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International Journal of Contemporary Pediatrics
Number of Followers: 6  

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ISSN (Print) 2349-3283 - ISSN (Online) 2349-3291
Published by Medip Academy Homepage  [12 journals]
  • Association of foot length and gestational maturity in neonates: a single
           centre study

    • Authors: Hareesh Resu, Vinod Kumar, Atul Goel, Uppu Praveen
      Pages: 723 - 727
      Abstract: Background: As the prematurity is one of the important causes of neonatal mortality/ morbidity in a developing country like India. It is important to differentiate between preterm and term babies and timely refer them to higher centre. But it's difficult to assess the Gestation age (GA) in rural areas by existing methods like New Ballard score, and Antenatal ultrasound (due to lack of equipment and experienced person). So that shows the importance of the alternative, reliable, and easy to use method for identification of term, preterm and post-term babies. The present study carried out to find out the importance of Foot length in the assessment of GA.Methods: It is a hospital-based prospective observational study, 253 newborns were included in the study. The GA assessment was done by using New Ballard score. Foot length measured by using Digital sliding calliper and birth weight were recorded. Correlation of Fetal foot length with GA and birth weight was made by using appropriate statistical tests.Results: Among 253 neonates distribution of term, preterm, male and female were 65%, 35 %, 55%, 45% respectively. In this study positive Correlation between foot length and gestational age was found with the “r” value of 0.77. The study also showed a correlation between foot length and weight with the “r” value of 0.74.Conclusions: To conclude most of the newborn in our study have a good correlation of Foot length with gestational maturity and Birthweight. Derived equation from this study can be used as an alternative to New Ballard score in the estimation of gestational age in poor sources situations like in rural areas and also in emergencies by ASHAs (Accredited Social Health Activist) & Anganwadi workers.
      PubDate: 2020-03-21
      DOI: 10.18203/2349-3291.ijcp20200854
      Issue No: Vol. 7, No. 4 (2020)
       
  • Effect of kangaroo mother care on the growth and morbidity pattern of low
           birth weight infants: a hospital based cross sectional study

    • Authors: Shanthi Ramesh, S. Sundari
      Pages: 728 - 732
      Abstract: Background: Kangaroo mother care provides Low birth weight babies with warmth, protection from infection and increases the success of breast feeding. Babies who had received KMC care were found to have better neurologic outcome. The aim of the study is to compare the outcome of Kangaroo mother care and conventional method of care among Low birth weight babies in terms of growth and reduction of morbidities such as length of hospital stay, hypothermia and hypoglycemia.Methods: This cross-sectional study included 48 neonates with a birth weight of <2000 grams. Out of them 24 babies received KMC and the other 24 babies were given conventional care with a radiant warmer. The weight gain, length of hospital stay, occurrence of hypothermia and hypoglycaemia were monitored for all babies till discharge.Results: Babies who received KMC had a better weight gain (21.11±2.8 grams/day) versus (15.61±2.6 grams/day) those who received conventional care, and this was found to be statistically significant (p=0.001). Kangaroo mother care provided a statistically significant reduction in the risk of having hypothermia (p=0.03) and hypoglycemia (p=0.04). The babies who received Kangaroo mother care had a shorter length of hospital stay and this was found to be statistically significant (p=0.03).Conclusions: Kangaroo mother care improved the growth and reduced the problems of low birth weight babies such as hypothermia, hypoglycaemia and prolonged hospital stay. Hence, it should be recommended in the care of all these high-risk neonates.
      PubDate: 2020-03-21
      DOI: 10.18203/2349-3291.ijcp20200583
      Issue No: Vol. 7, No. 4 (2020)
       
  • The influence of family history of cardiovascular disease on blood
           pressure, waist hip ratio and body mass index in adolescents

    • Authors: Utkarsh Bansal, Aakash Raja, Prashant Agarwal, Ekansh Rathoria, Abhishek Gupta, Nyay Bhai Gupta, Shwinka Agarwal
      Pages: 733 - 738
      Abstract: Background: Cardiovascular Diseases (CVDs) are the major cause of mortality in the world. Reducing the incidence of CVDs has been a challenge due to the multifactorial risk profile of their origin. Among the non-modifiable risk factor for CVDs family history holds a lot of importance. Objective of the study was to study blood pressure, waist hip ratio and body mass index among adolescents and verify the possible the relation with a family history of cardiovascular disease.Methods: This is a cross-sectional study, which was conducted in 286 school children aged 10 to 19 years, of either sex, from Barabanki. After getting consent from school authorities, children and their parents, a detailed history was taken with a pre-designed proforma. Anthropometric and blood pressure measurements were taken.Results: In the presence of any risk factor of CVDs, 33.9% of the adolescents were overweight/obese, 45.8% had abdominal obesity, 26.3% had elevated systolic BP and 35.6% had elevated diastolic BP. The group with family history of CVDs had significantly higher number of adolescents with obesity and/or hypertension.Conclusions: The present studied showed an important association between family history of CVDs and blood pressure, waist hip ratio and body mass index in adolescents.
      PubDate: 2020-03-21
      DOI: 10.18203/2349-3291.ijcp20200855
      Issue No: Vol. 7, No. 4 (2020)
       
  • Device associated infections among neonates in neonatal intensive care
           units: a single unit survey study in Cairo, Egypt

    • Authors: Mohamed Farouk M. Ibrahim, Hanem Abdullah Mohamed, May Abdelfattah, Sara S. ElTatawy
      Pages: 739 - 746
      Abstract: Background: Device Associated Infection (DAI) namely Ventilator Associated Pneumonia (VAP) and Central Line Associated Blood Stream Infection (CLABSI) is one of the challenges for both neonatal nurses and doctors. Aims of the study were 1) Assess the rate of DAI occurrence among neonates, 2) explore the relationship between DAI rates and certain risk factors such as nurse patient ratio, hand hygiene practice, gestational age (GA), weight, and length of hospital stay among neonates.Methods: Descriptive correlational survey research design. Sample: All neonates admitted in twelve months-duration were included (total number 1090 neonates). Nurses and doctors were observed for compliance to adequate hand hygiene technique. Tools: 1) Center for Disease Control (CDC) criteria to calculate DAI rates, 2) Hand hygiene five points checklist 3) Review of neonates charts to collect data as weight, GA 4) Ballard score and 5) nurse/patient ratio.Results: 24 neonates developed DAI, high significant negative correlations between DAI and infants’ weight, GA, nurse/patient ratio and overall compliance to hand hygiene techniques were reported (p-value ≤0.05). Length of hospital stay, inadequate hand hygiene technique had strong positive correlations with DAI rate (p-value ≤0.05).Conclusions: Factors that could affect DAI were infant’s weight, GA, length of hospital stay, inadequate hand hygiene technique and nurse/patient ratio. Recommendations: implementation of infection control programs to raise nurses as well as physicians’ compliance to adequate hand hygiene technique and increase number of nurses in the Neonatal Intensive Care Unit (NICU) per shift.
      PubDate: 2020-03-21
      DOI: 10.18203/2349-3291.ijcp20201063
      Issue No: Vol. 7, No. 4 (2020)
       
  • A study to determine the level of cord blood albumin in predicting
           neonatal jaundice

    • Authors: Usha Hirevenkanagoudar, Pranam G. M., Sanjeev Chetty
      Pages: 747 - 750
      Abstract: Background: Most unconjugated bilirubin formed by the fetus is cleared by the placenta into the maternal circulation. Albumin constitutes 70 - 75% of Plasma oncotic pressure. Another important function of albumin is its antioxidant property. Bilirubin binds to albumin in an equimolar ratio. Free bilirubin is anticipated when the molar bilirubin- to- albumin (B: A) ratio is >0.8 Objective of the study was to predict the proportion of newborn requiring intervention for NH (phototherapy or exchange transfusion) based on cord serum albumin level at birth.Methods: The present prospective study was conducted at Navodaya Medical College, Raichur from October 2018 to November 2019. A total of 180 babies which were born during the study period were included in the study. INCLUSION CRITERIA• Term babies both genders• Mode of delivery (normal and C-section)• Birth weight ≥2.5kg.• APGAR ≥7/10 at 1 min. Cord Serum Albumin level was estimated at birth. Total Serum Bilirubin (TSB) estimation was done at 72-96 hours of age. All the babies were followed up daily for first 4 postnatal days and babies were daily assessed for NH and its severity.Results: In our study nearly 54.4% of them had Cord Serum Albumin levels of less than 2.8 gm/dl, 27.3% of them had albumin levels of 2.9 to 3.3 gm/dl, 18.3% of them had Serum Albumin of 3.4 gm/dl. Out of 180 study subjects, 13.9% of them required phototherapy to treat neonatal hyper bilirubinemia and 2.8% of the study subjects required exchange transfusion.Conclusions: From the present study, cord serum albumin level of ≤2.8g/dl has a correlation with incidence of significant hyperbilirubinemia in term newborns. So, this ≤2.8g/dl of cord serum albumin level can be used as risk indicator to predict the development of significant hyperbilirubinemia.
      PubDate: 2020-03-21
      DOI: 10.18203/2349-3291.ijcp20201040
      Issue No: Vol. 7, No. 4 (2020)
       
  • Knowledge attitude and practice of paediatricians regarding tuberculosis
           case management in five major districts of Punjab state, India

    • Authors: Harmeet Pal Singh, Harmesh S. Bains, Gurdeep Singh Dhooria, Puneet A. Pooni, Deepak Bhat
      Pages: 751 - 756
      Abstract: Background: The operational research was done to assess the Knowledge, Attitude and Practice regarding TB case management of Pediatricians. Place were five major cities of Punjab state, India. i.e. Ludhiana, Jalandhar, Amritsar, Patiala and Bathinda.Methods: Study design was observational cross-sectional study. Period was one year. The data collection was done from Paediatricians from 5 cities inhabiting approximately half of the urban population of Punjab, using a pre-tested, structured questionnaire and knowledge of TB and its management was assessed.Results: Total of 139 pediatricians participated in the study, 69% were male. Majority pediatricians had adequate knowledge of TB disease and case suspicion. Adequate knowledge of TB diagnosis was seen in 87% doctors. Only 20% doctors had adequate knowledge about treatment of TB cases. Overall 64% of Pediatricians referred TB cases to DOTS centre for treatment.Conclusions: Improving the treatment knowledge of paediatricians can go a long way in improving management of TB cases.
      PubDate: 2020-03-21
      DOI: 10.18203/2349-3291.ijcp20201005
      Issue No: Vol. 7, No. 4 (2020)
       
  • Study of number of children preferred and knowledge, attitude, practice
           regarding birth spacing and contraception among primigravida in urban
           setting

    • Authors: C. G. Raghavendra Vailaya, C. R. Shubha Vailaya
      Pages: 757 - 763
      Abstract: Background: Overpopulation is a major problem in 21st century India. 2012 census shows birth rate of 20.97/1000 people and death rate of 7.48/1000 people. Fertility rate in 2019 was 2.28 children per women. Many states implemented 2 child norms. Purpose of study is to understand the number of children preferred.Methods: A Cross sectional study was done amongst 200 primigravida women who attended antenatal clinic at SMC, Shimoga. A predesigned and pretested standard Questionnaire was used to know the number of children preferred, KAP about birth spacing, contraceptive use and unsafe abortions using objective questions.Results: Most women preferred 2 child norms across most subclasses. Most Muslims (85.7%) preferred ≥3 children. Though 100% were aware of family planning, only 46% chose to space their next pregnancy. 56.5% were in support of 2-child norm. Family pressure plays crucial role in 83.5% cases and 65.5% still opted sterilization as the first choice for contraception.Conclusions: India with high population density is staring at demographic disaster due to limited life resources. Right attitude towards birth spacing, contraceptive use, avoidance unwanted pregnancies and unsafe abortions is needed. Better female literacy, societal awareness and good medical facility at last mile is crucial. Male partner’s involvement in every step is vital.
      PubDate: 2020-03-21
      DOI: 10.18203/2349-3291.ijcp20201003
      Issue No: Vol. 7, No. 4 (2020)
       
  • A single centre 10-year experience of Mitrofanoffs procedure for varied
           indications with its outcome

    • Authors: Hemangi R. Athawale, Shivaji B. Mane, Natasha Vagheriya, Hussain Kotawala, Prathamesh More, Taha Daginawala
      Pages: 764 - 769
      Abstract: Background: To evaluate long term efficacy and complications of Mitrofanoffs procedure in patients with bladder dysfunction.Methods:
      Authors retrospectively reviewed the medical records of 51 patients who underwent construction of a continent catherisable channel (mitrofanoffs and monti) from 2009 till 2019 in our institution. Clinical findings and investigations result along with surgical techniques used were noted for these patients. Postoperative complications along with urinary continence and renal outcome were evaluated.Results: Mean age was 7 years and mean follow up was for 3 years. 27 patients were with neurogenic bladder and 24 with non-neurogenic bladder. The most common type of conduit was appendicovesicostomy (38) followed by illeal monti (12) and ureter (1). The most common stomal site was umbilicus (44) followed by right lower abdominal quadrant (6). Catherterizable conduit complications included stomal leakage in 3, mucosal prolapse at the stoma site in1 and an intra peritoneal leak requiring exploratory laprotomy and revision in1. Relative stomal continence was achieved in 98%. The preoperative serum creatinine & blood urea nitrogen (BUN) at the time of mitrofanoffs procedure at the last follow up after the procedure were sought and compared using Chi square test showed statistically significant improvement (p<0.01). No differences in outcome and complication rates were noted between different types of conduit, sites of implantation, or segments used for augmentation.Conclusions: Mitrofanoff is a safe and reliable procedure in children who are dependent on intermittent catherisation in developing countries. Appendicovesicostomy is our first option followed by yang -monti illeovesicostomy.  While stomal continence is excellent patient education, family motivation and cost reduction are important factors for its lasting efficiency.
      PubDate: 2020-03-21
      DOI: 10.18203/2349-3291.ijcp20200856
      Issue No: Vol. 7, No. 4 (2020)
       
  • Knowledge, attitude and practices among parents of asthmatic children in
           Rajasthan: a hospital based descriptive observational study

    • Authors: Prerna Vaishnav, Gaurav Ameta
      Pages: 770 - 775
      Abstract: Background: Asthma is chronic inflammatory disorder associated with variable airflow obstruction and bronchial hyper responsiveness with different phenotypes. The objective of this study was to study the knowledge, attitude and practices among parents of Asthmatic children.Methods: It was a prospective observational study, conducted at Fortis Hospital Jaipur, from April 2016 to March 2018. All Asthmatic children fulfilling inclusion were included, 120 children were studied. A detailed interview of all the children/parents was conducted by pre-validated KAP questionnaire. Subjects were labelled as Bronchial Asthma in children above 5 years of age on the basis of symptoms and measurement of Peak Expiratory Flow (PEF) both baseline and post bronchodilator by PEF meter and in children less than 5 years of age by clinical symptoms, family history and response to bronchodilator according to GINA guidelines. Statistical analysis was done by one-way ANOVA test and Chi-square test.Results: In this study 26.4% parents were ignorant about etiology, 32% believed it to be allergy and 39.62% believed it to be hereditary. 1.9% had misconception of contagious. 68% parents know that their child have asthma while 32% parents did not know. Majority (52.1%) attributed it to cold air and rainy season followed by Dust mite and pollution in (42%).Conclusions: Knowledge about Asthma has improved over last few decades but still needs replenishment. Knowledge gap between recommended and actual practices, lack of adherence to aerosol therapy and fear of medication side-effects still persists. Parental education is important part of management of Asthma.
      PubDate: 2020-03-21
      DOI: 10.18203/2349-3291.ijcp20200994
      Issue No: Vol. 7, No. 4 (2020)
       
  • Mortality profile of extreme to very preterm infants in an extramural
           tertiary care neonatal unit of a teaching hospital in Southern India: a
           retrospective study

    • Authors: Ramya S. Shanmugam, Arun Karthik, Muthukumaran N., Chinnathambi Kamalarathanam
      Pages: 776 - 782
      Abstract: Background: Neonatal deaths account for 47% of all deaths in children younger than 5 years globally. More than a third of deaths are due to preterm related complications. Understanding the factors contributing to preterm deaths and pattern of mortality is needed to implement interventions that are essential in improving neonatal survival.Methods: This was a retrospective study done in neonatal intensive care unit, Institute of Child Health (ICH) and Hospital for Children, Chennai, a tertiary care regional center. All preterm (<32 weeks) deaths registered in the neonatal medical records from 1st of January 2018 to 31st of December 2018 were analysed. Primary causes of deaths were analysed by two consultants. When there were more than one cause contributing to responsible for death the most significant problem was taken as the cause of death.Results: Overall neonatal mortality was 312 (14.2%) of 2189 neonates. Out of 148 admissions in the study population mortality was 74.2% (26 of 35) for extreme preterm (<28 weeks) infants and 42.7% (48 of 113) for very preterm (28 to 32 weeks) infants. Predominant causes of death were sepsis 44.5% (33), prematurity-related complications 37.8% (28) followed by congenital anomalies 12.1% (9) and miscellaneous causes 2.7% (2). Respiratory Distress Syndrome (RDS) and Intra Ventricular Haemorrhage (IVH) attributed to 75% (21/ 28) of deaths among prematurity-related complications.Conclusions: This study identified sepsis; prematurity related complications were the predominant causes of mortality in the extreme to very preterm population. Understanding the specific causes of preterm mortality would help to implement interventions to promote their survival.
      PubDate: 2020-03-21
      DOI: 10.18203/2349-3291.ijcp20201097
      Issue No: Vol. 7, No. 4 (2020)
       
  • Follow up of growth, development and clinical outcome in neonates
           discharged from the NICU of tertiary care hospital in central India

    • Authors: Prithvichandra K. C., Pawan K. Ghanghoriya
      Pages: 783 - 789
      Abstract: Background: To assess the growth and neurodevelopmental outcome of all newborn discharged from the NICU of Netaji Subhash Chandra Bose Medical College, Jabalpur on follow up for 6 months.Methods: Prospective observational cohort study of 200 high risk newborn discharged from NICU. Babies were called for follow up at 1 month, 2 months, 4 month and 6 months of corrected age and detailed information was taken regarding NICU stay and morbidity with the help of data available from discharge card. Anthropometric parameters like weight, length, and head circumference were noted.  Suitable screening tests like denver’s developmental screening test for Indian infants (DDSTII) for NDD (neurodevelopmental delay) and Amiel Tison scoring for tone assessment was done.Results: Among the 200 NICU graduates chosen, 40 lost during follow up. The neurodevelopmental delay in this study was 31.3%.
      Authors also analysed NDD according to gestational age wise groups. NDD in pre-terms was 39.6%. The developmental delay was more in babies with neonatal sepsis, perinatal asphyxia, prematurity, RDS, NEC etc.Conclusions: The morbidities like severe perinatal asphyxia, hypoglycaemia, seizures, shock, hypoxia, hypothermia, low gestational age have direct association with NDD.
      PubDate: 2020-03-21
      DOI: 10.18203/2349-3291.ijcp20201131
      Issue No: Vol. 7, No. 4 (2020)
       
  • Risk factors and clinical outcome of hypomagnesemic patients in pediatric
           intensive care

    • Authors: Poornima Shankar N., Kavya C., Varsha Monica Reddy
      Pages: 790 - 794
      Abstract: Background: Hypomagnesemia is a common finding in current medical practice, especially in critically ill patients. Magnesium ion plays a vital role in various metabolic processes in body and its deficiency leading to serious clinical consequences. Since hypomagnesemia is most often asymptomatic, it goes unsuspected and therefore undiagnosed. Hence, early detection of hypomagnesemia has prognostic and therapeutic implications. It is imperative to understand the various risk factors and their clinical outcome that is associated with hypomagnesemia.Methods: This is an observational study done in a tertiary centre in Bangalore, India where-in 100 children who met the inclusion criteria, admitted to the PICU were recruited and prospectively studied. Serum Magnesium along with various clinical and biochemical parameters were correlated to enumerate the various risk factors associated with hypomagnesemia.Results: In this study authors found the incidence of hypomagnesemia to be around 53%.
      Authors found higher incidence in age group of 1-5 yrs (40%) and least were in the age groups of <1 year and more than 10 years (19%) and there was no gender preponderance.
      Authors also evaluated the various risk factors associated with hypomagnesemia. There was significant association of hypocalcemia (60%) and hypokalemia (45.2%) with hypomagnesemia. Infections (33.9%) and neurological disorders (26.41%) seemed to collectively comprise around 60% of the hypomagnesemic group. All patients admitted secondary to sepsis and Traumatic Brain Injury (TBI) had hypomagnesemia proving to be a significant risk factor.
      Authors also found increased mortality among hypomagnesemic group. However, found no association between low serum magnesium and PICU stay.Conclusions: There is high prevalence of hypomagnesemia in critically ill patients and is associated with a higher mortality. It is also commonly associated with infections, CNS disorders, respiratory diseases and metabolic derangements like hypokalaemia and hypocalcaemia. There is no association of Hypomagnesemia with duration of PICU stay.
      PubDate: 2020-03-21
      DOI: 10.18203/2349-3291.ijcp20201132
      Issue No: Vol. 7, No. 4 (2020)
       
  • Correlation of serum leptin levels with clinical and biochemical
           parameters in obese children

    • Authors: Lingaraja Gowda C. Patil, Srinivas S.
      Pages: 795 - 800
      Abstract:  Background: Leptin plays a crucial role in the regulation of appetite, glucose homeostasis and body fat.
      Authors described various clinical and biochemical parameters of obese children aged 6 to 18 years visiting to outpatient department in a tertiary care hospital followed by their correlation with serum leptin levels. It was a prospective observational study.Methods: Obese children with Body Mass Index >2 standard deviation according to WHO chart were included. Endocrinological and syndromic obese children were excluded.
      Authors first compared leptin level of obese children with age and sex matched nonobese children. Followed by correlation of serum leptin levels with various clinical and laboratory parameters in obese children. Pearson’s correlation coefficient was used to compute the strength of relationship of leptin with various quantitative parameters. Mann-Whitney Test was also used when standard deviation was high, to calculate statistical significance.Results: Leptin concentration was significantly higher in obese children than non-obese. No significant difference in sex distribution was found. Serum leptin levels showed positive correlation with BMI, skin fold thickness and abdominal circumference, and blood pressure. No statistical correlation of leptin with biochemical parameters such as dyslipidemia, fasting blood glucose and insulin resistance was seen.Conclusions: In this study though serum leptin levels had a positive correlation with various clinical parameters, but no statistically significant correlation was seen with biochemical parameters. There is need for further investigation with a larger sample size on the role of leptin in childhood obesity.,
      PubDate: 2020-03-21
      DOI: 10.18203/2349-3291.ijcp20201133
      Issue No: Vol. 7, No. 4 (2020)
       
  • Early weight trends in preterm babies post discharge

    • Authors: Madhura P. Fadnis, Sanjay Prabhu, Shakuntala S. Prabhu
      Pages: 801 - 806
      Abstract: Background: Prematurity is the major determinant of morbidity and mortality in newborns. Infants born preterm are at increased risk for impaired growth. The postnatal growth pattern is dependent on biological factors like birth weight, gestational age, sex and intrauterine growth. The present study was undertaken to study the risk factors associated with the preterm delivery and to study the weight gain pattern among the preterm neonates after NICU discharge for a period of one month. Aims and objectives to study the risk factors associated with preterm and to analyze the weight gain pattern of the preterm till one-month post NICU discharge.Methods: A total of 40 preterm were included during the study period of 2 months, the various maternal risk factors were studied and correlated with preterm delivery. The neonatal complications were studied. The neonates were divided on the basis of their gestational age and birth weight. They were then followed for a period of 1-month post NICU discharge.Results: There was significant correlation of lower gestational age with neonatal complications and prolonged duration of hospitalization. The weight gain pattern was highly variable with a maximum gain of 188 gm after first week of NICU discharge. Weight gain was significantly more in first week after discharge amongst neonates who had birth weight less than 1.5 kg and also the total weight gain was significantly more in neonates who weighed less than 1.5 kg at birth.Conclusions: Lower gestational age group 28-32 weeks was significantly associated with neonatal complications and prolonged duration of hospitalization. Immediate follow up of the preterm is necessary as there is wide variability in the weight gain pattern in various gestational age groups.
      PubDate: 2020-03-21
      DOI: 10.18203/2349-3291.ijcp20201134
      Issue No: Vol. 7, No. 4 (2020)
       
  • Effect of kangaroo mother care in preterm versus term intra uterine growth
           restriction neonates

    • Authors: Devesh N. Joshi, Lalit Nainiwal
      Pages: 807 - 813
      Abstract: Background: Low Birth Weight newborns are either Preterm or IUGR. These both have different morbidities and outcomes. KMC is an effective intervention for LBW infants. Here authors study the effectiveness of KMC in preterm babies and full term IUGR babies.Methods: Prospective, Observational, comparative study in which 50 Preterm AGA and 50 Term IUGR included which are hemodynamically stable. effective KMC given and their daily weight gain were observed.Results: Term IUGR having average birthweight is 2083.7±177.9 gm and discharge weight 2179.4±183.8 and preterm AGA are having average birthweight 1972.9±198.9gm and weight on discharge 1962.2±201.0. IUGR term newborns had mean weight loss for 0.90±1.05 days with mean weight loss of 17.94±28.8 grams with average weight loss of 0.9% followed by mean weight gain of 26.6±14.2 grams per day for mean 4.36±0.74 days. Preterm AGA shows weight loss for 3.54±1.5 days with mean weight loss of 98.06±80.83 grams and average 5.4% followed by mean weight gain of 20.4±8.9 grams 4.22±0.97 per day for mean 4.36±0.74 days. With average hospital stay of 5.26±1.2 and 7.76±1.51 days respectively for Term IUGR and Preterm AGA.Conclusions: KMC helps in decreasing the morbidities, achieving physiological weight gain and early discharge in both IUGR term and preterm AGA new-borns but maintaining their physiological pattern of weight gain.
      PubDate: 2020-03-21
      DOI: 10.18203/2349-3291.ijcp20201135
      Issue No: Vol. 7, No. 4 (2020)
       
  • Comparison of determinants of morbidities of late preterms and terms

    • Authors: Gagandeep Kaur, Gurpreet Singh Chhabra, Karuna Thapar
      Pages: 814 - 819
      Abstract: Background: To compare the determinants of neonatal morbidity in late preterms and terms.Methods: A total of 100 live late preterm (34-0/7 to 36-6/7 weeks) and 100 term infants (37-0/7 to 41-6/7 weeks) admitted in sri guru ram das institute of medical sciences and research were randomly selected to participate in this case control study. The study group include 100 neonates within gestation age of 34 0/7 to 36 6/7 weeks. Equal number of terms between 37 0/7 to 41-6/7 gestation age was taken for comparison. The maternal history including both antenatal and natal history as well as new-born profile was taken.Results: Maternal risk factors have been found to be the major determinants of morbidity in late preterms with PROM (p<0.0001), sepsis and hypertension being significant contributors. Respiratory distress, neonatal jaundice, sepsis has been found to be major morbidity factors in late preterms. The average duration of admission was higher in late preterms than terms.Conclusions: Late preterm infants have higher risks for acute metabolic complications, mortality and long-term disabilities as compared to term infants. Morbidities like respiratory distress, neonatal jaundice, sepsis, hypoglycaemia and hypothermia are more in late preterms due to their immaturity. The risks associated with late preterm birth suggest the need for refinement of obstetric paradigms to extend pregnancy duration if benefits outweigh risk to fetus and mother. There is need to make obstetricians and families aware of complications pertaining to late preterm birth and improving surveillance of high-risk pregnancies.
      PubDate: 2020-03-21
      DOI: 10.18203/2349-3291.ijcp20201136
      Issue No: Vol. 7, No. 4 (2020)
       
  • Red cell distribution width as a diagnostic marker in neonatal sepsis

    • Authors: Anupama Deka, Aravind P.
      Pages: 820 - 825
      Abstract: Background: The early diagnosis of neonatal sepsis, a significant cause of neonatal morbidity and mortality still remains a challenge. Red-cell Distribution Width (RDW) vary significantly in conditions associated with inflammation and infection like sepsis. The study aims to find the normal range of RDW in healthy newborns and investigate the role of RDW in the early diagnosis of neonatal sepsis.Methods: This is a prospective observational study, 50 normal and 50 sepsis neonates were considered for the study. The neonatal sepsis group consisted of neonates with (i) Positive sepsis screen with/without clinical features of neonatal sepsis and/or (ii) Blood, urine or CSF culture positive or signs of pneumonia on chest x-ray. The mean RDW and the relationship between RDW and neonatal sepsis were analysed using appropriate statistical methods in SPSS-25 software.Results: Mean RDW (%) was significantly higher in sepsis neonates (18.59±1.28) than in normal newborns (16.21±1.35). RDW had statistical significance with CRP (C-Reactive Protein) in the sepsis group. RDW had significant relationship with the diagnosis of neonatal sepsis with a p value of 0.000. An RDW cut-off level of 17.25% had 86% sensitivity, 87% specificity, and 93.5% accuracy in diagnosing neonatal sepsis.Conclusions: RDW helps as a diagnostic test in the early diagnosis of neonatal sepsis. 
      PubDate: 2020-03-21
      DOI: 10.18203/2349-3291.ijcp20201137
      Issue No: Vol. 7, No. 4 (2020)
       
  • A study to determine the effect of maternal prepregnancy body mass index
           on the anthropometric measurements of the newborn

    • Authors: Brinda Prasanna Kumar, E. Adarsh, Sahana G.
      Pages: 826 - 830
      Abstract: Background: Maternal pre-pregnancy BMI is well established to be a detrimental factor for prenatal development and neonatal anthropometric measures. Objectives of the study was to study the association between maternal pre-pregnancy Body Mass Index (BMI) and the anthropometry of the newborn.Methods: A hospital based cross-sectional, observational study was conducted that included 236 normal newborns and their mothers. A pre-designed questionnaire was used to collect relevant socio-demographic data and obstetric history. Details regarding maternal pre-pregnancy weight was collected from antenatal records at first antenatal visit, maternal height was measured and BMI was calculated. Neonatal anthropometric measurements including birth weight, recumbent length, head circumference, chest circumference and the mid arm circumference was measured.Results: In this study 49.6% of the women were in the age group of 21-25 years, 52.5% of them were multi-gravida and 56.4% had normal vaginal delivery. Among the newborns included in the study 25.8% had low birth weight. We saw a significant positive correlation between BMI and age, BMI and birth weight, BMI and chest circumference that is with increase in BMI there was significant increase in the age, birth weight and chest circumference and vice versa. There was no association between maternal BMI and mid-arm circumference or head circumference of the newborn.Conclusions: Study showed the association between maternal BMI and anthropometry of the newborn especially with respect to the BMI and birth weight, BMI and chest circumference. Thereby, establishing that interventions aimed at improving the nutritional status of the mother have a direct impact on the fetal growth outcomes.
      PubDate: 2020-03-21
      DOI: 10.18203/2349-3291.ijcp20201138
      Issue No: Vol. 7, No. 4 (2020)
       
  • Does H. pylori therapy augments the effect of iron therapy among children
           with iron deficiency anemia'

    • Authors: Arif Husain, Shrish Bhatnagar
      Pages: 831 - 837
      Abstract: Background: To assess beneficial effects of H. pylori therapy on children with pre-existing Iron Deficiency Anemia (IDA).Methods: A total of 218 consecutive patients with iron deficiency anemia (Hb 6-11 gm/dl) were invited to participate in the study. Patients underwent endoscopic biopsy and rapid urease test for H. pylori detection. A total of three groups were formed- Group I (n=13) - positive for H. pylori, underwent treatment for H. pylori therapy and IDA, Group II (n=16) - positive for H. pylori, underwent treatment for IDA only, Group III (n=101) - negative for H. pylori, underwent treatment for IDA only. All the patients were followed up after every 4 weeks till week 12. Change in haematological parameters and anaemic and iron status was assessed. Chi-square paired ‘t’-test and ANOVA were used using SPSS 21.0.Results: All the 3 groups showed a significant increase in S. Hb, Ferritin and iron levels and a decrease in S. TIBC levels. At 12 weeks, mean S. ferritin and S. iron levels were significantly higher in Groups I and III as compared to Group II while Mean S. TIBC levels were significantly higher in Group II as compared to that in Groups I and II. A total of 73.3% of Group III, 53.8% of Group I and 56.3% of Group II patients had hemoglobin levels >11 g/dl, but difference was not significant (p=0.175).Conclusions: The findings of study showed that H. pylori therapy augments the effect of iron therapy among H. pylori positive children with iron deficiency anemia.
      PubDate: 2020-03-21
      DOI: 10.18203/2349-3291.ijcp20201139
      Issue No: Vol. 7, No. 4 (2020)
       
  • Institutional births analysis from labour room registries in North Indian
           hilly state

    • Authors: Mangla Sood
      Pages: 838 - 842
      Abstract: Background: India is the second most populous country in the world contributing to one fifth of global deaths among under 5-year-old children. Of these under 5 deaths, Infant mortality contributes to more than 89% and neonatal mortality is responsible for 70% of IMR. Of the many proximal determinants of neonatal mortality, inadequate utilization of health services and poor skills of health care providers contribute significantly. The lack of data constrains targeted interventions for these. This study is an attempt to analyze the existing data quality along with gaps in the reporting system to initiate timely course correction for improved programmatic outcomes.Methods: The labour room birth registries from 12 District hospitals and two Government Medical Colleges in the state of Himachal Pradesh (India) were analyzed. The data was extracted from archives in the State Child health Nodal Officer for the year 2017-2018 and 2018-2019.Results: Over these two years the proportion of institutional delivery has improved. The number of newborns resuscitated remained constant at 4.5%.  There was an improved coverage of birth dose immunization. Improvement in Antenatal Corticosteroids coverage among preterm laboring mothers was also observed.Conclusions: Continuous data analysis for improving its quality to take evidence informed decisions is needed.  Hands on skill improvement for staff is need of the hour to ensure timely and maximum returns on investment in reproductive and Child Health program.
      PubDate: 2020-03-21
      DOI: 10.18203/2349-3291.ijcp20201140
      Issue No: Vol. 7, No. 4 (2020)
       
  • Influence of serum vitamin D levels on control and severity of asthma in
           children

    • Authors: Savitha M. R., Gayatri R. Pawar
      Pages: 843 - 847
      Abstract: Background: To determine the association between the serum vitamin D levels with the control and severity of asthma.Methods: A total of 113 asthmatic children were enrolled in the study who were on regular follow-up and treatment for the past 6 or more months. The demographic details, presenting complaints, aggravating factors, allergic rhinitis, atopic dermatitis, hospital and ICU stay, duration of sunlight exposure, drug compliance and detailed clinical examination findings were noted in the predesigned proforma. Control of asthma was assessed based on GINA guidelines 2018 as well controlled, partly controlled and poorly controlled. The partly controlled and the poorly controlled group were further combined and labelled as not well controlled group. Severity of asthma was categorized into intermittent, mild persistent, moderate persistent and severe persistent. Serum 25 hydroxy vitamin D was assessed by solid phase ELISA. The well controlled and partly controlled group were compared for all studied parameters.Results: Asthma status of the subjects was categorized as well controlled (59%) as partly controlled (40%) and as poorly controlled (1%). Children with partly and poorly controlled asthma had significantly more vitamin D deficiency (10.9%) and insufficiency (32.6%) compared to well controlled group (4.5% and 4.5% respectively), with p value= 0.000. Low serum vitamin D levels are significantly associated with moderate and severe persistent asthma (p value= 0.009). Exercise significantly induced symptoms in 47.8% of not well controlled group and about 25.4% in well controlled group (p value= 0.014). Examination findings such as wheeze on auscultation was significantly more in not well controlled group.Conclusions: Low serum vitamin D levels are associated with poor control of asthma in children and the severity of asthma is inversely proportional to the serum vitamin D levels.
      PubDate: 2020-03-21
      DOI: 10.18203/2349-3291.ijcp20201141
      Issue No: Vol. 7, No. 4 (2020)
       
  • Awareness and attitude regarding postnatal care and immunization practice
           among antenatal mothers

    • Authors: Srinivasa S., Avinash Agrawal, Madhurya R. M., Shrisha Hiremath
      Pages: 848 - 852
      Abstract: Background: Under 5 mortality is a key indicator of health status of the country. Optimum care in postnatal period with immunization as per recommended schedule and exclusive breastfeeding with appropriate technology are the most essential factors for optimum growth and development of the child and to prevent under five mortality. The study was done to assess the knowledge and attitude of antenatal mothers on vaccination and postnatal care.Methods: Total 150 pregnant women were required to answer a series of questionnaire related to demographic data, awareness and attitude towards postnatal care, breastfeeding and immunization.Results: Total 90% of the women are aware regarding immunization at birth, 87% of them got the information from a person, who is directly related to health system. Statistically 97.3% mother were aware about importance to keep the baby covered. Every 3 out of 4 women knew that breastfeeding to be started within 1 hour of life. Only 40% were aware that prelacteal feed should never be given to newborns and 74% of the women think that jaundice in newborn requires evaluation.Conclusions: There is a need to educate antenatal mothers about various aspects of immunization and postnatal care including breastfeeding.
      PubDate: 2020-03-21
      DOI: 10.18203/2349-3291.ijcp20201142
      Issue No: Vol. 7, No. 4 (2020)
       
  • Evaluation of chronic cough in children aged 2 year to 12 years

    • Authors: Debbata Srikanth, Gangadhar B. Belavadi
      Pages: 853 - 859
      Abstract: Background: Chronic cough is a common complaint in children which causes distress and affects the quality of life of parents and children. While cough may be seen as a common condition of childhood without serious consequences, ignoring a cough that may be the sole presenting symptom of an underlying illness can lead to delayed diagnosis and progression to a chronic respiratory morbidity. Aims and objectives of the study was to evaluate the specific diagnosis and prognosis of chronic cough in children aged 2 to 12 years.Methods: A prospective study was done in 100 children with chronic cough (history of cough >4 weeks) at Narayana Hospital, Nellore. Routine investigations like complete blood count with differential count, Mantoux test, sputum examination, and X ray chest and other investigations like bronchoscopy, HIV, CT scan chest and paranasal sinuses, barium swallow, endoscopy and biopsy whenever needed. Pearson Chi square test carried out to quantify significance difference, p value <0.05, considered significant.Results: The mean duration of chronic cough was 56.27 days (1-5 months). Most of the children belonged to <6 years age with higher boys’ prevalence. Breathlessness and fever noticed in 79% cases; it was found mostly in pneumonia cases as compared to other diagnosis (p=0.001). Sputum production noticed in 4, which found to be bronchiectasis. 1 case noticed with regurgitation, which is gastro oesphageal reflux disease. History of triggers for the symptoms of cough, wheeze and breathlessness is found to have a significant correlation with asthma (p=0.000). Asthma in 14% of cases, of which 12 were mild persistent and 2 were moderate persistent. Tuberculosis was diagnosed in 14% cases, Pneumonia in 12% cases, and Bronchiectasis in 12 cases. Undernourished children noticed in 56%, maximum number in tuberculosis group. Asthma was associated with pneumonia, mucous plug obstruction and collapse lung. Recurrent pneumonia was associated with airway anomaly, gastro esophageal reflux disease.Conclusions: It should be remembered that a prolonged cough can be indicative of a more serious underlying condition, and always warrants thorough investigation. 
      PubDate: 2020-03-21
      DOI: 10.18203/2349-3291.ijcp20201143
      Issue No: Vol. 7, No. 4 (2020)
       
  • A clinico-etiological evaluation and EEG correlation of neonatal seizures
           in a tertiary care hospital: a prospective cohort study

    • Authors: Kuldeep Kumar Sharma, Sandeep D. Paimode, Navjot Kour
      Pages: 860 - 864
      Abstract: Background: Neonatal seizure is defined as a paroxysmal alteration in neurological function. The diagnosis of neonatal seizures is difficult to establish because of varied etiologies involved. The incidences vary from 1.5-3.7/1000 live births in term babies.Methods: Hospital based observational study was conducted from December 1, 2016 till March 31, 2018. Universal sampling technique was followed. 93 neonates fulfilling the inclusion criteria were included in the study after consent from parents.Results: This study results showed that 60.2% were males. Pre-term delivery occurred in 12.9% neonates. Most common etiology of neonatal seizures was birth asphyxia with 47.3% followed by metabolic abnormalities 32.3%. Abnormal EEG pattern was seen in 29% cases of neonatal seizures.Conclusions: To conclude, the most common aetiology for neonatal seizures was birth asphyxia followed by metabolic abnormalities in which hypoglycaemia was the most common type. A significant association of seizures due to meningitis and metabolic abnormalities was observed with pre-term gestation while abnormal EEG pattern was observed with birth asphyxia and meningitis. EEG findings were found normal in majority of cases of neonatal seizure.
      PubDate: 2020-03-21
      DOI: 10.18203/2349-3291.ijcp20201144
      Issue No: Vol. 7, No. 4 (2020)
       
  • Effect of low dose aspirin on fetal outcome in women at risk for
           developing pregnancy induced hypertension

    • Authors: Madhusmita Pradhan, Jyotiranjan Champatiray, Kishore V. S.
      Pages: 865 - 870
      Abstract: Background: Though pregnancy induced hypertension is a worldwide problem, it is more prevalent in developing countries particularly south east Asian and African countries. It contributes to 20% of perinatal death and 40-50% of low birth weight babies in India. Fetal salvage is also an important consideration in providing quality care. Low dose aspirin given between 12 weeks to 28 weeks of gestational age in high-risk women at Developing Pregnancy Induced Hypertension (PIH) is anticipated to prevent the development of PIH and complications that arises especially those regarding maternal and fetal mortality due to PIH.Methods: This prospective randomized controlled trial was conducted in the dept of O and G, SCB MC and Hospital, Cuttack during November 2018 to October 2019. Pregnant women between the gestational age of 13 to 28 week were screened for risk factors and included in this study. Low dose aspirin of 60 mg daily till delivery was given to pregnant women who consented to be a part of study randomly with the other group taking placebo.Results: Incidence of IUGR babies in low dose aspirin treated mothers was as low as 1%. Incidence of LBW babies is lower in low dose aspirin treated mothers than with those who were not treated. Mean birth weight in cases was 2780 gm±352 gm vs control 2592 gm±483 gm. There is increased incidence of still birth in high risk group not treated with aspirin. No significant difference in reducing incidence premature deliveries between case and control.Conclusions: Low dose aspirin has a definite role in the prevention of PIH in high risk pregnancy and its complication like IUGR and low birth weight. Low dose aspirin reduces the incidence of PIH. Low dose aspirin can be considered a safe drug without any deleterious side effect for mother and the fetus. Benefits of prevention of PIH, justifies its administration in women at high risk.
      PubDate: 2020-03-21
      DOI: 10.18203/2349-3291.ijcp20201145
      Issue No: Vol. 7, No. 4 (2020)
       
  • Assessment of mean testicular volume in adolescent school boys of Udaipur
           district in 10 to 18 years at different stages of pubertal development

    • Authors: Tarun Babani, Devendra Sareen, Dileep Goyal
      Pages: 871 - 875
      Abstract: Background: The most obvious and important changes during puberty are secondary sexual characters. To check the correlation between testicular volumes with secondary sexual characters, nutritional status in Udaipur schoolboy’s assessment of testicular volume by prayer orchidometer is easy and reliable and accurate method in community. Aim of the study was to find out mean testicular volume by prader orchidometer at different stages of pubertal development.Methods: Children between 10 to 18 years of age (525 in numbers) from schools of Udaipur city were included. Children thoroughly examined for presence of any systemic disorders or major surgery was excluded. Informed consent with parents was taken Testicular volume assessment done by praders orchidometer with Tanner staging and correlation was statically analysed.Results: Maximum boys belonged to 15-16 years of age group (14.7%), and minimum belongs to 10-11 years age group (9.3%). Secondary sexual characters increases as mean testicular volume increases. The mean testicular volume for P1 (4.46 ml) and P5 (22.68 ml) and G1 (4.69 ml) and G5 (23.27 ml) with a p<0.05.Conclusions: Testicular volume adds more objectivity in SMR detection and helps to differentiate early genital maturation than pubic hair. Study population had early rise of testicular volume before pubic hair clinically visible which shows that testicular volume is the first to increase with the onset of puberty.
      PubDate: 2020-03-21
      DOI: 10.18203/2349-3291.ijcp20201146
      Issue No: Vol. 7, No. 4 (2020)
       
  • A study of serum zinc levels among children with seizures in comparison
           with febrile children without seizures

    • Authors: Pranam G. M., Usha Hirevenkanagoudar, Sanjeev Chetty
      Pages: 876 - 879
      Abstract: Background: Infants and children are more prone to have seizures than adults. This reflects the greater neuronal excitability at certain ages as the excitatory glutamate system and inhibitory GABA system do not always balance each other. Febrile seizures are the most common type of seizures observed in pediatric age group. Febrile seizures occur in young children at a time in their development when seizure threshold is low. Objective of the study was to determine the levels of zinc in children with febrile seizures when compared to children with fever without seizures.Methods: To determine the levels of zinc in children with febrile seizures when compared to children with fever without seizures. A total of 50 Study subjects were selected into each group. Group 1: Children with Febrile Seizures. Group 2: Children with Fever and Without Febrile Seizures.Results: Among the cases with fever and convulsion Zinc level was found to be low among 72% of the subjects, 22 % of them had normal zinc levels and only 6% had high zinc levels. Among the subjects with Fever and no convulsions nearly 80% of them had normal zinc levels, 16 % had low levels of zinc and 4% had high zinc levels. The association of levels of Zinc between both the groups was found to be statistically significant.Conclusions: This study shows that serum zinc levels are decreased in children with febrile convulsions when compared to children with fever alone without convulsions, thus indicating that zinc deprivation plays significant role in the pathogenesis of febrile convulsions.
      PubDate: 2020-03-21
      DOI: 10.18203/2349-3291.ijcp20201023
      Issue No: Vol. 7, No. 4 (2020)
       
  • Comparison of neonatal electroencephalogram changes in three month old
           neonates with seizure in Bu-Ali Hospital of Ardabil city, Iran 2017

    • Authors: Farzad Ahmadabadi, Mehrdad Mirzarahimi, Masoumeh Babaei, Sanaz Karimi Dardashti
      Pages: 880 - 883
      Abstract: Background: The prevalence of neonatal seizure in term neonates is 3 per 1000 births, but in preterm newborns is 50 per 1000 births. Babies who have seizures are at high risk of death or neurological disabilities. Seizure is often the first sign of neonatal dysfunction and may be effective in long-term prognosis. EEG is the only available method for the diagnosis of seizures in neonates. Therefore, authors compared EEG changes in the first EEG infant seizure with 3 months of age in newborns who referred to the Aristotelian hospital in Bouali Hospital.Methods: The present study is a cross-sectional descriptive analytical method. In this study, neonates referred to Ardabil Booali Hospital, EEG, were screened for seizure and EEG was monitored 3 months later and the results were evaluated. Finally, all the data were entered into the SPSS-24 statistical analysis program and authors analyzed the data according to the type of variables by statistical tests.Results: In this study, 50 neonates with seizure were enrolled in this study, 70% of which had an average age of 14.92 days. 80% of infants were born at the time of term. The average birth weight was 3.208 kg. 6.2% of infants had abnormal CT scan findings, with an IVH infant and one baby showing brain edema. In this study, only 14% of neonates with abnormal brain strain were observed in the neonatal period and near the seizure. However, after 3 months, 40% of infants experienced abnormal brain stroke findings. Among the changes in EEG with age (p=0.173), gestational age (p=0.616), gender (p=0.176), seizure (p=0.145), neonatal hypoglycemia (p=0.594), hypocalcaemia (p=0.607) no statistic was found.Conclusions: The  results of  this study  showed  that a  small  percentage of  neonates had abnormal EEG in the neonate, but after 3 months of seizure, the larger percentage of them found abnormal EEG.
      PubDate: 2020-03-21
      DOI: 10.18203/2349-3291.ijcp20201147
      Issue No: Vol. 7, No. 4 (2020)
       
  • Barriers to exclusive breast feeding, the missing links: a cross sectional
           study from Puducherry, India

    • Authors: Gayathri G. Nair, Arul Kumaran Arunagirinathan, Nirmal S. R., Rajesh Yadav B.
      Pages: 884 - 890
      Abstract: Background: Breast milk, the first natural food for a new-born, provides all the energy and essential nutrients an infant requires for the first 6 months of life. The NHFS -4 survey shows only 45.5% of children are exclusively breastfed (EBF) in Puducherry. This study aims at assessing the socio-demographic characteristics associated with exclusive breastfeeding in a tertiary hospital in Puducherry and identify the barriers in the promotion of exclusive breastfeeding.Methods: Community-based cross-sectional study at a tertiary hospital in Puducherry. Sample size: 115 mothers of 6 months to 2-year-old children, born term gestation with a birth weight of >2.5 kg, attending the Paediatric OPD. Questionnaire-based study comprising of socio-demographic and parameters pertaining to exclusive breast-feeding.Results: Only 44.3% of the mothers have exclusively breastfed in the first 6 months. Shorter duration of spacing between births and caesarean section had significant negative association with exclusive breast-feeding. Most of the mothers received postnatal counselling on breast-feeding (94%) of which 58% were by health care personnel. Despite that, only a sixth (19%) of them were well versed with proper breastfeeding techniques. Poor secretion (45.3%), sore/inverted nipple (23.5%) amounted to the most common of the barriers. Among working mothers, 42.9% attributed their jobs as the cause for early weaning.Conclusions: The prevalence of exclusive breastfeeding is still low even among a literate study group. There were no significant association with socio-demographic factors found, but lacunae were identified. A more objective post-natal counselling to mothers involving their caregivers may improve the current scenario.
      PubDate: 2020-03-21
      DOI: 10.18203/2349-3291.ijcp20201148
      Issue No: Vol. 7, No. 4 (2020)
       
  • Effect of oral 25% dextrose on pain relief in newborn infants undergoing
           venepuncture

    • Authors: H. N. Yashwanth Raju, Rudrappa Sudha, Shwetha B. N.
      Pages: 891 - 895
      Abstract: Background: Aim of this study was to study effect of oral 25% dextrose for pain relief in newborns undergoing venepuncture.Methods: This is a case control study conducted in NICU, Cheluvamba hospital attached to Mysore medical college and research institute during the period between September 2018 to November 2018. Babies with gestational age between 34 to 40 weeks of gestation who had clinical indication for blood sampling were included in the study. Neonates who are critically ill, suffered perinatal asphyxia and having congenital anomalies were excluded from the study. Hundred newborn babies admitted to NICU who had clinical indication for blood sampling were enrolled in the study. Study population were divided into 2 groups, dextrose (cases) and non-dextrose group (controls). The data analysis included gestational age, postnatal age, weight, sex, heart rate, oxygen saturation, crying time and behavioural pain assessment.Results: Mean pain score, crying time and heart rate at 5 minutes of venepuncture were studied in both the groups. Mean pain score in dextrose group was 2.68 and in non-dextrose group was 7.18 with significant p value of 0.0062. Mean crying time in dextrose group was 8.98 minutes and in non-dextrose group was 42 minutes with significant p value of 0.001. Mean heart rate in dextrose group was 142 beats/minute and in non-dextrose group was 146bpm with p value of 0.08.Conclusions: Pain in the newborns should be recognised and adequately treated. Lingual 25% dextrose can be used as safe and effective analgesia in neonates undergoing minor invasive procedures like venepuncture.
      PubDate: 2020-03-21
      DOI: 10.18203/2349-3291.ijcp20201149
      Issue No: Vol. 7, No. 4 (2020)
       
  • A prospective study of inflammatory biomarkers in neonatal sepsis at a
           tertiary level hospital

    • Authors: Sandeep D. Paimode, Kuldeep Kumar Sharma, Navjot Kour
      Pages: 896 - 900
      Abstract: Background: Sepsis in neonates is a syndrome which is characterized clinically by systemic symptoms or signs of infection and associated with bacteremia in the first 28 days of life. More than 40% of under-five deaths globally occur in the neonatal period, resulting in 3.1 million newborn deaths each year. Procalcitonin (PCT) is an early diagnostic tool for neonatal sepsis.Methods: Present prospective cross- sectional observational study was conducted at NICU of Base hospital, Delhi Cantonment from 1st Dec 2016 to Jan 31st, 2018. Universal sampling technique was followed. SPSS version 21 was used for statistical analysis. A p-value of less than 0.05 was taken as significant.Results: Out of the total 440 cases, 63% were males while rest 37% were females.  Mean gestation age and birth weight of the babies was 35.6 weeks and 2.13 Kg respectively. Raised/ decreased Total Leucocyte Count (TLC) and raised pro calcitonin levels were seen in 23% and 19.8% cases respectively.Conclusions: These results indicated that the sensitivity of procalcitonin was higher than TLC for the diagnosis of culture proven neonatal sepsis. Hence, PCT is a more sensitive and useful biomarker for the diagnosis of neonatal sepsis.
      PubDate: 2020-03-21
      DOI: 10.18203/2349-3291.ijcp20201150
      Issue No: Vol. 7, No. 4 (2020)
       
  • Clinical profile and antibiotic sensitivity pattern of typhoid fever in
           children: a hospital based prospective study from a tertiary care center

    • Authors: Shekar V., Chapay Soren, Lakshmi Aparnadevi V. V., Umadevi M., Malathi Vanka
      Pages: 901 - 904
      Abstract: Background: Typhoid fever is a serious public-health problem in many developing countries including India. There is a wide spectrum of clinical presentation and with the emergence of multidrug resistant typhoid now a days, the treatment has become still more complex. The present study authors describe the clinical profile and antibiotic sensitivity pattern of typhoid fever in children from a tertiary care in Mahabubnagar, Telangana, South India.Methods: This hospital based prospective observational study was done in Department of Pediatrics, SVS Medical College, Mahabubnagar, Telangana over a period of 3-year period from January 2017 to December 2019. The study was approved by institutional ethics committee. Written informed consent was obtained from children’s parents. All pediatric patients diagnosed as typhoid fever if presented with fever (temperature >38ºC) for at least 3 days with positive blood culture for S. typhi or paratyphi were included in the study. The demographic profile and clinical data were recorded and tests including antibiotic sensitivity and resistance were done.Results: A total of 136 patients were included in the study. Majority of the children were between 8 to 12-year age group (38.2%). Out of 136 children, 78 were males and 58 were females. Majority of the cases were from rural areas accounting for 69%. Drinking water source was tap water in 63% cases and bore well water in 37% cases. Majority (65%) belonged to lower socioeconomic class and 68% were during rainy seasons. The clinical findings observed were fever (100%), vomiting (98, 72%), diarrhea (55.8%), headache (45.5%), and splenomegaly (42.6%). Other clinical features found were coated tongue, abdominal pain, hepatomegaly, constipation, and dehydration. Six children had complications, 3 had enteric hepatitis, 2 had shock, and 1 had encephalopathy. Ampicillin, amoxicillin and chloramphenicol resistance was observed in 76%, 71% and 22% of patients with typhoid fever respectively. Maximum sensitivity was observed with ceftriaxone (95%), followed by aztreonam (92%), ciprofloxacin (84.5%), and azithromycin (77%).Conclusions: Clinical presentation in the study subjects was similar to available reports from literature. Increasing resistance of salmonella to Ampicillin and amoxicillin were observed.
      PubDate: 2020-03-21
      DOI: 10.18203/2349-3291.ijcp20201151
      Issue No: Vol. 7, No. 4 (2020)
       
  • Diagnostic value of polymerase chain reaction targeting insertion sequence
           IS1081 for the diagnosis of pediatric tuberculosis

    • Authors: Shehraz Firoz, Sonia Bhatt
      Pages: 905 - 908
      Abstract: Background: Aim of this study was to evaluate the efficacy of PCR targeting IS1081in diagnosis of pediatric tuberculosis and compare the results with MGIT culture.Methods: This prospective study was conducted in the department of pediatrics, S.N. medical college, Agra. 100 subjects (28 pulmonary 72 extra pulmonary) were registered in study. The specimens obtained from these cases were subjected to Ziehl–Neelsen staining (ZN), MGIT 960 TB culture and PCR targeting insertion sequence IS1081. Sensitivity, specificity, PPV and NPV of PCR were calculated in pulmonary and extra pulmonary specimens. The results of PCR IS1081 were compared to MGIT culture.Results: Microscopy with ZN staining was positive in 12 (12%) samples. MGIT culture was positive in 44% samples with maximum positivity in sputum (70%). PCR IS1081 has shown 93.3% sensitivity in pulmonary tuberculosis, while PCR IS1081 has shown 93.1% sensitivity in extra pulmonary tuberculosis.  In diagnosis of childhood tuberculosis PCR IS1081 was found to be statistically significant (p value <0.05) as compared with MGIT culture. Result was statistically significant (p value <0.05) in CSF samples only.Conclusions: The study concluded that the PCR targeting sequence IS1081 technique is the most sensitive technique for a quick identification of MTB in pulmonary and extra pulmonary tuberculosis.
      PubDate: 2020-03-21
      DOI: 10.18203/2349-3291.ijcp20201152
      Issue No: Vol. 7, No. 4 (2020)
       
  • Compliance with 14 day zinc therapy for acute diarrhoea: a prospective
           observational study

    • Authors: Ajayprakash Veerapandiyan, Deepti Pandit, Sujatha Sridharan, L. Umadevi
      Pages: 909 - 913
      Abstract: Background: Acute diarrheal diseases remain a leading cause of global morbidity and mortality in young children. The effective implementation of provision of zinc in addition to low osmolarity ORS remains very poor.Methods: A prospective observational study was done to determine compliance with zinc therapy on 103 children aged between two months to five years with acute gastroenteritis. They were started on WHO ORS and zinc in the form of syrup (20 mg/day in those >6 months of age and 10mg/day in those <6 months of age) and advised to continue for 14 days. Further episodes of diarrhea was considered as the primary outcome variable. Number of days zinc taken was considered as the primary explanatory variable. p-value <0.05 was considered statistically significant.Results: The mean age was 19.49±14.41 months. The compliance to complete 14-day zinc therapy was 62.14%.  The mean number of days zinc was taken was 11.28±3.81 days. In 11.65% of participants, there was further episodes of diarrhea. The main reasons for discontinuation were diarrhea stopped (45%), Ignorance (37.5%), URI (12.5%).Conclusions: Findings indicate that the syrup formulation is acceptable, but further efforts are required to enhance adherence. These findings also highlight the importance of guiding in ensuring adherence to zinc duration while also addressing the tendency of caregivers to terminate treatment once a child appears to have recovered from an acute diarrheal episode.
      PubDate: 2020-03-21
      DOI: 10.18203/2349-3291.ijcp20201153
      Issue No: Vol. 7, No. 4 (2020)
       
  • Randomized control trial evaluating the effectiveness of ear plugs in
           hearing loss in NICU preterm babies

    • Authors: Fathma Thahmi Shingeri, Ashvij R. Shriyan, Roshan Ann Maben, Santosh T. Soans
      Pages: 914 - 917
      Abstract: Background: The prevalence of hearing loss is higher in neonates admitted to NICU compared to the general population. Preterm babies are more vulnerable to the hearing damage due to their immature inner ear exposing them to various high frequency noises in the NICU to which they were not accustomed. Most NICU in India exceed the recommended sound levels. In order to reduce damage to the ears, foam-based earplugs are used to reduce the sound intensity reaching the ears of these premature babies.Methods: Babies admitted to NICU are allocated alternatively to receive earplugs or not. Cases are preterm babies with earplugs and controls are the ones without earplugs. The incidence of hearing loss is found by OAE testing of the ears at the end of NICU stay.Results: Out of 40 in each group, 6 babies in control group failed the OAE compared the 3 in the earplug group. Babies who did wear earplugs had longer period of NICU stay.Conclusions: Use of earplugs in babies admitted to NICU reduced the incidence of hearing loss and also length of NICU stay. 
      PubDate: 2020-03-21
      DOI: 10.18203/2349-3291.ijcp20201154
      Issue No: Vol. 7, No. 4 (2020)
       
  • Role of urinary nitrites in predicting steroid responsiveness of nephrotic
           syndrome: a study conducted in tertiary care center

    • Authors: Yerroju Kodandapani, Ajay Mohan Varahala, Rajesh Kumar Songa
      Pages: 918 - 924
      Abstract: Background: Nephrotic Syndrome (NS) is a common chronic disorder, characterized by alterations of selective permeability at the glomerular capillary wall, resulting in its inability to restrict the urinary loss of protein. Urinary nitrite excretion serves as a useful investigation in differentiating between steroid responsive and steroid resistant nephrotic syndrome. The aim of the study was to assess the relation between urinary nitrite levels and steroid responsiveness in nephrotic syndrome in children.Methods: 76 children were enrolled in the study suffering with nephrotic syndrome of which 58 children were Steroid Sensitive (SSNS) and 18 were Steroid Resistant (SRNS). 25 children were enrolled as controls. The urinary nitrites were estimated in these subjects and the results were analyzed.Results: All the control subjects were tested negative for urinary nitrites. After achieving remission with steroids, out of 58 SSNS subjects’ 27 subjects tested positive for urinary nitrites, remaining 31 tested negatives for the same. Of the 18 SRNS subjects 1 subject tested positive for urinary nitrites remaining 17 subjects were tested negative for the same.Conclusions: The findings of present study suggest that urinary nitrite excretion is increased in patients with steroid responsive nephrotic syndrome. The urinary nitrite estimation has low NPV and high PPV in predicting steroid responsiveness.
      PubDate: 2020-03-21
      DOI: 10.18203/2349-3291.ijcp20201155
      Issue No: Vol. 7, No. 4 (2020)
       
  • Assessment of pSOFA-L score in predicting the clinical outcome of
           critically ill children

    • Authors: Shrishail Kumbar, Chandrashekhara .
      Pages: 925 - 931
      Abstract: Background: Recently Pediatric Sequential Organ Failure Assessment (pSOFA) score was adapted and validated in critically ill children to predict the clinical outcome. This study was aimed to evaluate the lactate level association with the outcome and thereby formulating pSOFA-L score to predict the clinical outcome better in critically ill children.Methods: This hospital based prospective, observational, analytical study was conducted in the Department of Paediatrics, A. J Hospital, Mangalore, Karnataka. Requirement of oxygen, inotrope support and other parameters were studied and compared the score with clinical outcome. A total of 75 cases were studied.Results: In this study total of 51 children had high serum lactate levels (68%). Out of 28 expired children 23 children had higher serum lactate levels that accounts for about 82.14% which is statistically significant (p<0.001). ROC curve of pSOFA-L score in predicting the mortality yielded AUC: 0.92 and cut off value: 10.5 which is statistically significant (p<0.001). In the present study mortality rate was 26.09% in children whose pSOFA-L score was less than 9 and mortality rate of 38.89% and 50.00% in children whose pSOFA-L score was 9 to 11 and more than 11 respectively.Conclusions: In this study increase in pSOFA-L score is associated with high mortality and poor outcome. The findings of the present study validate and emphasize that, pSOFA-L score helps in accurate prediction of mortality of critically ill children.
      PubDate: 2020-03-21
      DOI: 10.18203/2349-3291.ijcp20201156
      Issue No: Vol. 7, No. 4 (2020)
       
  • Does full enteral feed from day one of life influence weight gain in
           hemodynamically stable VLBW babies weighing between 1000-1500 grams as
           against standard feeding' a randomized controlled trial

    • Authors: Ramya S. Shanmugam, Mangala Bharathi, Kumutha Jayaraman
      Pages: 932 - 937
      Abstract: Background: Preterm neonates post-natal growth should be similar to the intrauterine growth of the fetus of the same gestational age. This study aims to  evaluate the effects of full enteral feed (60 ml/kg/day of human milk on day one, 20ml/kg/day during feeding advancement) started from day one of life (intervention) in enhancing   the regain of birth weight compared to that of standard feed (both human milk feeds and intravenous fluid) in a group.Methods: Babies were started on enteral feeds with human milk at the rate of 60ml/kg/day from day one and progressed by increments of 20 ml/kg/day up to maximum enteral feed of 180 ml/kg/day. The primary outcomes like Number of days taken to regain the birth weight, Duration of hospital stay, Incidence of Necrotising Enterocolitis (NEC), Incidence of sepsis, need for intravenous fluid therapy was assessed and statically analysed.Results: Full enteral feeding group infants had lesser days of intravenous fluids. Full enteral feeding group regained birth weight at a mean age of 17.37±4.9 days and in the standard feeding group, birth weight was regained at a mean age of 19.8±4.3. Full enteral feeding group regained birth weight at a mean age of 13.12±2.17 days and in standard feeding group at a mean age of 15.38±3.57and this was statistically significant (p - 0.009). Full enteral feeding group babies had lesser number of days of intravenous fluids compared to babies in standard feeding group. It was statistically significant (p - 0.003).Conclusions: There is lack of awareness regarding dog bite and its management among the rural population.
      PubDate: 2020-03-21
      DOI: 10.18203/2349-3291.ijcp20201087
      Issue No: Vol. 7, No. 4 (2020)
       
  • Health status of adolescent school going children with special reference
           to waist hip ratio

    • Authors: Halak J. Vasavada, Snehal V. Patel, Purvi R. Patel, Heli S. Mehta
      Pages: 938 - 944
      Abstract: Background: A school is a key location for educating adolescents about health, hygiene and nutrition. Adolescence is period of critical development and transition. These changes have important implications for health. Aims and objectives of the stud was to study the role of WHR in nutritional assessment in adolescent school children and compare it with BMI as an assessment tool and to study nutritional status of municipal and private school.Methods: It was a cross sectional study conducted in 10-17-year-old school children in Ahmedabad, Gujarat. There were 2 private and 2 municipal schools selected randomly by purposive sampling. Child absent or not well on the day of study were excluded.Results: Incidence of obesity is 42.9% and 57.1% in municipal and private school respectively. Incidence of overweight is 47.2% and 52.8% in municipal and private schools respectively. (2.9%) adolescents had BMI range of 25-29.9 which is considered to be overweight. However, the percentage of overweight and obese was raised at 28% and 23.5% respectively when classified as per WHR.Conclusions: The difference between incidence of overweight and obesity in private and municipal schools were not statistically significant. A combination of increase BMI with increase WHR is a stronger indicator of increase health risk.
      PubDate: 2020-03-21
      DOI: 10.18203/2349-3291.ijcp20201162
      Issue No: Vol. 7, No. 4 (2020)
       
  • A case report of congenital lobar emphysema

    • Authors: Aditya K., Parvathi K., Prabhakar V.
      Pages: 945 - 947
      Abstract: Congenital lobar emphysema (CLE), also known as congenital alveolar overdistension, is a developmental anomaly of the lower respiratory tract that is characterized by hyperinflation of one or more of the pulmonary lobes. CLE is a rare congenital malformation with a prevalence of 1 in 20,000 to 1 in 30,000. We are reporting a 4-month-old boy presented with complaints of cough and cold for 3 days with history of similar complaints in the past at age of 1month and 2 months. Investigations revealed hyperlucency of left upper zone with tracheal shift and mild shift of the heart to the right. Elective Left Upper Lung Lobectomy was done and Appropriate supportive therapy given and child recovered well.
      PubDate: 2020-03-21
      DOI: 10.18203/2349-3291.ijcp20201004
      Issue No: Vol. 7, No. 4 (2020)
       
  • Ketoacidosis as a presenting symptom of diabetes in a eighteen month old
           infant: a case report

    • Authors: Amrita Mohan, Sunkad M. A., Javali S. B., Sowmya Vernekar Vernekar, Shilpa Hidakal Hidakal
      Pages: 948 - 951
      Abstract: There is a world-wide trend in rise of diabetes cases. There is also rise in the trend of any one person getting diabetes at an early age. However, diabetes is fairly less common in children less than 5 years. The manifestation of diabetes too can be peculiar in very young children. Then managed as per standard protocol, results can be rewarding. Ours is secondary healthcare facility with all diagnostic equipment and consultants available round the clock.
      Authors describe one case finding of diabetic ketoacidosis. The baby aged 18 months presented with cold, cough, fever and air hunger (breathing deeply), referred by family doctor. The prompt diagnosis, rehydration, insulin infusion helped in recovery. Complete blood tests confirmed the presence of random blood sugar 345mg%, pH 7.05, Ketone bodies present in urine. While there was Leukocytosis, tests for Dengue Fever and Typhoid were negative.Identification of ketoacidosis and prompt treatment can save children.
      PubDate: 2020-03-21
      DOI: 10.18203/2349-3291.ijcp20201157
      Issue No: Vol. 7, No. 4 (2020)
       
  • A rare cause of pediatric respiratory distress: pulmonary embolism

    • Authors: Vinayaka H. S., Dhananjaya Sarji Rudrappa, Shivashankara T. H.
      Pages: 952 - 954
      Abstract: Pediatric Pulmonary Embolism (PE) is a very rare condition as compared to adults. However, the incidence of pulmonary embolism in children is increasing as a result of accurate and timely diagnosis.
      Authors hereby reporting a 7-year-old female child who presented to us with acute onset respiratory distress and hypotensive shock, with no other significant illness in the past. The diagnosis of pulmonary embolism was made based on chest x ray, electrocardiogram and echocardiography. After ascertaining the diagnosis of PE, child was started on unfractionated heparin infusion along with other supportive measures. But the child went into refractory shock followed by asystole, could not be revived. Pulmonary embolism is a rare and potentially fatal, condition that often goes unrecognized among the pediatric population. There should be high index of suspicion on PE in a child who presented with sudden onset respiratory distress with other supportive radiological, 2d echo and lab findings.
      PubDate: 2020-03-21
      DOI: 10.18203/2349-3291.ijcp20201158
      Issue No: Vol. 7, No. 4 (2020)
       
  • Non RhD isoimmunization causing severe hemolytic disease of fetus and
           newborn in Rh positive pregnancies: report of 2 cases with review of
           literature

    • Authors: Geetika Sharma, Sangeeta Pahuja, Deeksha Singh, Ramvilash ., Manisha .
      Pages: 955 - 960
      Abstract: Anti D immunoprophylaxis widespread use in antenatal patients has led to dramatic reduction in the rates of alloimmunization due to anti D, which is the most common Rh antibody causing severe Hemolytic Disease of Fetus and New born (HDFN). However, there has been increase in the rates of non Rh D antibodies causing alloimmunization in pregnant women and leading to moderate to severe HDFN. We hereby report two cases of neonates presenting with moderate to severe HDFN with strongly positive DAT due to Rh anti-c antibody in Rh-positive mothers. Thus, antenatal antibody screening should be done in all Rh-positive pregnant women to prevent the diagnostic delay of HDFN occurring due to Non anti-D isoimmunization in the fetus.
      PubDate: 2020-03-21
      DOI: 10.18203/2349-3291.ijcp20201159
      Issue No: Vol. 7, No. 4 (2020)
       
  • Hypothalamic hamartoma with gelastic seizures: a case report

    • Authors: Zosangliani ., Avishek Datta, Rukuwe Thele, Bishal Gurung, T. Kambiakdik
      Pages: 961 - 962
      Abstract: Hypothalamic Hamartoma (HH) may have diverse clinical manifestations. Its hallmark association is with gelastic seizures. Gelastic epilepsy is characterized by episodes of loud, hollow, mirthless, stereo-typed, forced laughter. The patient may stare and giggle briefly without any other motor manifestations. Hypothalamic hamartoma is most often the cause of gelastic seizures. Here, authors report a case of gelastic seizure with hypothalamic hamartoma in a 14-month-old boy with an associated tonic clonic seizure.  This case highlights the possibility of underdiagnosed hypothalamic hamartoma in younger age groups among pediatric population.
      PubDate: 2020-03-21
      DOI: 10.18203/2349-3291.ijcp20201160
      Issue No: Vol. 7, No. 4 (2020)
       
  • Five-year girl with advanced lupus nephritis and insulin dependent
           diabetes mellitus

    • Authors: Kishore S. V., Sucheta Barman, Subal Kumar Pradhan
      Pages: 963 - 965
      Abstract: Systemic Lupus Erythematosus (SLE) and Insulin Dependent Diabetes Mellitus (IDDM) are two common auto immune disorder occurring in children which can involve the renal system. The condition when occurs simultaneously in a child and its effects and follow up on the kidneys and its management have been mentioned here. A five-year-old girl was presented with low grade fever, dryness of mouth and bilateral pain over knee joints over four months. She had facial puffiness, mild bilateral pedal edema, and ascites on admission. She was treated immunosuppressive medications following a renal biopsy and insulin for IDDM
      PubDate: 2020-03-21
      DOI: 10.18203/2349-3291.ijcp20201161
      Issue No: Vol. 7, No. 4 (2020)
       
 
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