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International Journal of Contemporary Pediatrics
Number of Followers: 9  

  This is an Open Access Journal Open Access journal
ISSN (Print) 2349-3283 - ISSN (Online) 2349-3291
Published by Medip Academy Homepage  [12 journals]
  • An assessment of the pattern of congenital heart disease in children:
           study in a tertiary care hospital, Rajshahi, Bangladesh

    • Authors: Kuntal Roy, Humayun Shahed, Kaushik Roy, Quazi Sahely Sarah, Nandita Sur Chowdhury
      Pages: 1 - 6
      Abstract: Background: Congenital heart disease is defined as a gross structural abnormality of the heart or intrathoracic great vessels that is actually or potentially of functional significance. The aim of this study was to assess the pattern of congenital heart disease.  Methods: It was a hospital based Cross-sectional study carried out prospectively in the department of pediatrics of Rajshahi medical college and hospital from July 2011 to December 2011. The study population was all the children up to 12 years of age admitted in three pediatric units of this hospital during the study period.Results: Among the 147 clinically suspected cases congenital heart disease was confirmed in 110 cases by echocardiography. Thrill was mostly present in 60.5% of VSD cases, in 42.1% of PDA, in 50% of A-V canal defect and 10% of multiple lesions patients. Palpable P2 was present in 27.9% of VSD cases, 15% of TOF, 50% of PS and 30% of multiple lesions patients. Left parasternal heave was found in 25.6% of VSD cases, 15.6% of ASD, 88.2% of TOF, 50% of PS and 40% of multiple lesions patients. Cardiomegaly was present in 5.3% of PDA, 50% of COA, 50% of PS and 20% of multiple lesions cases. Plethoric lung field with cardiomegaly & consolidation was observed in 10% of VSD and 21% of PDA cases. Cardiomegaly with consolidation was observed in 11.6% of VSD & 15.6% of ASD cases. Boot shape heart with oligamic lung was observed in 88.2% of TOF patients. Pulmonary opacity/consolidation was found in 4.7% of VSD cases.Conclusions: It appeared that incidence of CHD is quite significant in RMCH.
      PubDate: 2020-12-23
      DOI: 10.18203/2349-3291.ijcp20205500
      Issue No: Vol. 8, No. 1 (2020)
  • Evaluation of outcome of early appendectomy in appendicular lump

    • Authors: A. S. M. Rezbanul Haque, Bablu Kumar Saha, M. Mahfuzul Haque, M. Abdus Sattar, Upendra Nath Ray, M. Anisur Rahman, Most Arifa Begum, Miratul Jesmin, Shamima Najma, M. Golam Shorwer
      Pages: 7 - 12
      Abstract: Background: Appendicular lump is a well-known sequalae of acute appendicitis encountered in 2-6% of patients. Successful management of appendicular lump is controversial with different approaches. This study aims to evaluate the outcome of early appendectomy in an appendicular lump.Methods: A total of 210 patients were admitted in surgery and pediatric surgery department of Rangpur medical college and hospital with the diagnosis of acute appendicitis and its sequalae over two years.Results: In this study, sixty patients were included who were presented with an appendicular lump. Maximum patients (50%) were found in the age group of 21-30 years. Males (66.67%) were more affected. Eighty percent of patients were coming from below-average socio-economic conditions. In group I, early appendicectomy had done and outcomes were satisfactory and favorable. In group II, eighteen patients were operated who were admitted at 6 to 8 days after an attack of acute appendicitis, and twelve patients were continued the conservative treatment. In group II, who had done surgery, among them, fourteen patients (77.78%) were found an appendicular abscess, and four patients (22.22%) were found perforated appendix per-operatively. In group I, the mean recovery period was less and they had minimum complications. In group II, the mean recovery period was more and they had more complications.Conclusions: Based on these findings, it can be concluded that early exploration in appendicular lump patients confirm the diagnosis, cures the problem, reduces the cost of management, and shortens the convalescence period and hospital stay with reasonably satisfactory outcomes.
      PubDate: 2020-12-23
      DOI: 10.18203/2349-3291.ijcp20205501
      Issue No: Vol. 8, No. 1 (2020)
  • Association between maternal and fetal outcomes in high BMI diabetic and
           non-diabetic groups

    • Authors: Rezwana Kabir, Sumona Parvin, M. Ubaidul Islam, Ferdousi Begum
      Pages: 13 - 19
      Abstract: Background: BMI has increased among the women of reproductive age worldwide. Insulin resistance associated with obesity and diabetes are mostly responsible for the adverse outcomes like macrosomia, maternal morbidity, increased operative interference and NICU admission. Objectives of the study was to assess maternal high BMI and its association with maternal and neonatal outcomes in diabetic and non-diabetic groups.Methods: A cross sectional study was conducted in the BIRDEM General Hospital Dhaka on 200 pregnant women with high BMI at 3rd trimester. Patients were allocated in two equal groups- Group I Diabetic and group II Non-diabetic.Results: Age range was 18 to 35 years with mean age of 26.9±8.3 years among diabetic and 25.7±7.8 years among non-diabetic women. BMI was comparatively higher in diabetic group. Overall frequency of C/S was higher (89.5%) and on comparison between the groups, frequency was significantly higher in diabetic group (94% vs 85% in group I and group II respectively). The postpartum complications were also significantly higher in diabetic group (22% vs 7% in Group I and Group II respectively). About 23 (11.5%) of the babies had birth weight more than 3.5 kg (maximum among diabetic mothers 15% vs 8% in group I and II). The mean birth weight was higher in diabetic group 3.7 ± 0.4 kg vs 2.6±0.5 kg in non-diabetic group respectively. On the neonatal outcomes, significant number of macrosomia were found in the diabetic group, and NICU admissions were also higher in the diabetic group.Conclusions: High BMI diabetic mothers have significantly higher maternal and neonatal complications.
      PubDate: 2020-12-23
      DOI: 10.18203/2349-3291.ijcp20205502
      Issue No: Vol. 8, No. 1 (2020)
  • A study on correlation of waist indices with body mass index among school
           children in North Kerala

    • Authors: Divya Krishnan K., Shyna K. P., Urmila K. V., Anand K. V.
      Pages: 20 - 25
      Abstract: Background: Childhood obesity is a serious problem worldwide. Body mass index (BMI) has been the widely used tool to detect obesity. Central adiposity detected by waist indices is a better predictor of obesity related complications like metabolic syndrome. Objective of this study was to analyze the correlation of waist indices with BMI as indicators of overweight (OW)/obesity in school going children.Methods: This study was done in 880 adolescents from two schools in Kerala. Anthropometric measurements including waist circumference (WC) were taken according to guidelines and BMI, waist hip ratio (WHR), waist height ratio (WHtR) calculated. We categorized children as normal, OW/obese according to BMI charts by centers for disease control and prevention (CDC). A cutoff 70th centile in WC charts by Khadilkar et al, WHR of more than 0.85 in girls and 0.9 in boys, WHtR >0.5 were taken as central obesity.Results: The prevalence of overweight/obesity (BMI >85th centile) was estimated to be 26.3%. Prevalence of central obesity was 12.3% when measured by WC, 22.8% measured by WHR, 14.8% measured by WHtR. All three waist indices showed statistically significant correlation with OW/obesity and BMI (p<0.001). Multivariate regression showed association of OW/obesity with urban school, acanthosis nigricans, hypertension, WHtR (p<0.001) and with WC (p=0.004).Conclusions: The prevalence of overweight and obesity is alarmingly high in adolescent children.  Waist height ratio was best correlated with Body mass index and overweight/obesity, followed by Waist circumference. We recommend waist height ratio as a screening tool to predict obesity in school going children.
      PubDate: 2020-12-23
      DOI: 10.18203/2349-3291.ijcp20205428
      Issue No: Vol. 8, No. 1 (2020)
  • Having a common ancestor; significance of consanguinity and genetic

    • Authors: Madhurasree Nelanuthala, Brahmapreet Kaur, Vinod Ingale, Suvarna Magar, Pradnya Joshi
      Pages: 26 - 29
      Abstract: Background: Consanguinity is prevalent in India, which is one of the high-risk factors for increased risk of single gene diseases. Global developmental delay is heterogeneous group of genetic diseases which includes chromosomal and single gene diseases. The aim of the study is to determine impact of consanguinity on these 2 groups of diseases.Methods: A retrospective review of children coming to genetic OPD with global developmental delay (GDD) and children who were proven inborn errors of metabolism (IEM) was done. Presence of consanguinity or its absence was noted in all the children in both groups.Results: Out of 194 cases visited to genetic OPD, 103 (54%) of the patients were product of consanguineous marriage and 91 (46%) were product of non-consanguineous marriage. Out of 103 cases born of consanguineous marriage, 59 (57.3%) were GDD and out of 91 children who were born of non-consanguineous, 70 (68.35%) were having GDD. The difference was statistically significant with p value of 0.003. Out of 103 cases which were product of consanguineous marriage 44 (42.7%) were IEMs and out of 91 children who were product of non-consanguineous, 21 (23%) were having IEMs. The difference was statistically significant with p value of 0.004.Conclusions: Genetic drift or founder mutations need to be considered in Indian communities, where small sub-communities are genetically isolated pools and can have distinct genetic diseases belonging to particular communities not having impacted by consanguinity. Consanguinity increases risk of autosomal recessive diseases like inborn errors of metabolism.
      PubDate: 2020-12-23
      DOI: 10.18203/2349-3291.ijcp20205453
      Issue No: Vol. 8, No. 1 (2020)
  • Clinical profile and major co-morbidities among hospitalized children with
           severe acute malnutrition: experience from a tertiary care teaching
           hospital of North India

    • Authors: Ashish Marwah, Poonam Mehta Nee Marwah
      Pages: 30 - 34
      Abstract: Background: Malnutrition is still a leading cause of morbidity and mortality in children aged less than 5 years and responsible for 60% of the 10 million deaths. The study was designed to evaluate the clinical profile and major clinical co-morbidities among hospitalized children with severe acute malnutrition (SAM).Methods: A prospective study was conducted in a pediatric department of a tertiary care teaching hospital of Haryana. All children aged 6 months to 5 years with SAM admitted between 1st April 2018 to 31st March 2019 were included in the study. The socio-demographic details, anthropometry, clinical details and outcome were recorded in a pre-designed structured performa. Statistical analysis was done using SPSS software version 16. P value<0.05 was considered significant.Results: After screening a total of 131 children, 102 children met the inclusion criteria and were enrolled in the study. Out of these, 50 were males and 52 were females. Majority of children (i.e., 59.8%) belonged to 6-12 months age group. Majority (92.16%) belonged to lower socio-economic status. Exclusive breastfeeding during first 6 months was documented in 74.51% of the children. Delayed initiation of complementary feeds was observed in 78.43% of children and had a significant association with poor future outcome (p<0.05). Major clinical co-morbidities were severe anemia (56.86%), diarrhea (27.45%) and lower respiratory tract infection (19.6%).Conclusions: In our study, most vulnerable age group for severe malnutrition was 6-12 months infants. Low socioeconomic status of family and delayed initiation of complementary feeding were the major risk factors. Most common co-morbidities were severe anemia, diarrhea, lower respiratory tract infections and sepsis emphasizing the need to target these factors.
      PubDate: 2020-12-23
      DOI: 10.18203/2349-3291.ijcp20205431
      Issue No: Vol. 8, No. 1 (2020)
  • Study of antimicrobial use in paediatric inpatients in a tertiary care
           hospital in Ahmedabad, India

    • Authors: Hetal N. Jeeyani, Rutvik H. Parikh, Sheena Sivanandan, Harsh J. Muliya, Shivam N. Badiyani, Manan B. Patel
      Pages: 35 - 40
      Abstract: Background: Inappropriate use and overuse of antibiotics are important factors leading to increased bacterial resistance apart from increased risk of adverse reactions. The aim of this study was to derive antibiotic use percentage, study its pattern and compare antibiotic prescribing indicators with standard indicators.Methods: This prospective observational study was conducted from 1st August 2018 to 31st July 2019 on paediatric inpatients from 1 month to 14 years. All the relevant data was taken from the case records of patients at the time of discharge. The data included: age, sex, hospital stay, clinical diagnosis and details of antimicrobial treatment.Results: From 989 patients, 85.9% were diagnosed with infectious illness, of which 60.1% had viral and 36.7% had bacterial infection. The use of antimicrobial drugs was 42.7% and antibiotics was 40.4%. The mean number of antibiotics received was 1.13±0.31. 90% patients received single antibiotic. 88.8% drugs were prescribed by generic name and 99% drugs were prescribed from essential drug formulary. 17 different antibiotics were used out of which ceftriaxone (62.5%) was the most commonly used. Groupwise, antibiotic use was cephalosporins (68.4%), penicillin (20.2%), aminoglycosides (4.31%), fluoroquinolones (0.9%) and macrolides (0.22%). The use of higher antibiotics like vancomycin (3.86%) and carbapenems (0.68%) was quite less.Conclusions: The antibiotic use in our hospital was higher than the WHO standard but less as compared to majority of other studies. Use of cephalosporins was more and penicillin was less as compared to other studies. This suggests that there is a need of implementing antibiotic stewardship programs to enhance rational antibiotic prescribing.
      PubDate: 2020-12-23
      DOI: 10.18203/2349-3291.ijcp20205430
      Issue No: Vol. 8, No. 1 (2020)
  • Assessment of thyroid function among children with epilepsy receiving
           anticonvulsant monotherapy: a hospital based prospective study

    • Authors: Ushuf Rahman, Munshi Safikul Islam
      Pages: 41 - 47
      Abstract: Background: Data on influence of antiepileptic drugs (AED) on thyroid profile in children is limited and is still controversial. This study aimed to investigate the effects of valproate, levetiracetam, phenobarbitone and oxcarbazepine monotherapy on thyroid function in children after one year of therapy.Method: A total of 106 children (39 girls and 67 boys) with new onset and controlled epilepsy treated with valproate (n=52), phenobarbitone (n=12), oxcarbazepine (n=14) and levetiracetam (n=28) were enrolled in the study. Serum thyroxine (T4, T3) and thyroid-stimulating hormone (TSH) level were measured before and at one year of therapy.Results: At baseline average T4, T3 and TSH concentrations were not different between the drug groups. Except levetiracetam all antiepileptics increased TSH after one year of therapy and there was significant difference in TSH increment in valproate treated patients compared to other anticonvulsants. All anti-epileptics except levetiracetam was found to decrease T4 and T3 after one year of therapy but there was no significant difference among the groups, unlike TSH. Sodium valproate was the most frequently used antiepileptic drug. None of children had any symptoms of hypothyroidism, only 3% had signs of hypothyroidism which included goitre on examination. Out of various seizure disorders generalised tonic clonic type was most common (47.5%) followed by atypical febrile seizure (23%).Conclusions: All antiepileptic drugs studied except levetiracetam had varying degrees of deleterious effects on thyroid function.
      PubDate: 2020-12-23
      DOI: 10.18203/2349-3291.ijcp20205503
      Issue No: Vol. 8, No. 1 (2020)
  • An assessment of knowledge and practices of breastfeeding among mothers
           having child less than 2 years of age in a city of central Uttar Pradesh,

    • Authors: Bipul Kumar, Tathagata Bose, Saurav Das, Ashish Kumar Gupta, Ashutosh Kumar, Ashok Bhandari
      Pages: 48 - 54
      Abstract: Background: Breastmilk is the natural first food for babies which provides all the energy and nutrients that the infant needs for the first few months of life. More than two thirds of the 2.4 million child deaths occurring each year in India are related to inappropriate infant feeding practices. Initiation of breastfeeding within 1 hour of birth in central Indian states is among the lowest. The situation in central Indian states especially Uttar Pradesh is worse than the rest of India which is usually attributed to prevalent socio-economic and cultural factors.Methods: A cross-sectional descriptive study that was conducted among 144 mothers visiting a tertiary care hospital in Lucknow, Uttar Pradesh, India over a period of nine months using a questionnaire-based interview.  Results: The study found that majority of subjects has good knowledge about breastfeeding. 92.4% mothers reported knowledge of putting the baby on the breast within an hour of birth. 65% had the correct breastfeeding position knowledge. Majority were aware that breastfeeding protects from various infections and that colostrum or first milk serves as the first immunization for the baby. 90.3% knew the correct definition of complementary feeding. Most of the subjects planned to breastfeed their baby for a year or more (86.8%).  Conclusions: Majority mothers had good knowledge of breastfeeding and complementary feeding and good breastfeeding practices were being followed. This study brought out that educated mothers had better breastfeeding knowledge and practices, thus highlighting to the importance of formal education in mothers.
      PubDate: 2020-12-23
      DOI: 10.18203/2349-3291.ijcp20205504
      Issue No: Vol. 8, No. 1 (2020)
  • Impact of Rashtriya Bal Swasthya Karyakram, in management of childhood
           cataract, at a tertiary eye care center of Eastern Uttar Pradesh

    • Authors: Rahul Bhardwaj, Sandeep Sharma, Vijay Pratap Singh Tomar, Kunal Vikram Singh, Sindhuja Singh, Prakhar Chaudhary, Nikita Jaiswal, Rachana Gaur
      Pages: 55 - 59
      Abstract: Background: Cataracts in children are rare, accounting 7.4-15.3% of pediatric blindness. Pediatric cataract is a treatable leading cause of childhood blindness. Rashtriya bal swasthya karyakram (RBSK) is an important initiative aiming at early identification and early intervention for children from birth to 18 years. The objective of our study was to know the impact of RBSK, in management of childhood cataract, at a tertiary eye care center.Methods: This was a hospital based retrospective study, done from December 2018 to December 2019. This study included all patients of congenital and developmental cataract during this study period. The patients aged less than or equal to 18 years were included. All statistical analyses were done at 5% (p<0.05) significance using Graph Pad instat version 3.0 and Microsoft excel 2019.Results: During a study period of thirteen months, 357 eyes of 210 patients with congenital or development cataract were included. There were 142 (67.61%) male patients and 68 (32.38%) were female. The maximum number of patients were seen in the age group of 4-6 years 52 (24.7%), followed by the age group of 7-9 years 48 (22.8%). Bilateral cataracts were seen in 148 (70.4%) patients and unilateral cataract in 61 (29.0%) patients. The most common type of cataract was lamellar cataract seen in 150 (42%) eyes.Conclusions: RBSK is changing the lives of children and their families by reducing the burden of childhood blindness due to cataract and improving the quality of the life, especially in financially underprivileged families. 
      PubDate: 2020-12-23
      DOI: 10.18203/2349-3291.ijcp20205505
      Issue No: Vol. 8, No. 1 (2020)
  • Clinical profile and outcome of children admitted with acute encephalitis

    • Authors: Arpita Adhikari, Mona Gajre, Rini Kothari, Nayan Chaudhari, Deepali Sangale
      Pages: 60 - 64
      Abstract: Background: Acute encephalitis syndrome (AES) is an important cause of mortality and morbidity in children. We undertook this study for better understanding of clinical profile and outcome of AES in our settings.Methods: It was a prospective observational study. We studied 15 patients of AES admitted in a tertiary care hospital from December 2016 to May 2017. For investigating AES cases, WHO case definition was adopted. Clinically a case of AES is defined as fever or recent history of fever with change in mental status (including confusion, disorientation, coma, or inability to talk) and/or new onset of seizures (excluding simple febrile seizures). Other early clinical findings could include an increase in irritability, somnolence or abnormal behavior greater than that seen with usual febrile illness. We evaluated their clinical characteristics and outcomes at the time of discharge.Results: Fever, altered sensorium, seizures and headache were the most common symptoms observed in this study. Among 15 cases of AES patients, 6 (40%) recovered completely, while 5 (33.33%) cases had neurological sequelae with a wide range of severity varying from mild to severe at the time of discharge, 4 (26.66%) patient died in the hospital.  Conclusions: This study offers a description of the present etiology, clinical presentation and short-term outcome of AES. Use of mechanical ventilation, lower Glasgow coma score, and concurrent seizures are predictors for a poor outcome. Reporting and appropriate workup of all cases would strengthen the AES surveillance and help in reducing the morbidity and mortality due to this disorder.
      PubDate: 2020-12-23
      DOI: 10.18203/2349-3291.ijcp20205506
      Issue No: Vol. 8, No. 1 (2020)
  • A comparative study on the effect of nebulized budesonide and
           levosalbutamol versus ipratropium bromide and levosalbutamol in the
           management of acute asthma in children aged 5-11 years

    • Authors: Jose P. Cyril, Baburaj S., Priya S. Nair, Tinu A. Kuruvilla, Bobby C., Lini B. Das
      Pages: 65 - 69
      Abstract: Background: Asthma is a non-communicable chronic inflammatory condition of lung airways. The availability of new diagnostic methods, introduction of a number of drugs, both oral and inhaled has revolutionized management of asthma in children. Goal was to achieve maximum effect with least amount of medication and allowing infrequent use of quick relievers. The present study was, therefore, designed to compare the effectiveness of single dose nebulization with combination of nebulized budesonide and levosalbutamol (group A) versus commonly used ipratropium bromide and levosalbutamol (group B) in children (5-11 years) with mild-moderate exacerbation of asthma.Methods: Was an observational comparative study involving 2 treatment groups of children in age group of (5-11) years, with mild-moderate exacerbation of asthma assessed by peak expiratory flow rate (PEFR) and pulmonary score (PS).Results: Of 160 children analyzed, post nebulization mean predicted PEFR improved in both of the study groups, and the mean PS decreased in both the groups post nebulization which was statistically significant (p<0.001). But when comparing between the groups, the mean percentage of improvement in predicted PEFR and PS were almost similar.Conclusions: Even though, both the groups gave the same end result the group in which budesonide was used had a higher recovery time with the least number of nebulization.
      PubDate: 2020-12-23
      DOI: 10.18203/2349-3291.ijcp20205507
      Issue No: Vol. 8, No. 1 (2020)
  • Effectiveness of an instructional module regarding first-aid of pediatric
           emergencies on knowledge among mothers of 1-6 years children

    • Authors: Km Arti, Rina Kumari, Sciddhartha Koonwar, Anugrah Charan
      Pages: 70 - 76
      Abstract: Background: The first aid is given to preserve and protect life, prevent further injury or deterioration of the victim, and help to promote recovery. The objectives of the study were to assess the pre- test knowledge scores regarding first aid of pediatric emergencies among mothers of 1-6 years children, to evaluate the effectiveness of an instructional module regarding first aid of pediatric emergencies on knowledge among mothers of 1-6 years children, to find out the association between the post-test knowledge scores of mothers with their demographic variables.Methods: Quasi-experimental with one group pre-test post-test design was used for 48 mothers at pediatric medical ward, surgery ward and trauma emergency KGMU, Lucknow and   purposive   sampling   technique   was   used.   Self-structured knowledge questionnaires on first aid of pediatric emergencies were used. Based on the objectives and the hypotheses the data were analyzed by using various statistical tests.Results: The result reveals that the overall score was 13.17 in pre-test and 20.13 in post- test after distribution of Instructional module to mothers 22 (45.83%) had good knowledge and 26 (54.17%) had average knowledge regarding first aid of selected conditions of pediatric emergencies. Paired ‘t’ test showed that there was a significant improvement between pre-test and post-test scores with a 't' value of -24.639, p<0.05.Conclusions: The study findings revealed that the Instructional module regarding first aid of Pediatric Emergencies was effective in improving knowledge of mothers of 1-6 years children. 
      PubDate: 2020-12-23
      DOI: 10.18203/2349-3291.ijcp20205508
      Issue No: Vol. 8, No. 1 (2020)
  • Anganwadi based nutritional survey of children in Attappadi

    • Authors: K. K. Rakesh Raju, V. T. Ajithkumar, T. P. Ashraf, A. Riyaz, N. C. Cherian, K. C. Rajagopalan, K. P. Aravindan, Geeta Govindraj
      Pages: 77 - 81
      Abstract: Background: Malnutrition and anaemia form major public health problems among the school age children, particularly in the developing countries.Methods: A cross sectional study was conducted among children between 6 months and 18 years, in randomly selected 25 Anganwadis of Attappadi area. Objective of the study was to estimate the prevalence of anaemia and malnutrition among the children of Attappadi. Children were divided in to tribal and nontribal. Anthropometric measurements, haemoglobin estimation by cyanmethemoglobin method and peripheral smear examination were done.Results: 65.5% tribal and 54.1% non-tribal were anaemic. Among males 65.9% tribal and 56.4% non-tribal were anaemic. Among females 65.1% tribal and 52.6% nontribal were anaemic. In the age group less than 6 years, 9% tribal females, 8.9% nontribal females, 12% tribal males and 5.8% nontribal males were severely stunted. Above 6yrs it was 3.3% tribal females, 2.7% nontribal females, 2.4% tribal males and 7.4% nontribal males. In the age group less than 6 years, 12.5% tribal females, 3.9% nontribal females, 15.9% tribal males and 4.3% nontribal males had severe underweight. Above 6 years it was 8.3% tribal females, 0% non-tribal females, 19% tribal males and 3% non-tribal males.Conclusions: Anaemia and malnutrition are common among children of Attappadi. Tribal children are more affected than non-tribal children. Anaemia is more common among two age groups, less than 5 years and more than 11 years. Among females’ adolescent girls are more affected. Periodic assessment of growth parameters and early detection and treatment of anaemia are needed.
      PubDate: 2020-12-23
      DOI: 10.18203/2349-3291.ijcp20205509
      Issue No: Vol. 8, No. 1 (2020)
  • A clinic-epidemiological study of organophosphorus poisoning in children
           in a tertiary care medical college hospital

    • Authors: Mohammed Anees-ur-Rahman, Karthik Suresh, Kumar Gowripura Visweswaraiah, Ananda Kumar Tumkur Subbaraya
      Pages: 82 - 85
      Abstract: Background: Acute organophosphorus (OP) pesticide poisoning is widespread and is the most common poisoning in many developing countries and varies in different geographic regions. Organophosphorus compounds are anti acetyl cholinesterase which exert their toxicity by interfering with the normal function of acetylcholine, an essential neurotransmitter throughout the autonomic and central nervous system.Methods: The present study was conducted in department of pediatrics Sri Siddhartha medical college, Tumkur. All children with OP poisoning admitted in the pediatric ward were included in the study. Unknown compound/tablet poisoning, which was contradictory to the diagnosis of OP compound were excluded.Results: Out of 5,274 cases which were admitted in pediatric ward, 15 children were diagnosed as OP poisoning.  In the present study the incidence of OP poisoning was 2.84%. Out of 15 cases 3 cases were below 1 year of age, 2 cases were in the age group of 1-5 years, 5 cases were in the age group of 6-10 years and 5 cases were seen in above 11 years of age. Among 15 cases 13 (86.7%) cases were accidental poisoning and 2 (13.3%) cases were attempt to suicide. Out of 15 cases 4 (26.7%) cases were seen in monsoon, 4 (26.7%) cases were seen in winter and 7 (46.6%) in summer season. Out of 15 cases 14 (93.3%) cases improved with treatment and 1 (6.7%) case discharged against medical advice.Conclusions: Most cases of accidental poisoning are preventable by close watch on the toddlers and younger children who have a habit of tasting unknown things. Educate school children in all aspects of childhood poisoning.
      PubDate: 2020-12-23
      DOI: 10.18203/2349-3291.ijcp20205510
      Issue No: Vol. 8, No. 1 (2020)
  • Correlation of vitamin D level with its related biochemical parameters and
           impact of different treatment regimens on their correction

    • Authors: Amit Gupta, Sachin Kumar
      Pages: 86 - 91
      Abstract: Background: Vit D is a fat-soluble vitamin that is produced when ultraviolet rays from sunlight strike the skin and trigger vit D synthesis. Aims and Objectives of the study were to find out the correlation of vit D level with its related biochemical parameters and impact of two different treatment regimens on their correction. Methods: A total of 107 patients were followed up out of which 89 were vit D deficient and rest were vit D insufficient. Results: Mean age of the patients was 6.11±4.49 and males comprised 66%. Mean BMI of children included in group A, B and C was 19.40±2.69, 19.60±3.18 and 20.95±3.72 kg/m2 respectively. Vit D levels at baseline had a significant inverse correlation with ALP (r=-0.27, p value=0.008).  Before and after comparison of mean serum calcium levels revealed significant improvement in both the treatment groups. Severity of vit D deficiency, at baseline, 9.10, 77.30 and 13.60% of patients had vit D levels of less than 5, 5 to 15 and more than 15 for group A respectively. In group B at baseline, 6.70, 71.10 and 22.20% of patients had vit D levels of less than 5, 5 to 15 and more than 15 respectively.Conclusions: Present study found that 60,000 IU/week and dose of 2000 IU/day for infants or 5000 IU/day for 1 to 18 years of age, along with 500 to 800 mg oral calcium for 6 to 8 weeks can result in correction of vit D deficiency.
      PubDate: 2020-12-23
      DOI: 10.18203/2349-3291.ijcp20205511
      Issue No: Vol. 8, No. 1 (2020)
  • A retrospective study of predisposing factors and outcome of persistant
           pulmonary hypertension among newborns at rural tertiary care centre

    • Authors: B. C. Yelamali, Gangadhar S. Mirji, Mirnalini Rajput
      Pages: 92 - 97
      Abstract: Background: Persistent pulmonary hypertension in newborns (PPHN) remains a significant cause of perinatal morbidity and mortality. Early recognition of factors that increase the risk of PPHN is of great importance in either to prevent or to treat PPHN optimally. Aim was to study the neonatal predisposing factors, profile and outcome of PPHN.Methods: This retrospective study was conducted in level III neonatal care unit, a rural referral centre of North Karnataka, India from January 2018 to April 2020.Results: During the study period a total of 50 infants with PPHN were identified with the incidence of 5.43/1000 live births. Mean gestation age (±SD) was 38.28±2.49 weeks and mean birth weight (±SD) was 2624±512 gm. The most noted risk factors were meconium aspiration syndrome (42%), birth asphyxia (16%), RDS (10%), positive pressure ventilation at birth (52%) and male gender (62%). Out of 50 infants with PPHN, high mortality was seen in low birth weight babies (66.6%). Use of sildenafil showed increased mortality (56.2%) whereas use of surfactant scored better with decreased mortality of 42.8%.Conclusions: Major risk factors for PPHN are MAS, birth asphyxia, RDS and low birth weight. Poor prognosis is seen in male gender, prematurity and CDH with increased risk of mortality. The use of systemic pulmonary vasodilators can be considered with caution and use of surfactant has a role in management of PPHN.
      PubDate: 2020-12-23
      DOI: 10.18203/2349-3291.ijcp20205512
      Issue No: Vol. 8, No. 1 (2020)
  • Study and correlate the severity of birth asphyxia with serum levels of
           glucose, uric acid and electrolytes in the cord blood of asphyxiated

    • Authors: Kavya M. Y., Sudha Rudrappa, Girish Gopal
      Pages: 98 - 101
      Abstract: Background: Perinatal asphyxia one of the most common primary cause of mortality and morbidity among neonates in India and is the commonest cause of stillbirths.Methods: This prospective study was conducted for a period of 18 months which included cases (124) and controls (124) comprised of asphyxiated and non-asphyxiated neonates respectively.  The umbilical cord arterial blood was collected by double clamp technique and sent for analysis of electrolytes, uric acid and glucose.Results: Umbilical arterial sodium, calcium and glucose concentration was significantly lower in cases as compared to Control and potassium, uric acid and creatinine concentration was found to be on the higher in the cases as compared to the controls, and the difference was statistically significant with p<0.001.Conclusions: Metabolic abnormalities like hyponatremia, hypocalcaemia and hyperuricemia are significant risk factors for perinatal brain injury. Identification and treatment of such abnormalities results in improved outcome in affected neonates.
      PubDate: 2020-12-23
      DOI: 10.18203/2349-3291.ijcp20205513
      Issue No: Vol. 8, No. 1 (2020)
  • Bicytopenia/pancytopenia in children - clinico etiological profile and
           importance of bone marrow evaluation in a tertiary care centre

    • Authors: Lalita Wadhwa, Suman Chirla, Maheshwari K., Puneet Wadhwa
      Pages: 102 - 106
      Abstract: Background: Peripheral cytopenia is a common hematological problem in our day-to-day clinical practice resulting from various diseases ranging from transient infection induced bone marrow suppression to life threatening hematological malignancies. The objective of this study was to know the clinicoetiological profile,hematological analysis and importance of bone marrow evaluation of bicytopenia/pancytopenia in children in a tertiary care teaching hospital.Methods: This was a retrospective, observational study, conducted in pediatric department, NRIIMS, Visakhapatnam, Andhra Pradesh from May 2019 to May 2020. All children in the age group of 1-18yrs of age admitted with new onset bicytopenia/pancytopenia who underwent hematological analysis and bone marrow examination in our hospital were included in this study. Children with bicytopenia/ pancytopenia evaluated outside/treated in other hospitals were excluded from our study. Data was obtained from bone marrow biopsy register from pathology department, admission register of pediatric ward and hospital medical records.Results: Out of the 31 children studied, males were (54.8%), females were (45.2%).11-18 years of age were (51.6%), 1-5 years of age were (38.7%). Fever (77.4%), pallor (74.1%), hepatosplenomegaly (41%) was the most common clinical feature noted in these patients. ALL (52.3%), followed by ITP (9.52%) was the most common etiology for bicytopenia. Aplastic anaemia (40%), megaloblastic anaemia (20%) were most common etiology noted for pancytopenia. Bicytopenia (67.7%) was more common than pancytopenia (32.2%).Peripheral smear examination picked up only 11 out of 14 cases of haematological malignancy, identified by bone marrow examination. Most common bone marrow finding noted was ALL (38.7%), followed by hypocellular bone marrow (22.5%).Conclusions: When there is high index of clinical suspicion and peripheral smear is unable to pick up these cases, it is advisable to do bone marrow examination at the earliest for early confirmation.
      PubDate: 2020-12-23
      DOI: 10.18203/2349-3291.ijcp20205514
      Issue No: Vol. 8, No. 1 (2020)
  • Predictors of mortality in extramural very low birth weight neonates: a
           prospective observational study

    • Authors: Rajkumar M. Meshram, Ruchi A. Gedam, Shivangi Garg, Kalyani S. Kadu, Madhabika R. Chakraborty, Swaroop B. Kumar
      Pages: 107 - 113
      Abstract: Background: Over the past few decades, the burdens of very low birth weight (VLBW) preterm infants are increasing due to advances in obstetrics and perinatal services. Objectives of the study were to assess predictors of mortality of extramural VLBW neonates.Methods: Prospective one year cohort study was undertaken on VLBW neonates fulfilling the inclusion criteria at a tertiary institute. Maternal and neonatal demographic data were analyzed.Results: Male to female ratio was 1.26:1. One hundred and thirty seven (74.9%) neonates had birth weights from 1000-1499 g while 46 (25.1%) had birth weights <1000 g (ELBW) and 90% were preterm. One hundred and sixty five (90.2%) neonates were admitted in early neonatal period. Anaemia was the commonest maternal illness and preeclampsia/eclampsia was the most common obstetric complication. Respiratory distress, temperature instability and lethargy were common clinical presentations. Respiratory distress, sepsis and perinatal asphyxia were common diagnoses on admission. Mortality rate in VLBW neonates was 59.6% and respiratory distress was the commonest cause of death. Male gender (p=0.01), home delivery (p=0.04), vaginal delivery (p=0.05) and positive septic screen (p=0.003) had significantly higher mortality while mode of delivery (aOR 0.27 CI 0.086-0.83 p=0.02) and positive septic screen (aOR 4.0 CI 1.67-9.84 p=0.002) were independent risk factors for mortality.Conclusions: In extramural VLBW neonates, male gender, home delivery, vaginal delivery and positive septic screen had significantly higher mortality whilst mode of delivery and positive septic screen were independent risk factors for mortality.
      PubDate: 2020-12-23
      DOI: 10.18203/2349-3291.ijcp20205515
      Issue No: Vol. 8, No. 1 (2020)
  • Effect of neonatal sepsis on platelet counts and their indices

    • Authors: Gonesh N. Mevundi, Harsha S.
      Pages: 114 - 119
      Abstract: Background: Neonatal septicemia is a clinical syndrome characterized by signs and symptoms of infection with or without accompanying bacteremia in the first month of life. Objective of the study was to know the effect of sepsis on platelet counts and their indices.Methods: The study was carried out over a period of one and half year from December 2015 to July 2017 at Sangmeshwar and Basaveshwar hospital attached to M. R. medical college, Kalaburagi. 100 cases were considered for this study after proper screening for complete blood count (CBC), platelet count and their indices like mean platelet volume, platelet distribution width and C-reactive protein (CRP) and blood culture in neonates admitted in our neonatal intensive care unit (NICU) with proven sepsis.Results: A total of 100 neonates with blood culture positive for bacterial cases were considered for the study. Early onset septicaemia (59%) was more common than late onset septicaemia (41%). Out of 100 cases 57% cases had growth of gram negative organisms, 40% had growth of gram positive organisms and 3% had growth of fungal. Tachypnea (27%), lethargy (20%) and refusal of feeds (8%) were the commonest clinical presentation followed by, fever (6%), convulsions (5%) and jaundice (5%). 60% neonates had thrombocytopenia of varying severity. Staphylococcus aureus was the most common organism associated with thrombocytopenia (43.3%). Mean platelet volume (MPV) was high in 85% of cases and platelet distribution width (PDW) was high in 96% of cases.Conclusions: The present study highlights the association of thrombocytopenia, mean platelet volume and platelet distribution width with causative organism in proven neonatal sepsis. Staphylococcus aureus was the most common organism causing thrombocytopenia in our NICU.
      PubDate: 2020-12-23
      DOI: 10.18203/2349-3291.ijcp20205516
      Issue No: Vol. 8, No. 1 (2020)
  • A study of prevalence of abnormal EEG and its association between various
           clinical presentations of atypical febrile seizures

    • Authors: Bruntha Priyavathani J., Sriram Pothapregada, Anuradha Varadhan, Suresh C. Thirunavukarasu
      Pages: 120 - 126
      Abstract: Background: Quantitative EEG is a rapidly emerging tool in the diagnosis and follow up of various neurological disorders and can act as predictive marker for subsequent epilepsy in children with complex febrile seizure. The present study aimed to estimate the prevalence of abnormal electroencephalogram (EEG) and to find the association between Quantitative EEG (qEEG) and various clinical features of atypical febrile seizures(AFS).Methods: EEG was recorded along with clinical features including the age at onset, duration of episode, number of episodes in a day, type of seizure and the recurrences from the children aged between 6-60 months with atypical febrile seizures. EEG recordings were classified into Normal and abnormal EEG with epileptiform changes by the expert interpretation and the distribution of above said clinical features in the both groups were analyzed. It is also attempted to find the association between qEEG and few of the clinical features.Results: Prevalence of abnormal EEG in atypical febrile seizures was 33.9%. There were no significant differences in the distribution of abnormal EEG and their association with various clinical features of AFS. Significantly increased absolute power of θ and α waves were recorded from the frontal montages in the children with epileptiform changes in the EEG.Conclusions: qEEG changes can be also considered as marker of severity of febrile seizure episodes. Many prospective studies with long-term follow up are required to establish the predictability of future epilepsy by qEEG.
      PubDate: 2020-12-23
      DOI: 10.18203/2349-3291.ijcp20205517
      Issue No: Vol. 8, No. 1 (2020)
  • Influence of infant feeding practices on baby weight by the first birthday
           vis-à-vis nutrition status: a prospective cohort study

    • Authors: Sunkad M. A., Sowmya Vernekar, Javali S. B., Zaharah Sulaiman, Alina Tengku, Seo Ah Hong
      Pages: 127 - 133
      Abstract: Background: Aim of the study was to examine the under nutrition among infants aged one to twelve months. Also, find out the influence of infant feeding practices on baby weight by the first birthday. This was a prospective cohort study to collect the data by visiting the village health centres.Methods: This was a prospective cohort study of infants. We enlisted 157 new-born infants by a multi-cluster random sampling method representing the entire Primary Health Centre area. We obtained the written consent of mothers who participate in our study. These babies are followed up by periodic visits for a year. The data compiled, descriptive summary made, analysed with the Kolmogorov Smirnov test, chi-square test to infer statistical significance using SPSS 20.00 Software.Results: There were 157 babies (n) who met the inclusion criteria, Male 51%, female 49%, Birth order ≤2 are 85%, Gestational age ≥38 weeks are 85%, all the babies gained weight, however, only 73.9% of them weighed more than third percentile growth curve, at the first birthday. Among those babies who weighed less, 6% of babies too low weight, less active, while 20% is thin and active. A significant relationship is seen between the baby weight with feeding practices, Clinical Features, and lactation at a 5% level (p<0.05).Conclusions: The under nutrition has its origin in infancy. In our observation, 26.1% of babies remained undernourished by their first birthday. The main reasons for under nutrition is inadequate to breastfeed, an inherent lack of appetite, and imbalanced feeding practices.
      PubDate: 2020-12-23
      DOI: 10.18203/2349-3291.ijcp20205518
      Issue No: Vol. 8, No. 1 (2020)
  • Short term outcome of neonates born to mothers with SARS-CoV2 infection

    • Authors: Shweta Pathak, Monica Lazarus, Asha Tiwari
      Pages: 134 - 137
      Abstract: Background: Objectives of the study was to assess the clinical presentation and risk of mother-to-infant transmission of SARS-CoV2 in infants born to mothers with COVID-19 infection.Methods: This was a prospective observational study. This study was conducted in tertiary care centre and a dedicated covid hospital in central India. Infants born to mothers diagnosed to have COVID-19 at the time of delivery, born between 1 June and 25 September 2020 will be included in the study.Results: Total 60 infants were born to mothers with COVID-19 at the time of delivery. Three neonates tested positive for SARS-CoV2 after birth-one had mild respiratory symptoms and the other two infants remained well. A preterm baby who was negative for covid died due to extreme prematurity with sepsis (early onset) with respiratory failure on day 4 of life and another baby who was negative died due to hypoxic ischaemic encephalopathy stage 3 with Meconium aspiration syndrome with respiratory failure. Remaining 58 neonates and their mother roomed in while in hospital and all were breast fed. None of the other neonates developed any significant health issues or developed symptoms attributable to SARS CoV2.Conclusions: The risk of mother-to-infant transmission of SARS-CoV2, in the perinatal period is very low. Breast feeding and rooming in can be practiced safely with adequate infection control precautions with negligible clinical risk to the infant.
      PubDate: 2020-12-23
      DOI: 10.18203/2349-3291.ijcp20205519
      Issue No: Vol. 8, No. 1 (2020)
  • An observational cohort study on the etiology and outcomes of neonates
           with thumb in flexion sign

    • Authors: Sruthy Gnanasekaran, Natarajan P.
      Pages: 138 - 142
      Abstract: Background: One constant observation by Pediatricians during postnatal rounds is that many of the early neonates exhibit a sign with thumb adducted and flexed over the palm and the rest of the fingers flexed over the thumb. In an otherwise normal neonate with no obvious etiological factors, we do come across TIF sign in more than half of the early neonate. This study attempts to know weather this sign is physiological or pathological and what would be the neurological outcome of the neonates exhibiting this sign in the early neonatal period.Methods: The study was conducted in the department of Pediatrics (post-natal ward in) of Sri Venkateshwara Medical College Hospital & Research centre, Ariyur, Puducherry, a tertiary care hospital loacted in a rural area.Results: Among 227 study participants 152(67%) had TIF sign. The infants born after history of fetal distress had higher incidence of TIF sign (76.1%) with a p value 0.05. One significant finding was that all the 7 infants who had language delay had history TIF sign within 7 days of life. The p value was 0.01.Conclusions: The pathological view of the TIF sign is, perhaps, a sign of minimal insult to the developing brain from which it recovers over a period of few months. From our study we conclude that the incidence of TIF sign was about 67 %. Thumb in Flexion sign has clinical significance with etiological factors like fetal distress in apparently healthy full-term infants. The secondary outcome of TIF sign was isolated language delay which was present in babies who had TIF sign within first week of life without neurological deficits up to 1 year of life with statistical significance. Hence it is recommended that the neonates with this sign need periodic neurological evaluation.
      PubDate: 2020-12-23
      DOI: 10.18203/2349-3291.ijcp20205520
      Issue No: Vol. 8, No. 1 (2020)
  • Clinical profile and aetiological factors of neonatal jaundice from a
           rural area of Kutch, Gujarat, India

    • Authors: Avinash Patel, Karan Saradava, Hasmukh Chauhan
      Pages: 143 - 146
      Abstract: Background: Etiology of hyperbilirubinemia is not only crucial for optimal management of the patient but also it may have implications for subsequent pregnancies. The objective of this study was to study the clinical profile and the underlying aetiological factors leading to neonatal jaundice in this rural setting of Kutch District, Gujarat, India.Methods: This prospective observational study was conducted in the neonatal intensive care unit (NICU) and Post Natal ward Gujarat Adani Institute of Medical Science, Bhuj, Kutch, Gujarat. Total of 150 cases were enrolled for the study. Blood grouping and Rh typing of baby and mother were done. Cord blood bilirubin and haemoglobin, direct coomb's test (DCT) and bilirubin monitoring were done whenever there was a setting for Rh incompatibility.Results: Among 150 neonates studied, majority had birth weight between 2501g and 3000g. Only 21 babies had birth weight <2.5kg (14%) (Table 2). Of the 150 neonates 85 were males and 65 were females.Conclusions: This study concludes that physiological jaundice is the most common cause of neonatal jaundice in our hospital. This is followed by ABO incompatibility, sepsis, Rh incompatibility and idiopathic cases.
      PubDate: 2020-12-23
      DOI: 10.18203/2349-3291.ijcp20205521
      Issue No: Vol. 8, No. 1 (2020)
  • Assessment of quality of life in transfusion dependent thalassemic
           children - need to address parents/care givers

    • Authors: Veeraraja B. Sathenahalli, G. R. Rajashekar Murthy, Netra Gouda, Sanjay K. Shivanna
      Pages: 147 - 150
      Abstract: Background: Thalassemia is an autosomal recessive congenital disease caused by the reduced or absent beta globin chain synthesis of hemoglobin tetramer. The degree of imbalance between alpha and non alpha globin chains determines the severity of clinical manifestations. The disabling nature of the disease and chronic therapy affects the normal life causing psychosocial burden. Overall patient’s life, such as education, free-time, physical activities, skills, capabilities, and family adjustment is affected. The effects of which often result in psychological, emotional and social compromise. Health-Related Quality of Life (HRQoL) measurement is a multidimensional concept that focuses on the impact of the disease and its treatment on the well being of an individual.Methods: A descriptive observational hospital based study was conducted over a period of 3 months. Transfusion dependency in thalassemic children aged between 5 years and 18 years was the inclusion criteria. Thalassemic children having debilitating illnesses unrelated to thalassemia were excluded. Quality of life was assessed using Pediatric Quality of Life Inventory (PedsQL™ 4.0)4. The tool assesses the quality of life in five domains: physical functioning (PF: 8 items), psychosocial functioning (sum of emotional, social and school functioning), emotional functioning (EF: 5 items), social functioning (SF: 5 items) and school functioning (SC: 5 items).Results: Total of 125 children were enrolled with a mean age of 9.4±4.6 years (age range 5-18 yrs). According to the PedsQL questionnaire, the quality of life was similarly assessed by both parents and children. The total mean QoL score of the parents was 72.36±11.47 and of the children was 77.63±14.17. Emotional, school and psycho-social function were significantly affected according to both child and parents without statistical significance.Conclusions: Thalassaemia patients and their parents require lifelong psychological support for prevention of mental health issues. By increasing the awareness and knowledge levels of the parents, we can help sick children in developing countries to get the best care locally and to thus improve HRQoL.
      PubDate: 2020-12-23
      DOI: 10.18203/2349-3291.ijcp20205522
      Issue No: Vol. 8, No. 1 (2020)
  • Perceptions, attitudes and practices of physicians regarding use of
           complementary and alternative medicine in autism spectrum disorder

    • Authors: Ashwini A. Marathe, Koyeli S. Sengupta
      Pages: 151 - 159
      Abstract: Background: Use of Complementary and Alternative Medicine (CAM) in children with Autism Spectrum Disorder (ASD) has been reported as highly prevalent in literature. Our objective was to assess the perceptions, attitudes and practices of Indian physicians regarding use of CAM in ASD.Methods: An online survey was emailed to pediatricians, developmental pediatricians, pediatric neurologists and psychiatrists. We had 417 respondents, 78% being primary-care pediatricians. Descriptive analysis was conducted. Results: Of 417 respondents, 75% physicians were unaware or minimally aware of the risks and benefits of CAM. 60% of pediatricians rarely or did not ask families about their use of CAM, and 57% felt that families too do not bring up CAM. 67% of pediatricians felt that less than 25% of their patients used CAM, though 50% regularly prescribed nutritional supplements to children with ASD. Pediatricians reported either not offering an opinion or referring to a specialist for questions about GFCF (83%), stem-cell transplant (69%), hyperbaric oxygen (71%) and ayurveda or homeopathic remedies (49%). Lack of ASD-specific intervention services, time, training and practice guidelines were perceived as barriers to care. 97% physicians desired autism training, while 81% also desired CAM training.Conclusions: Most pediatricians perceive use of CAM in ASD to be lower than reported and do not discuss or opine on CAM modalities with families of children with ASD, possibly due to inadequate doctor-patient communication and limited awareness and knowledge about CAM in ASD, underscoring need for capacity building in this area.
      PubDate: 2020-12-23
      DOI: 10.18203/2349-3291.ijcp20205523
      Issue No: Vol. 8, No. 1 (2020)
  • Efficacy of site of pallor to detect anemia and its correlation with
           etiology in under five children

    • Authors: Divya Krishnan K., K. Shreedhara Avabratha, K. Varadaraj Shenoy, Anand K. V.
      Pages: 160 - 164
      Abstract: Background: The diagnosis and management of anemia largely depends on clinical assessment for pallor. Objective was to evaluate the usefulness of clinical pallor to detect anemia, to correlate pallor with grades and etiology of anemia.  Methods: This case control study included 300 children in the age group of 6months to 5years. Pallor was assessed in four sites conjunctiva, tongue, nailbed and palm. Children with pallor at any one site were taken as study group (n=150) and without pallor at all 4 sites as controls (n=150). Hemoglobin estimation and other relevant investigations were done. Anemia was diagnosed according to WHO criterion (Hb<11 g/dl in 6 months-5 years) and graded as mild, moderate and severe.Results: Both groups were comparable in characteristics of age and gender (p value>0.05). In pallor group, 119 had anemia, whereas non pallor control group had 45 anemics. Sensitivity and specificity of pallor for anemia detection were 72.6% and 77.2% respectively. Maximum sensitivity, specificity and predictive values were found for palmar pallor. Tongue turned out to be least sensitive for identifying pallor. All the four sites were found to have statistically significant correlation in identifying mild, moderate and severe grades of anemia. Among causes of anemia; iron deficiency anemia was the etiology in 81.1% of cases. Pallor at each site showed no statistically significant correlation with etiology.Conclusions:Pallor is useful in detecting anemia. Multiple site examination is suggested as its increases the sensitivity. No positive correlation observed between pallor and its etiology.  
      PubDate: 2020-12-23
      DOI: 10.18203/2349-3291.ijcp20205429
      Issue No: Vol. 8, No. 1 (2020)
  • A rare case of neuro regression in an Indian child: beyond the realm of
           nervous system

    • Authors: Preeti Srivastava, Sarala Sunder, Nilanjan Sarkar
      Pages: 165 - 169
      Abstract: When we encounter a child with dysmorphism and developmental delay or regression, we are prompted to think on lines of a disorder of nervous system. However, at times a disorder primarily involving another system, more importantly, a modifiable condition, could be responsible for same phenotypic presentation. A 6 years old male child with global developmental delay, dysmorphism, seizures and new onset regression appeared to be suffering from some neurodegenerative disorder on first impression. As detailed examination, lab investigations and imaging findings were noted, a rare endocrinal disorder was unravelled and a diagnosis of pseudohypoparathyroidism (PHP) type 1A was made and was genetically confirmed.
      PubDate: 2020-12-23
      DOI: 10.18203/2349-3291.ijcp20205452
      Issue No: Vol. 8, No. 1 (2020)
  • Henoch-Schonlein purpura masquerading as vesiculobullous lesions in a

    • Authors: Rajeshwari N., Prahada J., Kala K.
      Pages: 170 - 173
      Abstract: Henoch-Schönlein purpura (HSP) is a systemic small vessel vasculitis occurring commonly in children presenting with palpable non-thrombocytopenic purpura, arthralgia and abdominal pain. Haemorrhagic bullous and ulcerative lesions are rare in HSP in children and can be a diagnostic challenge. We present a case of 6-year-old boy child who presented with bullous purpuric lesions in lower limbs, arthralgia and increased serum IgA. Histopathology of skin lesion revealed leukocytoclastic vasculitis. However, the direct immunofluorescence was negative for IgA deposits. 
      PubDate: 2020-12-23
      DOI: 10.18203/2349-3291.ijcp20205417
      Issue No: Vol. 8, No. 1 (2020)
  • Misled by the Xpert-Kikuchi’s disease masquerading as tuberculosis

    • Authors: Aparna Krishnakumar, Elayaraja Sivaprakasam, Latha Ravichandran, Umapathy Pasupathy, Sarala Premkumar, Ram Mohan
      Pages: 174 - 176
      Abstract: Kikuchi-Fujimoto disease (KFD), also called histiocytic-necrotizing lymphadenitis is a rare, idiopathic and self-limiting cause of lymphadenitis. Clinical presentation of KFD closely resembles nodal tuberculosis (TB). Here we present a case of an adolescent female whose diagnosis of KFD was made despite being misled in the course. A 15-year-old female, previously treated for tuberculous lymphadenitis was brought with complaints of fever for 1 month. Various possibilities considered were TB reactivation, autoimmune disorders, lymphoma. Lymph node biopsy for gene Xpert showed TB bacilli detected but low with no RIF resistance. Despite anti tuberculous treatment initiation, there was no improvement in the clinical condition. Histopathology of cervical node showed features of Kikuchi lymphadenitis. Literature search revealed that gene Xpert can detect the intact DNA of Mycobacterium tuberculosis even years after the previous treatment. On stopping anti tuberculosis therapy (ATT) and starting IV steroid, she started improving dramatically. KFD should always be kept as a differential diagnosis in any individual with fever and lymphadenopathy. Diagnosis can be misled in any patient based on gene Xpert reports alone which often turns out to be positive if there is past history of TB as gene Xpert detects DNA from non-intact cells suggesting that dead bacilli contribute to the false positivity.
      PubDate: 2020-12-23
      DOI: 10.18203/2349-3291.ijcp20205439
      Issue No: Vol. 8, No. 1 (2020)
  • An unusual band causing intestinal obstruction: case report

    • Authors: Suresh Chelliah, Sathia Dev Jayabalan, Meganathan Pachamuthu, Nimisha Puthiya Veettil
      Pages: 177 - 178
      Abstract: We report an unusual case of intestinal obstruction. The child presented with intermittent abdominal pain. Initial USG abdomen and CT abdomen were inconclusive. Diagnostic laparoscopy followed by Laparotomy was done to remove bezoar made up of a rubber band and thread balls. Iron and zinc deficiencies are the preventable causes of pica. Plasticobezoars are rare and should be suspected when symptoms are not consistent with other common causes of obstruction.  
      PubDate: 2020-12-23
      DOI: 10.18203/2349-3291.ijcp20205524
      Issue No: Vol. 8, No. 1 (2020)
  • A rare case of neonatal parotid abscess

    • Authors: Jatinder Singh, Jaskaran Singh, Vaneeta Bhardwar, Manmeet Kaur
      Pages: 179 - 181
      Abstract: Acute suppurative parotitis is not common in children and is exceptionally uncommon in neonates. Most common microorganism isolated is Staphylococcus aureus. We present a 22-day old, full-term, breast-fed, male neonate with a left-sided parotid abscess. The infant displayed a preauricular swelling, pain and redness. Pus discharged from cleared out Stensen's channel on compression of the gland remotely. Early determination and intravenous anti-microbials are the keys to the treatment.
      PubDate: 2020-12-23
      DOI: 10.18203/2349-3291.ijcp20205525
      Issue No: Vol. 8, No. 1 (2020)
  • Hereditary spastic paraplegia-a differential for spastic paraplegia in

    • Authors: Niharika Shetty, Sahana Devadas, Mallesh Kariappa
      Pages: 182 - 184
      Abstract: Hereditary spastic paraplegia (HSP) is a group of neurodegenerative disorders with familial origin mainly affecting the lower limbs. It has a prevalence of 3-10/100,000. The diagnosis is by symptomatology, clinical examination and neuroimaging to rule out other causes of spastic paraplegia. The diagnosis is confirmed by genetic analysis. Since this disorder is slowly progressive with nonspecific MRI brain findings the diagnosis can be delayed with delay in the start of rehabilitation measures. This disorder is usually diagnosed in the adult life and the literature has very few cases of paediatric HSP and hence we are reporting a case of HSP. Here we present the case of two siblings who presented to us with progressive weakness of both the lower limbs.
      PubDate: 2020-12-23
      DOI: 10.18203/2349-3291.ijcp20205526
      Issue No: Vol. 8, No. 1 (2020)
  • Chronic compensated iron deficiency anaemia in a 12-year-old cerebral
           palsy child

    • Authors: Jayasurya Suresh, Nidheesh Chandran
      Pages: 185 - 186
      Abstract: A 12-year-old male child, known case of cerebral palsy (CP), presented as a case of severe anaemia with congestive heart failure to the paediatric casualty. The child was worked up for the same and investigations revealed chronic compensated iron deficiency anaemia. The child was treated with blood transfusions, anti-heart failure medications and was discharged on oral iron. Special care and follow up are required for the nutritional needs of CP children as often they are neglected leading to catastrophic presentations.
      PubDate: 2020-12-23
      DOI: 10.18203/2349-3291.ijcp20205527
      Issue No: Vol. 8, No. 1 (2020)
  • Dyke Davidoff syndrome: a rare cause of cerebral hemiatrophy in 11 months

    • Authors: Amit Vatkar, Ipsita Vashishtha, Vinaykumar P. Hedaginal, B. Revanth Sai Madhav
      Pages: 187 - 189
      Abstract: Dyke-Davidoff-Masson syndrome (DDMS) is an uncommon condition, characterized radiologically by cerebral hemiatrophy with homolateral hypertrophy of the skull and sinuses, of unknown frequency resulting from brain injury due to large no of causes; especially in early life. Mostly presents early in life with seizures, learning difficulty, contralateral hemiparesis and facial symmetry. Here we present a case of 11 months old female child with developmental delay, visual abnormality, microcephaly and spastic hemiplegia. CT-brain done which was suggestive of infantile type of cerebral hemiatrophy or DDMS.
      PubDate: 2020-12-23
      DOI: 10.18203/2349-3291.ijcp20205528
      Issue No: Vol. 8, No. 1 (2020)
  • Intussusception in an infant complicating dengue infection

    • Authors: Fadila ., Md. Faraz Omair, Neeta Kevlani
      Pages: 190 - 192
      Abstract: Intussusception is the most common abdominal emergency in children younger than 2 years of age. A 6-month-old child presented as dengue with gross abdominal distension to our hospital. Dengue was managed using standard therapy as per world health organization protocol, while abdominal pathology, later found out to be intussusception, required exploratory laprotomy. At the outset, abdominal distensions in the setting of a severe dengue infection, could be misdiagnosed as ascites due to capillary leakage, masking the clinical findings of acute abdomen on examination.  Although unusual, it is possible to find two concurrent illnesses simultaneously, one complicating the typical clinical course expected from the other, and this needs high index of suspicion due to different management strategies of both. We describe here the diagnostic dilemma of such a case.
      PubDate: 2020-12-23
      DOI: 10.18203/2349-3291.ijcp20205529
      Issue No: Vol. 8, No. 1 (2020)
  • Henoch-Schonlein purpura in child: a case report and review of the

    • Authors: Vijay B. Sonawane, V. A. Kotrashetti, Kapil S. Bainade, Shweta Nair, Sushil Yewale
      Pages: 193 - 196
      Abstract: Henoch-Schonlein purpura (HSP) is the most common vasculitis of childhood and is characterized by leukocytoclastic vasculitis and immunoglobulin A deposition in the small vessels in the skin, joints, gastrointestinal tract and kidney. We report a 6 year old female child presented with rashes over both legs and buttocks along with joint pain and abdominal pain and multiple episodes of vomiting. Patient was diagnosed with HSP and treated with oral prednisolone followed by methylprednisolone and other supportive care.
      PubDate: 2020-12-23
      DOI: 10.18203/2349-3291.ijcp20205530
      Issue No: Vol. 8, No. 1 (2020)
  • Infection associated hemophagocytic lymphohistiocytosis: a report of three

    • Authors: Magesh Kumar, Dharmesh ., D. B. Santra, Chirag Jain
      Pages: 197 - 199
      Abstract: HLH (Hemophagocytic lymphohistiocytosis) is not an uncommon disorder; it is an overreaction of the immune system. It can be familial or acquired and both share one common feature of a highly stimulated and ineffective immune response. Acquired HLH is commonly seen with infection (infection associated hemophagocytic syndrome-IAHS); malignancies and rheumatic disease where it is also known as (macrophage activating syndrome). Here we are reporting three cases of secondary HLH associated with dengue, typhoid and vivax malaria. 
      PubDate: 2020-12-23
      DOI: 10.18203/2349-3291.ijcp20205531
      Issue No: Vol. 8, No. 1 (2020)
  • Prevalence and correlates of neurodevelopmental disorders among children
           in India: a narrative review

    • Authors: Leena Gaikwad, Sravani Lagala
      Pages: 200 - 206
      Abstract: Neurodevelopmental disorders (NDD) are seen disproportionately affecting the low-income communities. Paucity of consistent and large-scale studies in India and variations in assessment and diagnostic tools reduce the scope for generalization of prevalence estimates to national level. This review tried to consolidate the existing community-based evidence of the prevalence of NDDs, risk factors and comorbidities among children in India. We searched studies related to the review objectives on search engines PubMed and Google Scholar. The community or school-based studies in India, published in English language were included. The prevalence of each of these NDDs differed in different locations and age groups. The prevalence appeared to be increasing with increase in age. Non-institutional delivery, perinatal asphyxia or delayed crying, low birth weight or prematurity, neonatal illness or neurological infections were significantly associated with the NDDs. Most of the significant risk factors are modifiable with the help of effective programs to improve maternal and child healthcare and nutrition. Further large-scale, good-quality epidemiological studies in community settings are needed to develop and prioritize the delivery of the prevention and rehabilitation interventions.
      PubDate: 2020-12-23
      DOI: 10.18203/2349-3291.ijcp20205438
      Issue No: Vol. 8, No. 1 (2020)
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Heriot-Watt University
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