
      Issue No: Vol. 6, No. 2 (2019)
       
  • Prevalence of vitamin D deficiency in exclusively breastfed infants

    • Authors: Prabu Velusamy, Kavitha Devarajulu
      Pages: 299 - 301
      Abstract: Background: Vitamin D deficiency in exclusively breast fed infants was increasing in young infants. Many studies were done previously but still the data on vitamin D status of healthy term infants are scanty. Hence the present study was done to determine the prevalence of subclinical vitamin D deficiency among exclusively breast fed babies by estimating the serum levels of relevant parameters.Methods: The present descriptive study included 40 babies that are exclusively breast fed healthy term babies with birth weight >2.5kg. After collection of complete demographic and antenatal data, serum was collected from all the babies to estimate serum levels of vitamin D (25OH-D3) and calcium, phosphate, and alkaline phosphatase.Results: Out of 40 babies, vitamin D deficiency was found in 33 (83%) babies. Of them, hypocalcaemia was seen in 13 (39.3%) infants. Raised ALP was noticed in all babies with a mean value of 464.97 IU/L. Phosphorus levels were normal in all babies with a mean value of 6.12 mg/ml.  Serum 25 OH vitamin D3 levels were low (mean-10.02 ng/ml) and mean calcium was 8.81 mg/dl.Conclusions: Prevalence of vitamin D deficiency was found to be high in exclusively breastfed babies with hypocalcemia in 39% of babies and associated seizure in one baby in this study.
      PubDate: 2019-02-23
      DOI: 10.18203/2349-3291.ijcp20190072
      Issue No: Vol. 6, No. 2 (2019)
       
  • Nutritional anaemia: clinical and haematological presentation in children

    • Authors: Sunil S. Vaidya, Dayanand P. Nakate, Shahaji Y. Gaikwad, Ramesh S. Patil, Manoj S. Ghogare
      Pages: 302 - 305
      Abstract: Background: There are three main causes of anemia, decreased production of RBCs, and excessive destruction of RBCs or Excessive blood loss. In India, the main reason of anaemia is the decreased production due to nutritional deficiency. The main nutrients required in the process of haemoglobin production are iron, folic acid and cyanocobalamine. The objective of the present study was to find the clinical presentations and hematological changes in children with nutritional anaemia.Methods: This Cross-sectional study was conducted from January 2018 to October 2018 in the department of Paediatrics of Ashwini Rural Medical College Hospital and Research Centre, Solapur. Children visiting the paediatric OPD due to any illness and having clinical suspicion of anemia were initially screened for inclusion in the study. Detailed laboratory investigation such as CBC, peripheral blood for Leishman’s stain and reticulocyte count were performed. Serum Ferritin, vitamin B12, folic acid levels were also done to ascertain the cause of anemia. World Health Organization recommended criteria were used to diagnose and grade the anemia.Results: A total of 405 anemic children were included in the study. Out of that 213 were boys and 192 were girls. A total of 226 children presented with mild anemia. The most common clinical presentation was respiratory tract infection, found in 62.22 % of children followed by fever in 53.09 % of children. Maximum numbers of patients were suffering from iron deficiency anemia, followed by folic acid deficiency. Deficiency of both of these nutrients was also common. Vit B12 deficiency was found in only 5 children.Conclusions: The study concluded that iron deficiency anemia was the commonest nutritional anemia in children in the age group of 5 to 15 years. Second most common deficiency was of folic acid. Majority of the anemic patients presented with respiratory tract infection and fever.
      PubDate: 2019-02-23
      DOI: 10.18203/2349-3291.ijcp20190096
      Issue No: Vol. 6, No. 2 (2019)
       
  • Pulmonary function tests in β thalassemia major and its correlation
           with serum ferritin levels

    • Authors: Manaswita Gadiparthi, Nalini Bhaskaranand, Pushpa G. Kini, Shrikiran Hebbar, Suneel C. Mundkur
      Pages: 306 - 309
      Abstract: Background: Extensive studies are conducted on heart, liver and endocrine abnormalities in thalassemia owing to their direct effect on survival, however, lung dysfunction has never been focused upon and is one of the least understood complications in β thalassemia. There’s a vacuum for data on pulmonary function tests in β thalassemia major in literature from India.
      Authors aimed to study pulmonary function and type of abnormality in cases with β thalassemia major above the age of 8yrs and to correlate the result with age and serum ferritin levels.Methods: Demographic data, hemoglobin value, serum ferritin levels, chelation details and transfusion requirement were analyzed. Spirometry was performed using COSMED pulmonary function test (PFT).Results: Among the 34 subjects studied, 21 were boys, and 13 were girls. Mean serum ferritin levels of the group was 3610.82±2679.51ng/mL and did not show a significant correlation with age, years of transfusion, and years of chelation. Forced vital capacity (FVC), forced expiratory volume in 1st second (FEV1) % values were lower in boys when compared to girls. PFT showed a restrictive pattern in the study group (FEV1/FVC=>0.7) with significant involvement in 73.5% of cases (FEV1<80%). A statistically significant negative correlation was observed between age and FEV1% (r=-0.577, p=<0.01) highlighting the importance of duration of iron overload. However, there was no significant linear correlation between restrictive lung disease and serum ferritin level (r=-0.06, p=0.75).Conclusions: Restrictive pattern was the most common abnormality, and it did not correlate with serum ferritin. Pulmonary function monitoring would help in identifying children with significant morbidity and help in initiating an early intervention to improve the quality of life.
      PubDate: 2019-02-23
      DOI: 10.18203/2349-3291.ijcp20190450
      Issue No: Vol. 6, No. 2 (2019)
       
  • Efficacy of MAGPI procedure in the management of hypospadias

    • Authors: Ravindra G. Khasnis, Rajshankar S.
      Pages: 310 - 314
      Abstract: Background: Hypospadias is a relatively common congenital defect of male external genitalia. It is present in approximately 1 in 300 males new born. The meatus may be located anywhere along the shaft of the penis from glans to scrotum or even perineum. The objective is to study the efficacy of MAGPI procedure in the management of hypospadias.Methods: Detailed case study was done as per the proforma, in majority of cases patient’s mother were informants, thorough clinical examination was done in all cases and looked for any congenital anomalies and family history was also taken, and any drugs intake was also taken. All the cases routine investigation was done like (Hb, BT, Ct, Wt). USG was done in required cases. Routine pre-operative preparation was done like keeping nil orally, preparing parts was done. The type of surgery for each patient was assessed after clinical examination of location of meatus: Anterior, Middle, and Posterior. On discharge, the patients and mothers were advised to bring their children for regular check up to hospital.Results: Most common position of hypospadias was glanular and coronal. The most common surgery performed was Snodgrass technique and for distal and mid penile hypospadias and MAGPI for glanular type of hypospadias. MAGPI procedure was most commonly performed for glanular and coronal type of hypospadias. Other minor Complication was wound infection and penile torsion of mild degree and was managed conservatively.Conclusions: There is significant difference in outcome of hypospadias surgery done by pediatric urologist and other surgeons.
      PubDate: 2019-02-23
      DOI: 10.18203/2349-3291.ijcp20190439
      Issue No: Vol. 6, No. 2 (2019)
       
  • Predischarge risk factors for predicting significant hyperbilirubinemia in
           term of infants

    • Authors: Nirali Mehta, R. G. Bhatt, Hetal Vora, Dlvya Reddy
      Pages: 315 - 319
      Abstract: Background: The objective of the study to compare the predictive ability of predischarge serum total bilirubin (STB) and clinical factors for significant hyperbilirubinemia (SHB) in newborn to observe the prediction of the hyperbilirubinemia.Methods: In the prospective study, enlist of healthy newborn infants with >35 weeks gestation, in a tertiary hospital in western India. The serum bilirubin between 36-48 hours of age and risk factors for SHB were identified before discharge. SHB was distinct as a bilirubin level that exceed or was within 1mg/dL (17µmol/L) of the hour-specific phototherapy conduct threshold recommended by American Academy of Pediatrics (AAP) guideline on the management of neonatal hyperbilirubinemia.Results: Of 505 infants, 380 infants were included in final analysis, among which 70 babies (22.5%) developed SHB. On univariate analysis STB, gestational age (GA) and percentage of weight loss were found to be predictive of SHB. On multiple logistic regressions, the prognostic ability of predischarge STB is higher than that of percentage of weight loss and GA. The predictive accurateness of predischarge (<48 hours) STB level was comparable to that of percentage of weight loss (AUC=0.88, 95% CI 0.84-0.93). However, the prediction model that combined multiple risk factors such as predischarge STB, GA and percentage of weight loss have the best accuracy for predicting SHB.Conclusions: Combination of specific clinical factors (gestational age and percentage of weight loss) with predischarge serum total bilirubin described best predicts development of considerable hyperbilirubinemia.
      PubDate: 2019-02-23
      DOI: 10.18203/2349-3291.ijcp20190526
      Issue No: Vol. 6, No. 2 (2019)
       
  • Prevalence of urinary tract infection in febrile preschool children

    • Authors: Swatantar Singh, Sangeeta Parihar
      Pages: 320 - 324
      Abstract: Background: Children with fever is a common and comprise a substantial proportion of the practice in outpatient department and emergency department. Little attention has been focused on the identification of urinary tract infection (UTI) in febrile in infants and children in the emergency department, despite recent information that suggests a high prevalence of urinary tract infections and significant associated morbidity in these patients. The present study is undertaken to estimate the prevalence of urinary tract infection in febrile preschool children (less than 5 years of age) in febrile children.Methods: Febrile children less than 5 years attending outpatient department or admitted in Department of Paediatrics were enrolled into the study. Children below 1 month and above 5 years; any child who has received antibiotics 48 hours prior to evaluation; children with known congenital genitourinary anomalies; and were excluded from the study. Children with symptoms suggestive of UTI were interviewed using structured case record form (CRF). All symptomatic children were referred for urine routine microscopy and culture tests.Results: The prevalence of culture positive cases for UTI was 6.36%. Male infants and female infants affected equally. But females affected more in the age between 1 years to 5 years as compared to males. Apart from fever, the commonest symptoms were dysuria, abdominal pain, vomiting, chills and rigors and loss of appetite. More than two-third of the patients with CP-UTI have E. coli as causative organism for UTI. Overall most sensitive antimicrobials were Ceftriaxone.Conclusions: UTIs in preschool children are often having vague and variable symptoms, often fever is the only symptoms. An untreated UTI can lead to subsequent damage and impairment of renal structure and function, it is very important to diagnose and treat UTI in preschool children.
      PubDate: 2019-02-23
      DOI: 10.18203/2349-3291.ijcp20190677
      Issue No: Vol. 6, No. 2 (2019)
       
  • Meconium-stained amniotic fluid as a risk factor for perinatal asphyxia

    • Authors: Vidhi Mehta, Adarsh E., Spoorthi ., Archana ., Muhammed Hassan
      Pages: 325 - 328
      Abstract: Background: The aim of this study was to find out immediate fetal outcome in meconium-stained amniotic fluid in relation to perinatal asphyxia.Methods: This retrospective study includes medical records of all neonates admitted to Neonatal Intensive Care Unit (NICU) between December 2016 and July 2018. The variables reviewed are age, sex, weight, mode of delivery, gestational age, presence of meconium aspiration syndrome (MAS) and perinatal asphyxia.Results: Out of 408 total admissions in NICU, 69.1% were male babies and remaining 30.9% were female babies. In the study out of 36 subjects with Perinatal Asphyxia, 38.9% had MAS and 61.1% had not MAS. Out of 372 subjects without perinatal asphyxia, 93.8% had no MAS and 6.2% had MAS. There was significant association between MAS and perinatal asphyxia. Odds ratio was 9.656. i.e. those with MAS had 9.656 times higher risk for perinatal asphyxia.Conclusions: The management of MAS, which is a perinatal problem, requires a well concerted and coordinated action by the obstetrician and pediatrician. Prompt and efficient delivery room management can minimize the sequelae of aspirated meconium and decrease the chance of perinatal asphyxia in the new born babies.
      PubDate: 2019-02-23
      DOI: 10.18203/2349-3291.ijcp20190678
      Issue No: Vol. 6, No. 2 (2019)
       
  • Prevalence of protein energy malnutrition among children: a cross
           sectional study

    • Authors: Venkatesha K. R., R. Ravikumar Naik
      Pages: 329 - 332
      Abstract: Background: In the world, hunger and malnutrition are most significant threat. Malnutrition is global risk factor for significant death among infants and pregnant woman. malnutrition increases the chances of several infections.Methods: A cross sectional study was undertaken in children age group of 1 to 18 years, suffering from protein energy malnutrition, attending Department of Paediatrics, tertiary care hospital, Bangalore during the period January 2016 to December 2016. Results: In the present study, maximum number of cases (44) belongs to age group of 1-5 years, followed by 32 cases belongs to 6-12-year age group and 24 cases belong to 13-18-year age group. Maximum cases (59) belongs to female with male female ratio is 1:1.4. In the present study out of 100 cases, 81 cases came positive for protein energy malnutrition. Out of 81 cases positive for PEM, 34 cases belong to grade I followed by 24 cases belongs to grade II, 13 cases belong to grade III and 1o cases belongs to grade IV protein-energy malnutrition (PEM).Conclusions: Malnutrition is like an iceberg, most people in the developing countries live under the burden of malnutrition.
      PubDate: 2019-02-23
      DOI: 10.18203/2349-3291.ijcp20190679
      Issue No: Vol. 6, No. 2 (2019)
       
  • Prospective study of spectrum, clinico-epidemiology, profile complication
           and outcome of pesticide poisoning in children

    • Authors: K. Visweswara Rao, G. Ramesh, Anand Acharya
      Pages: 333 - 337
      Abstract: Background: Konaseema region of Andhra Pradesh is a rural area having well irrigated lands and rice fields. Agriculture is the major some of income, and pesticide use is high.  As per one report of deccan chronicle (a daily newspaper) Andhra Pradesh and Telangana accounts for 24% share of pesticide consumption in the country. Pediatric pesticide poisoning is under reported in India as well. In this background resent study has been designed to study clinic-epidemiology, profile, complication and treatment outcome of pesticide poisoning in Konaseema region of Andhra Pradesh.Methods: In present study clinico-epidemiology, clinical profile, complication and outcome of the patient admitted in the Department of Emergency medicine and Paediatric were evaluated over a period of 12years.Results: Most of the children were above 5years of age that is 74.0% (n=40), rest were below 5years of age. Male children out numbered female children and accounted for 77.78% (n=42). Accidental poisoning was more than suicidal poisoning that is 94.59% of the patients. 9.35% patient (n=5) developed respiratory failure and required ventilator support. Non-carcinogenic pulmonary edema was present in 8 (14.81%) patients. Four patients have atropine toxicity, electrolyte in balance was found in 7.4% (n=4) patients. Acute kidney injury was present in two patients, 5.5% (n=3) patients developed cardiac arrhythmia.Conclusions: Chlorpyrifos was common agent which is responsible for poisoning most common complication in our patients were respiratory complications which required ventilatory support. Lack of information, improper disposal of container, non-existence of training and regulation is supported to the cause of accidental exposure of pesticide to paediatric patients.
      PubDate: 2019-02-23
      DOI: 10.18203/2349-3291.ijcp20190680
      Issue No: Vol. 6, No. 2 (2019)
       
  • Finding out incidence of deafness among neonates at a tertiary care centre
           of western Rajasthan, India using otoacoustic emission

    • Authors: Ashish Gupta, Vinod Kumar
      Pages: 338 - 342
      Abstract: Background: Newborn hearing screening is conducted to identify suspected hearing loss and not to confirm the presence/absence of hearing loss or define features of the loss. Speech and hearing are interrelated, i.e., a problem with one could mean a problem with the other as speech and language is acquired normally through auditory system.Methods: A descriptive study conducted in the Department of Paediatrics, Dr. S. N. Medical College, Jodhpur, from June 2016 to December 2017. 5000 neonates were screened using otoacoustic emissions (OAE) in 2 stages at birth during 3rd to 7th day and 15-30 days respectively, followed by BERA at 3 months of age.Results: 1.4 infants per thousand infants had hearing loss. Presence of high-risk factors was seen to be associated be associated with hearing loss more than normal infants on screening with distortion product otoacoustic emissions (DPOAE) tests. However, on testing with BERA no such association was seen.Conclusions: 1.4 per 1000 infants had hearing loss. This study has shown that two stage distortion product otoacoustic emissions (DPOAE) hearing screening followed by british educational research association  (BERA) to confirm the hearing deficit, can be successfully implemented as new born hearing screening method in a hospital set-up, for early detection of hearing impaired, on a large scale, to achieve the high-quality standard of screening programs in a resource limited and developing nation like India.
      PubDate: 2019-02-23
      DOI: 10.18203/2349-3291.ijcp20190681
      Issue No: Vol. 6, No. 2 (2019)
       
  • A study on reliable diagnosis of allergic respiratory diseases by using
           eosinophil count in nasal and blood smear: a prospective study in tertiary
           care centre

    • Authors: Korisipati Ankireddy, Mallikarjuna M.
      Pages: 343 - 348
      Abstract: Background: Allergic rhinitis and asthma are two very common allergic diseases of respiratory tract in pediatric patients. In this geographical area, where the prevalence of allergens exists, the role of allergens as the etiological factor is higher in allergic respiratory disorders. Confirmation of allergen as etiologic agent is cumbersome in a small setup, where IgE estimation and allergy tests are not accessible. In this study, the simple test of peripheral smear and nasal smear eosinophil count as a reliable diagnosis to solve the above problem and establishing allergy as etiological agent has been tried.Methods: A present study which was conducted over 2 years in children between 2 to 12 years who visited tertiary health care centre, Kurnool medical college and general hospital. The allergic respiratory cases based on typical history and clinical features were included in the study and investigated for nasal and blood eosinophilia. Children with TB, recurrent and chronic pneumonia, malnutrition, malignancy, collagen vascular disorders and those who are on steroid therapy were excluded from the study. The clinical profile of allergic rhinitis with or without asthma and nasal and blood eosinophils are studied.Results: Out of 120 patients, there was male predominance and incidence was increasing as age increases. Dust is the most common risk factor for allergic rhinitis followed by weather changes, whereas in allergic rhinitis with bronchial asthma, weather change is common risk factor followed by dust and family history.Conclusions: In children with allergic rhinitis with or without bronchial asthma, there is positive relation between nasal and peripheral smear eosinophil count.
      PubDate: 2019-02-23
      DOI: 10.18203/2349-3291.ijcp20190682
      Issue No: Vol. 6, No. 2 (2019)
       
  • Mid-stream clean catch urine collection in newborns: a non-invasive and
           safe technique

    • Authors: Rajendra Kumar, Nithin ., Sudha Rudrappa
      Pages: 349 - 351
      Abstract: Background: The aim of this study is to determine the success rate and safety of a non-invasive technique to obtain clean-catch midstream urine samples in newborns.Methods: Prospective bedside clinical study. After obtaining written informed consent,120 consecutive newborns admitted in NICU with no dehydration, poor feeding, need for immediate urine sample by invasive method  for whom urine collection was advised for various reasons who met the inclusion criteria were included in the study with consent being taken from the parents. After adequate milk intake supra pubic and lumbar para vertebral areas were stimulated in repeated cycles of 30 s until micturition began.Results: Success rate in obtaining a midstream urine sample within 5 min. The success rate was 90%. The mean time taken to collect urine was 64.24s, for males it was 62.55s and for females 65.93s.Conclusions: The technique has been demonstrated to be safe, quick and effective. The discomfort and time consumption usually associated with bag collection methods as well as invasive techniques can be avoided.
      PubDate: 2019-02-23
      DOI: 10.18203/2349-3291.ijcp20190496
      Issue No: Vol. 6, No. 2 (2019)
       
  • Measuring impact of Surya Namaskar and Pranayama for management of child
           obesity in India

    • Authors: Gorav Kumar, Guneet Monga, Nilesh Gothi
      Pages: 352 - 357
      Abstract: Background: Obesity is fast becoming the developed world's greatest health problem. Moreover, childhood obesity is a major public health crisis nationally and internationally. The prevalence of childhood obesity has increased over few years. It is caused by imbalance between calorie intake and calories utilized.Methods: The current paper analyses the impact of Surya Namaskar and Pranayama on management of child obesity. For this purpose, a group of 120 respondents were selected for a 4-month program to measure that whether the program can improve their living standards or not.Results: The result revealed positive impact on the obesity of the participants, further the variables of their medical condition and living standards improvement is identified.Conclusions: One variable Rate_yoga_1 is predicting the Overall_quality of Surya Namaskar and Pranayama. Further, four variables medi_conImp_3, medi_conImp_2, medi_conImp_5 and medi_conImp_4 are predicting the medical condition improvement under session of Surya Namaskar and Pranayama, and two variables Livi_stanimpr_4 and Livi_stanimpr_3 are predicting the living standard improvement under session of Surya Namaskar and Pranayama.
      PubDate: 2019-02-23
      DOI: 10.18203/2349-3291.ijcp20190049
      Issue No: Vol. 6, No. 2 (2019)
       
  • Liver function tests to predict the severity of dengue fever in
           serologically positive children below 18 years of age

    • Authors: Yashwanth Raju H. N., Rajendra Kumar, Sudha Rudrappa
      Pages: 358 - 364
      Abstract: Background: Dengue fever presents with a diverse clinical spectrum. Although liver is not a major target organ, hepatic dysfunction is a well-recognized feature. In this study authors attempted to study the pattern of hepatic involvement in children with dengue and its association with disease severity.Methods: This was a cross sectional study conducted at Cheluvamba hospital during the period of 1 year. Children <18 years of age with dengue Ns1 Ag and IgM positive were included in this study. After obtaining informed consent, a pre-structured proforma was used to record the relevant information from each subject. After detailed clinical examination and haematological investigation children were categorized into three groups as dengue fever with no warning signs (DNWS), dengue fever with warning signs (DWWS) and severe dengue fever (SDF) according to WHO classification. Statistical analysis was done to know the strength of association between different clinical and biochemical variables and outcome of the disease.Results: The mean age of the study population was 8.65 years with male preponderance. The mean total bilirubin, serum albumin, SGOT, SGPT, ALP, PT and INR were 0.76 mg/dl, 3.8g/dl, 233.18U/L, 118.15U/L, 200.65 U/L, 12.9s and 1.09 respectively. The mean SGOT was significantly higher than SGPT. The degree of deranged LFTs was significantly more in SDF group than DNWS and DWWS groups. Serum albumin was significantly decreased in children with SDF group correlating with disease severity, prognosis and outcome.Conclusions: Hepatic dysfunction was present in all forms of dengue infection, with SGOT rising significantly more than SGPT. All biochemical liver parameters were significantly deranged in patients with severe dengue fever indicating prolonged illness and poor prognosis.
      PubDate: 2019-02-23
      DOI: 10.18203/2349-3291.ijcp20190069
      Issue No: Vol. 6, No. 2 (2019)
       
  • Association of vitamin D levels with simple febrile seizures in under five
           children: a case control study

    • Authors: Virender Singh, Preeti Sharma, Deepika Dewan
      Pages: 365 - 368
      Abstract: Background: There is increasing concern that vitamin D deficiency may play etiological role in Febrile seizures. Few studies have reported vitamin D deficiency in children with recurrent febrile seizures and hypocalcemia seizures.  The objective of this study is to explore vitamin D status in children aged 6 months to 5 years with first episode of febrile seizure and to find the association between vitamin D levels and febrile seizure.Methods: A hospital-based case control study was conducted in sub district hospital, Katra over a period of three years. Cases were children of age group 6 months to 5 years presenting with first episode of simple febrile seizure to the casualty or OPD. For each case, a control was selected with similar age group and same sex who came for short duration fever (<2 days) but without seizures. A 5ml of blood sample for measurement of 25 hydroxy vitamin D was taken from the peripheral vein of each participant by trained laboratory technician. In order to categorise various degrees of vitamin D deficiency, Indian Academy of paediatrics criteria was used. Results were presented in the form of percentages and Odds ratio was calculated as measure of association.Results: A total of 75 cases and 75 controls were included in the study. Cases and controls were comparable as per baseline characteristics. Strong and significant (p<0.01) association of febrile seizures with vit D levels was observed.Conclusions: There was a high prevalence of vitamin D insufficiency among cases of simple febrile seizure.
      PubDate: 2019-02-23
      DOI: 10.18203/2349-3291.ijcp20190019
      Issue No: Vol. 6, No. 2 (2019)
       
  • Early health issues in late pre-terms

    • Authors: Monica Choudhary, Kamna Jain
      Pages: 369 - 374
      Abstract: Background: Rates of preterm birth are increasing worldwide, mostly due to late preterm births (i.e. 34-36 6/7 weeks). The objective of the study is to calculate incidence of early morbidity and mortality in late preterm neonates (within first 7 days of life) compared with term neonates.Methods: It was a prospective cohort study. All live inborn late preterm infants (34 0/7 to 36 6/7 weeks) and term infants (37 0/7 to 41 6/7 weeks) who were born between November 2010 to October 2011. Study was done to find out early morbidity and mortality in late preterm births.Results: Present study included 256 late preterm infants and 498 term infants, amongst whom 95 (37.10%) late preterm and 98 (19.67%) term infants required NICU care (p<0.001). Late preterm infants were at significantly higher risk for overall morbidity due to any cause (P<0.001; Odds Ratio (OR):2.4; 95% CI: 1.7-3.3), respiratory morbidity (P<0.001; OR:3.64; 95% CI:1.7-7.4), neonatal depression (p<0.001; OR:2.94; 95% CI:1.00-8.62), any resuscitation/ventilation (P<0.05; OR: 3.1; 95% CI:1.15-8.31), probable sepsis (P<0.001; OR:11.2; 95% CI:2.5-49.8), confirmed sepsis (p=0.05; OR:7.7; 95% CI:0.9-63.9), or other problems like jaundice, hypoglycemia, hypothermia and feeding difficulty. The incidence of morbidity increased as gestational age decreases from 19.67% in term infants (>37 weeks) to 27.8%, 43%, 54.5% at 36, 35 and 34 weeks, respectively (P<0.001).Conclusions: The morbidity risk in late preterm births is 1.3 times more at 36 weeks, 2 times more at 35 weeks and 2.7 times more at 34 weeks as compared with term neonates. The mean cost of stay increased 1.8 times in the late preterm neonates as compared to the term neonates.
      PubDate: 2019-02-23
      DOI: 10.18203/2349-3291.ijcp20190005
      Issue No: Vol. 6, No. 2 (2019)
       
  • Clinico-laboratory profile of central nervous system infection by scrub
           typhus at a tertiary care hospital

    • Authors: Ruchi Jha, Anil Kumar Jaiswal
      Pages: 375 - 379
      Abstract: Background: Scrub typhus is an emerging epidemic in India. Its course can be complicated by involvement of Respiratory system, cardiovascular system, gastrointestinal system and central nervous system. Central nervous system involvement can lead to major morbidity and mortality.Methods: It is an observational study conducted in the Department of Pediatrics, Patna Medical College and Hospital, Patna from January 2016 to August 2018.  All cases of AES who were serologically proven to be due to scrub typhus were clinically examined, signs and symptoms were noted, and complete blood counts were done. Lumbar puncture was done, and CSF was sent for analysis of cells, sugar and protein, IgM for scrub typhus in CSF, gram staining and CSF culture.Results: Seventy-eight cases were tested positive for scrub typhus. Incidence of scrub typhus among AES cases was 19.4% in the study. Among cases of Scrub typhus, a male predominance and sex ratio was 1.68. Age at presentation ranged from 2 months to 12 years with a mean age of 7.28 years. Most of the cases were seen in the months of September and October with a mini peak in the month of March. Fever and Altered consciousness were present in all the cases. Among laboratory investigations, thrombocytopenia was the most common feature followed by raised Transaminases. CSF Analysis shows mildly increased cell count with lymphocytic predominance and presence of few polymorphs, sugar mildly decreased, and protein mildly raised.Conclusions: Scrub typhus is an important causative agent of AES in the Eastern parts of India. It should be suspected in cases which present as AES with symptoms of hepatosplenomegaly, thrombocytopenia, and elevated liver enzymes in addition to dengue encephalitis which forms its close differential.
      PubDate: 2019-02-23
      DOI: 10.18203/2349-3291.ijcp20190020
      Issue No: Vol. 6, No. 2 (2019)
       
  • Paediatric Jatropha poisoning: a retrospective study at Government General
           Hospital, Gulbarga, Karnataka, India

    • Authors: Shashidhar V., Sharanabasappa S. Dhanwadkar, Yogesh Khanage, Rakesh Navale, Ashwini Kumari N. B.
      Pages: 380 - 383
      Abstract: Background: Plant poisonings are one of the significant causes of accidental poisoning among pediatric age group. As jatropha is being increasingly being cultivated in new regions for its economic benefit as a source of biodiesel, accidental poisoning among children are being reported. As with many members of the family euphrobiaceae, Jatropha contains compounds that are highly toxic. Jatropha Curcas is one of the best oil seed plants and identified as most suitable oil seed bearing plant due to its various favorable attributes. The objectives of this study were to determine the spectrum of clinical presentation and morbidity and mortality related to this poisoning.     Methods: Data was collected from January 2012 to December 2013, total 19 cases of Jatropha were examined. Descriptive analyses and measures of central tendency were performed on the demographic data to describe the sample.Results: Overall 78 % of children presented with vomiting, pain abdomen and loose stool, while 15% were admitted with only complaints of vomiting, furthermore only 5 % had both symptoms of vomiting and loose stools. There was no mortality related to Jatropha poisoning out of 19 cases.Conclusions: In recent years there are increasing number of children being admitted to hospital with accidental ingestion of Jatropha seeds. Like in other reported studies present patients had predominant gastrointestinal symptoms and recovered well with supportive measures. There were no mortality or complications in present patients.  Extensive awareness among the rural community and medical fraternity alike is needed about this potential lethal plant poison. 
      PubDate: 2019-02-23
      DOI: 10.18203/2349-3291.ijcp20190006
      Issue No: Vol. 6, No. 2 (2019)
       
  • Neonatal sepsis in a tertiary care hospital in Delhi, India: study of
           microbial profile and antimicrobial susceptibility pattern

    • Authors: Sangita Gupta, Varun Kumar Singh, Sanjay Singhal, Priti Chowdhary
      Pages: 384 - 389
      Abstract: Background: Sepsis is one of the most common cause of neonatal deaths globally more so in low and middle-income countries. The key to management is high degree of clinical suspicion and prompt initiation of empirical antibiotic therapy pending investigations’ results. Knowledge of one’s own NICU flora and antimicrobial susceptibility pattern guides in choosing correct antibiotic therapy to pediatrician. If this data is standard and comparable across different sites, then it also helps in formulating regional and National treatment guidelines. Present study was therefore undertaken to study microbial flora of present NICU and analyze their antimicrobial susceptibility pattern and formulate antimicrobial policy.Methods: Data of blood culture isolates sent from suspected cases of neonatal sepsis received from January 2017 to July 2018 was analysed by “WHONET”.Results: One hundred ninety-three non-repeat isolates were obtained from 992 blood culture samples. Coagulase negative Staphylococcus and K. pneumoniae were the most common isolates. Non albicans Candida were responsible for majority of fungal infection. There was an outbreak of C. pelliculosa for six months. Most of the bacteria were multidrug resistant (MDR). However, except one all other Candida isolates were sensitive to antifungal drugs.Conclusions: WHO guidelines suggest use of penicillin and gentamicin for neonatal sepsis. But in present study, they were not found useful, instead amikacin, netilmicin and piperacillin-tazobactam were found useful and changes were made in antibiotic policy.
      Authors therefore recommend regular monitoring of antimicrobial susceptibility pattern followed by necessary changes in antibiotic policy for reasonable empirical therapy.
      PubDate: 2019-02-23
      DOI: 10.18203/2349-3291.ijcp20190036
      Issue No: Vol. 6, No. 2 (2019)
       
  • A study on clinical correlation of EEG in neonates with perinatal asphyxia

    • Authors: Rajendra Shinde, Kiran Haridas, Madhavi Shelke, L. S. Deshmukh, P. S. Patil
      Pages: 390 - 393
      Abstract: Background: Perinatal asphyxia is the most common and important cause of preventable cerebral injury occurring in the neonatal period. The WHO has estimated that 4 million babies die during the neonatal period every year. According to WHO, perinatal asphyxia is defined as the failure to initiate and sustain breathing at birth. The objective is to study the electroencephalographic changes and correlation between severity of Perinatal asphyxia with EEG changes.Methods: It is prospective observational study, which includes 40 term neonates admitted in NICU with perinatal asphyxia in GMCH Aurangabad. EEG analysis focused on background activity and classified into four categories.Results: The EEG was normal in 45%, mild abnormal in 25%, intermediate in 15%, and severely abnormal in 15%.  Outcome at discharge was normal in 19(47.5%) and abnormal in 21(52.5%) including 1 death. Abnormal outcome was seen in 27% of newborns with normal EEG and 72% of abnormal EEG.Conclusions: Severity of perinatal asphyxia correlated well with abnormality of EEG. EEG changes and severity showed good correlation with immediate outcome of newborn in terms of duration of hospitalization and normal neurological examination.
      PubDate: 2019-02-23
      DOI: 10.18203/2349-3291.ijcp20190683
      Issue No: Vol. 6, No. 2 (2019)
       
  • A study of prevalence of culture positive UTI in children: clinical
           profile, risk factor analysis, and microbiological profile

    • Authors: K. Rajendran, Kiruba Shankar
      Pages: 394 - 397
      Abstract: Background: Urinary infection is one of the common infections occurring in children. Different literature says different definition for UTI. Indian Academy of Pediatrics defines urinary tract infection as the growth of a significant number of organisms of single species in urine culture with the presence of symptoms of UTI. The objective is to study the clinical profile of children with urine culture positive UTI.Methods: The study was conducted in Kovai medical centre and hospital Coimbatore. The sample size is 150 children. The study population includes children with culture-positive UTI who are admitted between October 2015 to September 2016 over a period of 1 year. Child’s history was then recorded as answers to the pre-prepared questionnaire in a proforma. Clinical examination was done, and the findings were recorded. Blood sampling was done for all patients and sent to a laboratory to measure total count, differential count, ESR.Results: Previous urinary tract infection was present in 2.7% of children. All children had the same organism grown in urine culture as in previous episode suggesting unresolved or persistent bacteremia. This is comparable with the literature stating unresolved bacteremia as the most common type of recurrent.Conclusions: The study group in which the risk factors were analysed had a female preponderance (may be due to the short urethra, easy ascending infection). In present study population fever and increased frequency are two important symptoms followed by abdominal pain.
      PubDate: 2019-02-23
      DOI: 10.18203/2349-3291.ijcp20185518
      Issue No: Vol. 6, No. 2 (2019)
       
  • Correlation of clinical and laboratory parameters of acute
           glomerulonephritis in children

    • Authors: Chandra Sekhar Kondapalli, Kalyan Chakravarthy Gondi, Faisal Mohammed
      Pages: 398 - 405
      Abstract: Background: The present study was conducted to study the clinical and laboratory parameters of acute glomerulonephritis in children admitted in the department of Pediatrics, Katuri Medical College and Hospital, Guntur.Methods: A prospective study was done at Katuri Medical College and Hospital in all children who are clinically diagnosed edema, oliguria, Cola coloured urine and hypertension. Children presenting with Oliguria, Oedema, Haematuria, Hypertension, Pharyngitis or skin lesions were included, both genders male and female. 50 cases of post-streptococcal glomerulonephritis were evaluated by taking detailed history, thorough clinical examination and appropriate investigation were done for establishment of diagnosis. Lab investigations, CUE, RFT, ASO titres, Serum Complement were done. All the statistical analysis was performed by using EPI INFO 3.5-1. The results were expressed as percentages. Test of significance was done by chi square test. P<0.05 was considered significant.Results: 4156 cases were admitted, out of which 50 cases were having acute glomerulonephritis comprising of 1.2%. The incidence of glomerulonephritis was more from July to December. The sex ratio from male to female is 1.17:1. The incidence of glomerulonephritis was more in children coming from low socio-economic families. Signs wise analysis of glomerulonephritis, it was observed that puffiness of face, edema feet and hypertension were the common features. Incidence of hyper tension were more in male children than female children. The incidence of edema and proteinuria are the commonest clinical presentation. The comparison between incidence of oliguria and blood urea is statistically significant. 1/4th of patients of oliguria are associated with increase serum creatinine level.Conclusions: Acute glomerulonephritis is completely a preventable and completely curable disease if proper precaution is like personal hygiene is observed. Proper knowledge of pathophysiology of glomerulonephritis is important for proper management, institution on appropriate treatment and careful follow up of cases are the corner stones for successful outcome of patients.
      PubDate: 2019-02-23
      DOI: 10.18203/2349-3291.ijcp20185517
      Issue No: Vol. 6, No. 2 (2019)
       
  • Serum zinc level: a prognostic marker for severe pneumonia in children

    • Authors: I. Abhiram, Suresh Panchanathan, Rajaguru Ganesan, Antony Jenifer
      Pages: 406 - 410
      Abstract: Background: Pneumonia is one of the leading causes of under 5 mortality among children in developing countries. Zinc deficiency is postulated as cause of severe pneumonia, but evidences shows conflicting results on whether serum zinc levels predicts the severity of pneumonia. So prospective study was undertaken to study the relationship between serum zinc levels and severity of pneumonia in children with community acquired pneumonia.Methods: Fifty cases of pneumonia (group 1) and 50 cases of severe pneumonia (group 2) according to WHO classification were enrolled into the study. Demography, anthropometry and immunization status were recorded. A single zinc measurement was performed for all the patients within 24 hours of admission. The severity, clinical course including recovery to discharge was compared between two groups with respect to their serum zinc levels.Results: Mean (±SD) age group of the study population was 22 months±16.05 and 21.88 months±15.97 months in boys and girls respectively. Pneumonia was high in girls (59%) and children between 2 to <12 months had higher (36%) infection rate. Mean zinc level in pneumonia and severe pneumonia group were 68.69µg/dl±28.77 and 68.08µg/dl±27.55 respectively. There was no difference in the nutritional status (weight for height and height for age) of the study group. Serum Zn level was low in 56 % and 52% of pneumonia and severe pneumonia group respectively. Comparison of serum zinc levels between the ARTI groups did not achieve statistical significance (p=0.430). However, the duration of recovery is earlier than 1 week in pneumonia cases when compared to severe pneumonia patients (p<0.001, OR 1.375).Conclusions: Normal zinc levels was associated with early recovery in simple pneumonia patient, so study of serum zinc levels in severe pneumonia patients has prognostic value. 
      PubDate: 2019-02-23
      DOI: 10.18203/2349-3291.ijcp20190435
      Issue No: Vol. 6, No. 2 (2019)
       
  • Study of serum levels of CRP and procalcitonin as early marker of sepsis
           in children with sepsis above neonatal age group

    • Authors: Vinaya Kumar, Ramesh Neelannavar
      Pages: 411 - 415
      Abstract: Background: Sepsis caused by infection remains a major cause of mortality and morbidity among children.  Blood culture though gold standard requires lot of time for diagnosis, hence it’s necessary to rely on early diagnostic markers such as blood counts, micro-ESR, CRP, Procalcitonin. The objective of this study is to evaluate the serum levels of CRP, Procalcitonin as reliable and as early marker of sepsis in pediatric patients above neonatal age group.Methods: Children aged above neonatal age group with clinically suspected sepsis as per the definition given by the International Paediatric sepsis Consensus Conference were selected. Patients were classified as those with sirs, sepsis, severe sepsis and septic shock. Patients were divided into two groups one with culture proven sepsis and the other with non-culture proven sepsis. All patients had CRP, Procalcitonin levels measured at admission and 24hrs after admission. The primary outcome was to determine reliable marker in differentiating between the culture proven and non-culture proven sepsis, and to determine the early marker of sepsis.Results: Total 104 patients formed the study group, of which 42 belonged to SIRS group, 26 were sepsis, 19 were severe sepsis and 17 were septic shock. A total of 36 cases had culture positive. In present study PCT was found to be more reliable marker of sepsis as the sensitivity and specificity of PCT was more than CRP and AUC for PCT was significantly higher than CRP. PCT was found to be early marker as the AUC for CRP at 24hrs was significantly more than AUC for CRP at admission and there was no statistically significant difference between AUC for PCT at admission and 24 hours after admission.Conclusions: Both CRP and PCT levels have favourable test performance but PCT is more reliable. PCT is earlier to rise compared to CRP.
      PubDate: 2019-02-23
      DOI: 10.18203/2349-3291.ijcp20190037
      Issue No: Vol. 6, No. 2 (2019)
       
  • Clinical study of anemia in rural school children of Mangalore, Karnataka,
           India

    • Authors: Mahroof M. K., Shamshad Ahmed Khan, Prakash Saldanha
      Pages: 416 - 421
      Abstract: Background: The study was conducted to know the prevalence of anemia in rural school children located within 15km radius of Yenepoya Medical college hospital, Mangalore and to study the risk factors associated with anemia also to correlate the detection of anemia by clinical examination and by lab estimation of hemoglobin.Methods: A total of 550 children in the age group of 6-15 years were included in this study. Parental informed consent was obtained. A preplanner questionnaire was used to collect the health and socio demographic details. Blood was collected by venepuncture method and haemoglobin was determined by automated sysmex machine. Diagnosis of anemia was made according to WHO cut off value of Hb.Results: Out of 550 children 114(20.6%) were anemic. There was no significant difference between age and sex. Anemia was found to be more prevalent in children with h/o passing worms, undernourished, pica and low socio-economic status. Out of 550 children 174 children had conjunctival pallor on clinical examination. Among that 58 (33.3%) children had anemia on hemoglobin estimation. Majority of the children 116 (66.7%) who had pallor on clinical examination was found as non-anemic on hemoglobin estimation. On kappa co efficient, statistics showed that two examinations to detect anemia was 18.47 %, which indicates poor agreement.Conclusions: The overall prevalence of anemia among rural population is variable depending upon the region. Major factors which influence the prevalence of anemia were nutrition, socioeconomic status, pica and worm infestation. Clinical diagnosis by examination of pallor is poorly correlated by estimation of haemoglobin, hence anemia cannot be diagnosed by detection of pallor alone and it requires lab haemoglobin estimation to prevent wrong diagnosis of anemia.
      PubDate: 2019-02-23
      DOI: 10.18203/2349-3291.ijcp20190051
      Issue No: Vol. 6, No. 2 (2019)
       
  • SNAPPE II score: predictor of mortality in NICU

    • Authors: Sujana Rachuri, Saritha Paul, Jaidev M. D.
      Pages: 422 - 426
      Abstract: Background: Advances in the NICU (neonatal intensive care unit) have significantly decreased mortality and morbidity and increased survival rate in neonates. SNAPPE II (Score for Neonatal Acute Physiology-Perinatal Extension II) score, which is a modified version of the SNAP score (Score for Neonatal Acute Physiology) helps in predicting the neonatal mortality. The aim of the study was to assess the risk of mortality using SNAPPE II score in neonates admitted to NICU.Methods: It was a prospective validation study done in a tertiary care hospital. Data was collected from 116 new borns admitted to NICU within 48 hours of birth who required respiratory support between December 2017 to June 2018.Results: A total of 116 newborns admitted to the NICU was included in present study. Out of 116 babies, 56 (48%) had mild SNAPPE-II score, 44 (38%) had moderate score and 16 (14%) had severe score. Among the 44 babies with moderate score, 12 (27%) died, which was statistically significant (P<0.001). Among 16 babies with severe score, 13 (81%) babies died, which was highly statistically significant (P<0.0001). Urine output, seizures, serum pH in the first 24 hours of life are independent predictors of mortality with significant p value (0.001).Conclusions: The SNAPPE-II score recorded in the first 48 hours of life could be a good predictor of mortality in babies admitted to NICU.
      PubDate: 2019-02-23
      DOI: 10.18203/2349-3291.ijcp20190544
      Issue No: Vol. 6, No. 2 (2019)
       
  • Prevalence of HIV infection among children with TB and correlation of CD4
           cell count level with types of TB

    • Authors: Sivabalan T., Rajkumar G.
      Pages: 427 - 430
      Abstract: Background: Tuberculosis (TB) is the second most common cause of death from infectious diseases at the global level, being second only to HIV/AIDS. The present study has been undertaken to find out the prevalence of HIV infection among children with TB and correlation of CD4 cell count level with different types of TB.Methods: This cross-sectional study was carried out in children below 12 years who were diagnosed as having TB, using the modified Kenneth Jones criteria (742 TB infected children) between 2008 and 2010. Descriptive statistics were used to calculate the frequency, mean, median and standard deviation. The linear trend of proportions and trend of chi-square was used to find out the test of association.Results: The HIV prevalence rate among children with Tuberculosis was 9.7%. In TB/HIV coinfection, Pulmonary TB was 44 (61.1%), lymph node TB was 22 (30.6%), Central Nervous System TB was 4 (5.6%), abdominal TB was 1 (1.4%) and spine TB was (1.4%). Pulmonary TB was the most common type is the not significant, mild and advanced grade of immune suppression. CNS tuberculosis was the most common type in the severe grade of immune suppression. CNS TB occurred more commonly in children more than 60 months of age. Lymph node TB is the commonest type of tuberculosis in children with HIV coinfection less than 35 months of age.Conclusions: The prevalence of HIV among tuberculosis children was 9.7%. This prevalence rate indicates the need for routine screening of all newly diagnosed tuberculous children for HIV coinfection. 
      PubDate: 2019-02-23
      DOI: 10.18203/2349-3291.ijcp20190436
      Issue No: Vol. 6, No. 2 (2019)
       
  • Assessment of knowledge level on learning disability among primary school
           teachers

    • Authors: Basim Ali C. T., Fysal N., Akhila Thasneem A., Aswathy P. S.
      Pages: 431 - 435
      Abstract: Background: Learning disability (LD) is one of the major causes of poor scholastic backwardness. Undetected and unmanaged specific LDs result in chronic scholastic backwardness ensuing school dropouts, emotional and behavioral problems such as depression, substance abuse and social delinquency. Since teachers are the ones who first encounter academic difficulties of children, their knowledge and training on LD is of utmost importance in identifying it at an initial stage and to prevent further mental and social damage. This study is to assess the knowledge level of primary school teachers on learning disability.Methods: This cross-sectional study was conducted among government primary school teachers of Malappuram district, Kerala from April 16, 2018 to May 20, 2018.Convenient sampling method was adopted. The study sample consisted of 709 primary school teachers from 21 schools in Malappuram district of Kerala and the teacher’s knowledge level on learning disability was assessed using a questionnaire.Results: Even though majority of the teachers had some knowledge about the outcome and treatment of learning disability, they lack sufficient knowledge about its concepts and causes and it is grossly insufficient for its practical application in the class room.Conclusions: There is a need to improve the knowledge of primary school teachers on LD and to enhance their basic skills in recognizing learning disability at the earliest. This is very important for the management of these children by introducing and applying the appropriate remedial measures on time. This can go a long way in improving the quality of learning among children with poor scholastic performance.
      PubDate: 2019-02-23
      DOI: 10.18203/2349-3291.ijcp20190545
      Issue No: Vol. 6, No. 2 (2019)
       
  • Clinical profile of neonates admitted with hypernatremia in NICU at
           tertiary hospital in Vadodara, Gujarat, India

    • Authors: Nimisha Pandya, Kedar G. Mehta
      Pages: 436 - 439
      Abstract: Background: Neonatal hypernatremia is less common but significant  metabolic problem  with acute morbidity as well as long term consequences. Many causative  factors have been identified such  as inadequate breastfeeding, hot  weather with high  evaporative losses ,  infections etc. It is important to identify, anticipate and correct the condition before it leads to damaging consequences. The objective of the present study was evaluation of clinical profile, renal parameters and causative factors associated with hypernatremia in exclusively breast-fed infants.Methods: A retrospective review of  30 new-borns less than 28 days of age admitted in  GMERS General hospital for hypernatremia was conducted. The study group included inborn and out born admissions. Records were reviewed, feeding history, severity of hypernatremia and altered renal parameters were analysed. The study period was from April 2018to June2018i.e summer months.Results: Total NICU admissions were 303 during these months  out of which 30 were diagnosed  with hypernatremia completely and discharged. Mean age of presentation was 8.4 days. Sodium levels ranged from 146-179 mmol/l. Mild hypernatremia was most common (56.7%), followed by moderate hypernatremia in 40%. All neonates were on  exclusive breast feeding. Majority of the affected neonates were term SGA followed by term AGA and preterm AGA. Renal parameters were altered in quarter of affected  infants.  Most common clinical feature noted was lethargy(70%), followed  by fever(53.3%),significant weight loss ,jaundice and dehydration. 29 patients were successfully discharged on breast milk feeding.Conclusions: Hypernatremia though rare, is common in young infants in summer months. It is preventable and treatable condition. It is important to anticipate, identify and treat such patients at the earliest. Treating physicians and nursing staff should be more vigilant for establishment of breast feeding in low birth weight infants. Exclusive breast feeding for first six months of life should always be promoted.
      PubDate: 2019-02-23
      DOI: 10.18203/2349-3291.ijcp20190227
      Issue No: Vol. 6, No. 2 (2019)
       
  • Association of vitamin D deficiency with early onset sepsis in term
           neonates

    • Authors: Ashwani Kumar, Gursharan Singh Narang, Gurmeet Singh, Navneet Virk
      Pages: 440 - 444
      Abstract: Background: Vitamin D is a fat-soluble steroid hormone. Vitamin D also has immunomodulatory effects on immune function. Early onset sepsis (EOS) is characterized by signs and symptoms of infection with or without accompanying bacteremia in the first three days of life. The objective of the study was to determine the possible association between neonatal vitamin D levels and EOS in term neonates.Methods: 100 term neonates with clinical and laboratory findings of EOS (study group) and 100 healthy infants with no signs of clinical/laboratory infection (control group) were enrolled. Sera was drawn during first 3 postnatal days of life in both groups for measurement of 25-hydroxyvitamin D (25-OHD) levels.Results: Neonatal 25-OHD levels (17.4ng/dL) in the study group were significantly lower than those of the control group (26.8 ng/dL) (p=0.001). In present study negative correlation was found between vitamin D level and CRP.Conclusions: Lower neonatal 25-OHD levels are associated with EOS. Adequate vitamin D supplementation during pregnancy may be helpful to prevent EOS in term neonates.
      PubDate: 2019-02-23
      DOI: 10.18203/2349-3291.ijcp20190500
      Issue No: Vol. 6, No. 2 (2019)
       
  • The prevalence of malnutrition in children with cleft lip and cleft
           palate: a case-control study

    • Authors: Shashidhar V., Sharanabasappa S. Dhanwadkar, Ashwini Kumari N. B., Ravikumar Kurle, Rakesh A. Navale
      Pages: 445 - 448
      Abstract: Background: Children with cleft lip and cleft palate come across lot of impediment, hurdles in society. There are several social factors which hinders the proper nourishment of CL only, CP or CLP children, so majority of them tend to suffer malnutrition due to lack of standard care especially from their parents and society. Due to even low socio-economic status, impact on growth of these children is vexatious. However potential risk of malnutrition is particularly more during early childhood. Moreover, till date there are not much significant data on malnutrition in CL only, CP or CLP children. The aim of the study was to assess the prevalence of malnutrition in non syndromic CL only, CP or CLP in south India.Methods: Anthropometric parameters weight for age z score (WAZ), height for age z score (HAZ), of children with CLP were compared with age matched controls.Results: Prevalence of PEM and stunting for cleft group were 40% and 21.3% respectively compared to 33.33% and 17.33% for the control. Differences in the underweight, and stunting between the two groups were not statistically significant (χ2=2.83, p value=0.58, and χ2=1.48, p value=0.69 respectively).Conclusions: There is no statistically significant difference in the occurrence of malnutrition in children with non- syndromic cleft lip and Palate compared with control.
      PubDate: 2019-02-23
      DOI: 10.18203/2349-3291.ijcp20190448
      Issue No: Vol. 6, No. 2 (2019)
       
  • How safe are our children in our own homes' accidental ingestion in
           children: a 6 year retrospective study from a tertiary care centre

    • Authors: Sujay Kumar Earan, Revathi Krishnakumar, Sivaraman Sangili, Arulkumaran Arunagirinathan, Duvvur Preethika Reddy, Uma Maheshwari R.
      Pages: 449 - 453
      Abstract: Background: According to the World Health statistics, in 2016 more than 100000 deaths were caused due to unintentional poisonings. Children are vulnerable due to their smaller body surface area, an inherent behaviour of negation, curiosity in exploring their surroundings, their initial phallic stage where they tend to put any objects they come across into their mouth.Methods: This study is a hospital based retrospective observational study where the records of all the children admitted due to poisoning, accidental or intentional from June 2012 to November 2018 were reviewed. All the children admitted due to food poisoning and idiosyncratic drug reactions were excluded from the study.Results: A total of 203 cases of accidental ingestion were admitted during the study period, of which the majority of the patients were male children. The age group varied from 5 months to 14 years. Majority of the accidental ingestions were due to kerosene (108), followed by insecticides (25) and cleaning agents (20).Conclusions: Poisoning in young children is unintentional and accidental; hence the introduction of safe child resistant containers should be encouraged in storing harmful chemicals. Knowledge about the chemicals, awareness about their hazardous effects and education of the care givers about safe storage would be the first step in the prevention of accidental ingestion. Establishment of a reporting system from all the health care centres and establishment of poison information system at all the levels is the need of the hour.
      PubDate: 2019-02-23
      DOI: 10.18203/2349-3291.ijcp20190546
      Issue No: Vol. 6, No. 2 (2019)
       
  • Study on etiological profile of respiratory distress in new borns in a
           teaching hospital

    • Authors: C. P. V. Ramana Sastry, Maram Padmavathi
      Pages: 454 - 461
      Abstract: Background: The aim is to study the various risk factors associated with development of severe respiratory distress in the new born.Methods: This was a prospective study of 200 new-borns with respiratory distress. Clinical details, etiology for the respiratory distress, system-wise factors responsible for the distress, severity and duration of respiratory distress, oxygen therapy, type of treatment, mortality, maternal and antenatal risk factors, radiological findings were noted in all the cases and were analysed.Results: Of the 200 cases with respiratory distress, 118 (59%) had severe respiratory distress. 154 cases with distress were of respiratory system in origin out of which 45% (70 out of 154) were due to Meconium aspiration syndrome, 42% (64 out of 154) were due to Respiratory distress syndrome, 12% (18 out of 154) were due to transient tachypnea of new-born and 2% were due to congenital pneumonia. More number of female patients had severe respiratory distress. Mortality was 2.5%.Conclusions: Meconium aspiration syndrome is the most common cause of respiratory distress in new born. Almost 60% of new borns with respiratory distress developed severe respiratory distress who required intensive monitoring. Risk factors like meconium stained liquor, vaginal delivered new borns, preterm gestation age, and female gender of new born were associated with severe respiratory distress in new borns.
      PubDate: 2019-02-23
      DOI: 10.18203/2349-3291.ijcp20190449
      Issue No: Vol. 6, No. 2 (2019)
       
  • Prevalence of hypomagnesemia in children admitted to pediatric intensive
           care unit and its correlation with patient outcome

    • Authors: Siddappa F. Dandinavar, Suma D., Vinod H. Ratageri, Prakash K. Wari
      Pages: 462 - 467
      Abstract: Background: Magnesium deficiency is common in critical illness and is said to be associated with increased need for mechanical ventilation, mortality and prolonged ICU stay. The knowledge of hypomagnesemia is essential as available data is scarce and it could have prognostic and therapeutic implications. This study was undertaken to estimate the prevalence of hypomagnesemia at the time of admission in PICU and its correlation with length of PICU stay, duration on mechanical ventilator and outcome at the end of hospital stay-death or discharge.Methods: This is a prospective observational study including 343 children aged 1month to 12years admitted to PICU. Detailed history taking and clinical examination was done for all enrolled children. At admission, blood was collected for estimation of serum magnesium. Patients were categorized into three groups i.e., hypomagnesemia, normomagnesemia and hypermagnesemia and data was analysed.Results: Out of 343 children, 28% had hypomagnesemia, 7.3% had hypermagnesemia and 64.7% had normomagnesemia. Hypomagnesemia was more common in neurological disorders. No association was found between magnesium and length of mechanical ventilation. PICU stay was significantly longer in hypomagnesemia group (p=0.031). 37.5% patients with hypomagnesemia also had hypocalcemia and 35.4% had hypokalemia. Mortality rate was higher in those with hypomagnesemia (30.2%) compared to those with normomagnesemia (22.1%).Conclusions: Patients with hypomagnesemia had increased duration of PICU stay, other associated electrolyte abnormalities and higher mortality. Hence monitoring of magnesium levels in critically ill patients is indicated.
      PubDate: 2019-02-23
      DOI: 10.18203/2349-3291.ijcp20190228
      Issue No: Vol. 6, No. 2 (2019)
       
  • Clinical course of dilated cardiomyopathy in children

    • Authors: Sivakumar E., Ramasubramaniam P.
      Pages: 468 - 472
      Abstract: Background: Dilated cardiomyopathy (DCM) in children is a serious disorder. Here authors study the risk factors for predicting prognosis of dilated cardiomyopathy in children.Methods: An observational case series study done in Institute of child health and research centre, Government Rajaji hospital, Madurai during September 2012 to August 2014. The diagnosis of DCM was based on clinical examination and echocardiographic evidence. Patients were followed up and grouped according to the outcome as improved or cured (group I), no change in clinical status (group II) and worsened or dead (group III).Results: 31 children less than 12 years of age were diagnosed as DCM. 13 children came under group I with a mean age of 2.15±2.5 and the mean cardiothoracic diameter ratio in chest X-ray was 59.8±3.3. The mean left ventricular ejection fraction at the time of admission was 38.7±3.04 and was 52.1±2.7 on last follow up. 11 children came under Group III with a mean age of 5.35±4.4 and the mean cardiothoracic diameter ratio was 65.3±2.7. The mean left ventricular ejection fraction was 35.8±3.7 at admission and 32.6±2.9 on last follow up. Only two children came under Group II and hence their comparison is negligible.Conclusions: Children with higher age at the time of diagnosis, higher cardiothoracic diameter ratio in chest X-ray and a low left ventricular ejection fraction on serial echocardiogram were associated with a poor outcome.
      PubDate: 2019-02-23
      DOI: 10.18203/2349-3291.ijcp20190501
      Issue No: Vol. 6, No. 2 (2019)
       
  • Are adolescents studying in private schools more obese' a comparative
           study among adolescents from different types of schools in Kerala, India

    • Authors: Aby Dany Varghese, Geethu Mathew, Anoop Ivan Benjamin
      Pages: 473 - 476
      Abstract: Background: Adolescent obesity is a serious public health challenge of this century. It is associated with many factors including sleep patterns among adolescents.Methods: This cross-sectional study was conducted in Pathanamthitta district, Kerala. Adolescents studying in high school and higher secondary classes were included using stratified random sampling. Study tools included a structured questionnaire and anthropometric measurements.Results: 657 students were enrolled from Government, Government-aided and Private schools. The mean age of the participants was 15.09±1.33 years. The overall prevalence of overweight and obesity was 13.8% and 6.5% respectively. Students in private schools were found to have higher prevalence of overweight (17.8%) and obesity (9.8%) compared to Government-aided (15.3% and 5.4%) and Government schools (8% and 4.5%). Students with lesser sleep duration had higher BMI values. Factors such as higher age, family income, parental education, lack of regular physical activity were associated with obesity. Students with more siblings and family members had low BMI compared to others.Conclusions: High prevalence of overweight and obesity was observed among adolescents especially among private school students. Inadequate sleep duration was also found to be associated with obesity. Primary prevention approach aimed at spreading adequate awareness among students, parents and teachers should be practiced. 
      PubDate: 2019-02-23
      DOI: 10.18203/2349-3291.ijcp20190527
      Issue No: Vol. 6, No. 2 (2019)
       
  • Study of foot length as an alternate measurement for assessment of
           gestational maturity in neonates

    • Authors: Ananya S. L. Tenali, Ravi Kumar Tenali
      Pages: 477 - 481
      Abstract: Background: The aim was to study neonatal foot length as a simple method for quick gestational age assessment which can be done by basic healthcare personnel overcoming the technicality required by other assessment methods.Methods: Prospective descriptive study was done. Live born neonates at Saveetha Medical College, Kanchipuram from June 2016 to June2017 were enrolled. Gestational age was assessed by New Ballard’s Scoring and footlength was measured using the paddle blades of automated digital Vernier calipers within 24 hours while birth weight was taken within 72 hours of birth. Based on gestational age, babies were grouped into preterm, term and post term and were subclassified as small for gestational age (SGA), appropriate for gestational age (AGA) and large for gestational age (LGA) based on Lubchenco’s intrauterine growth chart. Correlation and regression analysis and Scattergram was done.Results: Out of 300 neonates, term, preterm and post-term were 70.3%,28.3% and1.3% while SGA, AGA, and LGA babies were 9%, 88% and 3%. Mean foot length was 7.728cm±0.59 with a range of 5-8.8cm. Foot length strongly correlated with gestational age in Preterm AGA, SGA and Term AGA babies (<0.001). Correlation coefficient of foot length with gestational age was higher in preterms (r=0.95). Gestational age in 54% of study population could be calculated with the derived regression equation derived.Conclusions: Foot length maybe useful for quick estimation of gestational age in preterm and term neonates for early referral of newborns requiring special care and can even be done by basic healthcare personnel.
      PubDate: 2019-02-23
      DOI: 10.18203/2349-3291.ijcp20190684
      Issue No: Vol. 6, No. 2 (2019)
       
  • A study on efficacy of oral administration of colostrum fortified
           lactoferrin in the weight gain of low birth weight infants

    • Authors: Raghul Jayaseelan, Chidambaranathan Sivaprakasam, Logesvar Palanisamy
      Pages: 482 - 486
      Abstract: Background: Low birth weight babies is the result of being small for gestational age (i.e. under 10th percentile of the reference population) and preterm (i.e. before 37 weeks of gestation. Preterm infants have higher protein, calorie requirement, which cannot be met with unfortified breast milk feeds.Methods: This study was conducted prospectively in the Department of Pediatrics, Rajah Muthiah Medical College and Hospital, Chidambaram from October 2016 to April 2018. 20 low birth weight babies were selected by randomization technique and they were administered with 2 grams of oral colostrum fortified lactoferrin daily for 4 weeks. The rate of weight gain, length gain and head circumference gain were assessed prospectively for a period of 4 weeks. They were analysed statistically by ANOVA and tabulated. Babies weighing less than 2.5 kg and on exclusive breast feeding, were included. Babies more than 2.5kg and less than 1kg, at risk for neonatal sepsis, congenital heart disease, necrotizing enterocolitis were excluded from the study.Results: In the present study, 20 low birth weight babies were included. 11 maternal risk factors were identified. Out of which anemia stands as a single risk factor. The rate of weight gain in oral colostrum fortified lactoferrin, is 320 grams with P value of 0.703 which is not statistically significant. The rate of length gain is 3.3cm, p value is 0.093 which is statistically insignificant. The rate of head circumference gain in oral colostrum fortified lactoferrin is 2.8cm, with the p-value of 0.001 which is statistically significant.Conclusions: The rate of weight and length gain was normal, but the rate of head circumference gain is significantly increased in oral colostrum fortified lactoferrin supplementation.
      PubDate: 2019-02-23
      DOI: 10.18203/2349-3291.ijcp20190685
      Issue No: Vol. 6, No. 2 (2019)
       
  • Blood culture positive sepsis and sensitivity pattern in a tertiary care
           neonatal centre in eastern India

    • Authors: Soumini Rath, Santosh Kumar Panda, Manas Kumar Nayak, Deepti Damayanty Pradhan
      Pages: 487 - 490
      Abstract: Background: The objective of this study is to evaluate sensitive pattern of causative organisms of neonatal sepsis with its clinical outcome in a tertiary neonatal care unit of eastern India.Methods: This retrospective observational cohort study was done in a tertiary care hospital of Odisha. All the blood culture positive neonatal sepsis cases, excluding neonates with multiple congenital malformations, diagnosed during January 2017 to December 2018 were analysed using descriptive summary statistics.Results: A total of 73 neonatal sepsis cases were diagnosed by BacT/Alert and VITEK-2 blood culture method. Among them, 50 (68%) babies had gram negative sepsis,14 (19%) cases of gram-positive sepsis and nine (13%) cases of fungal sepsis. In present study 38 (52%) cases were early onset sepsis, 38(52 %) babies were term, 55(75%) were male and 44 (60%) babies were out born. Klebsiella pneumonia and Acinetobacter were the most common organism in early onset and late onset sepsis respectively. Among gram negative organism (GNB), 66% were multi drug resistant. A fifty percent of gram-negative organism were sensitive to meropenem and 28% were sensitive to piperacillin/tazobactam. The sensitivity of GNB to colistin, ciprofloxacin, amikacin was 76%, 64% and 56% respectively. The sensitivity of gram-positive organisms to linezolid, vancomycin, teicoplanin and penicillin were 92%, 85%,85% and 20% respectively. Survival rate among culture positive sepsis was 83%.Conclusions: Multi drug organisms are emerging in modern neonatal care practice. Practice of antibiotic stewardship may save the babies from multidrug resistance organism in future.
      PubDate: 2019-02-23
      DOI: 10.18203/2349-3291.ijcp20190686
      Issue No: Vol. 6, No. 2 (2019)
       
  • Clinical study of babies born through meconium stained amniotic fluid

    • Authors: Shilpasri Y. M., Madhurya B.
      Pages: 491 - 496
      Abstract: Background: Meconium stained amniotic fluid has been considered a sign of fetal distress and associated with poor fetal outcome, but others considered meconium passage by fetus is physiological phenomena and produce environmental hazards to fetus before birth. Such magnitude of different opinion was the object behind taking up of this study and aim was to find out incidence and effect of meconium in terms of morbidity and mortality.Methods: Two hundred babies born with meconium stained amniotic fluid considering the inclusion and exclusion criteria from December 2012 to June 2013 in the Department of Paediatrics, Cheluvamba hospital attached to Mysore Medical College and Research Institute, Mysore. Fetal monitoring, mode of delivery, Apgar score, birth weight, resuscitation of baby are noted. All babies followed-up up to 1st week of neonatal life.Results: In present study 200 babies born through meconium stained amniotic fluid was randomly selected-thin 37% and thick 63%. Major complications like birth asphyxia, meconium aspiration syndrome, early neonatal death seen in 5.5% (11 cases), morbidity in 37%, 12.5% in thin and 24.5% in thick MSAF. Causes of death were meconium aspiration syndrome in 3 cases, sepsis in 1 case, pneumonia in 1 case and birth asphyxia in 6 cases.Conclusions: Immediate airway management, need for suction and intubation should be guided by state of newborn rather than presence of meconium. Timely diagnosis and management of meconium stained amniotic fluid may improve fetal outcome. From present study authors conclude that MSAF adversely affect fetal outcome mostly by thick meconium.
      PubDate: 2019-02-23
      DOI: 10.18203/2349-3291.ijcp20190687
      Issue No: Vol. 6, No. 2 (2019)
       
  • A study to assess the association between early childhood caries and
           relationship of Streptococcus mutans in saliva of mother, child and
           sibling pairs

    • Authors: Ashwini Avanti, Sucheeth Avanthi, Shivaprakash P. K., Kiran Raj H., Sawinderjith Saini, Pooja M. Naik
      Pages: 497 - 501
      Abstract: Background: Early childhood caries (ECC) is a specific form of rampant caries that initially affects the primary maxillary anterior teeth of infants and children.  According to American Academy of Pediatric Dentistry (AAPD) 2011, early childhood caries is defined as the presence of one or more decayed (non-cavitated or cavitated lesions), missing (due to caries) or filled tooth surfaces in any primary tooth in a child under the age of six. The objective of this study was to assess the association between early childhood caries and relationship of Streptococcus mutans in saliva of mother, child and sibling pairs.Methods: Group 1 consists of fifty children with early childhood caries along with their mothers and siblings with the child age between 15 months to 5 years and sibling’s age between 4 years to 10 years, whereas group 2 consists of fifty caries free children along with their mothers and siblings. For both groups, saliva samples were taken from the child, mother and sibling pairs to estimate the Streptococcus mutans count and to determine pH of saliva in these children. DMFT scores, debris scores checked for child, mother and sibling pairs.Results: Streptococcus mutans count was significantly high in group 1 than that of the group 2. Mothers were more co related to the children in the acquisition of Streptococcus mutans than the siblings. Increased no of meals of the child, pacifier use, low socio-economic status and low maternal education showed significant high correlation with caries prevalence. Low pH score was also significantly correlated with the increase in caries rate.Conclusions: Maternal factors such as high DMFT scores, low education levels, prolonged bottle-feeding with sweetened milk, pacifier use are strong risk indicators for identifying high caries-susceptible children.
      PubDate: 2019-02-23
      DOI: 10.18203/2349-3291.ijcp20190437
      Issue No: Vol. 6, No. 2 (2019)
       
  • Knowledge and beliefs of parents of asthmatic children presenting to the
           outpatient department in Kovai medical centre and hospital, Tamil Nadu,
           India

    • Authors: Rajendran ., P. Aarthi
      Pages: 502 - 506
      Abstract: Background: Childhood asthma has a major impact on a child’s quality of life and that of their parents. To assess the level of understanding and beliefs by parents of asthmatic children about causation, pathophysiology, treatment, and prognosis.Methods: The study was conducted in Kovai medical centre and hospital Coimbatore in 2017. Totally 101 asthmatic children were included in the study. Asthmatic children aged 6 years to 15 years. A total of 101 parents participated in this study. The sex and age of the informant, mother’s literacy and mother’s occupation were noted. The socio-economic status of the family was computed using modified Kuppuswamy scale 2016.Results: In present study among the 101 children, 38.61% are in the school age (5-8 years), 38.61% are in the tweens (9-12 years) and 22.78% are teenagers. 45.54% of the children are from the rural area. Half of the children are experiencing the disease for more than 6 years now, the other half less than 6 years. 5.94% of the parents interviewed were not aware of the diagnosis. 71.29% thought that asthma is a hereditary condition.Conclusions: A wide gap exists between recommendations and the actual practice. Hence by improving parents’ knowledge about asthma, their attitude and practice can be positively affected.
      PubDate: 2019-02-23
      DOI: 10.18203/2349-3291.ijcp20185520
      Issue No: Vol. 6, No. 2 (2019)
       
  • Evaluation of congenital heart disease clinically and by echocardiography
           in children of age group 0-12 years

    • Authors: Chandra Sekhar Kondapalli, Kalyan Chakravarthy Gondi, Sravya Madana
      Pages: 507 - 514
      Abstract: Background: The present study was conducted to evaluate clinical and echo-cardio graphic findings of congenital heart disease in children of age-group 0-12 years attending present hospital.Methods: A study was done at Katuri Medical College and hospital in 65 patients aged 0-12 years; both sexes; for a period of 2 years. study design is exploratory, with proforma been designed to study congenital heart diseases. Alexander Nada’s criteria is used.Results: Out of 4145 cases; 65 cases aged 0-12 years have congenital heart disease over a period of 2 years; (acyanotic 55 cases and cyanotic 10 cases). 23 cases are between 1-5 years and 20 cases are >5 years; 1/3rd cases diagnosed before 1 year of age. male 40 cases and female 25 cases. Urban cases-27 and rural cases are 38.48 cases have consanguinity and family history in 12 cases. extra cardiac manifestations in 6 cases. Normal sized heart with normal vascularity of lung was seen in 14 / 65 cases. 51/65 cases showed various radiological features depending on type of lesion based on echo findings. Among the ACHDs VSD was the commonest CHD seen in children. Among the cyanotic heart diseases TOF was the commonest CHD observed, comprising of 6 cases.Conclusions: Chest X-ray was abnormal in 80% of cases with increased CT ratio in 58.3% cases. ECG was abnormal in 73.3% of cases and majority of them had left axis deviation.95%of CHDs, including ACHDs and CCHDs which were diagnosed clinically include ASD, VSD, PDA, AS, PS, CoA, TOF, TGA. Most common clinically diagnosed CHD was VSD. Clinico echo correlation was accurate in 75% cases. Clinico echo correlation was highest with isolated lesions like VSD, ASD and in cases with typical findings like CoA, PDA, AS, TOF and least with multiple lesions or atypical findings.
      PubDate: 2019-02-23
      DOI: 10.18203/2349-3291.ijcp20185516
      Issue No: Vol. 6, No. 2 (2019)
       
  • Prevalence and risk factors associated with severe acute malnutrition
           (SAM) in ICDS block of rural Hubli, Karnataka, India

    • Authors: Shivanand Illalu, Naveen Kumar P., Vinod H. Ratageri, Prakash K. Wari
      Pages: 515 - 521
      Abstract: Background: Malnutrition is one of the leading causes of morbidity and mortality in children under the age of five years in developing countries. Despite economic growth of nearly 10% per annum, in India in 2006 the NFHS-3 indicated that 6.4% of children below 60 months of age were suffering from severe acute malnutrition. This study was undertaken to know the prevalence and the risk factors associated with SAM in ICDS block of rural Hubli.Methods: This was a cross sectional observational community based study conducted in the ICDS block of rural Hubli. All children in the age group of 0- 59 months were included in the study. The study is conducted by the department and it is self-funded by the authors, no monetary benefit either from the institute or from the government or its organization.Results: Among 1796 children who were examined in present study, the prevalence of SAM children was 5.79% (104 children). 48% were in the age group of 37 months to 59 months. Male: female ratio was 2:3. 51% of the mothers and 47.1% of fathers were illiterate. 82.7% of the parents had per capita income belonged to class 5 of the modified B.G. Prasad classification. 60% of the SAM children were seen in families who had 3 or 4 children. Maternal anemia, IUGR and PIH were seen in 53.6%, 21.6% and 18% respectively. Low birth weight (<2.5kg) and Birth asphyxia were seen in 80.6% and 11.1%.Conclusions: The risk factors for SAM were illiteracy, low per capita income, high order births, maternal anemia, IUGR, PIH, low birth weight and Birth asphyxia. Due emphasis should be given in improving the knowledge and practices of the parents on appropriate infant and young child feeding practices.
      PubDate: 2019-02-23
      DOI: 10.18203/2349-3291.ijcp20190497
      Issue No: Vol. 6, No. 2 (2019)
       
  • Comparison of midupper arm circumference and weight-for-height z score for
           assessing acute malnutrition in children aged 6-60 months: an analytical
           study

    • Authors: Nirali Mehta, R. G. Bhatt, Hetal Vora, Bharat Parmar
      Pages: 522 - 526
      Abstract: Background: In clinical settings, wasting in childhood has primarily been assessed with the use of a weight-for-height z score (WHZ), and in community settings, it has been assessed via the mid upper arm circumference (MUAC) with a cutoff <115mm for severe wasting and 115-125mm for moderate wasting. Our recent experience indicates that many wasted children were not identified when these cutoffs for MUAC were used.Methods:
      Authors determined the cutoffs for MUAC to detect wasting in Indian children aged 6-60 mo. A secondary analysis was carried out on data from 1446 children aged 6-59 mo. The area under the receiver operating curve was used to indicate the most appropriate choice for cutoffs that related MUAC with WHZ. The MUAC measurement of each subject was taken using standard technique. Following the World Health Organization (WHO) age and sex-specific cut-off points, nutritional status of children was determined.Results: The mean±SD age for the entire group was 19.8±13.6 mo, MUAC was 132±13mm, and 45% of subjects were girls. Age-stratified analyses revealed that, for ages 6-24 mo, MUAC cutoffs were <120mm for a WHZ <-3 and <125mm for a WHZ <-2 with a sensitivity of 68.3% and 64.7%, respectively, and a specificity of 82.6% and 83.4%, respectively; for ages 25-60 mo, MUAC cutoffs were <135mm for a WHZ <-3 and <140mm for a WHZ <-2 with a sensitivity of 63.7% and 65.4%, respectively, and a specificity of 81.6% and 78.3%, respectively.Conclusions: The respective cutoffs for MUAC to better capture the vulnerability and risk of severe (WHZ <-3) and moderate (WHZ <-2) wasting would be <120 and <125mm for ages 6-24 mo, <135 and <140mm for ages 37-60 mo.
      PubDate: 2019-02-23
      DOI: 10.18203/2349-3291.ijcp20190525
      Issue No: Vol. 6, No. 2 (2019)
       
  • A prospective study to determine etiology, clinical profile and
           neurodevelopmental outcome of neonatal seizures admitted in newborn unit
           of Chengalpattu Medical College and Hospital, Tamil Nadu, India

    • Authors: Yalaguraswami B. Kolkar, Madhivannan Sailavasan
      Pages: 527 - 534
      Abstract: Background: Newborn with neonatal seizures is at risk of neurodevelopmental delay. The aim of this study was to determine the factors affecting the adverse outcome of neonatal seizures and to study the significant factors associated with poor neurodevelopmental outcome in neonatal seizures.Methods: This was a prospective study done at neonatal intensive care unit (NICU) in Chengalpattu Medical College during the period from June 2017 to September 2018. A total of 110 neonates with seizures admitted in NICU from first hour of life to 28 days of age were included in the study. Detailed history was collected in preformed proforma, and followed up to one year and neurological assessment done at 4th month, 8th month and 1 year. The Hammersmith infant neurological examination (HINE) was done at 4 and 8 month and the Bayley–III assessment was done at 1 year of age to determine the neurodevelopment outcome.Results: Out of 110 newborns with seizures, 86 cases were followed up to 1 year of age. Neurological assessment done by HINE determined abnormal neurodevelopment in 33.6% neonates. Bayley-III scale assessment found cognitive delay in 10.9%, language delay in 20%, motor delay in 5.55%, socio-emotional delay in 30%, and adoptive delay in 31.8% cases. Delayed developmental outcome is significantly associated with onset of seizures, frequency of seizure, poor 5 minute Apgar score, abnormal EEG, and hypoxic ischemic encephalopathy (HIE).Conclusions: The delayed developmental outcome high among the neonates with subtle and myoclonic seizures. Mortality and neurological impairment was after neonatal seizure is associated with Onset and frequency of seizures, low Apgar score at 5 min, findings of USG cranium, CT brain, EEG, and HIE.
      PubDate: 2019-02-23
      DOI: 10.18203/2349-3291.ijcp20190688
      Issue No: Vol. 6, No. 2 (2019)
       
  • The practice of exclusive breastfeeding: its socio-demographic
           determinants in Kashmir, North India

    • Authors: Suhail A. Naik, Mohd. Irshad, Ghulam Rasool, Wasim A. Rafiq
      Pages: 535 - 539
      Abstract: Background: Breastfeeding is a well-established and recommended intervention for the improvement of child nutrition. Formula feeding is a major public health problem. Objective of the current study was to know the significance of demography, socioeconomic, parental education and employment and mode of delivery on exclusive breast-feeding Kashmir, North India.Methods: A prospective hospital-based study, carried out in the Department of Pediatrics, G.B Pant Hospital Srinagar Kashmir India over the period from 2014 July to June 2015. A teaching, research and tertiary care hospital at Srinagar Kashmir North India. All the mothers who were having infants in the age group 0 to 6 months were included in study. Procedure of this variables recorded were modes of feeding, demographics, socioeconomic status, literacy level, mode of delivery, place of delivery etc.Results: A total of 600 mothers were included in study. Less than 35% of mothers were exclusively breast feeding their infants. Exclusive breast feeding was significantly high in babies born by normal vaginal delivery, more than 3 antenatal visits, mother knowing advantages of breast feeding and higher parental education.Conclusions: Exclusive breast feeding is very low (less than 35%) in this part of world and formula feeding is a major public health problem.
      PubDate: 2019-02-23
      DOI: 10.18203/2349-3291.ijcp20190050
      Issue No: Vol. 6, No. 2 (2019)
       
  • A study to evaluate the prognostic significance of thrombocytopenia among
           critically ill children

    • Authors: Suneel C. Mundkur, Ranjani Upadhyay, Shrikiran A. Hebbar, Pushpa Kini, Nalini Bhaskarananda, Sowmya Shashidhara
      Pages: 540 - 544
      Abstract: Background: Pediatric critical care differs from Adult critical care not only in age but also in the outcomes. There are no studies regarding thrombocytopenia in the pediatric population. Therefore, in the current study, our objective was to study the prevalence and, the severity of thrombocytopenia, clinical features, and prognostic significance of low platelet count as an independent predictor of mortality and prolonged hospital and ICU stay.Methods: This was a prospective observational study conducted at tertiary care paediatric intensive care unit in India. Children between 1 month to 18 years admitted to the Pediatrics intensive care unit with thrombocytopenia due to any cause at admission were involved in the study. Detailed history was documented. Haemoglobin levels, total leucocyte counts, platelet counts, and platelet indices were recorded on the first and fourth day of admission. Outcomes were analysed in term of survivors and non-survivors and duration of ICU and hospital stay.Results: The study group consisted of 150 children with mean age of 8.458(± 5.604) years. Majority of children in the study group had severe thrombocytopenia 77 (51.3%). Moderate and mild thrombocytopenia was seen in 35(23.3%) and 38(25.4%) children respectively. Infection (50.66%) was the most common cause of thrombocytopenia, followed by sepsis (10.66%). Sepsis (27.5%) was observed to be the most common cause of mortality. Rise in platelet count on the fourth day among survivors, and no survivors were observed in 79.1% and 15.9% respectively.  Failure of the rise in platelet count on the fourth day of admission was significantly associated with mortality (p value=0.001). The severity of thrombocytopenia does not correlate with duration of hospital and ICU stay.Conclusions: Platelet counts and indices at the time of admission to a critical care unit have limited use as a prognostic marker for predicting mortality in children.
      PubDate: 2019-02-23
      DOI: 10.18203/2349-3291.ijcp20190428
      Issue No: Vol. 6, No. 2 (2019)
       
  • A clinical study on management of hydronephrosis detected antenatally

    • Authors: Ravindra G. Khasnis, Rajshankar S.
      Pages: 545 - 548
      Abstract: Background: It is important to detect and manage hydronephrosis early for improved clinical outcomes. The objective of this study is to detect and manage the hydronephrosis which occurs antenatally.Methods: Hospital based cross sectional study was carried out in 20 cases of hydronephrosis in pregnant women as per the inclusion and exclusion criteria laid down for the present study. Patients with mild hydronephrosis were observed. Patients with PUJ obstruction underwent pyeloplasty. Patients with posterior urethral valves underwent cystoscopic dilatation. Patients with VUR were put on prophylactic antibiotic and observed. The patients were followed up post operatively with USG and DTPA scan as indicated.Results: Among the 20 cases with hydronephrosis, majority were males. All cases in terms of side affected were found to be equally distributed. Hydronephrosis was found to be mild in seven (35%) of the cases. Renal dysplasia and bilateral hydronephrosis were found to be the predictors of post natal pathology. Grade 3 and grade 4 were 40% each. There was no persistent case. The most common cause of hydronephrosis was transient hypertension in 5 (33.3%) of the cases.Conclusions: Mild hydronephrosis resolves early and there is no persistence. Renal dysplasia and bilateral hydronephrosis are the important predictors of the post natal hydronephrosis.
      PubDate: 2019-02-23
      DOI: 10.18203/2349-3291.ijcp20190438
      Issue No: Vol. 6, No. 2 (2019)
       
  • Biochemical indices and radiological examination to evaluate bone health
           in children with β-thalassemia major

    • Authors: Madhu P. K., Bhagwan B.
      Pages: 549 - 555
      Abstract: Background: β-Thalassemia major is a serious hematological problem requiring regular blood transfusions. In regularly transfused thalassemic patients, metabolic bone disease is an important cause of morbidity. Problems include bone pain, deformities, short stature, osteopenia/osteoporosis, rickets, osteomalacia, spinal deformities, nerve compression and fractures. This study was undertaken to evaluate the status of bone health in children with β-thalassemia major by selected biochemical indices and radiological examination.Methods: Fifty children with β- thalassemia major were enrolled. Detailed history, examination and anthropometry were done. Serum calcium, phosphorus, magnesium, alkaline phosphatase, and vitamin D levels were measured. X-ray of skull, wrist, and knee were studied for radiological changes. Biochemical indices were analysed with appropriate statistical tests.Results: Stunting and wasting was observed in 58% and 44% children respectively. Hypocalcaemia was seen in 22%, hyperphosphatemia in 56% and 24% children had raised alkaline phosphatase levels. Vitamin D levels were severely deficient in 12%, deficient in 50%, and insufficient in 38% of children. There was no significant difference between vitamin D levels of cases and controls. Radiologically almost all children had a range of osteopathy, like thinned out cortex (96%), medullary expansion (54%), loss of density (40%), diffuse osteoporosis (18%) and growth arrest lines were seen in 8% children.Conclusions: Vitamin D abnormalities and radiological features suggestive of decreased bone mineralization are seen in all the children with β-thalassemia major treated with periodic blood transfusion at this institute. No biochemical predictors of bone disease in these children were identified. 
      PubDate: 2019-02-23
      DOI: 10.18203/2349-3291.ijcp20190071
      Issue No: Vol. 6, No. 2 (2019)
       
  • Clinical and socio-demographic profile of children with hearing impairment
           who had undergone cochlear implant surgery

    • Authors: Jaishree Ambhore, Nitesh Upadhyay, Minhajuddin Ahmed
      Pages: 556 - 558
      Abstract: Background: The aim was to analyze the clinical and socio-demographic profile of children with hearing impairment who had undergone cochlear implant surgery in a tertiary care centre in central India.Methods: This was a retrospective study conducted in Department of Pediatrics, Chirayu Medical College and Hospital, Bhopal, Madhya Pradesh during the period from January 2014 to December 2017 to find out clinical and socio-demographic profile of cochlear implant patient.Results: A total of 114 patients have been operated via posterior tympanotomy (MPTA) approach at present centre. Out of which 61(54%) were males and 53(47%) were females with a mean average age 5 years and 11 months. The number of patients with right ear defect were 107 (93%) whereas with left ear were as low as 7 (6%).  Most of the patients with cochlear disease were from lower socio-economic class and was not highly educated who lived in rented or kachcha houses. They were mostly living in big families with limited space with minimum earnings. 90% of the total patients had normal siblings with no deafness and only family had previous deaf child whose male baby was operated.Conclusions: Present study highlights that problem of hearing impairment is prevalent in population. Although treatment for this condition is freely available under Government scheme, but lack of awareness results in late presentation to facilities. There is a need to spread awareness amongst the population and regular screening at birth.
      PubDate: 2019-02-23
      DOI: 10.18203/2349-3291.ijcp20190095
      Issue No: Vol. 6, No. 2 (2019)
       
  • Assessment of the utility of Yale observation scale as a predictor of
           bacteremia in children aged 3 months to 36 months

    • Authors: P. Sudhakar, P. Ajitha
      Pages: 559 - 563
      Abstract: Background: The Yale observation scale (YOS) is an illness severity helps to diagnose bacteremia based on simple noninvasive clinical signs and symptoms. The aim of the present study was to assess the utility of YOS as a predictor of bacterial infection in febrile children aged 3 to 36 months.Methods: This prospective observational study was conducted on 200 children aged 3 to 36 months presenting with fever, at the Institute of Child Health and Hospital for Children during the period from April 2016 to September 2016. Rectal temperature was taken for all children. Clinical examination was done as required based on the YOS and scores were given accordingly at the time of initial presentation of the child before invasive investigations. All the observation was assessed statistically and receiver operating characteristics (ROC) curve was performed to analyze the sensitivity of the YOS.Results: Highly significant correlation (p=0.0001) was found to exist between the age of the child, duration of the fever, higher body temperature >104, WBC count, ANC and improved condition of patient with higher YOS. ROC curves showed that the sensitivity and specificity of YOS at the best cut off value of 14.5 was found to be 97% and 79.6% respectively.Conclusions: YOS is very good tool for predicting bacteremia in young febrile children based on simple non-invasive clinical signs and symptoms. The findings ruled out by YOS aids in the immediate and early management of bacterial infections before the arrival of the results of the biochemical diagnostic tests.
      PubDate: 2019-02-23
      DOI: 10.18203/2349-3291.ijcp20190081
      Issue No: Vol. 6, No. 2 (2019)
       
  • Prevalence and determinants of nocturnal enuresis in school going children
           in Southern Maharashtra, India

    • Authors: Dayanand P. Nakate, Sunil S. Vaidya, Shahaji Y. Gaikwad, Ramesh S. Patil, Manoj S. Ghogare
      Pages: 564 - 568
      Abstract: Background: Nocturnal enuresis or bedwetting is a common health problem in children in the age group of 5 to 15 years. In India the prevalence of nocturnal enuresis ranges from approximately 7% to 12.6%. The prevalence from other parts of the world ranges from 6% to 42%. This study was planned to find the prevalence and determinants of nocturnal enuresis in school going children.Methods: This cross-sectional study was conducted in four primary and secondary schools in Solapur. A predefined questionnaire, prepared in English and translated to local languages, Marathi and Kannada, was handed over to all the children attending the selected schools. Children were asked to hand over the questionnaire to their parents and return with the filled questionnaire. The questionnaire was prepared to obtain the information related to the socio-demographic factors of the family and child, frequency of enuresis and information related the risk factors. Nocturnal enuresis was defined if the frequency of enuresis was more than twice per week.Results: The overall prevalence of nocturnal enuresis was 11.4 %. The maximum prevalence was found in the age group of 8 -9 years (22.96 %). The prevalence of nocturnal enuresis in boys (14.34 %) was significantly more than the prevalence in girls (8.31 %). The study showed that nocturnal enuresis was significantly associated with stress, poor school performance, sleep pattern (hard to awaken), family history, burning micturition etc. But it was not associated with maternal or paternal education, birth order, type of family.Conclusions: The prevalence of nocturnal enuresis is 11.40 % in school going children and it is associated with age, sex, stress, family history, burning micturition, hyperactive child, poor school performance, sleep pattern (hard to awake) avoidance of going to micturate before sleep etc. 
      PubDate: 2019-02-23
      DOI: 10.18203/2349-3291.ijcp20190427
      Issue No: Vol. 6, No. 2 (2019)
       
  • A study of etiology, clinical profile and outcome in children aged 1-12
           years presenting with fever of 1-3 weeks duration in a tertiary hospital

    • Authors: Kavitha Devarajulu, Prabu Velusamy
      Pages: 569 - 573
      Abstract: Background: The objective of the study was to find out the etiology, associated signs and symptoms of fever of 1-3 weeks in the age group of 1-12 years and their outcome following treatment in a tertiary care hospital.Methods: This was an observational prospective study conducted at Institute of child health and hospital for children, Egmore, Chennai during the period from January 2011 to October 2012. A total of 621 children aged 1-12 years with 1-3 weeks of fever were included in the study. Demographic, clinical and diagnostic data were collected and analyzed for each patient and outcome was assessed for different types of febrile illness.Results: Out of 621 patients enrolled in the study, enteric fever was diagnosed in majority cases followed by respiratory tract infection, urinary  tract  infection  in  102  (16.4%), leptospirosis in 78 (12.6%), malaria in 60(9.7%), dengue fever in 8 (7.7%) rickettsia infection in 36 (5.8%), tuberculosis in 24 (3.9%), CNS infection in 18 (2.9%), viral hepatitis in12 (1.9%), malignancy in 5(0.8%), connective tissue disorder in 4 (0.6%), localized infection in 2 (0.3%) cases. The incidence was unknown in 10 patients (1.6%). Fever and vomiting were the common symptom seen in all the patients. Mortality was observed 18 (2.94%) cases.Conclusions: The similarity of illness and complexity in etiological conditions demonstrates the complications of diagnosis and treatment of fevers. The present study findings provided rationale information for development of guidelines necessary for treatment and thereby reducing the mortality rate in children of age 1-12 years with incidence of febrile illness.
      PubDate: 2019-02-23
      DOI: 10.18203/2349-3291.ijcp20190073
      Issue No: Vol. 6, No. 2 (2019)
       
  • A study on symptoms of children mechanically ventilated in a paediatric
           

    • Authors: Korisipati Ankireddy, Aruna Jyothi K.
      Pages: 574 - 577
      Abstract: Background: Mechanical ventilation, a lifesaving intervention in a critical care unit is under continuous evolution in modern era. Despite this, the management of children with invasive ventilation in developing countries with limited resources is challenging. The study analyses the clinical profile, indications, complications and duration of ventilator care in limited resource settings. Methods: A retrospective study of critically ill children mechanically ventilated in an intensive care unit of a tertiary care government hospital.   Results: A total of 120 children required invasive ventilation during the study period of 1 year. Infants constituted the majority (70%), and males (65%) were marginally more than female children (35%). Respiratory failure was the most common indication for invasive ventilation (55%). The major underlying etiology for invasive ventilation was bronchopneumonia associated with septic shock (30%); and the same also required a prolonged duration of ventilation of >72 hours (35%). Prolonged ventilator support of >72 hours predisposed to more complications as well as a prolonged hospital stay of >2 weeks and above, which was statistically significant. Upper lobe atelectasis (50%) and ventilator associated pneumonia (25%) were the major complications. The mortality rate of present study population was 40% as opposed to the overall mortality of 10%.   Conclusions: Present study highlights that critically ill children can be managed with mechanical ventilation even in limited resource settings. The child should be assessed clinically regarding the tolerance to extubation every day, to minimise the complications associated with prolonged ventilator support.
      PubDate: 2019-02-23
      DOI: 10.18203/2349-3291.ijcp20190689
      Issue No: Vol. 6, No. 2 (2019)
       
  • Clinical characteristics of childhood vitiligo in Nigeria

    • Authors: Ehiaghe L. Anaba, Adebola O. O.
      Pages: 578 - 582
      Abstract: Background: Literature specifically documenting clinical characteristics of childhood vitiligo are few when compared to the documentation in adults in Nigeria. This study aims to document the clinical characteristics of childhood vitiligo.Methods: This was a retrospective cross-sectional study of 35 children diagnosed to have vitiligo from January of 2005 to December of 2010 at the dermatology outpatient clinic of the University College Hospital, (UCH) Ibadan. A proforma was used to extract socio-demographic variables and clinical features from the chats. Ethical clearance for the study was given by the research and ethics committee of the hospital.Results: Over the 5 year period, 35 out of 264 children were diagnosed to have vitiligo giving an incidence of 13.3 %. The children were made up of 34.3% males and 65.7% females. At presentation, 71.4% of the children were aged 0-10 years. In 80% of the children, age at onset of vitiligo was before age 10 years especially at age 6-10 years. The commonest area of onset was the face/scalp (51.4%) and the commonest type of vitiligo was segmental. Severity of vitiligo was <9% in 97.1% of cases. Vitiligo was in an exposed part of the body in 88.6% of the children. Only females had the genitalia as area of onset of vitiligo.Conclusions: Childhood vitiligo is mainly segmental, re-pigments well and occurs more in females. Only females have the genital area as the area of onset.
      PubDate: 2019-02-23
      DOI: 10.18203/2349-3291.ijcp20190690
      Issue No: Vol. 6, No. 2 (2019)
       
  • Clinical profile of type 1 diabetes mellitus among children in eastern
           part of Nepal

    • Authors: Dipak Muktan, Lisa Tamang (Ghising), Rupa Rajbhandari Singh
      Pages: 583 - 587
      Abstract: Background: The objective of this study is to determine the clinical profile of Type 1 diabetes mellitus (T1DM) among children.Methods: Descriptive cross sectional study was conducted at B.P. Koirala institute of Health Sciences (BPKIHS), Dharan, Nepal, the eastern part of Nepal. A total of 42 diabetic children of less than 20 years old diagnosed with T1DM were included in the study. Data were collected via semi-structured interviews and medical records of patients attending diabetic clinic at the time of follow up.Results: The mean age at diagnosis of disease was 11.1±4.9 years. Polyuria 33 (78.6%) was found to be the commonest symptom followed by polydipsia 27 (64.3%), weight loss 23 (54.8%) and polyphagia 13 (30.9%). The mean duration of symptoms before diagnosis was 14.3±9.7 days. DKA was present in 25 (59.5%) children at the time of diagnosis. Mean Glycosylated hemoglobin (HbA1c) value was 10.6±2.7. Obesity was observed in 9 (21.4%) children. Nine (21.4%) children had family history of diabetes. In most of the cases, primary caregiver was mother, among them only 24 (57.2%) had formal education. Almost half of the caregivers were using FRIO, an insulin cooling case, for insulin storage.Conclusions: Polyuria was the most common presenting symptom followed by polydipsia, weight loss and polyphagia. Moreover, most of the children had landed up in diabetic keto-acidosis (DKA) at the time of diagnosis. Therefore, community awareness programs should be emphasized among parents and primary health care workers especially in rural areas regarding T1DM for early recognition and prompt treatment.
      PubDate: 2019-02-23
      DOI: 10.18203/2349-3291.ijcp20190691
      Issue No: Vol. 6, No. 2 (2019)
       
  • Clinico-epidemiological profile of hepatitis A virus and hepatitis E virus
           

    • Authors: Shikha Handa, Sanober Wasim, B. P. Kalra, Anil Rawat, Vipan Chandar, Alpa Gupta
      Pages: 588 - 592
      Abstract: Background: Hepatitis-A virus (HAV) and Hepatitis E virus (HEV) are two major hepatotropic viruses of great public health importance in the developing countries like India. Both HAV and HEV are enterically transmitted and there are speculations that their co-infection might be associated with a more severe clinical course and increased rate of mortality. The objective of this study is to determine the prevalence, clinical features and biochemical parameters of Hepatitis A and Hepatitis E co-infection in hospitalized patients at a tertiary care centre in Uttarakhand.Methods: It is a retrospective study, covering a period of 4years and conducted in Himalayan Institute of Medical Sciences, SRHU Jolly Grant, Dehradun. Records of the patients with Hepatitis A and Hepatitis E co-infection were retrieved and analyzed.Results: Out of total 125 patients of acute viral hepatitis, 13 patients had HAV and HEV co-infection. 100% of the patients with co-infection presented with complaints of fever and jaundice, followed by 76.92% with vomiting, 69.23% with pruritis, 61.53% with pain in abdomen and 23.07% with altered sensorium. Mean Bilirubin, ALT, AST were 8.69±7.27 mg/dl, 2030.69±1726.93IU/L and 1880.07±1881.11IU/L respectively. Average duration of stay was 8.2 days. Encephalopathy was seen in 2 patients. However, no mortality was reported.Conclusions: Co-infection of HAV and HEV is not rare in pediatric age group. Knowledge about this will be of immense help for planning of future vaccination strategies and for better sanitation program in developing countries like India.
      PubDate: 2019-02-23
      DOI: 10.18203/2349-3291.ijcp20190692
      Issue No: Vol. 6, No. 2 (2019)
       
  • A comparative study of morbidity pattern among term and late preterm
           infants in a tertiary care hospital

    • Authors: Kiran Haridas, Rajendra Shinde, Pritesh Nagar, Hemant Parakh
      Pages: 593 - 597
      Abstract: Background: The incidence of preterm birth, defined as delivery before the end of the 37th week of pregnancy from the first day of the last menstrual period, is increasing. India accounts for the 40% of the global burden of low birth weight babies with 7.5million babies born with a birth weight of <2500g. The objective of the study is to compare the morbidity suffered by the late preterm infants with that of term infants.Methods: This was a retrospective study and the data for this study came from the medical records of maternal and neonatal case sheets and discharge summaries. The data was collected for the period between January 2014 and December 2014. All the late preterm infants born and admitted during early neonatal period were compared with term infants who were born and admitted during early neonatal period to the Aditya Hospital on the basis of maternal, infant and clinical characteristics.Results: A total 292 infants including LPTI and term infant records were obtained. LPTI group had significant problems compared to term infants. The predominant clinical problems at birth and during the early neonatal period are neonatal jaundice, transient tachypnea of newborn, feeding difficulty and probable sepsis.Conclusions: LPTI are at increased risk of morbidity compared to term infants and hence require special attention and care for possible complication during their early neonatal period.
      PubDate: 2019-02-23
      DOI: 10.18203/2349-3291.ijcp20190693
      Issue No: Vol. 6, No. 2 (2019)
       
  • Study of serum calcium, phosphorus and vitamin D status in multitransfused
           β-thalassemia major children and adolescents of Jharkhand, India

    • Authors: Zeeshan Ahmed, Pushpanjali ., Md. Shahnawaz Kausar, Doyel Sinha
      Pages: 598 - 601
      Abstract: Background: The pattern of levels of calcium, phosphorous and vitamin D levels among the patients with thalassemia major undergoing repeated blood transfusions remain unexplored. Only very few studies have been undertaken among Indian population. The present study was an attempt to determine the levels of calcium, phosphorous and vitamin D levels among thalassemia major patients undergoing repeated multiple transfusions.Methods: In a prospective observational study, 65 patients suffering from β-thalassemia major, aged 2-18 years, having undergone regular blood transfusion and chelation therapy, were evaluated for the levels of serum calcium, phosphorus and vitamin D and the values were compared to the standard values of the same.Results: The mean values of serum calcium (6.72±0.66), phosphorous (5.51±1.07) and vitamin D (13.12±2.9) were significantly lower in our patients as compared to that of standard population values, the difference in each being statistically significant (p<0.05).Conclusions: It is evident from the present study that the levels of calcium, phosphorous and vitamin D are deficient among β-thalassemia major patients on repeated blood transfusion. The deficiencies may be due to iron overload or due to nutritional deficiency. Frequent monitoring and supplementation in deficient states is recommended.
      PubDate: 2019-02-23
      DOI: 10.18203/2349-3291.ijcp20190694
      Issue No: Vol. 6, No. 2 (2019)
       
  • Study to determine gender variation in severe acute malnutrition at
           nutrition rehabilitation centre

    • Authors: Suguna S., Vidyasagar V.
      Pages: 602 - 606
      Abstract: Background: The objective of this study is to know the gender variation in number of admissions, severity of malnutrition at the time of admission, gaining of weight and adherence to follow up in children admitted to nutrition rehabilitation center and during follow up.Methods: This is a retrospective study involving the review of existing programme records. Children who were admitted to nutrition rehabilitation centre, district hospital, Chamarajanagar, Karnataka, India, between January 2017 to December 2017 with severe acute malnutrition were involved in the study. The programme included 2 weeks of in-patient care, and four follow-up visits to the NRC subsequently as follows; 1st visit at 7 days, 2nd at 14 days, 3rd at 1 month and 4th at 2 months after discharge.Results: Among 57 children who admitted to NRC females were 30 (52.6%) and males 27 47.4%). 25 among 57 children (43.9%) could sustain weight gain of >5grams/kg/day as per one of the discharge criteria. 13 (52%) were females and 12 (48%) were males. 32(56%) among 57 admitted children to NRC, could achieve <-1SD during entire programmed. 15(46.8%) were females and 17 (53.1%) were males.Conclusions: There was no gender variation in either number of admission or severity of malnutrition at the time of admission or weight gain during NRC programme.
      PubDate: 2019-02-23
      DOI: 10.18203/2349-3291.ijcp20190695
      Issue No: Vol. 6, No. 2 (2019)
       
  • The outcome of resurgence of diphtheria in older children in a tertiary
           care hospital

    • Authors: Sachin K. R., Ramesh H., Sachin K. G., Siddharth E. S.
      Pages: 607 - 610
      Abstract: Background: Diphtheria is a fatal bacterial infection which affects the mucous membranes of oropharyngeal and nasal cavity, caused by aerobic gram-positive bacteria Corynebacterium diphtheriae. With the advent of universal immunization against diphtheria the incidence of this infectious disease has declined dramatically with few developed nations having eradicated the disease. No large outbreaks have been reported in India in recent times.Methods: In present study, authors reviewed an outbreak of diphtheria in Davangere between the months of June 2017 and July 2018. Case records of children suspected to have diphtheria, admitted to hospitals affiliated to JJM Medical College, Davangere were retrospectively analysed.Results: 15 cases were suspected to have diphtheria on clinical examination. The mean age of presentation was 7.5 years. Fever, sore throat, difficulty in swallowing, neck swelling and patch in oral cavity were the common signs and symptoms. Airway compromise, myocarditis and neurological complications were noted. Antidiphtheritic serum (ADS) was tried in all 15 cases. Case fatality rate was 40%.Conclusions: Diphtheria is a resurgent problem in India. Prompt identification and early appropriate treatment is essential to prevent morbidity and mortality. Strict adherence to the national immunisation schedule should also be emphasized.
      PubDate: 2019-02-23
      DOI: 10.18203/2349-3291.ijcp20190696
      Issue No: Vol. 6, No. 2 (2019)
       
  • A study on sleep patterns and sleep problems in children aged 6 to 15
           years as perceived by their parents

    • Authors: Riya Mary Tharakan, K. Varadraj Shenoy
      Pages: 611 - 614
      Abstract: Background: The objective is to study the sleep pattern and occurrence of sleep problems in children aged 6 to 15 years, visiting the Outpatient clinic at a tertiary care hospital, as perceived by the parents and to establish the common causal association as perceived by the parents for developing sleep problems.  Methods: The study design was based on the descriptive study. The duration of the study was from 1st June to 31st July. Data was collected from all the children visiting the Pediatric OPD and those who are admitted, Department of Pediatrics, Father Muller Medical College. Sample size: convenient sampling. Considering the prevalence of sleep disturbance in children as 10%, estimated error of 5% and confidence interval of 5%, sample size was 139. Children who followed the inclusion and exclusion criteria were considered for the study. Informed consent was taken from the parent. Relevant details were asked to the parents of the child and a pre-designed proforma was filled by the investigator accordingly. SDSC questionnaire was used and a cut off score of 39 was considered.Results: Out of the 140 children who completed the survey, 48% of the children had sleep disturbances.  The most common was disorder of initiating and maintaining sleep. The most common association was with need for accompaniment, followed by use of gadgets. The prevalence of sleep disorders is underestimated, and it is important to recognize them early.Conclusions: The increasing use of electronic gadgets could be a possible cause of sleep disturbances, which suggests that the exposure of children to these gadgets maybe reduced.
      PubDate: 2019-02-23
      DOI: 10.18203/2349-3291.ijcp20190697
      Issue No: Vol. 6, No. 2 (2019)
       
  • A qualitative study on experiences of mothers about control of diarrhoea
           of their children

    • Authors: Kanai Lal Barik, Uttam Kumar Paul
      Pages: 615 - 620
      Abstract: Background: Diarrheal disease poses a significant problem to the health, wellbeing and survival of children of less than five-year age group and is the second leading cause of mortality.  Most of the deaths are due to dehydration and it can be preventable by proper and timely use of oral rehydration salt solution (ORS). There is lack of awareness among the mothers about the appropriate use of ORS during diarrhea of children. So, authors have tried to find out the experiences of the mothers about the management of diarrhea of their children.Methods: The study is one of qualitative descriptive type involving 27 mothers of children who are suffering from diarrhoea in face to face in depth interviews (IDI).Results: The mothers of children were within the age group of 21 to 34 years of age group. On the basis of qualitative data analysis, the present study shows the data related to childhood diarrhea can be classified under six themes. The themes are : 'Perception of the participant mothers about the diarrhea of their babies', 'Measures taken by the mothers to combat diarrhea at home', 'How Oral rehydration salt solution is applied by the mothers', 'How Oral rehydration salt solution is beneficial', 'How Oral rehydration salt solution is causing undesirable effects on the baby' and 'What additional measures taken to control diarrhea of the baby'.Conclusions: There are several misconceptions and lack of awareness of the mothers about management of diarrhoea. However, it is possible to create awareness among them so that they can take all suitable measures to control diarrhoea.
      PubDate: 2019-02-23
      DOI: 10.18203/2349-3291.ijcp20190698
      Issue No: Vol. 6, No. 2 (2019)
       
  • Study of antenatal and postnatal factors affecting catchup growth in
           intrauterine growth retarded babies during first year

    • Authors: Vamsee Krishna Polepalli, Venu Gopala Sarma, Suresh Reddy D.
      Pages: 621 - 624
      Abstract: Background: The burden of IUGR is concentrated mainly in Asia with the proportion of IUGR 54% in India. Higher rates of IUGR should be a cause of concern because they signal high risk of malnutrition, morbidity and mortality for the new born. This study was done to see the factors affecting catchup growth (CUG) of IUGR babies during first year.Methods: The study was done in 120 SGA babies for a period of 18 months from October 2013 to March 2015. Antenatal, postnatal factors and anthropometry at 1st, 2nd, 3rd, 6th, 9th and 12 months were noted and analysed.Results: 78.3% babies showed CUG with in the first year. Preterm IUGR infants showed better CUG than full term. Asymmetric IUGR infants showed better CUG than symmetric. Teenage pregnancy, hypertensive disorders, multiple pregnancies, cardiac disease, anemia, type of IUGR, NICU stay, type of feeding, socioeconomic status, mother age, mother height, mother hemoglobin, gestational age, multiple gestation, birth weight, birth length, head circumference at birth all influenced CUG.Conclusions: Teenage pregnancies should be avoided. In SGA babies of pregnancy induced hypertension and preeclampsia, failure in CUG occurred more, these babies need to be followed in high risk clinics. SGA infants of mothers with low haemoglobin failed to show CUG, so antenatal nutrition improvement of mother should be done. Breastfed babies had higher CUG rates than formula fed babies, so exclusive breastfeeding should be promoted.
      PubDate: 2019-02-23
      DOI: 10.18203/2349-3291.ijcp20190699
      Issue No: Vol. 6, No. 2 (2019)
       
  • Clinicoepidemiology, clinical profile and outcome of venomous snake bite
           in children in Konaseema region of Andhra Pradesh, India

    • Authors: K. Visweswara Rao, G. Ramesh, Anand Acharya
      Pages: 625 - 629
      Abstract: Background: Venomous snake bite is an acute medical emergency, and children are more quickly and severely affected than adult. Venomous snake bite is responsible for 28.5 deaths per 1000 snake bite death among 5-15years old children. Most of them used to be from rural India and is more common in school going children. But there is no study regarding clinic epidemiology and treatment outcome among pediatric age group in this part of Andhra Pradesh. This retrospective descriptive has been conducted to evaluate the clinic epidemiology, clinical presentation, complication and treatment outcome in snake bite in pediatric patients in our set up.Methods: Present study is a retrospective, descriptive study conducted in the department of paediatrics Konaseema institute of medical science Amalapuram Andhra Pradesh, between 2006 to September 2018. This study protocol is approved by the institutional ethics committee. All the clinical parameters like, age, sex, season of bite, time of bite, socio economic statue, region, site, common clinical presentation, complications, reaction to ASV outcome of treatment were obtained from patient’s case record and was analysed.Results: In present study total 166 snake bite patient case records were evaluated, out of this 166 snake bite cases, 28 bites were by unknown snakes. Demographic profile of patient shows that out of 70 cases, 49 cases were in male child and 21 cases were in female child. Regarding clinical profile of the children with snake bite as mentioned in Table 3, local pain was present in (n=70) 100 % patients. Local blending was presenting symptom in 64.28 %(n=45) patients.Conclusions: From present study authors conclude that snake bite in children is more common among school going children, during monsoon and post monsoon, and in rural area. In our region vasculotoxic snake envanomation is more common and presented with cellulitis which required surgical intervention in most of circumstances. In neurotoxic envenomation some patient developed respiratory paralysis which required ventilatory support.
      PubDate: 2019-02-23
      DOI: 10.18203/2349-3291.ijcp20190700
      Issue No: Vol. 6, No. 2 (2019)
       
  • Estimation of coverage of pulse polio immunization round on 28th January
           2018

    • Authors: Zubin Ajay Mahajan, Sameera Rajendra Mehta, Tanvi Ajay Bafna, Narula A. P. S.
      Pages: 630 - 633
      Abstract: Background: India accounted for more than 50% of polio cases globally. India therefore started the intensive pulse polio immunization (IPPI) in 1995. The national immunization days (NID) were on 28th January and 11th March 2018. The objectives of this study were to determine the completeness of pulse polio immunization round on 28th January 2018, to evaluate the reasons for non-compliance of the community towards the vaccination round, to assess the demographic profile amongst the unvaccinated children.Methods: A cross-sectional descriptive study was conducted among 570 children of zero-five years were checked in major areas of Pune that is Katraj Zoo, Swargate, Saras baug and a school in Dhankawadi. The data was collected after the first round of PPI by viewing the ink mark on the left little finger nail of the child or by interviewing the parents. SIA monitoring chart was used to assess the completeness of immunization campaign. Statistical analysis: Microsoft Excel were used to calculate percentages.Results: Out of 570, 69 (12.1%) were unvaccinated with the highest number seen in nursery that is 28 (40.6%). Amongst the unvaccinated (n=69), 40 (57.9%) were males. In the unvaccinated children (n=69), 13 (18.84%) and 56 (81.15%) belonged to age group of  zero-two years and two-five years respectively. Reasons for being unvaccinated were 29(42%) parents were unaware of time and place of PPI, 21 (30.4%) were outside Pune and 19 (27.5%) were unwilling due to false beliefs..Conclusions: Awareness should be increased about benefits of PPI through mass media, local leaders and teachers to enhance community participation. The authorities’ in charge of the PPI should be informed regarding areas lacking significant coverage so that they can be concentrated upon during subsequent PPI rounds ultimately contributing to eradicate poliomyelitis.
      PubDate: 2019-02-23
      DOI: 10.18203/2349-3291.ijcp20190701
      Issue No: Vol. 6, No. 2 (2019)
       
  • Correlation of cord blood albumin values with neonatal jaundice in health
           new-borns: a prospective observational study

    • Authors: Jehangir Allam Bhat, Roshan Ara
      Pages: 634 - 639
      Abstract: Background: The objective of the present study was to investigate the predictability of pathological jaundice on cord blood albumin values.Methods: It was a prospective observation study conducted in Kurji holy family hospital on 289 healthy new-borns. Babies were divided into two groups. Group A who developed physiological jaundice and group B who developed pathological jaundice. Cord blood albumin was estimated in all new-born who were then followed up-to 5th day of life. Babies who developed jaundice requiring treatment were admitted in NICU for phototherapy. Rest where checked regularly up-to 5th day of life and value recorded on 5th day by estimation of serum albumin.Results: Incidence of pathological hyperalbuminemia in present study was 11.2%. There was statistically significant correlation between cord blood albumin and development of pathological jaundice. Gender, age, mode of delivery and birth weight has no correlation with cord albumin and the subsequent development of jaundice. Cord blood albumin <3.5mg/dl when compared with subsequent development of jaundice has high specificity (83.92%) and negative predictive value (87.35%). Cord blood value of >2.5mg/dl has high sensitivity (97.06%), specificity (99.22%), Positive predictive value (94.29%) and negative predictive value (99.61%) in predicting future development of pathological jaundice.Conclusions: The 87.35% negative predictive value in the present study suggests that in healthy term babies (Cord blood albumin ≤3.5mg/dl) cord serum albumin can help to identify those new-borns who are unlikely to require further evaluation and intervention. These new-borns can be discharged with assurance to parents. Babies with CBA level <2.5mg/dl should be followed more frequently. Thus, this study concludes that cord blood total albumin levels reliably predict the occurrence of pathological hyperalbuminemia.
      PubDate: 2019-02-23
      DOI: 10.18203/2349-3291.ijcp20190702
      Issue No: Vol. 6, No. 2 (2019)
       
  • Neurological outcome of high-risk neonates at 40 weeks of gestational age
           and at three months of corrected gestational age

    • Authors: Ameer Khan, Anil Galwa
      Pages: 640 - 644
      Abstract: Background: Infants born <30 weeks’ gestation is at increased risk of long-term neurodevelopmental problems compared with term born peers. The predictive value of neuro behavioral examinations at term equivalent age in very preterm infants has been reported for subsequent impairment. Therefore, this study aims to attempt to study incidence of neurological abnormality in high risk neonates in our neonatal intensive care unit.Methods: A prospective cohort observational study was conducted at centre for comprehensive child health, division of neonatology, Pushpanjali Crosslay hospital (Max super speciality hospital, Vaishali), Vaishali, Ghaziabad, Uttar Pradesh, India. Duration of study was October 2014 to September 2015. Seventy-five high risk neonates fulfilling the inclusion criteria admitted at NICU were recruited after taking informed consent from mothers /fathers.Results: Total 75 high risk newborns were studied. Their clinical data was noted, neurodevelopmental, neurosensory examination done at 40 weeks of completed gestational age and also at 3 months on follow up. The data was collected according to pre-decided proforma. Neuro developmental assessment was done by updated Amiel-Tison manual of neurological examination. On follow up at 3 months all the newborns who were normal (54) at 40 weeks were found to be normal (100%) and also all those who were definite abnormal (4) at 40 weeks were found to be definite abnormal (100%). But out of the 17 who were moderately abnormal at 40 weeks, 13 (76.5%) have become normal and 4 (23,5%) remained moderately abnormal and none progressed to definite abnormality.Conclusions: There is lack of awareness regarding dog bite and its management among the rural population.
      PubDate: 2019-02-23
      DOI: 10.18203/2349-3291.ijcp20190703
      Issue No: Vol. 6, No. 2 (2019)
       
  • Mortality and morbidity of very low birth weight and extremely low birth
           weight babies in neonatal period

    • Authors: Saroj Kumar Tripathy, Kripasindhu Chatterjee, Narendra Behera
      Pages: 645 - 649
      Abstract: Background: Preterm birth is one of the major clinical problems in neonatology as it is commonly associated with perinatal mortality, serious neonatal morbidity and in some cases, it leads to childhood disability. The objective of this study was to find out the outcomes of VLBW and ELBW babies in the form of mortality and morbidity in neonatal period.Methods: A cross sectional study was conducted in SNCU, MKCG Medical College, Berhampur, Odisha between 2011 to 2013. All babies with birth weight less than 1500gm, admitted between days 1 to day 7 of life were enrolled in the study. Babies were broadly divided in to two groups i.e.VLBW group (weight 1000-1499gm) and ELBW group (weight<1000gm). Details of antenatal history, sociodemographic profile and birth history including significant events were noted. Outcome measures included were death, cured and with sequelae.Results: Total number of babies enrolled in this study were two hundred twelve (n=212) and following observations were made. Mortality of ELBW babies was 61.11% and that of VLBW babies was 26.41%. Death rate in babies with weight range 500-749gm, 750-999gm, 1000-1249gm and 125-1499gm was 87.50%, 53.57%, 30.76% and 20.97% respectively. It was found that morbidities such as RDS, HIE, shock and hypoglycemia are significantly higher in ELBW babies as compared to VLBW babies.Conclusions: Extremely low birth weight babies have shown high mortality and morbidity compared to very low birth weight babies and its related death multiply when associated with complications like hyaline membrane disease, hypoxic ischemic encephalopathy, and sepsis.
      PubDate: 2019-02-23
      DOI: 10.18203/2349-3291.ijcp20190704
      Issue No: Vol. 6, No. 2 (2019)
       
  • Neonatal sepsis due to coagulase negative Staphylococci: a study from
           Kashmir valley, India

    • Authors: Asifa Nazir
      Pages: 650 - 655
      Abstract: Background: Neonatal sepsis is a leading cause of neonatal mortality and morbidity. Early diagnosis and treatment with appropriate antibiotics are important to improve the prognosis of neonatal sepsis. Coagulase-negative Staphylococci (CoNS) have emerged as prominent pathogens in the neonatal intensive care unit. These infections are rarely fatal, but they cause significant morbidity, especially among very low birth weight infants. This study was done to know the prevalence of Coagulase-negative Staphylococci in neonatal sepsis and to determine their antibiotic susceptibility pattern.Methods: A prospective study was conducted on blood samples of suspected neonatal septicaemia between August 2017 and May 2018 received at Department of Microbiology, Government Medical College, Srinagar. Blood culture was done by automated blood culture system, (BacT/Alert) and identification and antibiotic susceptibility was done by VITEK2 method.Results: Out of 356 neonates screened, there were 185 (53.4%) positive blood cultures. Among the culture positive cases, 107 (57.83%) were male and 78 (42.16%) were female. Early Onset Septicaemia cases (130 [70.27%]) were found to be three times higher than late onset Septicaemia (55 [29.72%]). Coagulase-negative Staphylococci (CoNs) (30.27%) were the most common organisms isolated followed by Acinetobacter sp (15.1%), Klebsiella sp (5.4%) S. aureus (4.8%) and E. coli (4.8%). All the isolates of CoNS were sensitive to linezolid and vancomycin and tigecycline. Methicillin resistance was seen in 84% isolates.Conclusions: Present study highlights the emergence of Coagulase-negative Staphylococci (CoNS) as predominant cause of neonatal septicaemia. Most of the isolates were resistant to methicillin which is alarming and a cause for concern.
      PubDate: 2019-02-23
      DOI: 10.18203/2349-3291.ijcp20190705
      Issue No: Vol. 6, No. 2 (2019)
       
  • A study of prevalence of iron deficiency anaemia in infants and toddlers
           (6-24 months) by measuring serum ferritin levels

    • Authors: Vaishali R. Chanpura, Nilesh T. Shah
      Pages: 656 - 659
      Abstract: Background: Nutritional anemia is a worldwide problem with the highest prevalence in the developing countries. One of the most vulnerable groups is 6-24 months of age. NFHS-3 survey shows that the incidence of anemia in children aged 6-35 months is 79.2% with 72.7% in urban areas and 81.2% in rural areas. First stage of iron deficiency is depletion of iron stores, which is reflected by decreased serum ferritin levels and increased total iron binding capacity (TIBC) levels. The objective of this study was to detect presence of iron deficiency in children even before clinical appearance of anemia by measuring serum ferritin levels.Methods: The study was conducted from March 2017 to November 2017 in the Department of Pediatrics of Sir Sayajirao Gaekwad General Hospital, a tertiary level hospital and government medical college, Vadodara. A cross sectional study was done in which a total of 111 asymptomatic infants and toddlers in age group of 6-24 months presenting to well-baby clinic were enrolled randomly. Haemoglobin, RBC indices and serum ferritin levels were estimated. The children were classified into mild, moderate and severe anaemia according to their haemoglobin levels. Correlation with their serum ferritin levels was carried out by using statistical analysis.Results: Prevalence of anaemia (Hb <11gm/dl) was 84.14% in 6-12 months age group, 81.25% in 13-18 months age group and 84.61% in case of 19-24 months age group. Overall 83.78% of infants and toddlers were found to be anemic among 6-24 months age group. 55 infants (49.54%) among 111 infants had mild anaemia, 29 infants (26.12%) had moderate anaemia, 9 infants (8.1%) had severe anaemia. Majority of children (87 of 111 infants) had microcytic and hypochromic RBCs in their peripheral smear examination. 78 infants (72.07%)) had low serum Ferritin levels while only 31 infants had normal ferritin levels which is statistically significant (p=0.0084). Out of these, 4 infants had normal hemoglobin level.Conclusions: Anaemia is highly prevalent in the age group of 6 to 24 months even in otherwise healthy infants. Serum ferritin level is a good indicator of iron deficiency in children.
      PubDate: 2019-02-23
      DOI: 10.18203/2349-3291.ijcp20190706
      Issue No: Vol. 6, No. 2 (2019)
       
  • Clinical profile of children with pneumonia admitted at KIMS hospital,
           Bangalore, India: a prospective study

    • Authors: Srinivasa S., Nithya E., Varsha Monica Reddy, Shiva Devraj
      Pages: 660 - 663
      Abstract: Background: In India acute respiratory infections are an important public health problem accounting for 15-30 % of under-five mortality. Early detection, timely intervention, standard management and a proper early referral service can reduce the mortality rate. The objective of this study was to study the sociodemographic and clinical profile of children admitted with pneumonia, to study its relation to the duration of stay at the hospital.Methods: The study was conducted in KIMS hospital, Bangalore from September 2016 to August 2017. Sociodemographic and clinical features of children aged from 2 months to 18 years of age were studied. A total of 92 children who fulfilled the inclusion criteria for community-acquired pneumonia were studied. The patient population comprises mainly of the low-income group from rural areas, urban slums, referred patients from surrounding rural areas, and other centres.Results: A total of 92 children were studied, 52 boys and 40 girls. 45% children were breastfed for <6 months, and 28% were incompletely immunized. Majority of children belonged to lower socioeconomic group. Passive smoking was present in 38 % of the patients and overcrowding was seen in 50% of children studied. There is a significant association between passive smoking, delayed hospital care, and length of stay.Conclusions: Present study concluded that ARI was more common in LES children and incompletely immunised children. And children who got early medical attention i.e. <4 days had a lesser duration of hospital stay i.e. <7 days.
      PubDate: 2019-02-23
      DOI: 10.18203/2349-3291.ijcp20190707
      Issue No: Vol. 6, No. 2 (2019)
       
  • Clinicopathologic study of Kikuchi’s disease in children in a
           tertiary hospital in South India

    • Authors: Anu Punnen, Kanagalakshmi ., Marie Therese Manipadam, Valsan Philip Verghese, Leni Grace Mathew, Sathish Kumar
      Pages: 664 - 669
      Abstract: Background: The aim of this study was to evaluate the clinical and laboratory characteristics, treatment modalities and outcome of children with Kikuchi’s disease.Methods: A retrospective cross-sectional study was conducted among all children, histopathologically diagnosed with KFD.  Clinical, laboratory data and treatment outcomes were analysed.Results: During the study period, 53 children histopathologically confirmed as KFD were enrolled in the study. There were 36 males and 17 females. The lymph node involvements were mostly cervical with bilateral predisposition (63.5%), firm (88%), matted (30.8%) and tenderness (38.5%). Fever, headache, vomiting, chills, myalgia and rash were other common presentations other than cervical lymphadenopathy. The associated laboratory findings include anemia (71.2%), leukopenia especially lymphopenia (31.4%), monocytosis (21.6%), thrombocytopenia (16.3%), elevated CRP (53.1%), ESR (83.7%), LDH (100%) and elevated liver enzymes. Most of the children were managed conservatively (49.1%). Corticosteroids were administered for (22.6 %) of patients. Recurrence occurred in 4 children (7.5 %) and 13 children (24.5%) had other associated diseases.Conclusions: KFD should be suspected in well children with febrile cervical lymphadenopathy, especially with leukopenia, monocytosis, and elevated CRP, ESR, LDH, Liver enzymes. KFD in children can have rarely atypical presentations and coexist with other diseases.
      PubDate: 2019-02-23
      DOI: 10.18203/2349-3291.ijcp20190708
      Issue No: Vol. 6, No. 2 (2019)
       
  • Prediction of significant hyperbilirubinemia by estimating cord blood
           bilirubin in neonates with ABO incompatibility

    • Authors: Ruchika Singh, Hemant Jain
      Pages: 670 - 675
      Abstract: Background: Neonatal hyperbilirubinemia is a common condition that may occur in 60-70 % of term babies and the most common pathological cause leading to hyperbilirubinemia is ABO incompatibility. ABO incompatible newborns are reported to be at greater risk of significant hyperbilirubinemia and are associated with significant morbidity like development of kernicterus.  So early intervention, at proper time, is mandatory to prevent this sequel.Methods: A prospective study included 240 term new-borns with gestational age of >37 weeks and birth weight >2.5 kg born to ‘O’ blood group mothers. Soon after delivery, cord blood was sent for blood group, total bilirubin and direct coombs test. All enrolled new-borns were assessed clinically daily till day 5th for appearance of hyperbilirubinemia using Kramer method. The data was analysed using descriptive analysis, ROC curve in SPSS version 14.Results: Among two hundred forty ABO incompatible newborns, 40 (17%) had developed hyperbilirubinemia and among them most common blood group associated was B+ve (75%). Association between cord bilirubin content and maximum serum bilirubin content among newborn who developed hyperbilirubinemia was found to be significant (P value <0.01). As per ROC curve analysis, cord blood total bilirubin cut off value of 1.79mg/dl had sensitivity (82.5%), specificity (55.5 %), PPV (27.04%) and NPV (94.06).Conclusions: Cord blood total bilirubin levels ≥1.79mg/dl has a good predictive ability for prediction of significant hyperbilirubinemia among ABO incompatible new-born. DCT is neither specific nor sensitive screening tool for development of Neonatal hyperbilirubinemia in ABO incompatibility.
      PubDate: 2019-02-23
      DOI: 10.18203/2349-3291.ijcp20190709
      Issue No: Vol. 6, No. 2 (2019)
       
  • Assessment of the prevalence of G6PD deficiency in RBCs of live new-borns
           born at tertiary care hospital

    • Authors: Surbhi Garg, Girish G. Joag
      Pages: 676 - 682
      Abstract: Background: Glucose-6-phosphate dehydrogenase is one of many enzymes that help the body process carbohydrates and turn them into energy. The mechanism by which G6PD deficiency causes neonatal hyper bilirubin may be due to hemolysis, but other mechanisms like secondary impairment of bilirubin conjugation and clearance by the liver may play a role. Therefore, through this study authors attempt to study the need for a newborn screening program for G6PD deficiency because of high prevalence and high risk of incidence due to consanguineous marriages in India.Methods: This study was a prospective cross-sectional study conducted among 350 consecutively born live new-borns in maternity wards and NICU of Krishna Institute of Medical Sciences and Hospital and Research Centre, Karad, Maharashtra during October 2016 to October 2017.Results: The maximum numbers of newborns were in the age group of 0-10 hours (36.80%), followed by in 11-20 hours (21.80%). The mean age among newborns was 2.86±5.83 hours. Out of 350 cases females were 181 (51.71%) and males (48.29%) and female to male ratio was 1.07:1.Conclusions: G6PD deficiency is one of the major causes of neonatal jaundice within 24 hours of life in new-borns. Hence, neonatal screening for G6PD deficiency could be an alternative to the haemolytic crisis prevention strategy in order to optimize affected young child care and prevention of crisis occurrence by avoiding taking contraindicated foods and drugs.
      PubDate: 2019-02-23
      DOI: 10.18203/2349-3291.ijcp20190710
      Issue No: Vol. 6, No. 2 (2019)
       
  • Burden of central nervous system infection in cases of fever with seizure
           and its association with outcome: an experience in a tertiary care center
           of Uttarakhand, India

    • Authors: Ramesh Chand, Yuvraj Sharma, Ritu Rakholia
      Pages: 683 - 692
      Abstract: Background: CNS infections have been linked to adverse neurological sequelae notably seizures and mortality. Although, various etiologies of AFE have been studied, but the mystery still remains untangled for the substantial risk factors for the diagnosis and outcome.Methods: This prospective study was carried out on 67 children between 2 months to 15 years, from (May 2016 to April 2017) tertiary care centre of Uttarakhand. Patients were analysed for demographic variables, haematological parameters, CSF analysis, neuroimaging and their outcome was assessed at one month of follow up.Results: This study showed, 70% (n=47) of the cases presented in acute febrile encephalopathy. Most cases were diagnosed with pyogenic meningitis (40%, n=27) and More commonly occur during rainy season (39%; n=26) radiologically meningeal enhancement (28%; n=18) as the most common finding. Cases of acute febrile encephalopathy with GCS ≤5 had significant association with mortality. (Fischer exact value of 0.005; significant at p<0.05).Conclusions: Clinical signs of meningitis are not always reliable, and a laboratory support is required to reach early diagnosis hence. Pseudomonas and MRCONS were the major pathogens responsible for the bacterial meningitis among the paediatric age groups, hence antibiotic management should be planned intensively while culture reports are awaited. Cluster of cases with meningoencephalitis were found in rainy season hence suggested possible etiologies are JE/ Scrub/ Enterovirus. Mortality as well as morbidity was high in cases with acute encephalitis syndrome cause' JE/unknown etiology in this era for modern medicine hence vector control strategies be encouraged.
      PubDate: 2019-02-23
      DOI: 10.18203/2349-3291.ijcp20190711
      Issue No: Vol. 6, No. 2 (2019)
       
  • A clinical study of retinopathy of prematurity in neonates in a tertiary
           care hospital

    • Authors: Srinivasa V., Vijay Yadav, Kumar G. V.
      Pages: 693 - 696
      Abstract: Background: Retinopathy of prematurity (ROP) is a disease process mostly reported in preterm neonates with a wide spectrum, ranging from mild, transient changes in the retina with regression to severe progressive vasoproliferation, scarring, detachment of retina and blindness. India shares 20% of the world childhood blindness. Besides congenital cataract, congenital glaucoma and ocular injuries, ROP is emerging as one of the important causes of childhood blindness in India.Methods: A cross sectional study was undertaken among all neonates born between 28-34 weeks of gestation admitted in NICU, who are under oxygen, screened for ROP. Babies with ocular disorder which interfere with fundus examination, babies who did not complete follow up till complete vascularisation of retina and babies with congenital retinal abnormalities were excluded from the study.Results: About 13.3% of male children and 18.0% of the female children had retinopathy of prematurity. Among the infants born before 30 weeks, 46.7% had retinopathy of prematurity. In the children with gestational age between 30- 32 weeks, 15.4%, 8.5% in the 32-35 weeks and none among those born between more than 35 weeks. About 27.9% of the newborns with birth weight of less than 1.5kgs and 5.8% of those who had birth weight of 1.5-2.5kgs had retinopathy of prematurity.Conclusions: This study had shown a significant association of retinopathy of prematurity with the low gestational age, birth weight and oxygen therapy. Reducing subsequent post-natal risk factors depends on optimal perinatal and postnatal care, as well as adhering to strict ROP screening guidelines. Recognizing and treating ROP in a timely fashion is critical for achieving the best visual outcome.
      PubDate: 2019-02-23
      DOI: 10.18203/2349-3291.ijcp20190712
      Issue No: Vol. 6, No. 2 (2019)
       
  • A study on prevalence of minor physical anomalies in mentally retarded
           children in a tertiary care centre of India

    • Authors: Mithun C. Konar, Kushal Karmakar, Kamirul Islam, Kaustav Nayek, Archan Sil
      Pages: 697 - 703
      Abstract: Background: Paucity of studies in world literature and lack of any Indian study assessing the frequency, prevalence and severity of minor physical anomalies (MPAs) in children with mental retardation (MR) as well as their importance for prediction and timely recognition of mental insufficiency, if any.Methods: A cross-sectional observational study involving 273 mentally retarded children aged 5-18 years was conducted over a period of one year and were compared with their age and sex matched controls. Waldrop and Halverson (1971) physical anomaly scale was used to assess those MPAs.Results: In the study group, higher percentage (79.85% vs. 40.29%) of children had MPAs with a predominance of multiple MPAs in comparison to healthy children (40.29% and 0%, respectively). Higher average frequency of MPAs per child was noted in the study group (1.42) than control group (0.40). Mean Waldrop weighting score was significantly higher among mentally retarded children than their controls (3.7±0.8 versus 0.8±0.2, P<0.0001).
      Authors noticed a gradual and significant decrease in Waldrop score with increase in intelligence quotient (IQ) [F=175.72, P<0.001]. A significant strong negative correlation between Waldrop score and IQ level (r=-0.89, P<0.001) was also observed. Out of eighteen variables of Waldrop score, seven were found as significant in binary logistic regression model for MR. Our model can explain 37.6% to 50.1% variability of the MR.Conclusions: MPAs are more prevalent in mentally retarded children than healthy children.  A clear-cut demarcation between these two groups is possible by the frequency of anomalies and the increased strength of their expression (i.e. their weighting scores).
      PubDate: 2019-02-23
      DOI: 10.18203/2349-3291.ijcp20190713
      Issue No: Vol. 6, No. 2 (2019)
       
  • Study of knowledge attitude practices and utilisation of existing health
           services by families with regard to newborn health at block level in rural
           India: a community based, cross sectional, observational study

    • Authors: Monica Choudhary, Rahul Verma, Shikhar Jain
      Pages: 704 - 712
      Abstract: Background: The present study was undertaken to identify KAP gaps and the objective of the study were to assessment of utilization of existing health service infrastructure at grass route level in rural community with regard to mother and neonatal care.Methods: A community based cross-sectional observational study. About 50 mother neonate pair residing in villages under study belonging to Dewas district, Madhya Pradesh.Results: Age old customs and practices of large family (80%), adolescent marriages (30%), high fertility (50%), poor housing and sanitation (48% or more) are still widely prevalent in rural India. Positive impact of NRHM with launch of JSSY and NSSK was seen in utilization of ANC services among beneficiaries with 100% ANC registrations, 98% institutional deliveries and 100% deliveries conducted by trained health professionals, prompt referral to SNCU. Birth weight was not known in 36% neonates and 18% had not received BCG vaccination. 22% were low birth weight and 22% neonate’s required SNCU care. Government emergency transport facility in form of ambulance was either absent (36%) or not utilized (26%) by majority.Conclusions: Lacunae were seen to be persisting regarding awareness and utilisation of few components of maternal and neonatal health care especially in government sector in spite of launch of third phase of NRHM. This was evidenced by, lack of awareness of Obstetric USG facility at civil hospital, non-utilisation of ambulance service for transport, not knowing neonates birth weight and no neonatal follow up care and failure to vaccinate the neonate even till 3rd or 4th week of life.
      PubDate: 2019-02-23
      DOI: 10.18203/2349-3291.ijcp20190714
      Issue No: Vol. 6, No. 2 (2019)
       
  • Clinical profile and outcome of respiratory distress in newborns admitted
           in rural tertiary health care centre of Maharashtra, India

    • Authors: Vinayak Y. Kshirsagar, Ashok Y. Kshirsagar, Rajsinh V. Mohite
      Pages: 713 - 717
      Abstract: Background: Respiratory distress is most common symptom complexes seen in newborn infants lead to high mortality. The objectives were to study various etiological factors, maternal and neonatal risk factors for development of respiratory distress along with need for CPAP, mechanical ventilation and surfactant to assess the immediate clinical outcome in newborns.Methods: The study was conducted at Krishna Hospital and Medical Research Centre, Karad in period of January to August 2018. A total of 100 neonates who were admitted in NICU within 72 hours of life were studied by clinical examination and relevant investigations. The severity of distress was assessed by Silverman-Anderson scoring, Downe’s scoring and APGAR scoring respectively for neonates.Results: It was observed that max, 90% of the distress cases were of respiratory in origin and high severity of distress was observed among 27% newborns. The proportion of respiratory distress was higher, 51% in males and low APGAR score was reported in 14% cases. Among respiratory etiology of respiratory distress, high proportion was of TTNB 35.55%. The maternal and new born factors like maternal age >30 years (32%), gestational age 28-30 weeks (87.5%), gravid 2 and 3 mothers (35%), female gender (32.6%), low birth weight (70%) developed severe distress respectively. The recovery rate of respiratory distress due to respiratory etiology was of 88.8%.Conclusions: Transient tachypnoea of new-born is the most common cause among new-borns with respiratory distress. New-borns with low gestational age, low birth weight baby, low APGAR score is more prone to develop severe respiratory distress.
      PubDate: 2019-02-23
      DOI: 10.18203/2349-3291.ijcp20190715
      Issue No: Vol. 6, No. 2 (2019)
       
  • Clinical profile of dehydration fever in neonates in a tertiary care
           hospital

    • Authors: Muhammad Hassan, Adarsh E., Rajanish K. V.
      Pages: 718 - 721
      Abstract: Background: The aim of this study was to determine the clinical profile of neonates admitted with dehydration fever and ascertain the maternal and neonatal factors affecting it.Methods: A observational descriptive study was conducted at Rajarajeswari Medical College and hospital, population included neonates who were admitted in NICU with dehydration fever.Results: The study were conducted among 50 neonates admitted with dehydration fever. Majority of neonates (72%) were diagnosed with dehydration fever on day 3 of life. 84 % neonates were born to primiparous mothers. In the study there was significant difference in mean birth weight, weight at admission and percentage of weight loss between birth weight and weight at admission with respect to symptoms on presentation. Mean % of weight loss was 12.06 when dehydration fever was presented with fever, 11.29 when dehydration fever presented with decreased urine output, 18.44 when presented with both fever and decreased urine output and 12.73 when presented with jaundice these values were statistically significant.Conclusions: Dehydration fever occurs most commonly on day 3 or after, effective measures should be initiated for early diagnosis and prevention of complications like effective breast-feeding counselling, proper techniques, good latching and supplementation of artificial feeds if required and monitoring of daily weight and daily urine output.
      PubDate: 2019-02-23
      DOI: 10.18203/2349-3291.ijcp20190716
      Issue No: Vol. 6, No. 2 (2019)
       
  • A study of zinc level in cord blood of neonates and its relationship with
           antropometric measurements in the neonates: a descriptive cross-sectional
           study

    • Authors: Syed Mohamed, Santosh Kumar, J. Kumutha
      Pages: 722 - 726
      Abstract: Background: During pregnancy, fast growth and cell differentiation takes place in both mother and foetus. Maternal nutritional factors play an important role in the growth of the neonate. Among the micronutrient zinc is an important micronutrient whose deficiency is associated with poor pregnancy outcomes. The objective the current study was to evaluate the relationship of serum zinc concentration of the maternal blood and the neonatal cord blood with that of the infant’s anthropometric measurements.Methods: A descriptive cross-sectional study was performed under the Department of Neonatology, Saveetha medical college. Duration of the study was from April 2017 to June 2018. The study included 82 singleton mother baby dyads born in Saveetha medical college. Anthropometric measurements such as birth weight, head circumference, neonate length apart from other clinical features of both the mother and neonates were recorded for statistical analysis. Serum zinc levels were estimated using 2-(5-bromo-2-pyridylazo)-5-(N-Propyl-N-sulfopropylamino)-phenol (5-Br-PAPS) protocol.Results: The mean maternal age of the study population is 25.3±2.3 years. Majority of the mother had natural mode of delivery (57%). The mean cord serum zinc level was found to be 94.0±1.6microgram /dl and the mother’s serum zinc level was 93.8±30.7microgram /dl (range from 49 to 171microgram /dl) which was not found to be statistically significant. Serum zinc levels of the cord was compared with the child anthropometrics and mother’s serum zinc levels to assess for the significance, but there was no correlation observed between the umbilical cord, and the birth weight (r=0.03), length of the child (r=-0.02), head circumference (r=-0.07) and mothers serum zinc levels (r=-0.002).Conclusions: According to our results authors were unable to establish a relationship between Neonates growth parameters and zinc levels in neonates cord blood and zinc levels in the mother. Further studies with a larger sample size and prospective design would establish a causal relationship between zinc and growth parameters in the neonate.
      PubDate: 2019-02-23
      DOI: 10.18203/2349-3291.ijcp20190718
      Issue No: Vol. 6, No. 2 (2019)
       
  • Antibiotic resistance pattern of Staphylococcus aureus infections in
           children

    • Authors: Senthil Kumar K., Ajith Brabhu Kumar C.
      Pages: 727 - 731
      Abstract: Background: Methicillin resistant Staphylococcus aureus (MRSA) is endemic in India and is a dangerous pathogen for hospital acquired infections. Analysing antibiotic susceptibility pattern of Staphylococcus helps us to overcome the therapeutic difficulties created by the rising anti-microbial resistant bacteria and guide us in choosing appropriate antibiotics. Hence, this study was conducted.Methods: Children with confirmed S. aureus infection between the age group of 0-12 years were classified into MSSA and MRSA subgroups. Isolates were identified as S. aureus using standard microbiological methodologies at diagnostic bacteriology laboratory, in the Microbiology department. Basic demographic variables and antibiotic resistance patterns were compared between MRSA and MSSA subgroups.Results: Majority of S. aureus were isolated from pus followed by blood culture. Prevalence of community acquired MRSA in present study (80%, with 95% CI from 68.56% to 91.44%) was significantly higher when compared to another studies (p value=0.004). Resistance to gentamicin and ciprofloxacin among the MRSA isolates was more than that in methicillin sensitive S. aureus (MSSA) (P<0.001).Conclusions: It is prudent to include MRSA coverage in empirical antibiotic regimens in settings where a significant proportion of patients hospitalized for S. aureus infection have MRSA.
      PubDate: 2019-02-23
      DOI: 10.18203/2349-3291.ijcp20190719
      Issue No: Vol. 6, No. 2 (2019)
       
  • Intermittent clobazam prophylaxis in simple febrile convulsions: a
           randomised controlled trial

    • Authors: Vinod Kumar, Ashish Gupta
      Pages: 732 - 735
      Abstract: Background: Febrile seizure (FS) is the most common type of childhood seizure disorder with a prevalence of 2-5% in children less than 5 years. Although the prognosis of febrile seizure is usually good, however, the possibility of recurrence keeps many parents and families in a state of anxiety and concerned, for years after the first seizure. Thus, intermittent prophylactic treatment might be advised in children with high risk of recurrence.Methods: The study was a prospective randomized, double blind, placebo-controlled trial conducted at Department of Pediatrics, Umaid Hospital, Dr S N Medical College, Jodhpur on neurologically normal children aged from 6 months to 5 years with a history of simple febrile seizures and normal electroencephalogram without any evidence of acute central nervous system infection. Subjects were randomly prescribed oral clobazam according to weight of child and placebo when they developed a febrile disease during the first 48 h of the onset of fever.  Temperature reduction measures with paracetamol and tepid sponging were also advised. Patients were followed up for the frequency and time of febrile seizure recurrence, febrile episodes and side effects of drugs for 12 months.Results: Ten (3.8%) of 257 episodes in clobazam group and 38 (14.07%) episodes in placebo group had seizure recurrence (p value <0.001). The two groups were not significantly different in terms of side effects. (p >0.05).Conclusions: Intermittent oral clobazam therapy is a very effective measure in preventing recurrence of febrile seizures.
      PubDate: 2019-02-23
      DOI: 10.18203/2349-3291.ijcp20190720
      Issue No: Vol. 6, No. 2 (2019)
       
  • Outcome of pre-term babies born in tertiary care institute

    • Authors: Nagaraj M. V., Saravanan P.
      Pages: 736 - 740
      Abstract: Background: Preterm babies’ survival has improved with advances in neonatology care in this era. Even with advances in treatments, there is still morbidity and mortality among preterm. The objective of this study was to know the incidence of prematurity and complications seen in them.Methods: A cross sectional study was conducted on all preterm babies born in Sapthagiri Institute of Medical Sciences, Bangalore, over period of one year from 1st August 2017 to July 2018.Results: Out of 500 babies born, 110 babies had RDS, among 110 babies 85 cases were preterm RDS babies included in study. Majority were males 55 (64.5%) and females 30 (35.2%). The gestational age group was maximum in the 28-32weeks,the most common morbidity noted was sepsis (77.7%) and RDS (22%). Death was 9(10.5%) only 4(4.7%) needed intervention in the form of CPAP.Conclusions: The study concluded that males were commonly affected by respiratory distress syndrome, sepsis was a common cause for morbidity and mortality. Inspite of advances in neonatology sepsis continues to be a leading cause of death. Proper hand cleansing has to be emphasized and reinforced to prevent sepsis in NICU. The best possible attempts to delay preterm delivery have to be followed. One should have a high index of suspicion and low threshold to treat sepsis in preterm.
      PubDate: 2019-02-23
      DOI: 10.18203/2349-3291.ijcp20190721
      Issue No: Vol. 6, No. 2 (2019)
       
  • Levetiracetam versus phenytoin for treatment of convulsive status
           epilepticus in pediatric population: a randomized controlled trial

    • Authors: Pooja Sharma, Sanjay Mandot, Subhash Bamnawat
      Pages: 741 - 745
      Abstract: Background: Status epilepticus is a major medical and neurological emergency. Despite advances in treatment, it is still associated with significant morbidity and mortality. The objective of the study was to compare the efficacy of levetiracetam versus phenytoin in treatment of convulsive status epilepticus.Methods: A Randomized control trial, was conducted at tertiary care hospital, Udaipur, Rajasthan, over a period of March 2017 to September 2018. Total 250 patients (age group 6 months to 18 years) who were presented with status epilepticus in PICU, were enrolled. These patients were divided into two groups by simple randomization. Levetiracetam was given to one group, while phenytoin was given to another group. Efficacy was decided by cessation of clinical seizure activity within 30 minutes of starting of drug infusion and patient was observed for recurrence of seizure within 24 hours.Results: A total of 250 patients were enrolled in this study. Seizure terminated in 107 patients in phenytoin group (85.6%) and in 114 patients in levetiracetam group (91.2%). The difference was significant. Recurrence of seizure (with in 24 hour) was high in phenytoin group (14.4%) in comparison with levetiracetam group (8.8%). Most common adverse effect in both the groups on treatment was hypotension, though in phenytoin group it was significantly higher than patients on levetiracetam group (7.2% v/v 2.4%).Conclusions: Levetiracetam may be an effective alternative to phenytoin as a second line drug in the management of benzodiazepine resistant convulsive status epilepticus in children.
      PubDate: 2019-02-23
      DOI: 10.18203/2349-3291.ijcp20190722
      Issue No: Vol. 6, No. 2 (2019)
       
  • A study on the length of stay of neonates in neonatal intensive care unit
           in a referral hospital in India

    • Authors: Kanimozhi P., Kumaravel K. S., Velmurugan K.
      Pages: 746 - 749
      Abstract: Background: Estimate of length of stay is important while counseling the parents of preterm infants and also make them prepared psychologically.Methods: A retrospective study done in the Neonatal Intensive Care Unit (NICU) of Government Mohan Kumaramangalam medical college hospital, Salem, Tamil Nadu, India between December 2017 and November 2018. All the neonates admitted during the study period formed the study group.Results: There were 3902 neonates admitted in the NICU during the study period. The mean duration of stay of neonates in the NICU during the study period was 7 days. Out of 3902 neonates in the study group, 37 (0.94%) neonates stayed less than 24 hours, 2208 (56.58%) neonates stayed for 1 to 5 days, 929 (23.8%) neonates stayed for 6 to 10 days, 668 (17.11%) neonates stayed between 11 to 30 days, 41(1.05%) neonates stayed for 31 to 60 days and 7 (0.18%) neonates stayed for more than 61 days. About 45% of neonates in the birth weight category of 1001 to 1500g stayed for 11 to 30 days. A similar trend was also observed in the analysis of length of stay of 29 to 32 weeks preterm neonates.Conclusions: Every hospital should have their own data to predict the length of stay of neonates in NICU. Future directions should include strategies in reducing the length of stay in NICU thereby optimising resources for the parents and the country.
      PubDate: 2019-02-23
      DOI: 10.18203/2349-3291.ijcp20190723
      Issue No: Vol. 6, No. 2 (2019)
       
  • Prevalence of attention deficit hyperactivity disorder, gender difference
           and its co morbidity among urban school children in a city of southern
           Rajasthan, India

    • Authors: Anubhuti Bhardwaj, Sanjay Mandot, Hemant Jain
      Pages: 750 - 756
      Abstract: Background: Attention deficit hyperactivity disorder (ADHD) is one of the most commonly diagnosed disorders of childhood (3-5%). The main characteristics of attention deficit hyperactivity disorder are inattention, hyperactivity, and impulsivity.  The Objective of this study was to study prevalence of ADHD in school aged children.Methods: A cross sectional descriptive school-based study was conducted in a private school of Udaipur from January 2017 to September 2018.  All eligible students were included. Total 1200 students were enrolled. They were assessed for the presence of ADHD using INCLEN diagnostic tool and those found positive were further assessed for the presence of co-morbid conditions using child behavior checklist (CBCL).Results: In present study out of total 1200 students 730(60.83%) were male and 470(39.17%) were female. 76 (6.3%) students out of 1200 were ADHD Positive. ADHD was more common in male students (73.7%), urban locality (57.89%), in age group 6 to 9 years (44.7%) and higher economic class (46.1%). Hyperactivity-Impulsivity type was most common type (51.32%). Male students had predominance of hyperactivity (60.7%) whereas in female student’s inattention type was predominant (45%). Aggressive Behavior (19.6%) and rule breaking behavior (80.4%) was more common in male. Somatic complaints were more common in females (60%). Oppositional defiant disorder was observed in male (21.4%) and female (10%) students. 15.8% of ADHD students had learning disorder.Conclusions: Present study shows 6.3% prevalence of ADHD. Hyperactivity type of ADHD was more common in boys, while Inattention type was more common in girls. Among associated co morbid conditions - aggressive behavior, rule breaking behavior and oppositional defiant disorder (ODD) was found to be more prevalent in boys while anxious behavior, somatic complaints and social problems were more commonly found in girls. Thought problems, learning disorders and conduct disorders are also observed in ADHD students.
      PubDate: 2019-02-23
      DOI: 10.18203/2349-3291.ijcp20190724
      Issue No: Vol. 6, No. 2 (2019)
       
  • A study on clinical profile and outcome of patients in PICU (paediatric
           intensive care unit) at tertiary care unit

    • Authors: Aruna Jyothi K., Korisipati Ankireddy
      Pages: 757 - 760
      Abstract: Background: This study was carried out with the objectives to study the clinical profile and to find the outcome of children admitted to pediatric intensive care unit (PICU) of Kurnool medical college and hospital, Andhra Pradesh.Methods: A retrospective study was carried in children aged more than 28 days to 12 years admitted in PICU from 1st January 2016 to 31st December 2016 when a total of 600 patients were admitted.Results: Out of these, 400 (66.66%) cases were males and 200 (33.33%) cases were females. Maximum numbers of patients were in the age group of more than 28 days to 1 year which constituted 325 (54.16%) cases. This was followed by 1 year to less than 5 years age group which constituted 150 (i.e. 25%) cases. Under 5 years aged children constituted 500 (83.33%) cases. Next most common age group admitted was 5 years to 10 years with 85 (i.e. 14.16%) cases and 10 to 12 years age group constituted 40 (6.66%) cases. In this study, central nervous system was the commonest system involved (n=195, 32.5%). Other systems involved were: respiratory system (n=122, 20.33%), cardiovascular system (n=65, 10.83%), gastro-intestinal system (n=32, 5.33%), hematological (n=35, 5.83%) and renal system (n=23, 3.83%).   Other causes include infections (n=97, 16.16%), metabolic (n=17, 2.83%), down syndrome (n=7, 1.16%) and poisoning (n=7, 1.16%) etc.Conclusions: Out of the 600 patients admitted to PICU, 168 (28%) patients died. 315 (52.5%) cases improved.  117 (19.5%) cases constituted those who were shifted to higher centre or another department or were taken against medical advice.
      PubDate: 2019-02-23
      DOI: 10.18203/2349-3291.ijcp20190725
      Issue No: Vol. 6, No. 2 (2019)
       
  • Clinical profile of dengue fever in children presented at a tertiary care
           hospital

    • Authors: Senthilkumar K. M., Hema Harini R.
      Pages: 761 - 764
      Abstract: Background: Dengue fever is a benign syndrome caused by an arthropod-borne virus and is characterized by Biphasic fever, myalgia, and arthralgia, rash, leucopenia, and lymphadenopathy. Dengue hemorrhagic fever and dengue shock syndrome are a severe, often fatal febrile disease caused by 1 of 4 dengue virus. It is characterized by increased capillary permeability, abnormalities of hemostasis and protein-losing shock syndrome. The aim of this study was to assess the clinical profile, complications and outcome of dengue infection in children.Methods: All children attending the hospital with symptoms and signs suggestive of dengue fever were tested for NS1 antigen and IgM/ IgG dengue antibody serology (depending on the day of fever) by enzyme-linked immunosorbent assay (ELISA) technique.Results: Of the 174-dengue serology positive children, fever was the most common major symptom (97.7%) followed by vomiting (85.6%), loss of appetite (81.6%), abdominal pain (77%), body pain/leg pain (62.6%). Severe dengue as per WHO criteria was seen in 29 (16.7%) children. Thrombocytopenia (platelet count less 1,00,000) was observed in 82 children (47%), Platelet count less than 20,000 in 8 children (4.5%). Dengue shock syndrome was seen it 26 children (15%). Mortality was nil.Conclusions: In children, if symptoms like fever, vomiting, loss of appetite, abdominal pain and body pain are present, a strong possibility of dengue fever is present especially in an epidemic setting. Early suspicion and effective management can reduce the severity.
      PubDate: 2019-02-23
      DOI: 10.18203/2349-3291.ijcp20190726
      Issue No: Vol. 6, No. 2 (2019)
       
  • Incidence of urinary tract infection in febrile children

    • Authors: R. Ravikumar Naik, Venkatesha K. R.
      Pages: 765 - 768
      Abstract: Background: Urinary tract infection is diagnosed by the growth of many organisms of a single specimen in the urine with presence of many symptoms. bacteriuria is defined as growth with a colony of >105/ml of a single species in a midstream clean catch urine sample.Methods: A cross sectional study was undertaken in febrile children with urinary tract infection attending Department of Paediatrics, tertiary care hospital, Bangalore during the period January 2017 to December 2017.Results: Out of the 200 children studied, 93 children belonged to the age group of 6 year to 12 year and 57 children belong to 1 year to 6-year age group and 50 children belongs to 12 year to 18-year age group. 97 children showed significant pyuria in centrifuged urine sample of which 49 were males and 48 were females. Majority 45 children were belonging to age group of 6 year to 12 year. Out of 97 children showed significant pyuria in centrifuged urine sample of which 46 children 5-10 cells/HPF and 27 children showed > 10 cells/HPF and 24 cases showed < 5cells / HPF. Out of 200 children, in 29 cases urine culture showed E. coli growth and 51 cases showed no growth.Conclusions: Urinary tract infections are common in childhood. Nearly all UTIs are caused by bacteria that enter the opening of the urethra and move upward to the urinary bladder and sometimes the kidneys.
      PubDate: 2019-02-23
      DOI: 10.18203/2349-3291.ijcp20190727
      Issue No: Vol. 6, No. 2 (2019)
       
  • Identifying risk factors for development of diabetic ketoacidosis in type
           1 diabetes mellitus

    • Authors: G. Anand Kumar, Rajendran ., Swaminathan .
      Pages: 769 - 773
      Abstract: Background: DKA [ Diabetic keto acidosis] It is the commonest cause of diabetes-related death in children. Children with diabetic ketoacidosis at diagnosis have poorer glycemic control, to identify the risk factors for the development of Diabetic Ketoacidosis in Type1 Diabetes Mellitus in a tertiary care center.Methods: The study was conducted in Kovai Medical Centre And Hospital Coimbatore in 2018.22 children were included in present study. Each consultant followed different standard DKA treatment protocols. The two protocols used were Milwaukee and BSPED guidelines.Results: Among the 22 children, 3 children (13%) had recurrent DKA (>1 episode). One child had his third episode and the rest 2 children had their second episode.19 children had their first episode of DKA.Conclusions: There was no death among the 22 children treated. This was because of the care is given by the team of doctors and adherence to treatment protocol (Milwaukee or BSPED) of DKA.
      PubDate: 2019-02-23
      DOI: 10.18203/2349-3291.ijcp20185521
      Issue No: Vol. 6, No. 2 (2019)
       
  • A clinical study of new onset seizures in children aged 3-12 years

    • Authors: Rinu Dwivedi, P. Sudha Priya, P. Padmavathi
      Pages: 774 - 780
      Abstract: Background: Seizures are common in pediatric age group and less than 1/3rd of seizures in children are caused by epilepsy. Aim of present study was to analyze the etiological factors and clinical profile of new onset seizures in children aged 3-12 years.Methods: This was a prospective study done at a tertiary care center of south India.
      Authors analyzed 98 children aged 3-12 years presenting with new onset seizures. Proper history and investigations including EEG, and CT brain were done to confirm the etiology.Results: Out of 98 children 51 were 3-5 yrs of age and 47 were 6-12 years. 66.3% had generalized seizure and 33.6% had partial seizure. Partial seizure were more common in 5-12 years of age. Intracranial infections were the leading cause (73/98) which included neurotuberculosis (26/73), NCC (20), bacterial meningitis (12), cerebral malaria (8) and viral encephalitis (7). Intracranial infections  were the  leading cause in both age groups. Space occupying lesions were more common in 6-12 years (46.8%) as compared to 3-5 years (19.6%). NCC and Tuberculoma were the leading CT findings in both age groups. There was significantly high incidence of focal EEG changes in partial seizure group compared to generalized seizure group.Conclusions: Intracranial infections were leading cause of new onset seizures especially GTCS. Good clinical evaluation and judicious use of investigations should be ensured. CT brain and EEG are more likely to be informative in partial seizures than in generalized seizures.
      PubDate: 2019-02-23
      DOI: 10.18203/2349-3291.ijcp20190728
      Issue No: Vol. 6, No. 2 (2019)
       
  • Association of patent ductus arteriosus (PDA) with prematurity and low
           birth weight neonates

    • Authors: Gh Rasool Wani, Nazir Ahmad Parray, Mohd Rafiq Lone, Nisar Ahmad Ganie, Anwar Hussain, Junaid Ul Islam, Syed Muneeb Mohammad, Syed Muneeb Mohammad
      Pages: 781 - 785
      Abstract: Background: Patent ductus arteriosus (PDA) is a major morbidity encountered in preterm neonates, especially in babies less than 28 weeks gestation or 1000g. It may close spontaneously in preterm neonates; however, failure to close spontaneously in preterm neonates results in significant mortality and morbidity in them.Methods: This prospective study was conducted in a tertiary care hospital in north India over a period of one year. The study cohort consisted of preterm, newborn babies admitted in the hospital with gestational age less than 37weeks and birth weight <2500g.Results: In this study total number of patients admitted during the study were 2930. Out of these preterm low birth weight neonates were 432. Among preterm low birth weight neonates admitted, 132 neonates were excluded as per exclusion criteria. Patent ductus arteriosus was detected in 56 among the 300 neonates giving an overall incidence of patent ductus arteriosus 18.6%, the incidence of patent ductus arteriosus was 56.2% for neonates weighing less than 1000gm, 24.7% for neonates weighing between 1000-1499g, 11.6% for neonates weighing between 1500-1999g and 5.6% for the neonates weighing between 2000-2499g.Conclusions: Thus, incidence of patent ductus arteriosus was inversely proportional to gestational age and birth. Data also suggest that immaturity is the major determinant of the persistent patency of ductus arteriosus.
      PubDate: 2019-02-23
      DOI: 10.18203/2349-3291.ijcp20190729
      Issue No: Vol. 6, No. 2 (2019)
       
  • Rational use of blood components in children with dengue by using WHO and
           NVBDC guidelines

    • Authors: Harish Tambekar, Sujata Sharma
      Pages: 786 - 790
      Abstract: Background: Dengue fever has become a major public health concern. The disease is now endemic in more than 100 countries with very high case fatality rate and children are the most affected age group worldwide. During explosive outbreaks, there is sudden surge in demands of blood components. Hence the aim of present research was to study the rational use of blood components in children with dengue by using WHO 2012 and NVBDCP 2015 (GOI) guidelines.Methods: Total 219 children of age ˂12 years, who has been diagnosed to have dengue and received blood component therapy during 12 months of study period, were included in the study. The transfusions of blood components [packed red cells (PRC), platelets and fresh frozen plasma (FFP)] were being given to the cases accordance to the WHO and NVBDCP guidelines. The patients’ demographic data, diagnosis, details of blood component therapy used the reason for transfusion was recorded.Results: Out of 219 children, 12(5.4%) children received platelet transfusion, 4(1.8%) children received PRC transfusion and 5(2.2%) children received FFP transfusion. One transfusion (4.7%) out of 12 platelet transfusion was inappropriate and all PRC and FFP transfusions were appropriate according to WHO and National Vector Born Disease Control Programme (GOI) guidelines.Conclusions: The need for platelet transfusion is often overemphasized and the fact is that the platelet count alone is not a predictor of bleeding. Unnecessary and empirical use of platelets should be completely avoided.
      PubDate: 2019-02-23
      DOI: 10.18203/2349-3291.ijcp20190730
      Issue No: Vol. 6, No. 2 (2019)
       
  • Effect of Kangaroo mother care on physiological parameters in low birth
           weight neonates

    • Authors: Ankit Ranjan, Sushma Malik
      Pages: 791 - 795
      Abstract: Background: Low birth weight (LBW) babies require special care as they suffer from several handicaps, including maintenance of temperature, feeding, adequate weight gain and optimum neurobehavioral adaptation to the external environment. Kangaroo mother care (KMC) is an important modality that helps in the easy transition of the newborn infant to the outside world and overcomes the above problems. This study was planned to assess the effect of KMC on physiological parameters of low birth weight neonates, in a tertiary care hospital.Methods: This was a single-centered prospective observational quasi-experimental study conducted over a period of 18 months on 70 eligible LBW neonates. The arterial oxygen saturation, blood pressure (systolic, diastolic and mean), heart rate and respiratory rate of the neonates were noted. The readings at 1 hour and 2 hours after KMC were compared with that of the reading at 10 minutes prior to initiating KMC to assess the changes in the mentioned physiological parameters.Results: Analysis suggested statistically significant improvement in the arterial oxygen saturation and stabilization of the systolic, diastolic and mean blood pressure, heart rate and respiratory rate with institution of KMC. There was better improvement in the physiological parameters on increasing the duration of KMC from one hour to two hours and these changes were statistically significant.Conclusions: LBW neonates receiving KMC showed significant improvement in oxygen saturation and blood pressure, heart rate and respiratory rate.
      PubDate: 2019-02-23
      DOI: 10.18203/2349-3291.ijcp20190731
      Issue No: Vol. 6, No. 2 (2019)
       
  • Clinico-bacteriological profile of neonatal sepsis

    • Authors: Rashmi P., Praveen B. K.
      Pages: 796 - 802
      Abstract: Background: Neonatal sepsis is the commonest cause of neonatal mortality responsible for about 30-50% of total neonatal deaths in developing countries. Surveillance of causative organisms and their antibiotic sensitivity pattern promotes rational use of antibiotics and antibiotic stewardship.Methods: A retrospective study, relevant data regarding the neonates diagnosed with culture positive sepsis was obtained from the case records during the period from July 2014 to June 2017. Culture positive sepsis was defined as isolation of bacterial pathogen from blood in neonates with clinical suspicion of sepsis.Results: Of the 414 neonates with clinical suspicion of sepsis, 110 neonates had blood culture positive sepsis. Sepsis was predominant in males (64.5%). Low birth weight (47.2%) and prematurity (40.9 %) were important neonatal risk factors for sepsis. Early onset sepsis occurred in 58.1% of the cases and late onset sepsis in 41.9% of the neonates. Gram-positive cocci constituted 67.52% of all isolates and gram negative 30.76%. The most frequently isolated organism in blood was methicillin resistant coagulase negative staphylococcus(MRCONS) (32.47%). Gram positive organisms included MRCONS, methicillin resistant Staphylococci aureus (MRSA), group B Streptococci (GBS), Staphylococcus aureus and Enterococci. Among Gram-negative organisms, Acinetobacter was most frequently isolated followed by Klebsiella, Escherichia coli, Pseudomonas, Citrobacter and Burkholderia species. The mortality in the study group was 13.5%. Gram negative organisms were most resistant to ampicillin and cephalosporins. Gram positive isolates were least resistant to vancomycin and linezolid.Conclusions: Gram positive sepsis was the most common type of sepsis among the neonates, although mortality was more in gram negative sepsis.
      PubDate: 2019-02-23
      DOI: 10.18203/2349-3291.ijcp20190732
      Issue No: Vol. 6, No. 2 (2019)
       
  • Study of risk factors for relapse in frequently versus infrequently
           relapsing nephrotic syndrome in 1-18 year age group: a combined
           prospective retrospective cohort analytical observational study

    • Authors: Simpal Shalini Minj, Surbhi Rathi, Santosh Kondekar, Jane J. E. David
      Pages: 803 - 810
      Abstract: Background: Early prediction and prevention of risk factors is the key to successful management of childhood nephrotic syndrome. This study was carried out to find the risk factors of relapse which will help in early prediction and reduce the risk of relapse in childhood nephrotic syndrome.Methods: It was a combined prospective-retrospective cohort analytical observational study of duration 18 months with sample size of 80 patients of age group 1-18 years who fulfilled the inclusion and exclusion criteria. The variables taken into account for the present study were demographic and disease related.Results: In the present study, 67.7% of patients with ≤6 year of age at first onset were frequent relapsers while 60% of patients with >6 year of age at first onset were infrequent relapsers. A 77.1% of patients belonging to lower socioeconomic strata and 60% of patients belonging to lower-middle socioeconomic strata were frequent relapsers. 100% of patients having ≥ 4 relapses within the 1st year after diagnosis were frequent relapsers while 73.2% of patients having ≤3 relapses within the same period were infrequent relapsers. In present study, out of 38 patients who had received 8 weeks of steroid therapy 92.1% were frequently relapsing while out of 42 patients who received 12 weeks of steroid therapy 64.3% were found to be infrequently relapsing.Conclusions: Younger age at first onset, higher number of relapses in first year and lower socio-economic strata is associated with frequently relapsing nephrotic syndrome. Longer duration of steroid therapy (12 weeks) lowers the chance of frequent relapses.
      PubDate: 2019-02-23
      DOI: 10.18203/2349-3291.ijcp20190733
      Issue No: Vol. 6, No. 2 (2019)
       
  • Prognostic value of laboratory and radiological parameters in kerosene
           poisoning

    • Authors: Venu Kulkarni, Dhanalakshmi K., Raju K., Megha P.
      Pages: 811 - 816
      Abstract: Background: Kerosene poisoning, a commonly encountered situation in pediatric emergencies, caused varied systemic manifestations ranging from asymptomatic state to altered sensorium and cardiac arrhythmias. Gupta score has been traditionally used to prognosticate such cases. Limited number of studies have been done previously despite high incidence rates pertaining to laboratory and radiological features. Present study aimed to determine association between these features and outcome in terms of duration of stay.Methods: A retrospective study consisted of all children presented with kerosene poisoning from May 2017 to May 2018. CBC was done within 12 hours of presentation and CXR was taken after 6 hours of exposure. These values were compared against duration of stay to predict prognosis.Results: Most children were in age group of 1-3 years, male predominance 62.9%. Quantity of consumption didn’t have any effect on outcome. Large proportion of children were asymptomatic 60%, followed by hurried breathing 31.5% - most frequent presenting complaint. Peak duration of consumption was 4 pm to 8 pm. CBC parameters- Hemoglobin status and WBC counts failed to have correlation with outcome in terms of duration of stay. CXR taken after 6 hours exposure- was imperative to predict outcome.Conclusions: Radiological features on CXR in addition to clinical symptoms could be used to decide likely outcome after kerosene consumption.
      PubDate: 2019-02-23
      DOI: 10.18203/2349-3291.ijcp20190734
      Issue No: Vol. 6, No. 2 (2019)
       
  • Comparative study between serum and transcutaneous bilirubin measurements
           in new-borns

    • Authors: Manish Mahadeo Tiwari, Harshal N. Pise
      Pages: 817 - 822
      Abstract: Background: Hyperbilirubinemia is one of the common problems in neonates. The transcutaneous bilirubin (TCB) measurement is non-invasive, easy and rapid not requiring expertise and manpower. Fewer studies have been carried out to whether newer TCB measurements can correlate with serum bilirubin measurements using newer generation of transcutaneous bilirubinometer in our region.Methods: An observational cross-sectional study to compare serum and transcutaneous bilirubin measurements in newborns admitted to a neonatal intensive care unit, conducted from December 2015 to November 2017. Blood samples were obtained from neonates collected from venous sample into plain bulb and sent for analysis. For transcutaneous bilirubin measurement, the reading from forehead and sternum were taken using bilirubinometer and an average reading was taken for comparison.Results: Total 172 neonates were admitted during study period and enrolled in the study. It was observed that out of 172 patients, studied 102(59%) patients were male and 70(41%) patients were female. Out of 172 patients maximum 89(51.74%) mother have O positive blood group and only 2(1.1%) have O negative blood group. Common cause of neonatal hyperbilirubinemia was ABO incompatibility 81(48%), Rh incompatibility 11(6%), and other causes 80(46%). The mean and standard deviation of TSB for first, second and third reading were 19.21±3.44, 15.76±2.79 and 12.89±2.44 respectively. While mean and standard deviation of TCB for first, second and third reading were 18.34±2.99, 15.48±2.36 and 12.31±2.28 respectively with correlation coefficient of r=0.806513, r=0.694273, r=0.785471 respectively indicating linear relationship between two.Conclusions: There was a strong correlation between serum and transcutaneous bilirubin levels before and even after the phototherapy. As transcutaneous bilirubin estimation is non-invasive, gives quick and reproducible results. So, by using this method has potential screening value especially in the high-risk neonates to start early intervention.
      PubDate: 2019-02-23
      DOI: 10.18203/2349-3291.ijcp20190735
      Issue No: Vol. 6, No. 2 (2019)
       
  • A study of echocardiographic changes in patients of thalassemia major

    • Authors: Vaishali R. Chanpura, Daxay Modi
      Pages: 823 - 828
      Abstract: Background: Thalassemia major is a chronic hematological disorder. Regular blood transfusion is the only modality of long-term survival for these patients. This leads to iron overload, the heart being the most severely affected organ. The gold standard for detecting myocardial iron deposition is cardiac MRI. However, very few patients can afford this investigation. Hence, authors carried out this study to find out whether early iron overload can be detected by echocardiography which is a simple and less expensive tool. The objective of this study was to document echocardiographic changes of cardiac iron overload in patients of thalassemia major even before appearance of symptoms.Methods: A comparative cohort study conducted from January 2018 to October 2018 in the Department of Paediatrics of SSG Hospital, and Government Medical College, Vadodara. The case group consisted of 35 patients of Thalassemia major. 35 age and sex matched normal children were selected as controls. Relevant blood investigations were performed in cases. 2-Dimensional M-Mode Echocardiography was performed in both patients and controls. Thalassemia major patients were compared to normal healthy children for various parameters in echocardiography indicating the systolic and diastolic function. Proportion and percentage were calculated for descriptive analysis. Independent t-Test was applied between two groups to find out significance level.Results: For all parameters except End systolic volume and fractional shortening, p values were less than 0.05 which is significant. 85% (30/35) had increase in interventricular septal dimensions (IVSD), 97%(34/35) had increase in posterior wall dimensions (PWD),  82%(29/35) had  increased left ventricular internal diameter diastole(LVIDD), 88%(31/35) had increased left ventricular internal diameter systole (LVIDS), 80%(28/35) had increased E/A RATIO .Ejection fraction was affected in 77%(27/35).This shows that patients of thalassemia major have significant cardiac dysfunction; possibly because of cardiac iron overload.Conclusions: Echocardiography is an effective tool for screening cardiac iron overload in patients of thalassemia major and should be done periodically in all patients.
      PubDate: 2019-02-23
      DOI: 10.18203/2349-3291.ijcp20190736
      Issue No: Vol. 6, No. 2 (2019)
       
  • Epidemiological profile of acute poisoning in children admitted to a
           tertiary care hospital

    • Authors: Mathivanan M., Vignesh K.
      Pages: 829 - 832
      Abstract: Background: Acute poisoning in children is most commonly encountered in day to day practice which contributes a major part of admissions in pediatric intensive units and ward. It is a preventable public health problem. There are limited community based data available because of several reasons including lack of standard case definition, regional variability, poor functioning regulatory and surveillance system. Therefore, authors carried out this study in present set-up.Methods: A prospective observational study carried out at a tertiary care hospital which included all children within the age of 12 years presenting with history and symptoms and signs suggestive of acute poisoning over a period of 1 year after getting consent from parents.Results: Incidence of acute poisoning among children was 4.7%. Maximum cases were in the age group of 1-5 years (79.85%). Among the 278 cases, male children were 154(55.4%) and female were 124(44.6%). Majority of cases were observed in upper lower (43.1%) socio-economic group of Modified Kuppusamy scale. Based on locality, majority of cases were from rural area (66.9%). Accidental poisoning was the most common cause including 88.5% cases. In our study, we found that hydrocarbons were the most common substance of poisoning (58%). The most common clinical presentation in our study was vomiting (24.5%).Conclusions: Incidence of acute poisoning among children is high in our set-up. Lower socio-economic class, rural populations are important epidemiological factors which influences the poisoning event in children.
      PubDate: 2019-02-23
      DOI: 10.18203/2349-3291.ijcp20190737
      Issue No: Vol. 6, No. 2 (2019)
       
  • Aetiological profile of fever in neonatal and paediatric population in
           hospital setting

    • Authors: Amitabh Dwivedi
      Pages: 833 - 836
      Abstract: Background: Febrile illness in children is a common cause of admission to hospital globally, with significant associated morbidity and mortality. Dengue, malaria, scrub typhus, typhoid and leptospirosis have been identified as major causes of acute undifferentiated febrile illness in Thailand, Malaysia, and Nepal. Climate variation, over population and urbanization may all contribute to the emergence and reemergence of infections in tropical regions like Tamil Nadu. The objectives of this study were to describe the aetiology of fever in hospitalized neonatal and Pediatric population. A descriptive study was designed.Methods: A prospective observational study was conducted. All children from 0 to 18 years admitted as in-patients. Sample size was calculated to be 650. Basic laboratory tests were done in all cases.Results: Out of a total of 650 children maximum number (40.7% n=265) of patients had short duration of fever between 1 to 3 days. Majority (56%) of patients had temperature between 100.4 to 101F. Only 5 children were confirmed to have malaria. Maximum number of pus cells found was 80 to 100 in 3 children in urine examination. Total Infectious cases were 631 (97.07%).Conclusions: Infectious aetiology was more common than non-infectious aetiology. Among all aetiologies, viral fever particularly dengue was the most common aetiology. Enteric fever was the second most common infectious cause of fever after viral fever.  Short febrile illness (1 to 5 days) was the most common type of fever in children admitted in hospital. In neonates, the most common cause of fever was probable sepsis followed by dehydration fever.
      PubDate: 2019-02-23
      DOI: 10.18203/2349-3291.ijcp20190738
      Issue No: Vol. 6, No. 2 (2019)
       
  • Evaluation of immunization coverage and its determinants in children aged
           12-24 months from rural and urban areas of Udaipur, Rajasthan, India

    • Authors: Hartesh Singh Pahwa, Dileep Goyal, Devendra Sareen
      Pages: 837 - 841
      Abstract: Background: Infectious diseases are now the world’s biggest killer of children and young adults. Over the last three decades a lot of progress has been made globally as far as protection against six important vaccine preventable diseases is concerned. The major cause of non-immunization and partial immunization in most of the studies conducted in India and abroad suggest lack of knowledge and awareness about vaccination in the community.Methods: 400 children aged 12-24 months from urban and rural areas (200 each) of Udaipur in a randomized manner were included in this study. For coverage and evaluation of vaccination in this study, informants preferably mothers were interviewed using pre-coded and pretested questionnaire by door to door visit from 1st April 2017 to 31st March 2018, in urban and rural areas of Udaipur and if mother was not available then father or any other person >18 years belonging to the household was asked to respond to questionnaire.Results: The present study was undertaken to find out the vaccination coverage in eligible population in rural and urban blocks of Udaipur. Out of 400 children evaluated. More than half (60.25%) of children were completely immunized. 29.5% children were partially immunized and 10.25% were not immunized at all.Conclusions: Lack of knowledge and awareness were the main reason for non-immunization (44.4%) and partial immunization (29.4%) respectively.
      PubDate: 2019-02-23
      DOI: 10.18203/2349-3291.ijcp20190739
      Issue No: Vol. 6, No. 2 (2019)
       
  • Prevalence of anemia in under five-year-old children: a hospital-based
           study

    • Authors: Swatantar Singh, Sangeeta Parihar
      Pages: 842 - 847
      Abstract: Background: Anemia affects individuals of both gender and all ages, there is a need for localized and age- and context-specific studies to improve our knowledge of prevalence patterns and associated risk factors of Indian population. The present study was done to determine the prevalence of and associated risk factors for anemia in under five-year-old children in a tertiary care teaching hospital.Methods: A prospective observational study was carried out among under five-year-old children suffering from anemia. For the diagnosis of anemia, WHO criteria for haemoglobin (Hb) threshold in different age group were used. The growth and development statuses of children were evaluated by WHO's Child Growth Standards 2006.Results: Total 240 anaemic children were enrolled into the study. Children of age group of between 2-5 years was more affected. A majority of the mother of anaemic children had primary level of school education. More than half of the children belong to lower socioeconomic classes (Class IV + Class V). Nutritional deficiency was the single most important causative factor in the development of anemia. Infectious diseases found to be more prevalent.Conclusions: Nutritional deficiency, particularly, iron deficiency is the leading cause of anemia in the present study. In addition to nutritional deficiency, socioeconomic factors like, gender, maternal education and SE class also play an important role in development of anemia.
      PubDate: 2019-02-23
      DOI: 10.18203/2349-3291.ijcp20190740
      Issue No: Vol. 6, No. 2 (2019)
       
  • Ventilator associated pneumonia: incidence and risk factors in a tertiary
           care hospital

    • Authors: Manish Rathor, Neetu Sharma
      Pages: 848 - 852
      Abstract: Background: The objective of this study is to find the occurrence and contributing risk factor of ventilator associated pneumonia (VAP) in 2 months-5 years age group.Methods: This was a prospective, observational, hospital-based study carried out in a tertiary care setting hospital. All patients between 2 months-5 years age admitted in the ICU who had undergone MV were included in the study. Inclusion criteria includes patients who developed pneumonia after the 48 hours of mechanical ventilation and those patients were excluded who developed pneumonia within 48 hours of mechanical ventilation and having respiratory system findings /involvement prior to the MV. After recruiting patients baseline clinical characteristics (age, sex, diagnosis, duration of MV) were taken, monitored and diagnosed VAP using CDC guidelines until they were discharged or deceased. The parameters such as fever, oxygenation, leucocytosis, other risk factors. chest X-ray and ETA>105CFU/ML or microscopy (grain stain>l bacteria/>10 polymorphonuclear cells) were collected every 48 hours.Results: This study was done in 133 patients while 42 patients (31.58%) developed VAP during their ICU stay. Early onset VAP occurred in 34 (80.9%) while late onset VAP was observed in the remaining 8 (19.1%) patients. In ETA culture CFU>105 Klebsiella (38%) was the predominant isolate followed by Pseudomonas (23%), Acinetobacter (17%), Staphylococcus (13%) and Citrobacter (10%) are offending organism responsible for VAP in MV patient in present study. On analysis (univariate) reintubation, altered sensorium at intubation and use of antacid are found significantly associated risk factors with the development of VAP.  Multivariate analysis revealed that reintubation was an important risk factor for the development of the VAP.Conclusions: The various risk factors can be minimized for better outcome of patients undergoing mechanical ventilation. Risk factors such as reintubation, altered sensorium at intubation and use of antacid are associated with VAP and also the physician treating must have knowledge and awareness about prevention of these risk factor to improve the outcome of patients.
      PubDate: 2019-02-23
      DOI: 10.18203/2349-3291.ijcp20190741
      Issue No: Vol. 6, No. 2 (2019)
       
  • Acute kidney injury in paediatric intensive care: need for extended vigil

    • Authors: Saritha P. J., Jayakrishnan M. P., Ashraf T. P., Geeta M. G.
      Pages: 853 - 856
      Abstract: Background: Acute kidney injury (AKI) is an important contributor towards morbidity and mortality among critically ill children. The objective of this study was to ascertain the etiological factors, categorize the severity and determine the immediate outcome of AKI among children admitted to the pediatric intensive care unit (PICU) of a tertiary referral hospital in south India.Methods: A prospective study was conducted from January to December 2012 in the PICU, Government medical college, kozhikode, a major referral hospital in north Kerala. The institutional ethics committee approved the study. Children in the age group of 1 month to 12 years admitted to the PICU for at least 48 hours were included if they had no previous renal disease/AKI at the time of admission. Serum creatinine levels of the children were measured at the time of admission, at 48 hours, and one month later. Outcome measures included normalization of serum creatinine or persistence of impaired renal function. Mortality was assessed both immediately and after one month.Results: A total of 1716 children were included in the study, of which 107 children developed AKI (6.2%). Among the 107 children, 56 children (52.3%) were boys. Majority of children were infants 75(70.1%). Infection was the commonest underlying condition   associated with AKI. Most of the children with acute kidney injury were in the earliest phase (Stage 1). Twenty-six children (24.29%) died. Among the survivors, 10% were found to have impaired renal function when followed up a month later.Conclusions: There is a high incidence of AKI in critically ill infants admitted in PICU. Residual renal impairment can persist even after discharge from hospital and these children need follow up for a longer time.
      PubDate: 2019-02-23
      DOI: 10.18203/2349-3291.ijcp20190742
      Issue No: Vol. 6, No. 2 (2019)
       
  • A study of survival of very low birth weight neonates in a tertiary care
           hospital

    • Authors: Rajendra Shinde, Kiran Haridas, Pritesh Nagar, Hemant Parakh
      Pages: 857 - 862
      Abstract: Background: Preterm birth is one of the major clinical problems in Obstetrics and Neonatology as it is associated with perinatal mortality, serious neonatal morbidity and in some cases childhood disability. Very low birth weight (VLBW) neonates comprise between 4-8% of live-births but about one-third of deaths during the neonatal period occur in this group of newborns. Data on the probability of survival of infant in high risk pregnancies can be of great value in guiding management. The objective is to study the survival at discharge of VLBW neonates admitted in a tertiary care hospital.Methods: Retrospective observational study of all VLBW infants admitted in Aditya Hospital NICU over 3 years between 1-7-2011 to 30-6-2014. Descriptive and inferential statistical analysis has been carried out in the present study.Results: In the present study maternal PROM was seen in 32.9% of cases, Preeclampsia in 31.7% of cases which constituted the most important antenatal risk factor for VLBW followed by multiple gestations in 25.2%. Common morbidities in VLBW neonates are Neonatal jaundice, Probable sepsis, Apnea of prematurity and RDS. Survival improved with increasing gestational age and weight.Conclusions: Birth weight and gestational age specifically predicts survival of preterm VLBW babies, facilitating decision making for obstetricians, neonatologists and parents. In the present study total survival rate was 86.6% with a mortality of 13.4%.
      PubDate: 2019-02-23
      DOI: 10.18203/2349-3291.ijcp20190743
      Issue No: Vol. 6, No. 2 (2019)
       
  • Comorbidities associated with cerebral palsy in children presenting at
           department of Pediatrics, K. T. children hospital Rajkot, India

    • Authors: Mauli V. Raja, Palak T. Hapani
      Pages: 863 - 866
      Abstract: Background: Cerebral palsy is a diagnostic term used to describe a group of motor syndromes resulting from disorder of early brain development. It describes a group of permanent disorders of the development of brain and posture causing activity limitation. The magnitude of cerebral palsy in our country is 2 to 2.5 per thousand live birth. The objective is to study co-morbidities associated in cerebral palsy patients.Methods: It was a hospital based cross sectional study carried out in KT Children Hospital, PDU Medical College, Rajkot for 1 year (April 2017-April 2018). Sample size: minimum 100 cases. Selection of subject: All the children suffering from cerebral palsy presenting at KT Children hospital, P.D.U. Medical college Rajkot, Gujarat. Cases were evaluated by history, clinical examination and necessary investigations.Results: From data collected in present study most common variety of Cerebral Palsy is spastic type (72.5%) followed by, dyskinetic (16%), ataxic (7%), and hypotonic (4.5%) type. Within spastic type; diplegic (48%) is the most common variety. Caesarean section delivered cases are more predisposed to Cerebral palsy in present study which might be due to other risk factors associated with it. Gender and consanguinity showed not major significance in association with CP child. Most of Cerebral palsy cases in present study were born full term (81.5%) and of normal birth weight (78.5%). The most common comorbidities in present study were cognitive impairment (77%) followed by epilepsy (38%), visual impairment (10%), hearing disability (9%) thyroid dysfunction (3%) and G.I. disturbances (2%). Perinatal asphyxia is the most common history finding in Cerebral palsy cases including in present study, followed by seizures during infancy, pathological jaundice, neonatal sepsis and history of NICU admission for any cause.Conclusions: Cerebral palsy in developing countries has a higher prevalence and different clinical profile regarding severity and associated disability. The perinatal and high-quality neonatal care together with physical therapy and rehabilitation programs have a significant role in preventing comorbidities in cerebral palsy cases, which is still lacking in developing countries.
      PubDate: 2019-02-23
      DOI: 10.18203/2349-3291.ijcp20190744
      Issue No: Vol. 6, No. 2 (2019)
       
  • Cross-sectional study reveals a high prevalence of vitamin D deficiency
           among healthy school children in central Kerala, India

    • Authors: Ayyappan Anitha, Suresh A. Poovathinal, Vijitha Viswambharan, Ismail Thanseem, Mahesh M. Vasu, Ranjitha M.
      Pages: 867 - 871
      Abstract: Background:
      Authors examined serum vitamin D status among the healthy school children belonging to the south Indian state of Kerala.Methods: A cross-sectional study, participants were recruited through medical camps organized in Thrissur and Palakkad districts of central Kerala during the months of March and April 2017. A 174 healthy school children (98 males and 76 females) aged 5-13 years were recruited for the study. The children were found to be healthy on the basis of physical examination by a Paediatrician. None of the children had any symptoms of skeletal deformities. All the children were drug-naive. Data on height, weight, skin color, food habits, physical activities and socio-economic status were recorded. A 2ml of peripheral blood samples were collected from the participants. Total vitamin D in the serum was estimated by chemiluminescence immunoassay (CLIA).Results: VDD was observed in 60.92% and insufficiency in 30.46% of the participants. Only 8.62% of the participants had normal vitamin D levels. The mean vitamin D level was 19.93 ng/ml. Males had significantly higher vitamin D levels compared to females. Factors such as age, height, weight, diet, skin color and socio-economic status did not influence vitamin D levels.Conclusions: This is the first study of vitamin D status among the school-age children of Kerala. This paper adds further evidence to the reports indicating high prevalence of subclinical VDD among children across India and calls for action.
      PubDate: 2019-02-23
      DOI: 10.18203/2349-3291.ijcp20190745
      Issue No: Vol. 6, No. 2 (2019)
       
  • Neonatal umbilical myiasis

    • Authors: Rakesh Kotha, Paramesh Pandala, Himabindu Singh, B. Swetha Reddy, S. Tejaswi Reddy, Mahesh Rathod, E. P. Rhajkumar
      Pages: 872 - 874
      Abstract: Infestation is a state of being invaded or overrun by parasites. Myiasis is an infestation caused by dipterous fly. Even though human myiasis is a rare infestation particularly in newborn period unlike animal myiasis as neonate is just newly introduced to the environment and during this period neonate usually more protected and taken care by us. In rural areas of tropical countries where good hygiene conditions will not be there, authors are still identifying these cases. Risk factors for myiasis usually poor socioeconomic conditions and unhygienic environment. Finding cases of umbilical myiasis usually indicates poor environmental sanitary measures at that particular place. Here authors are presenting a case of neonatal umbilical myiasis caused by Chrysomya megacephala. These flies usually lay their eggs over the wounds or moisture dead necrotic tissues unlike other species of flies where they usually lay eggs over the animal fecus. But some other free-living flies(saprophagous) also cause myiasis due to accidental laying of eggs over dead necrotic tissues due to open defecation. In present case authors identified myiasis as early as third completed day of life, means infestation occurred at the time of delivery as incubation period for hatching eggs to larvae usually 4-8 days. These larvae able to survive inside deep tissue by breathing through a small hole. Even though myiasis usually have good prognosis it will become a focus for secondary infections. If deep-seated causes severe morbidity and even in extreme cases causes death also. Diagnosis is mainly clinical, authors can identify the species by microscopic examination of third stage larvae and finding age of the larvae also useful in identifying time of infestation. Treatments usually direct removal of larvae from the site by manipulation, irrigation, suffocation by ether and surgery if deep-seated. As they usually create nadir for infection by bacteria ruling out secondary infection and treatment is necessary. It is better to take preventive strategies like birthplace cleanliness and environmental sanitation. Tracking the case helpful in finding the places where authors need to improve sanitary measures it is better to give feedback to appropriate administrative officers to prevent home deliveries.
      PubDate: 2019-02-23
      DOI: 10.18203/2349-3291.ijcp20190004
      Issue No: Vol. 6, No. 2 (2019)
       
  • Panayiotopoulos syndrome: a clinico-electroencephalographic presentation
           of three cases from Nigeria

    • Authors: Christian Chukwukere Ogoke
      Pages: 875 - 879
      Abstract: Panayiotopoulos syndrome (PS) is a common benign, childhood, focal, seizure susceptibility syndrome presenting with mainly focal aware or focal impaired awareness autonomic seizures and autonomic status epilepticus that is under diagnosed in our locality. Increased awareness through reporting will aid diagnosis, reduce misdiagnosis and prevent aggressive and deleterious interventions. The classic clinical and electroencephalographic (EEG) features of three cases are described and the literature reviewed. The aim is to underscore the presence in our locality of this remarkably benign epileptic syndrome that must be differentiated from febrile seizures, encephalopathy, migraine or cardiogenic syncope.
      PubDate: 2019-02-23
      DOI: 10.18203/2349-3291.ijcp20190746
      Issue No: Vol. 6, No. 2 (2019)
       
  • Brown Vialetto Van Laere syndrome, a fatal disease with a simple solution:
           a case series

    • Authors: Nishant Mittal, Mahesh Kamate
      Pages: 880 - 882
      Abstract: Brown Vialetto Van Laere (BVVL) syndrome is an extremely rare neuro metabolic disorder postulated to be caused by a defect in riboflavin transporter. The disease is characterized by progressive hearing loss with ataxia and difficulty in swallowing and breathing. The diagnosis of the disease requires great deal of suspicion on the part of treating physician. Here authors present 2 cases of BVVL who presented to us with dysphagia and hearing loss and responded to therapy. Brown Vialetto Van Laere (BVVL) syndrome is an extremely rare neuro metabolic disorder postulated to be caused by a defect in Riboflavin transporter. The disease is characterised by progressive hearing loss with ataxia and difficulty in swallowing and breathing. It is a subset in multiple acyl CoA dehydrogenase deficiency (MADD disorder). Age of onset is generally first to third decade of life. Lower cranial nerve involvement with LMN and UMN signs concomitantly is the striking feature. There is no specific treatment for BVVL except supportive care. Response to high dose riboflavin (20mg/kg/day) has produced promising results but the results may take anywhere from 1 week to 12 months to appear. 
      PubDate: 2019-02-23
      DOI: 10.18203/2349-3291.ijcp20190747
      Issue No: Vol. 6, No. 2 (2019)
       
  • Partial trisomy 15: a rare occurrence

    • Authors: Prachi Gandhi, Sushma Malik, Sharan Subramanian, Poonam Wade, Shruti Saxena, Vinaya Lichade
      Pages: 883 - 885
      Abstract: Partial trisomy 15q is a very rare entity and most of them are characterized by duplication of regions 15q21-15q26.3. This duplication is frequently associated with deletions in another chromosome resulting in unbalanced translocations.
      Authors report here, a rare case of partial trisomy 15, with breakpoints between 15q11.1 to q23, probably the first reported case with these breakpoints. Irrespective of the breakpoints, the phenotypic features are consistent in all affected cases and predominantly consist of craniofacial anomalies. In addition, finger abnormalities, very short neck, skeletal malformations and congenital heart disease may be present. Our neonate had typical dysmorphic features of arachnocamptodactyly, narrow face, large prominent, nose with broad nasal bridge, long philtrum, pointed chin, short neck, and low set deformed ears.  Neonates’ cytogenetic analysis revealed additional chromosomal material on the long arm of the chromosome 15 from q11.1 to q23.1, which was suggestive of partial trisomy of chromosome 15. Most cases reported have had a stormy clinical course, however, our proband had only mild respiratory distress at birth and she was discharged in a few days.
      PubDate: 2019-02-23
      DOI: 10.18203/2349-3291.ijcp20190748
      Issue No: Vol. 6, No. 2 (2019)
       
  • A rare case of Sprengel deformity associated with spondylocostal
           dysostosis in a four-year child

    • Authors: Syed Mohamed, Radha Kumar
      Pages: 886 - 889
      Abstract: Sprengel deformity is a complex congenital anomaly affecting one or both scapulae with mispositioning and dysplasia of scapula. It occurs due to failure of descent of scapula during intrauterine development and is the commonest congenital skeletal deformity of the scapula, often associated with other skeletal deformities. spondylocostal dysostosis is a rare genetic disorder which is characterized by malformation of the bones of the spine and ribs. It occurs in approximately 1 in 2,00,000 people worldwide. In spondylocostal dysostosis, affected children have wedge shaped vertebrae along with ribs that are fused, forked or sometimes missing. Based on the severity of the defect’s children may present with short stature, scoliosis or hypoplasia of lungs causing difficulty in breathing and recurrent respiratory tract infections. Management of both these skeletal deformities depends on their severity and the presence of associated deformities. Surgical intervention might be required for cosmetic and functional recovery of the shoulder.
      Authors had a rare and interesting case of a 4-year-old boy who had features of Sprengel deformity affecting left scapula which was associated with features of spondylocostal dysostosis.
      PubDate: 2019-02-23
      DOI: 10.18203/2349-3291.ijcp20190749
      Issue No: Vol. 6, No. 2 (2019)
       
  • Orbital compression syndrome: a rare complication of sickle cell disease
           in children

    • Authors: Prateek Kumar Panda, Srikant Kumar Padhy
      Pages: 890 - 892
      Abstract: Vasoocclusive crises in sickle cell disease commonly involve bone marrow of the long bones and vertebrae. Involvement of bones with less marrow space, including the bones of the orbit, is reported rarely in the literature. The present case is a 6-year-old boy, a known case of sickle cell disease, who presented with acute onset right upper and lower eyelid swelling, restriction of extraocular movement and pain. USG orbit showed a retroorbital hemorrhage compressing on the orbit, probably due to orbital bone infarction. The child was managed successfully with red blood cell transfusion and intravenous antibiotics, without steroids and surgical intervention. This report highlights the importance of maintaining a high index of suspicion in patients with known sickle cell disease presenting with pain, orbital swelling and restriction of ocular movement. Timely red blood cell transfusion only may be sufficient for uneventful recovery, without steroids or surgical intervention. Expedient diagnosis of orbital compression syndrome in children with sickle cell disease is crucial because this is a potentially sight-threatening entity.
      PubDate: 2019-02-23
      DOI: 10.18203/2349-3291.ijcp20190750
      Issue No: Vol. 6, No. 2 (2019)
       
  • Niemann-Pick disease type C-presenting as persistent neonatal jaundice: a
           rare case report

    • Authors: Jinka L. Narayana, Shaik M. Rafi, Uma M. Ramisetti, Kedarnath R. Tumati, Gangadhar B. Belavadi
      Pages: 893 - 896
      Abstract: Neimann-Pick disease (NPD) is an autosomal recessive lysosomal storage disorder caused by inherited deficiency of acid sphingomyelinase enzyme or its transport which leads to deposition of sphingomylin and cholesterol in the lysosomes of reticuloendothelial system. It is characterized by failure to thrive, hepatospleenomeagaly and neurodegenerative changes. There are four subgroups of neimann pick disease, type A, B, C and D. Here authors are reporting a case of 5 months old female child presenting with persistent jaundice since neonatal period, progressive abdominal distention and failure to thrive. On examination patient had significant abdominal distension with moderate hepatosplenomegaly. On laboratory evaluation child diagnosed to have NPD type C. This case emphasizes the need to keep NPD in differential diagnosis of children presenting with persistent neonatal jaundice, hepatosplenomegaly, failure to thrive.
      PubDate: 2019-02-23
      DOI: 10.18203/2349-3291.ijcp20190717
      Issue No: Vol. 6, No. 2 (2019)
       
  • Developing an integrated biosocial theory to understand juvenile
           delinquency: from the social, cognitive, affective, and moral (SCAM)
           perspectives

    • Authors: Yu Du
      Pages: 897 - 903
      Abstract: Biosocial theory has made considerable progress in explaining juvenile delinquency and making explicit references for juvenile justice policy during the past decades. However, because biosocial theory aims to identify multiple risk factors, it makes juvenile justice practice and develop delinquency prevention programs difficult. This paper proposes an integrated biosocial theory from the social, cognitive, affective, and moral (SCAM) perspectives to understand juvenile delinquency and facilitate the development and improvement of prevention and intervention programs. The article briefly summarizes the background and the key concepts of the chosen criminological theories and the logic of theoretical integration. Then it articulates the four aspects of the integrated biosocial theory and how it can contribute to criminology in details. Lastly, the paper identifies its potential limitations and provides practical implications.
      PubDate: 2019-02-23
      DOI: 10.18203/2349-3291.ijcp20190751
      Issue No: Vol. 6, No. 2 (2019)
       
  • Thyroid abnormalities among Down syndrome children from Kerala, India

    • Authors: Vijitha Viswambharan, Mahesh M. Vasu, Ismail Thanseem, Suresh A. Poovathinal, Ayyappan Anitha
      Pages: 904 - 905
      Abstract: Down syndrome (DS), caused by trisomy of human chromosome 21, is one of the most common chromosomal abnormalities in live born infants with a prevalence rate of 1 in 700 live births. Individuals with DS usually have comorbid conditions such as thyroid dysfunction, growth retardation, diabetes mellitus and obesity. The most frequent among these are the thyroid abnormalities which range from subclinical to overt hypothyroidism, and rarely hyperthyroidism.1-3 Individuals with DS are more susceptible to thyroid disorders compared to the general population. Primary hypothyroidism, referred to as elevated TSH, is the most common thyroid abnormality in DS; secondary hypothyroidism indicated by normal/reduced TSH is extremely rare. The prevalence of hypothyroidism varies between 3-54% in adults with DS.4 The aim of this study was to examine the incidence of thyroid abnormalities among children with DS registered in a tertiary referral center for neurodevelopmental disorders and non-communicable neurological disorders in Kerala, a south Indian state. 100 children with DS in the age range of 4 months-15 years, registered at Institute for Communicative and Cognitive Neurosciences (ICCONS), Shoranur, Kerala during the period of 2012-2016, were recruited for the study. The mean age of the participants (57 males, 43 females) was 5.4±3.8 years. The diagnosis of DS was confirmed by karyotyping. All the participants were drug-naive at the time of blood collection. 500 µl of serum samples was used for thyroid function test (TFT) which measured the levels of TSH, triiodothyronine (T3) and thyroxine (T4) by chemiluminescence immunoassay (CLIA). The reference range for TSH, T3 and T4 were as follows, TSH: 0.4-4mIU/ml, T3: 70-170ng/dl, T4: 4.5-12.5mg/dl.
      PubDate: 2019-02-23
      DOI: 10.18203/2349-3291.ijcp20190752
      Issue No: Vol. 6, No. 2 (2019)
       
 
 
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