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

Showing 1 - 12 of 12 Journals sorted alphabetically
Intl. J. of Advances in Medicine     Open Access   (Followers: 2)
Intl. J. of Basic & Clinical Pharmacology     Open Access   (Followers: 3)
Intl. J. of Clinical Trials     Open Access   (Followers: 2)
Intl. J. of Community Medicine and Public Health     Open Access   (Followers: 5)
Intl. J. of Contemporary Pediatrics     Open Access   (Followers: 4)
Intl. J. of Otorhinolaryngology and Head and Neck Surgery     Open Access  
Intl. J. of Reproduction, Contraception, Obstetrics and Gynecology     Open Access   (Followers: 11)
Intl. J. of Research in Dermatology     Open Access   (Followers: 1)
Intl. J. of Research in Medical Sciences     Open Access   (Followers: 5)
Intl. J. of Research in Orthopaedics     Open Access  
Intl. J. of Scientific Reports     Open Access   (Followers: 2)
Intl. Surgery J.     Open Access   (Followers: 1)
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International Journal of Contemporary Pediatrics
Number of Followers: 4  

  This is an Open Access Journal Open Access journal
ISSN (Print) 2349-3283 - ISSN (Online) 2349-3291
Published by Medip Academy Homepage  [12 journals]
  • Antibiotic susceptibility among under-fives with severe pneumonia: a
           prospective study

    • Authors: Loganathan Palanivel, Chidambaranathan Sivaprakasam, Logesvar Palanisamy
      Pages: 1 - 4
      Abstract: Background: In underdeveloped countries, lower respiratory tract infection (LRTI) remains the leading cause of under-five mortality. Judicious use of antibiotics prevents the emergence of multidrug resistant organisms, but appropriate selection is vital in the child requiring intensive care.Methods: The study in conducted prospectively in the paediatric wards and intensive care unit, Rajah Muthiah Medical College and Hospital, Chidambaram. Fifty children were enrolled in the study using simple random sampling. Data regarding the demographic details, mean duration of stay, antibiotics given, immunisation status, intensive care unit admission and complications were collected. Statistical analysis is done using the Microsoft excel 2010.Results: The complications (n=3) is more among the female children (n=2) belonging to the age group one to two years (n=2) with mean duration of stay of more than seven days (n=2) and non-immunized for age children (n=3).Conclusions: The gram positive and atypical pneumonia in Chidambaram is found to be sensitive to aminopenicillin with penicillinase resistant penicillin and macrolide respectively.
      PubDate: 2018-12-24
      DOI: 10.18203/2349-3291.ijcp20184696
      Issue No: Vol. 6, No. 1 (2018)
       
  • Immature platelet fraction in children infected with dengue fever

    • Authors: Amrutha B. S., Adarsh E., SreeKrishna Y., Apoorva Naidu, Shivtej N.
      Pages: 5 - 9
      Abstract: Background: Millions are infected with dengue every year.  Early diagnosis of dengue infection is important for proper treatment of DHF and DSS to avoid fatal outcome. Thrombocytopenia is a common hematological abnormality in dengue, which demands platelet transfusion in most of the severe dengue cases. Platelet transfusion though life-saving has its own hazards. Hence, we can use some new parameter like immature platelet fraction (IPF) which is a measure of reticulated platelets that reflects the rate of thrombopoiesis. The risk of platelet transfusion may be decreased by rapid identification of immature platelet fraction. This study was performed to establish reference of IPF values for the assessment of thrombopoiesis.Methods: Blood samples from 150 children were obtained on day of illness 3, 5 and 7. The IPF is identified by sysmex XE2100 hematology analyser in the reticulocyte channel using a fluorescent dye and a carefully designed gating system and counted by a special software termed IPF master7. IPF values against platelet count were assessed separately on day 3, 5 and 7.Results: The reference intervals of IPF > 8 % and IPF < 8 % were assessed against platelet count. Increase in IPF favored increase in platelet count on day 5 which was statistically significant with the p value <0.001.Conclusions: A rapid and inexpensive automated measurement of IPF can be integrated as a standard parameter to evaluate the thrombopoietic state of the bone marrow. From the study it can be concluded that IPF is an important predictor of increase in platelet count.  Increase in IPF>8 % suggests that platelet count will be increased in next 24 to 48hrs indicating that further blood transfusion will not be required.
      PubDate: 2018-12-24
      DOI: 10.18203/2349-3291.ijcp20185151
      Issue No: Vol. 6, No. 1 (2018)
       
  • Analysis of outcome of acute encephalitis syndrome after inclusion of
           coverage against scrub typhus

    • Authors: Ruchi Jha, Anil Kumar Jaiswal
      Pages: 10 - 14
      Abstract: Background: Acute encephalitis syndrome (AES) has emerged as a major epidemic in Bihar and is associated with high mortality. Owing to the increasing burden of disease and its associated morbidity and mortality, studies were undertaken to evaluate specific etiology of AES. Some studies suggested emergence of scrub typhus as a major cause of AES accounting for about 25% of the cases1. A Standard Operating Procedure (SOP) was developed for treatment of AES cases in Bihar which included addition of Injection Azithromycin (@ 10 mg/kg for 7 to 10 days in case of suspected mycoplasma/rickettsial infection. The objective of the study is to compare the outcome of AES before and after the inclusion of coverage against rickettsial infection.Methods: It is a randomized controlled trial conducted in the Department of Pediatrics, Patna Medical College and Hospital, Patna from January 2016 to August 2018.Results: Total number of patients enrolled in both the groups were 127 and 88 respectively. No significant difference were seen in the baseline socio- demographic characteristics of the two groups. Case Fatality Rate in the 1st group (without inclusion of Azithromycin) was 39.3% while in the 2nd Group (with Azithromycin) was 12.5%.Conclusions: Due to the emergence of scrub typhus as a major etiological factor for AES, inclusion of coverage against it along with measures like widespread immunization against Japanese Encephalitis and prompt management of complications and euglycemia, can result in steady decline in the death rates due to AES.
      PubDate: 2018-12-24
      DOI: 10.18203/2349-3291.ijcp20185001
      Issue No: Vol. 6, No. 1 (2018)
       
  • Study of nutritional and immunization status in children 6 months to 3
           years attending outpatient department at a tertiary care hospital in rural
           South Rajasthan, India

    • Authors: Vivek Parasher, Gaurav Dadhich, Rahul Khatri, Mansi Sharma
      Pages: 15 - 19
      Abstract: Background: Good nutrition, particularly in the first three years of life, is important in establishing and maintaining a good foundation that has implications on a child’s future physical and mental health. The present study has been undertaken to study the “Impact of the nutritional and immunization services on the children between 6 months to 3 years,” with special emphasis to identify moderate acute malnutrition (MAM) and severe acute malnutrition (SAM) cases.Methods: This observational study was conducted from August 2017 to July 2018 in department of paediatrics at pacific institute of medical science included 400 cases age between 6 months to 3 years.Results: Incidence of SAM and MAM is 7.5% and 30.75 % respectively. Female predominance was seen in SAM and MAM i.e. 53.4% and 54.6% respectively. Significant association of under-nutrition was found with LBW (p<0.05), not giving exclusive breast feeding up to 6 months of life (p<0.05) and, Low socioeconomic status (p<0.001). Higher numbers of females were unvaccinated.Conclusions: Despite introduction of various national programs at different levels for improvement of maternal and child health, we still have significant number of children who are undernourished and unimmunized. Children are future of our nation and their health is of paramount importance. It can only be achieved with strong political will, active participation of community and by increase commitment of health care professionals. We need to start from birth, institutional delivery, exclusive breast feeding, immunization, and timely introduction of complementary feeds, marriages at appropriate age, proper antenatal visits and birth spacing. 
      PubDate: 2018-12-24
      DOI: 10.18203/2349-3291.ijcp20184703
      Issue No: Vol. 6, No. 1 (2018)
       
  • Clinico-biochemical profile of hypoglycemia in neonates admitted in NICU

    • Authors: Kuldeep Singh, Anjali M. Kher
      Pages: 20 - 26
      Abstract: Background: In high risk neonates’ incidence of hypoglycemia is up to 30%. There is limited evidence-based consensus regarding screening and management of neonates at risk of hypoglycemia. This study was undertaken to know the incidence, clinical profile, sequential blood glucose level upto 72 hours and short-term outcome of neonatal hypoglycemia.Methods: Blood sugar was screened at admission, after feed or D10 bolus, 6, 12, 24, 48 and 72 hours of age. Detailed maternal history and neonatal history, clinical manifestation, management and short-term outcome of hypoglycemic neonates were noted. Statistical analysis of data was done by SPSS 22.0 software.Results: 200 neonates with blood glucose less than 40mg/dl at admission to NICU in which 47 had repeat episode of hypoglycemia. Incidence of hypoglycemia at admission was 22.49% and 5.29% was incidence of repeat episode of hypoglycemia. Pre-term (p=0.005), low birth weight (p=0.020) and SGA (p=0.012) had repeat episode of hypoglycemia. GDM (p=0.040), birth asphyxia (p=0.046) and early septicaemia (p=0.0001) were common risk factors for hypoglycemia. Poor feeding, jitteriness and respiratory abnormality were common presentation of hypoglycemic neonates. The blood glucose levels at admission were less than 30 mg/dl in neonates who later had repeat episode of hypoglycemia. Most hypoglycemic episode after admission occurred within 24 hours of life.Conclusions: LBW especially Preterm SGA neonates are at increased risk of hypoglycemia. Maternal and neonatal risk factors are GDM and birth asphyxia, early septicaemia. Screening for hypoglycemia is essential for high-risk neonates.
      PubDate: 2018-12-24
      DOI: 10.18203/2349-3291.ijcp20184694
      Issue No: Vol. 6, No. 1 (2018)
       
  • The first golden hour of breastfeeding: where do we stand'

    • Authors: Suneetha Bollipo, Deepthi Pagali, Harsha B. Korrapolu, Mohammed Abdul Rahman
      Pages: 27 - 32
      Abstract: Background: Breastfeeding is the corner stone of child survival, nutrition and development and maternal health. The World Health Organization recommends that all neonates be breastfed within one hour of birth. Early initiation of breast feeding (EIBF) is a sentinel indicator for successful breastfeeding. The aim of this study is to assess the practice of early initiation of breastfeeding among babies delivered in our tertiary care teaching unit and to list out the reasons for delay in implementation.Methods: This study is done on 409 postnatal mothers who delivered in our hospital. All the mother-baby dyads enrolled were interviewed within 12 hours of delivery. Data was collected through clinical records and interview of mothers.Results: EIBF is seen only in 19.8% of babies. Median time of initiation of breast feed is 110 minutes. Primiparous mothers had a delay in initiation of feed (p<0.01). The mothers who received practical support from health care providers had successful EIBF(p< 0.01). The main reasons for delay in feeding were lack of early, uninterrupted skin to skin contact between baby and mother and the separation of mother - baby dyads immediately after delivery.Conclusions: EIBF rate in our centre is extremely low compared to the national standards of 44.6%. Several gaps in EIBF need to be addressed and a strict institutional protocol need to be followed. Periodic review of EIBF rates needs to be done by every institute to achieve a global target of > 90%.
      PubDate: 2018-12-24
      DOI: 10.18203/2349-3291.ijcp20184688
      Issue No: Vol. 6, No. 1 (2018)
       
  • Air pollution and its association with respiratory dysfunction among
           healthy adolescents: a cross sectional study from South Western Punjab,
           India

    • Authors: Harshvardhan Gupta, Himanshu Jain, Varun Kaul, Gurmeet Kaur Sethi, Rajeev Sharma, Arzoo Allahabadi
      Pages: 33 - 39
      Abstract: Background: This study has been performed to compare the pulmonary functions of healthy adolescents studying in schools situated in highly polluted areas with those studying in schools of low polluted areas of south western Punjab.Methods: This study was conducted in various schools located at Faridkot and Bathinda city. These places had been identified by the Punjab Pollution Control Board (PPCB) as having low and high air pollution levels respectively. Study Population divided into two groups that is Group A: 300 children from schools situated in Bathinda city. Group B:  301 children from schools situated in Faridkot city. Spiro Excel spirometer was used, and following parameters were obtained: FVC, FEV₁, FEV₁% (relation of FEV₁ to FVC), PEFR, FEF25-75%. Results: FVC was low in males and females in the high polluted group as compared in the low polluted group (p = 0.042; significant; males) (p = 0.039; significant; females). FEV₁ was low in males and females in high polluted group as compared in low polluted group (p = 0.003; significant; males) (p = 0.026; significant; females). In this study only, males showed a significant fall in mean percentage of FEF25-75%. PEFR was low in males in high polluted group as compared to that in low polluted group (p = 0.007; significant) while in females it was insignificant.Conclusions: It is concluded that in South Western Punjab, air pollution has detrimental effect on pulmonary functions (FVC, FEV₁, FEV₁%, FEF25-75% and PEFR) in healthy adolescents.
      PubDate: 2018-12-24
      DOI: 10.18203/2349-3291.ijcp20184702
      Issue No: Vol. 6, No. 1 (2018)
       
  • Biochemical abnormalities in neonatal seizures in term and preterm
           neonates

    • Authors: Manoj D., Rajesh Reddy K., S. S. Prakash
      Pages: 40 - 45
      Abstract: Background: Neonatal seizures may arise as a result of diverse etiologies and can have varied presentations. Biochemical abnormalities are commonly observed in neonates which can be either primary or secondary. Early recognition and treatment of biochemical disturbances is essential for optimal management and satisfactory long-term outcome.Methods: A total of 100 neonates presenting with seizures admitted to NICU of JJM Medical College, Davanagere, from November 2015 to April 2017 were enrolled in the study. Detailed antenatal, natal, postnatal history along with detailed examination was done along with baseline characteristics of convulsing were recorded at admission along with relevant biochemical investigations before instituting any specific treatment.Results: In the present study, out of 100 neonates studied, 64 were full term of which 49(76.5%) were AGA and 15(23.5%) were SGA, whereas 36 cases were preterm. Most neonatal seizures occurred in first 3 days of life, i.e. 59% of which majority occurred on first day of life (34%). Birth asphyxia and septicemia are common cause of neonatal seizures in present study (38 cases each), followed by pure metabolic disturbances 19%. In pure metabolic seizures, hypoglycemia (47.8%) is most common more in preterm babies (55%) followed by hypocalcemia.Conclusions: Biochemical abnormalities are common in neonatal seizures and often go unrecognized and may significantly contribute to seizure activity. Hence, a biochemical work up is necessary for all cases of neonatal seizures.
      PubDate: 2018-12-24
      DOI: 10.18203/2349-3291.ijcp20184695
      Issue No: Vol. 6, No. 1 (2018)
       
  • Study of social and demographic determinants of severe acute malnutrition
           in children aged 6-59 months in a tertiary care centre of Odisha, India

    • Authors: Pravati Jena, Soumini Rath, Manas Kumar Nayak, Diptirekha Satapathy
      Pages: 46 - 51
      Abstract: Background: The objective is to study the various social and demographic determinants of severe acute malnutrition in children aged 6 months to 59 months in a tertiary care centre of Odisha, India.Methods: This is a hospital based prospective observational study done in a tertiary care centre of Odisha during the period of Nov 2015 to Oct 2017 in which all children with severe acute malnutrition as per WHO criteria in the age group 6 months to 59 months were enrolled and their socioeconomic and demographic details were evaluated.Results: Present study revealed a prevalence of severe acute malnutrition as 2.8%. Males (54.2%) were more affected than females (45.8%). Most common age group affected was 6-12 months (37.4%). Most of the children were from low socioeconomic status (96.4%) and from rural areas (84.8%).63.7% of the study population were unimmunised. Only 12.6% of the participants were exclusively  breast fed.100% of the children in the study population received top feeding with cow’s milk.Conclusions: The prevalence of malnutrition is high in Odisha but most of the causative factors are preventable. Adequate education regarding exclusive breastfeeding, complementary feeding, immunisation, promotion of proper referral and health care services can help to improve nutritional status in the state of Odisha.
      PubDate: 2018-12-24
      DOI: 10.18203/2349-3291.ijcp20185064
      Issue No: Vol. 6, No. 1 (2018)
       
  • A prospective study on the effects and prevalence of maternal, fetal and
           placental risk factors on low birth weight neonates

    • Authors: Raghul Jayaseelan, Chidambaranathan Sivaprakasam, Logesvar Palanisamy
      Pages: 52 - 55
      Abstract: Background: Maternal, foetal and placental risk factors have a causative effect in the prematurity and failure to thrive in the early infantile period. Timely diagnosis helps in the anticipation of complications specific to risk factors and managing by impairing their harmful effects on the growth and development of the baby.Methods: The study was conducted prospectively in Department of Paediatrics, Rajah Muthiah Medical College and Hospital, Chidambaram from January 2018 to June 2018. 361 Low birth weight babies were included. Neonates (n=361) weighing less than 2.5 kilograms with parental informed consent are included, whereas those with severe congenital anomaly, systemic disease or infection were excluded from the study. Various known maternal, placental and foetal risk factors are observed during the course of the study. The gestational age of the neonates was estimated using modified Dubowitz scoring. Other factors like mode of delivery of the babies were also noted. Statistical analysis (descriptive statistics) was done by using Microsoft Word 2010.Results: Out of 1040 babies born from January to July 2018, 341 babies weight less than 2.5 kg. Out of which 162 (44.88%) babies were born preterm. Of the full term births 52% were low birth weights The risk factors of the neonates are not mutually exclusive. In the present study 28 maternal risk factors were studied. The prevalence of maternal, fetal and placental risk factors was 85.32%, 74.79% and 6.65% respectively.Conclusions: Period prevalence of low birth weight babies and prematurity is 34.71% and 15.58% respectively. Risk factors are not independent to each other with maternal and foetal risk factors have almost have an effect on nearly three fourths of low birth weight neonates.
      PubDate: 2018-12-24
      DOI: 10.18203/2349-3291.ijcp20184737
      Issue No: Vol. 6, No. 1 (2018)
       
  • The prevalence and pattern of pediatric dermatoses in a tertiary care
           center at Garhwal, Uttarakhand, India

    • Authors: Ratan Singh, Varun Kumar Tiwari
      Pages: 56 - 62
      Abstract: Background: Analysis of skin diseases in the pediatric population and its trends reflects the health and nutritional status of a community. This study aimed to evaluate the prevalence and pattern of skin diseases in children registered at the Dermatology OPD department of Hemawati Nandan Bahuguna Teaching Base Hospital, Srikot over a period of 1 year.Methods: A prospective cross-sectional descriptive analysis was conducted at the Dermatology OPD department of HNB teaching hospital to determine the pattern of dermatoses in children aged 0 days to 17 years, between 1 April 2017 and 31 March 2018. Cases with incomplete data, non-compliant to treatment and patients whose primary lesions are altered by the application of topical medication, not related to the existing disease were excluded from the study. The results were entered and tabulated in MS-excel sheet and descriptive analysis was done.Results: Out of 23,359 outpatients 6,274 (26.85%) were of a pediatric age with a male to female ratio of 1.2:1. The majority of the children belonged to young teens and teenagers (2377;37. 88%). Majority of pediatric dermatoses belonged to Infectious group (1373;21.88%) followed by Disorders of skin appendages (1087;17.33%) and Infestations (722;11.5%). The three most common diagnoses were Scabies (694;11.06%) followed by Fungal infections (568;10.43%) and Acne vulgaris (398;6. 34%).Conclusions: This study showed the current pattern of pediatric dermatoses in Garhwal region of Uttrakhand with a high frequency of infection and infestations with young teen and teenagers as the identified focus group for the need of intervention.
      PubDate: 2018-12-24
      DOI: 10.18203/2349-3291.ijcp20185002
      Issue No: Vol. 6, No. 1 (2018)
       
  • Pattern of congenital anomalies in neonates at tertiary care centre in
           Hyderabad, India: a hospital based prospective observational study

    • Authors: Paramesh Pandala, Rakesh Kotha, Himabindu Singh, Nirmala C.
      Pages: 63 - 67
      Abstract: Background: With advancements of perinatal, neonatal care congenital defects were the most common cause of morbidity and mortality in developed world. It is one of the common causes of morbidity and mortality in India. Its incidence also influenced by many preventable risk factors. Hence, we are carried out this study to know the changing pattern of congenital anomalies and to know the effect of environmental risk factors on congenital anomalies.Methods: Prospective observational study conducted at Niloufer hospital Hyderabad during period from November 2017 to 2018. We included intramural and extramural babies. Analysed data by appropriate statistical methods.Results: Most common system involved was Central nervous system (CNS) with 25 cases out of 112 cases followed by Gastrointestinal system (GIT)and Cardiovascular system (CVS). Meningomyelocele, anorectal malformations and acyanotic heart diseases were most common type of congenital anomalies. Thirty seven to forty weeks gestational age group babies were most commonly have congenital anomalies than other gestational age group babies. Low birth weight babies had higher percentage of congenital anomalies (2.64%). Congenital anomalies were more in the male sex (2.53%) as compared to female babies (1.73%). Maternal obesity, consanguineous marriage and previous family history of congenital anomalies associated with increased risk of congenital anomalies with significant p values.Conclusions: Incidence of congenital anomalies was 2.15%. Most of congenital anomalies were involved in CNS. Birth weight, Gestational age, Male sex, consanguineous marriage, maternal Obesity and previous family history of congenital anomalies were significantly associated with increased risk of congenital anomalies.
      PubDate: 2018-12-24
      DOI: 10.18203/2349-3291.ijcp20185103
      Issue No: Vol. 6, No. 1 (2018)
       
  • Study of fingerprints in children under 15 years of age with acute
           lymphoblastic leukaemia

    • Authors: Srikar Sama, Saisree Simhadri, Mahesh Kumar Mummadi
      Pages: 68 - 72
      Abstract: Background: Acute Lymphoblastic leukaemia is a malignant condition resulting due to continuous clonally proliferation of progenitors of lymphoid cells. The objective is to identify the association between dermatoglyphics and acute lymphoblastic leukaemia and to assess the value of dermatoglyphics as a screening tool.Methods: A case-control study was conducted on a total of around 60 subjects below the age of 15, out of which 30 children were already diagnosed and suffering from Acute Lymphoblastic Leukaemia and the other 30 were age and sex matched controls. Fingerprints of 30 affected children were taken through an ink-pad method in both hands, analyzed and compared with controls. Information regarding any significant familial history was obtained.Results: The study suggested with an increased rate of incidence among children of age group 3-4 years and with a male preponderance (63.3%).The findings were found to be statistically significant with an association between whorls and loops among cases and controls with higher frequency of whorls in cases and loops in controls (p value < 0.05), whereas association between whorls, arches and loops, arches was not significant. In quantitative analysis, most of the cases (n=12, 39.6%) had a PII in the range of 16-20 whereas most of the controls (n=22, 72.6%) had it in the range of 11-15, with significant overlapping.Conclusions: The findings are suggestive of association of fingerprint pattern with the patients suffering from Acute Lymphoblastic Leukaemia and therefore they might help in early diagnosis of the condition in high risk children and thus can be helpful as a screening tool.
      PubDate: 2018-12-24
      DOI: 10.18203/2349-3291.ijcp20185086
      Issue No: Vol. 6, No. 1 (2018)
       
  • A prospective study on biochemical disturbances among cases of acute
           diarrhoea in children attending a tertiary care hospital of South India

    • Authors: Korsipati Ankireddy, Tenali Ravi Kumar
      Pages: 73 - 76
      Abstract: Background: Diarrhoea is one of the commonest clinical entities encountered regularly in clinical practice. In India, at least 1.5 million children die due to acute diarrhoea per year. Timely recognition, high index of suspicion and thorough understanding of various clinical signs in different types of dehydration is necessary in preventing the deaths. The present study focuses on the different types of biochemical alterations and electrolyte disturbances in cases of acute diarrhoea among children.Methods: A prospective study with ethical committee consent was done at a tertiary care hospital for two years in department of Paediatrics. All cases of acute diarrhoea attending with signs and symptoms of moderate and severe dehydration were included. Clinical history and necessary biochemical investigations including serum electrolytes were performed. The results and data were entered in an excel sheet and analysed.Results: 250 cases were enrolled in the study with males (57.6%) and females (42.4%). 1month to 5 years with 84 cases (33.6%) was the most common age group with mean age of 11.48± 2.4 years. History of passage of loose motions was with a frequency ranging from 6-12 /day with a mean frequency was 8.12/day. 80.8%cases had some kind of electrolyte abnormality with majority having isolated Hyponatremia and a combined Hyponatremia and Hypokalemia (33.6%) each.Conclusions: Diarrhoeal disorders can be easily prevented with proper hand hygiene practices, health awareness programmes, increased breast-feeding practices and proper disinfection of water. Hyponatremia, hypokalemia, combined Hyponatremia and hypokalemia are major electrolyte abnormalities in cases of diarrhoea.
      PubDate: 2018-12-24
      DOI: 10.18203/2349-3291.ijcp20185092
      Issue No: Vol. 6, No. 1 (2018)
       
  • Nutritional assessment in developmentally retarded children of 3-10 years
           age group

    • Authors: Vanagondi K. Kavitha, Khetavath Gopal Singh, Dundigalla Chandraiah
      Pages: 77 - 81
      Abstract: Background: Intellectual disability is a condition of arrested or incomplete development of mind of a child and is specifically characterized by sub average intellectual functioning existing concurrently with limitations in conceptual, social, practical adaptive skills. Non-nutritional factors may influence growth, but nutritional factors such as insufficient calorie intake, excessive nutrient losses and abnormal energy metabolism also contribute to growth failure.Methods: A hospital based descriptive study was conducted where children with intellectual disability of 3 years to 10 years age group brought to child psychiatry OPD during the study period were enrolled in the study. The study was conducted in Government Medical College, Nizamabad which is a teaching hospital. Study period was for one and half year - from January 2017 to June 2018.Results: Out of 100 children with intellectual disabilities 32% of children were 2-5 years and 68% of children were 6-10 years. 64% of children were thin with a BMI <5th percentile and 36% of children were normal BMI falling in the range of 5th-85th percentile. Energy intake, calcium, iron and zinc intake were low in all age groups of children with intellectual disabilities.Conclusions: Regular assessment of nutritional status of intellectually disabled children may be of value in correcting nutrient deficiencies promptly, as nutrient intake has a bearing on the growth, development and stature of an individual. Hence early detection and nutritional intervention prevents malnutrition and increases the quality of life in children with intellectual disabilities.
      PubDate: 2018-12-24
      DOI: 10.18203/2349-3291.ijcp20185087
      Issue No: Vol. 6, No. 1 (2018)
       
  • Effect of single dose and double dose antenatal corticosteroids on
           respiratory distress syndrome among preterm babies

    • Authors: Shivtej N., Prema R., Apoorva Naidu, Amrutha B. S., Vidhi B. Mehta
      Pages: 82 - 86
      Abstract: Background: Respiratory distress syndrome occurs primarily in premature infants. The increased risk of RDS is associated with lower gestational age. The length of gestation is the primary factor that influences the risk of RDS the risk for development of RDS increases with maternal diabetes, multiple births, cesarean delivery, precipitous delivery, asphyxia, cold stress, and a maternal history of previously affected infants. Antenatal corticosteroids (ACS) significantly reduced neonatal morbidity and mortality when administered to women with imminent preterm delivery Antenatal steroids accelerate development of type 1 and type 2 pneumocytes, leading to structural and biochemical changes that improve both lung mechanics (maximal lung volume, compliance) and gas exchange. Induction of type 2 pneumocytes increases surfactant production by inducing production of surfactant proteins and enzymes necessary for phospholipid synthesis. Alveolisation occurs rapidly as a result of the antenatal corticosteroids Antenatal corticosteroid is usually administered for fetal lung maturity and can be expected to induce negative maternal and fetal side-effects hence this study was conducted to know the beneficial effect of single dose antenatal corticosteroids verses double doses antenatal corticosteroids. The Objective of the present study was to observe the effect of single dose and double dose antenatal corticosteroids on respiratory distress syndrome in preterm babies born to less than 37 weeks of gestation admitted under department of pediatrics at Raja Rajeswari medical college Hospital, Kambipura, Bangalore.Methods: There were 55 babies born to mothers who received single dose of antenatal corticosteroids and delivered at 12hrs before receiving 2nd dose antenatal corticosteroids and 55 babies born to mothers who received double dose of antenatal corticosteroids. Once baby is born, they compared for the requirement of surfactant.Results: Multiple course of steroids significantly reduced Respiratory distress syndrome.Conclusions: It was concluded that there was significant reduction in RDS in babies whose mother received complete course of antenatal corticosteroids.
      PubDate: 2018-12-24
      DOI: 10.18203/2349-3291.ijcp20185152
      Issue No: Vol. 6, No. 1 (2018)
       
  • Predictors in profile of referred newborns for their outcome in a tertiary
           newborn referral facility

    • Authors: Avadhesh Verma, Ajay Gaur, Ravi Ambey
      Pages: 87 - 92
      Abstract: Background: This study was aimed to assess newborn referral and factors contributing to outcome of referred newborns.Methods: This prospective observational study was conducted in a tertiary newborn referral facility for a period of one year. Referred newborns fulfilling inclusion criteria were enrolled in study, and assessed in terms of demographic profile, transport characteristics, physiological variables. Investigations, management of neonatal illness was done as per standard management protocols, they were followed up to their outcome.Results: Out of 2000 enrolled referred newborns, 30.10% were expired. Mean gestational age for survived newborns was 36.54±2.92 (SD) weeks, for expired newborns 35.24±3.99 (SD) weeks. Mean weight for survived newborns 2312.27 gms ±555.71 (SD), for expired newborns 1936.71 gms ±665.67 (SD). Out of total 60.05% newborns transported from periphery, had higher mortality i.e. 35% as compared to newborns transported from urban place i.e. 25%. Mean transport duration for survived newborns 61.94 minutes ±55.18 (SD), for expired newborns 89.51 minutes ±88.94 (SD). Prolonged CRT was observed  in 57.45% newborns, grunting   19.70%, Cyanosis 11%, gasping 7.6%, apnea 5%, respiratory distress 39.80%, hypothermia 74.95%, and 25.50% required resuscitation on admission. Unattended delivery, self-arranged mode of transport, prolonged CRT, respiratory distress, apnea , hypothermia on admission, weight on admission(<1500gms), hypoglycaemia and duration of transport more than 1 hour  found statistically significant independent variables associated with mortality of referred newborns.Conclusions: A significant number of neonatal deaths can be prevented, if referral system is structured and organized. Improper referral leads to poor physiological profile of referred newborns, which leads to their poor outcome. There are many independent variables which are affecting the outcome of referred newborns. These independent variables can be taken care in holistic way once the referral system is cultured and nurtured in existing health system.
      PubDate: 2018-12-24
      DOI: 10.18203/2349-3291.ijcp20185126
      Issue No: Vol. 6, No. 1 (2018)
       
  • Neonatal morbidity pattern in early term births

    • Authors: Maya Menon, Sreejyothi G., Raveendranath K.
      Pages: 93 - 96
      Abstract: Background: Late preterm births are defined  as birth between 34 and 36 completed weeks gestation and term births as  born after 37 weeks of gestation. Maturation is a continuous  process till term and the severity of adverse outcomes with birth increases with decreasing gestational age. Recent studies showed increased risk of  morbidities for babies  at 37 weeks than its term counterpart babies  at 39 weeks. Considering the risk for adverse neonatal outcomes in early term births, various studies recommended that the label “term” be redefined as early term, full term and late term designations to more accurately acknowledge deliveries occurring at or beyond 37  weeks of gestation. This designation will help precise  identification and targeting these early term  babies for early intervention and for better neonatal outcomes.Methods: This is a prospective study which included all  term births delivered during the 12-month study between January 2017 and December 2017. Babies born between 37 and 38 6/7 weeks were designated as early term and those born after 39 weeks as full-term babies. Neonatal outcomes of these babies were recorded and monitored till discharge.Results: There were 660 term live births during the study period. The incidence of early term births account for 19.7%, as compared with full term births representing 80.3 %. Compared with term babies, early term births were at risk for transitional problems such as respiratory distress (61.5% vs 38.5%), hypoglycemia (76.2% vs 23.8%), hyperbilirubinemia requiring phototherapy (53.7% vs 46.7%) and feeding  problems (59.1% vs 40.9%).Conclusions: Early term births are associated with increased risk of neonatal morbidities as compared with full term births. This indicates need for more attention towards preventing early term births.
      PubDate: 2018-12-24
      DOI: 10.18203/2349-3291.ijcp20185153
      Issue No: Vol. 6, No. 1 (2018)
       
  • Risk factor and outcome of retinopathy of prematurity among premature
           babies admitted to tertiary care hospital: a prospective observational
           study

    • Authors: Vijaykumar Shegji, Sharanabasappa S. Dhanwadkar, S. S. Kalyanshettar, S. V. Patil, Ashwini Kumara N. B
      Pages: 97 - 101
      Abstract: Background: Retinopathy of prematurity is a multifactorial vaso-proliferative retinal disorder that increases in incidence with gestational age. ROP is a vascular retinal disease that can cause low vision or blindness. ROP is a common blinding disease in children in the developed world despite current treatment and is becoming increasingly prevalent in the developing world. The purpose of this study was to determine risk factor and outcome of ROP among premature infants admitted to NICU of Shri B M Patil Medical College Hospital and Research Centre-Vijaypur.Methods: Preterm babies less than 35 weeks of gestation or less than 2000grams of birth weight delivered in or referred to Department of Paediatrics at B. L. D. E. U’s Shri B M Patil Medical College Hospital and Research Centre, Vijayapur.Results: Of 153 neonates screened 49 infants had ROP. The incidence of ROP in this study was found to be 32.02% among the babies screened. 25 babies were in stage 1(51.0%) 19 babies were in stage 2(38.8%) two babies from stage 2 progressed to plus disease and 5 babies with APROP (10.2%).Conclusions: The present study reflects the problem of ROP in a tertiary care centre. The incidence of ROP in our study was 32.02 % for any stage. The percentage of neonates who had ROP in the gestational age group ≤32 weeks 36.5%, 24.1%in the 32-36 weeks gestational age group and 40 % in >35 weeks of gestational age group. A statistically significant correlation between birth weight and ROP was also shown in our study. Our study showed greater risk of developing ROP with birth weights less than 1750g. There exists a statistically very high significant correlation between ROP and supplemental oxygen. Also, there is a statistically significant correlation between RDS and ROP.
      PubDate: 2018-12-24
      DOI: 10.18203/2349-3291.ijcp20185188
      Issue No: Vol. 6, No. 1 (2018)
       
  • Utility of cord blood albumin as a predictor of significant neonatal
           jaundice in healthy term newborns

    • Authors: Yogesh N. Parikh, Jay C. Ghetia, Aarti M. Makawana
      Pages: 102 - 105
      Abstract: Background: The aim is to study the association between cord blood albumin level and subsequent development of significant neonatal jaundice (NNJ) in healthy term newborns.Methods: A prospective study was conducted on 106 term healthy neonates. Genders, gestational age, mode of delivery were taken into consideration. It was ascertained that there was no other risk factor for hyperbilirubinemia amongst the neonates. The neonates were divided into two groups based on cord blood albumin level of <3.2gm/dl and >3.2gm/dl.Results: Out of the 106 babies included in the study, 44 babies were under group A (<3.2mg/dl) and 62 babies were under group B(>3.2mg/dl). 24 babies (55%) in group A and 16 babies (26%) in group B developed clinical icterus of which 16(66.6%) in group A and 4(25%) in group B required phototherapy. There was no significant difference between the cases who did and who did not develop significant neonatal jaundice with respect to various factor such as type of delivery, gender and meconium stain liquor.Conclusions: Cord albumin levels help to determine and predict the possibility of hyperbilirubinemia among neonates. Hence this can help to identify the at-risk neonates. So routine determination of cord albumin can be advocated to keep a track on at risk neonates.
      PubDate: 2018-12-24
      DOI: 10.18203/2349-3291.ijcp20185189
      Issue No: Vol. 6, No. 1 (2018)
       
  • Schoolbag weight limit: should there be a cut off'

    • Authors: Srikanth S. Bhat, Vinay Kumar S., Sharanabasappa S. Dhanwadkar, Ashwini Kumari N. B.
      Pages: 106 - 109
      Abstract: Background: School children are at a development age and it is important that they do not carry excessive loads. Heavy school bags can change the body posture and the musculoskeletal system must react appropriately in order to compensate for this stress. There is still no consensus about a guideline for weight of school bags. The objective of the present study was to asses the bag weight in school going children, Compare the bag weight with the whole-body weight of children, Percentage of bag weight to whole body weight at different age groups.Methods: 727 children (413 males and 314 girls) were examined from different schools in Davangere. Descriptive analyses and measures of central tendency were performed on the demographic data to describe the sample.Results: Overall 21.7% of children carry a bag which is >25% of their body weight, 46.5% children are carrying a bag >20% of their body weight and 74.7% of children carry a bag of >15% of their body weight. 40.9% children between 8-10 years carry bag of >25% and 39.8% of them between 11 -13 years carry bag of >20% and this is statistically significant (p = 0.000).Conclusions: The weight of schoolbags of school children were higher than the internationally acceptable standards in majority of school children. The school authorities and ministry of health should further evaluate and take the necessary steps to rectify the situation. Early intervention and good regulation can prevent long term complication.
      PubDate: 2018-12-24
      DOI: 10.18203/2349-3291.ijcp20185190
      Issue No: Vol. 6, No. 1 (2018)
       
  • Prospective observational study for appropriateness of blood and blood
           components therapy in children up to 16 years of age admitted in a
           tertiary care hospital

    • Authors: Vinayaka P. Hegade, Anjana H. Rao
      Pages: 110 - 117
      Abstract: Background: Blood component therapy is a rational replacement therapy of proven clinical value and efficacy, but it is a double-edged sword as it is associated with many hazards of transfusion reaction. Because of ease of availability and gap in the knowledge of medical professional’s blood products are being used very liberally leading to huge mismatch in the demand and supply of life saving blood product.Methods: Prospective cross-sectional observational study was done over a period of 1 year in a tertiary hospital, in western part of India. 225 events of blood component therapy were studied in neonates (<1month) and pediatric (1month-16years) age groups. Indications and reactions to blood components therapy were studied in both the groups. Each component therapy was considered as one event and its indication was compared with standard guidelines for terming it as appropriate or inappropriate.Results: Out of total 225 events of transfusions, most commonly used was PRBC (48.9%) followed by FFP (24.9%), platelet (16.0%), IVIG (9.8%) and whole blood (0.4%). 
      Authors found that overall 17.3% of the component therapy  were inappropriate( neonates 10.2%  and 7.1% in the rest). Most commonly misused blood product was FFP (37.5%) followed by IVIG (22.7%), platelets (16.7%) and PRBC (6.4%).Conclusions: Regular audit of blood and its component usage is essential to assess the blood utilization pattern and set ideal policies in all the medical specialties to make it appropriate, ensure availability and save patients from its hazards.
      PubDate: 2018-12-24
      DOI: 10.18203/2349-3291.ijcp20185191
      Issue No: Vol. 6, No. 1 (2018)
       
  • A case series of cyclic vomiting syndrome in paediatric patients at a
           tertiary care hospital in Chennai, Tamil Nadu, India

    • Authors: Ruchi R. Mittal, Latha Ravichandran, Elayaraja Elayaraja
      Pages: 118 - 121
      Abstract: Background: Cyclic vomiting syndrome is an increasingly recognized disorder with sudden, repeated episodes of severe nausea, vomiting, and physical exhaustion that occur with no apparent cause. It is more common in children than adults. However, we don’t often see a diagnosis of cyclic vomiting syndrome being made. Hereby we report 7 cases of cyclical vomiting.Methods: This is a retrospective study. Medical records of 5 years were review and consecutive paediatric patients discharged with a diagnosis of cyclic vomiting syndrome were identified, data collected and analysed.Results: Total of 7 cases were found, all of which were adolescents. The mean age was 13.28. 57.14% (4) were females and 42.86% (3) were boys. 42.86% (3) presented with complications. 14.28% (1) had an association with menstrual cycles and 14.28% (1) had an association with psychological stress.Conclusions: Cyclic vomiting syndrome should be kept in mind when a child presents with multiple episodes of vomiting, especially when repeated admissions have been made for the same. Early diagnosis and treatment can improve the quality of life.
      PubDate: 2018-12-24
      DOI: 10.18203/2349-3291.ijcp20185192
      Issue No: Vol. 6, No. 1 (2018)
       
  • Comparison of diagnostic and prognostic value of serum procalcitonin and
           serum lactate in pediatric sepsis

    • Authors: Antony Leo Jerry, Sundari S., Alph Shirley S., Shanthi Ramesh, Shiji R.
      Pages: 122 - 126
      Abstract: Background: The clinical manifestations of sepsis are highly variable. The signs of both infection and organ dysfunction may be subtle, and thus the most recent international consensus guidelines provide a long list of warning signs of incipient sepsis. Lactic acid, which is a by-product of anaerobic metabolism, can be used as a marker of tissue hypoperfusion. It is being used widely. Procalcitonin has more recently been studied in children.Methods: Totally 60 Children admitted with Septic Shock in PICU between Ages 3 Months to 12 Years were assessed for Serum Lactate & Serum Procalcitonin levels. Evaluation of the biomarkers was done on individual and combinational basis using receiver operating characteristics curve.Results: Out of 60 children, male were 40, female were 20 children. In stage-1 serum lactate  level was 47.83 (mg/dl) sensitivity is about 35.63 and specificity was 63.82  off p-value <0.065**.In stage -2 serum procalcitonin was 49.62 (mg/dl) sensitivity is about 37.77 and specificity was 69.28  off p-value <0.549**.In stage -3 serum procalcitonin was 52.89 (mg/dl) sensitivity is about 41.63 and specificity was 73.89  off p-value <0.651**Conclusions: Early recognition of risk factors will help in timely appropriate therapy and thereby will help in reducing mortality and morbidity in pediatric septic shock. The results suggest that PCT is valid for auxiliary diagnosis of septic conditions in children and used as an indicator of the severity of patients.
      PubDate: 2018-12-24
      DOI: 10.18203/2349-3291.ijcp20185193
      Issue No: Vol. 6, No. 1 (2018)
       
  • Knowledge, attitude and practices of oral rehydration therapy among
           mothers coming to tertiary care centre

    • Authors: Haricharan K. R., Punith S., Harsha P. J., Gowtham R.
      Pages: 127 - 130
      Abstract: Background: Diarrhoea is a major cause of morbidity and mortality among under-five children. Correct knowledge regarding oral rehydration therapy (ORT) helps prevent morbidity and mortality due to diarrhoea. The objective of this study is to assess the knowledge, attitude and practice of mothers of under-five children regarding ORT and home management of diarrhoea.Methods: Study period from December 1st, 2017 to December 31st, 2017, total of 200 mothers were enrolled in this study. The data was entered in Microsoft excel sheet and percentages were calculated.Results: 95% of mothers were aware about ORS. ORS was given by parents on own in16%, 55% were advised by doctor. Only 60% knew how to prepare ORS correctly. About 45.7% had used bottle to give ORS and 55.3% used cup and spoon. About 67.9% had knowledge of quantity of ORS to be given during diarrhoea episode. Exclusive breast feeding was practised in 86% of mothers till 6 months of age. Misconceptions about the use of ORS were seen in 60% and more among illiterates. About 21% mothers’ felt ORS should be stopped if diarrhoea continues. Only 5% of mothers felt ORS can be given even if child has vomiting. About 9% mothers felt no fluids should be given during diarrhoea.Conclusions: Mothers’ knowledge and attitude on use of ORS in diarrhoea need to be improved.
      PubDate: 2018-12-24
      DOI: 10.18203/2349-3291.ijcp20185194
      Issue No: Vol. 6, No. 1 (2018)
       
  • Thrombocytopenia in children: a clinico-etiological profile in an urban
           tertiary care hospital

    • Authors: Subramanian V., Santosh Kumar K.
      Pages: 131 - 134
      Abstract: Background: Thrombocytopenia is a common haematological finding that we come across while managing a sick child. Etiological profile and presentation of thrombocytopenia varies among children. The objective of this study was to study the clinical and laboratory profile of children with thrombocytopenia, associated clinical complications and assess the relationship between platelet levels and severity of disease.Methods: The study was carried out in 644 children between 1 month and 12 years, admitted in Paediatric Department of Raja Rajeshwari medical college and hospital, Bangalore between August 2012 to August 2014.Results: The commonest causes of thrombocytopenia in our study were of infectious aetiology (86.6%). Among Infections Viral infections were the major cause in more than 78% of cases. Other causes included haematological problems, drug induced thrombocytopenia and connective tissue disorders. Bleeding manifestations were present in 33.07% of patients and the commonest bleeds were skin and mucous membranes. Bleeding manifestations were seen most commonly in children with a platelet count less than 50000/µl.Conclusions: Viral Infections were the commonest cause for thrombocytopenia in Children. Platelet count was neither predictive of bleeding manifestations nor predictive of need for platelet transfusion.
      PubDate: 2018-12-24
      DOI: 10.18203/2349-3291.ijcp20185195
      Issue No: Vol. 6, No. 1 (2018)
       
  • Prediction of gestational age of newborn by measurement of foot length at
           birth

    • Authors: Senthilkumar K., Senthilprabhu R., Mythili B., Ann Mary Zacharias
      Pages: 135 - 139
      Abstract: Background: Gestational age of the newborn can be assessed by various methods. Aim of this study was to estimate the gestational age using foot length of the neonate and to find the correlation between foot length and gestational age assessed by last menstrual period and first trimester ultrasound.Methods: It was a hospital based prospective cross-sectional study done at Newborn ward, Department of Pediatrics, MGM Govt. hospital attached to KAP Viswanatham Govt. Medical College, Tiruchirappalli, involving 170 newborns with 10 babies in each gestational age ranging from 26 weeks to 42 weeks. Gestational age of all babies were assessed using last menstrual period, first trimester ultrasound and New Ballard Score soon after birth. Right foot length of each baby was measured from heel to tip of great toe or second toe whichever was longer, within 12-24 hours of life. Measurements were taken using a plastic ruler, measuring tape and by measuring the length of foot print ink impression.  Gestational age obtained by various methods were assessed for their correlation with foot length.Results: Positive correlation was obtained between foot length and gestational age determined by LMP (r= 0.965) and ultrasound (r= 0.964). Hence foot length could be reliably used to predict gestational age of newborn.Conclusions: Foot length measurements can be used as a non-invasive alternative method to assess gestational age of newborn, especially by community health workers and thus can facilitate the early identification of preterm babies.
      PubDate: 2018-12-24
      DOI: 10.18203/2349-3291.ijcp20185196
      Issue No: Vol. 6, No. 1 (2018)
       
  • Nature and extent of disciplinary practices used by school teachers

    • Authors: Harmesh Singh Bains, Manu Sharma Sareen
      Pages: 140 - 143
      Abstract: Background: The aim of the study is to analyze the nature, extent and associated factors of disciplinary practices used by school teachers.Methods: A cross-sectional analytic study. Subjects: 165 school teachers. Methods: Teachers completed a structured questionnaire, which included nature and extent of disciplinary methods used and their views on the issue. Statistical analysis was done through Chi square test.Results: 70.9% Teachers felt that physical punishment is needed to discipline school children. 58.2% of teachers indulged in the same though of these 84.2% opinioned that it may be harmful. Methods used were: counselling followed by physical punishment 41.67 % , slapping (14.6%), angry shouting (11.5), shaking (9.4), swearing (6.2), and skin pinch (3.1). Common reasons for punishment included: telling a lie (31.3%), not good at studies (28.1%),disobeying (14.6%),tantrums (7.3%) and stealing (3.1%). Teachers disclosed that they learned it from personal experience (55.2%) and schools (29.2%).Stressful events were present in 47.3%. Physical punishment was significantly more in this category (Chi square 3.84,p 0.05). Almost 77% of teachers had received punishment during childhood. The modal age for getting last punishment was 14 years. Significantly greater number of teachers getting punishment during childhood opinioned in favor of punishing children(Chi square 5.769,p 0.016) and were also involved in this activity(Chi square 6.534,p o.o11).Conclusions: Physical punishment of school children by teachers is common. Stress in the family and punishment during childhood were significant risk factors.
      PubDate: 2018-12-24
      DOI: 10.18203/2349-3291.ijcp20185197
      Issue No: Vol. 6, No. 1 (2018)
       
  • Meconium aspiration syndrome: clinical profile, risk factors and outcome
           in central India

    • Authors: Milind B. Kamble, Poonam Jain
      Pages: 144 - 149
      Abstract: Background: Meconium aspiration syndrome (MAS) is a life-threatening respiratory disease affecting some neonates born through meconium-stained amniotic fluid (MSAF). MSAF complicates delivery in approximately 8% to 25% of live births, of which nearly 5% of the neonates born through MSAF develop MAS. The present study was undertaken to find out the prevalence of MSAF and MAS and to study the etiology, risk factors, clinical profile and outcome of MAS.Methods: By purposive sampling technique, all newborns, fulfilling the inclusion criteria during one year of study period were enrolled in this hospital based cross-sectional observational study. Risk factors and clinical profile were compared between those who died and survived.Results: Out of 8765 deliveries in hospital 1220 neonates were born with MSAF of which 94 neonates had MAS. Thereby, incidence of MSAF was 13.9% and incidence of MAS out of MSAF was 7.7 %. Of the 94 neonates who had MAS 13.82% died. Almost 3/4th of the MAS neonates were term and AGA. MAS were more common in primigravida mother (68%) and LSCS deliveries (53.2%). Of the total MAS 54.2% had thick meconium in whom mortality was 92.3%. The mortality in MAS cases was significant in low 5-minute APGAR score and non-vigorous baby.Conclusions: Since MSAF is associated with higher morbidity and mortality, if the knowledge of risk factors is known to health care personnel then timely referral or intervention can help in decreasing MAS and its complications.
      PubDate: 2018-12-24
      DOI: 10.18203/2349-3291.ijcp20185198
      Issue No: Vol. 6, No. 1 (2018)
       
  • Effect of lower respiratory tract infections on peak expiratory flow rate
           in children admitted to Rajarajeshwari medical college hospital,
           Bangalore, Karnataka, India

    • Authors: Sree Krishna Y., Aditi Banik, Muhammed Hassan
      Pages: 150 - 155
      Abstract: Background: Peak expiratory flow rate is the simplest , cost effective and easily available test to assess the respiratory function. PEFR is measured by a peak expiratory flow meter. Measurement of PEFR is most commonly used for asthmatic patients. To evaluate the effect of lower respiratory tract infection on peak expiratory flow rate in children. Methods: PEFR were measured in eighty children suffering from LRTI by peak flow meter . Height and weight were measured. PEFR was compared with the normal charts. mean PEFR was calculated and predicted percentage of PEFR was calculated.Results: Mean PEFR in pneumonia , para pneumonic effusion, bronchiectasis, and bronchitis was 187.2 , 187.6, 171.85 and 173.1 respectively. Mean PEFR was maximally reduced in bronchiectasis and bronchitis. Mean  PEFR was reduced in female children in comparison to males with LRTI. PEFR was decreased  more in children with severe clinical presentation and with malnutrition.Conclusions: In this study , most common LRTI was pneumonia followed by parapneumonic effusion. PEFR was maximally reduced in bronchiectasis and bronchitis. Undernourished children were more affected.
      PubDate: 2018-12-24
      DOI: 10.18203/2349-3291.ijcp20185199
      Issue No: Vol. 6, No. 1 (2018)
       
  • Complementary feeding practice in infants of 6-12 months: a study from
           tertiary care centre of eastern Nepal

    • Authors: Shankar Prasad Yadav, Anita Chamlagain, Sneha Dhakal, Gauri Shankar Shah
      Pages: 156 - 158
      Abstract: Background: Initial years of life are crucial for child growth and development.  Breast feeding for first six months of life, followed by adequate complimentary feeding is necessary for preventing malnutrition and its complication in children. This study accessed the complementary feeding practice and the time of initiation of complementary feeding among infants.Methods: This was a cross-sectional study conducted for 3 weeks, among 92 infants. Details of feeding practice were taken from the parents from semi-structured questionnaire and nutritional status was evaluated by anthropometric assessment tools.Results: Ninety-two mothers were interviewed, and their corresponding infants were evaluated. The mean age of infant was 8.8 months with equal proportion of male and female. The mean age of mother interviewed was 26.6 yrs. 59.8% had timely initiation of complimentary feeding. Timely complimentary feeding was directly related to maternal literacy where literate mother follows the practices of appropriate complimentary feeding (p<0.007). There was significant association between ethnicity and timely initiation of complimentary feeding practices. 78.2 % babies who had timely initiation were of higher ethnicity. Overall in our cohort 18.4% were stunted, 14.1% were wasted. The stunted and wasted child were significantly more in whom there was absence of timely initiation of complimentary feeding (p<0.05).Conclusions: Proper complimentary feeding is still lagging in our society, proper parental education and nutritional counselling will be required to prevent under nutrition in infants.
      PubDate: 2018-12-24
      DOI: 10.18203/2349-3291.ijcp20185200
      Issue No: Vol. 6, No. 1 (2018)
       
  • Prevalence of overweight, obesity and hypertension among school going
           children in District Kanpur, Uttar Pradesh, India: a longitudinal study

    • Authors: Pramod K. S. Yadav, Mukesh B. Yadav, Chetna Yadav
      Pages: 159 - 162
      Abstract: Background: India is undergoing a rapid epidemiological transition with increased urbanization and socio-economic development which has resulted in a dramatic change in lifestyle, consisting of physical inactivity, diet rich in fat, sugar and salt coupled with a high level of mental stress. Obesity is one of the most common diseases worldwide and the prevalence in school aged children appears to be increasing. Thus, the present study was planned to establish an association between body mass index (BMI) with hypertension among 10-16 years children.Methods: Present longitudinal study was conducted on 350 children in private schools of District Kanpur and children 12-16yrs of age have included in the study. BMI for age charts was used to assess the obesity and blood pressure was measured by sphygmomanometer and Blood pressure values were compared to the values given by the update of 1987 task force report of the National high blood pressure Education Programme Co-ordinating Committee and children who were found prehypertensive or hypertensive were followed up after 4 weeks duration.Results: In present study the prevalence of overweight and obesity was found 4%,2% respectively. Prevalence of Pre-hypertension and hypertension was found 1.14%, 2.57% respectively and pre-hypertension and hypertension were found more in overweight and obese participants.Conclusions: Prevalence of pre-hypertension and hypertension is more among overweight and obese children. Overweight and obesity are not only risk factor for hypertension but also other diseases, so health education should regularly give about the obesity and its deleterious effects in later part of life.
      PubDate: 2018-12-24
      DOI: 10.18203/2349-3291.ijcp20185201
      Issue No: Vol. 6, No. 1 (2018)
       
  • Profile of retinopathy of prematurity in late preterm newborn in a
           district level special newborn care unit of Eastern India

    • Authors: Syamal Kumar Sardar, Somnath Pal
      Pages: 163 - 167
      Abstract: Background: The aim of this study was to analyse the incidence, severity and risk factors of retinopathy of prematurity in late preterm newborn at a district level SNCU in eastern India.Methods: The initial examination was carried out at 3 weeks of postnatal age or at 31weeks of post-conceptional age, whichever was later. Retinopathy was graded into stages and zones as per the ICROP classification. Those who had ROP were examined every week till regression occurred or till they reached criteria for laser treatment which was type I Prethreshold ROP as per ET ROP guideline. Risk factors for the development of ROP were determined by reviewing maternal and perinatal history and hospital case records.Results: 212 late ptreterm newborn were examined. The incidence of ROP in late preterm was 16.51% (35 out of 212 newborn). Incidence of stage I ROP was 6.60 % (14 newborn had stage I ROP). Incidence of stage II ROP was 6.60% (14 had stage II ROP). None had stage III ROP. 7 had APROP. Incidence of APROP was 3.30 %. 5 out of 14 newborns with stage II ROP (35.71%) required laser treatment. All newborn with APROP required both laser and Anti VEGF treatment. Overall 34.28% of late preterm with ROP required treatment. There was no difference in gestational age and birth weight in late preterm with and without ROP. There was significant difference in the duration of oxygen therapy in late preterm with and without ROP (6.657±2.531days vs 0.694±1.397 days, p<0.001). In stepwise logistic regression analysis-use and duration of oxygen, birth asphyxia and anemia were found to be significant risk factors of ROP in late preterm.Conclusions: ROP is common in late preterm newborn in developing country like India.
      PubDate: 2018-12-24
      DOI: 10.18203/2349-3291.ijcp20185202
      Issue No: Vol. 6, No. 1 (2018)
       
  • Quality of life in children with thalassemia major following up at a
           tertiary care center in India (GOTQoL)

    • Authors: Ankush Ankush, Amit Dias, M. P. Silveira, Yash Talwadker, Joachim Piedade Souza
      Pages: 168 - 175
      Abstract: Background: This study aims to measure the quality of life (QoL) scores in children with thalassemia major following up at a tertiary care center for routine blood transfusion in comparison to healthy children.Methods: A case control study design was adopted, wherein on the QoL of 36 children with thalassemia in the age group 5 to 18 following up for blood transfusion at Goa Medical College, was measured using PedsQL™ 4.0. This was compared to the QoL in age and gender matched healthy children from a government school. A higher score on a subscale indicates better quality of life on this instrument.Results: The children with thalassemia had lower mean scores on physical (67.85 vs 84.24; P <0.001), social (78.34 vs 87.95; P=0.002) and school (62.64 vs 79.48; P <0.001) functioning subscales compared to the healthy children. They also had lower mean psychosocial summary score (73.32 vs 82.01; P=0.003) and total health summary score (71.95 vs 82.57; P <0.001). The physical functioning subscale had significantly higher score among the children who were on chelation and also among the ones whose parents reported as being informed about the condition.Conclusions: The children with thalassemia have poor QoL in physical, social and school functioning domains. Improvement in QoL requires consolidated efforts on part of doctors, parents, school authorities and policy makers. These patients should be provided with low cost-effective chelation therapy. The parents need to be counselled about this disease by the treating team.
      PubDate: 2018-12-24
      DOI: 10.18203/2349-3291.ijcp20185203
      Issue No: Vol. 6, No. 1 (2018)
       
  • Leave against medical advice from SNCU of a teaching hospital in Garhwal,
           Uttarakhand, India

    • Authors: Rakesh Kumar
      Pages: 176 - 180
      Abstract: Background: Patients who leave against medical advice (LAMA) is a universal problem. Neonates being unable to decide for their own, are dependent on parents for all decisions for their treatment. LAMA is a sensitive issue in neonatology practice with ethical and medico legal ramifications. This study was done to evaluate the factors associated with the decision of LAMA by care givers in our special newborn care unit (SNCU).Methods: This is a retrospective hospital based observational study and was conducted in SNCU of HNB Base Teaching Hospital, Srinagar, Garhwal. Data pertaining to LAMA between 1st August 2017 and 31st July 2018 was retrieved. Information obtained included place of birth, gestational age, weight, diagnoses, duration of hospital stay and reasons for LAMA. Data were entered into a Microsoft Excel Spread Sheet and analyzed using software. Graph Pad Prism v 7.04. Chi-Square test was used to test for significant difference among various groups.Results: Out of 689 neonates admitted in SNCU during the study period, 167 (24.24%) took LAMA. Male to female ratio of 1:1.1. 102 (61%) were inborn and 65 (39%) were out born. Term babies constituted 62.87%. 78.44% neonates were discharged within 7 days of admission. 58 (34.73%) neonates had sepsis and 30 (17.96%) had birth asphyxia. The commonest reason in 25.15% for taking LAMA was to take the neonate to better equipped facility followed by false perception that the baby is well enough to be discharged.Conclusions: Multiple factors contribute for getting a neonate discharged against medical advice. Improvement of infrastructure, training of health care staff for proper counselling, sensitivity and empathy towards neonate and the care givers can decrease the rate of LAMA.
      PubDate: 2018-12-24
      DOI: 10.18203/2349-3291.ijcp20185204
      Issue No: Vol. 6, No. 1 (2018)
       
  • Assessment of epidemiological profile of neonatal seizure cases admitted
           to a tertiary health center of Odisha, India: a cross-sectional study

    • Authors: Geetanjali Sethy, Dhaneswari Jena, Pullakranjan Mallik, Sithun Kumar Patro, Biswakalyan Mishra
      Pages: 181 - 184
      Abstract: Background: Neonatal seizures are common manifestations of neurologic dysfunction in newborns. The incidence of  seizures in neonatal period is higher than any other period of life. It is one of the common causes of admission to special newborn care unit. Therefore, it has been decided to assess the epidemiological profile of neonatal seizure.Methods: A cross-sectional study was conducted from January2017 to June 2018, in the SNCU of MKCG Medical College and Hospital, Berhampur. A total of 300 neonates admitted to SNCU with clinically apparent seizure were the study population and convenient sampling method was used for selecting them. The approval was taken from IEC MKCG Medical College to carry out the study. The data was collected by using a pretested proforma from parents and hospital records. Verbal informed consent was taken from parents. The data so collected was analysed in the department of Pediatrics.Results: Out of the total 300 babies, 66% were males, 61.34% were early neonates,77% babies were of primi  mothers,76% of babies were outborn . 62.12% of babies were born by vaginal route. HIE was most common (88%) cause of seizure. Out of the all seizure types, subtle seizure was most common (87.67%), followed by clonic seizure (35.67%). Various maternal risk factors were present in 81.81 % of cases. Most common risk factor was anemia (50.57%).18.93% of cases were born with  history of obstructed labor/prolonged labor. Overall mortality was 8%.Conclusions: Neonatal seizures are important causes of morbidity and mortality in newborns. Prevention of HIE and maternal risk factors along with early use of an effective drug with minimum side effects are the ways to overcome this problem.
      PubDate: 2018-12-24
      DOI: 10.18203/2349-3291.ijcp20185205
      Issue No: Vol. 6, No. 1 (2018)
       
  • Comparison of clinical and biochemical profile of obese and nonobese
           children

    • Authors: Lingaraja Gowda C. Patil, Srinivas S
      Pages: 185 - 190
      Abstract: Background: We compared clinical and biochemical parameters of obese children aged 6 to 18 years with normal controls visiting to outpatient department in a tertiary care hospital. It was a prospective case control study.Methods: Obese children with Body Mass Index > 2 standard deviation according to WHO chart were included. Endocrinological and syndromic obese children were excluded.  We described risk factors for obesity and compared clinical and biochemical parameters between cases and controls. Student’s t test, Chi-square test and ANOVA (analysis of variance) were used for statistical analysis.Results: We noted higher prevalence of intake of junk food and sedentary lifestyle in obese group. Anthropometric parameters including BMI, skin fold thickness and abdominal circumference were higher in obese children compared to control group. Both systolic and diastolic blood pressures were high in obese children compared to control group. We observed higher prevalence of insulin resistance and dyslipidaemia among obese children.Conclusions: This study reemphasises that junk foods and sedentary lifestyle are important risk factors for obesity. Always screen for glucose intolerance, hypertension, insulin resistance and dyslipidaemia in obese children.
      PubDate: 2018-12-24
      DOI: 10.18203/2349-3291.ijcp20185206
      Issue No: Vol. 6, No. 1 (2018)
       
  • Study of correlation between breast feeding and wheezing in children

    • Authors: Sagar Potharajula, Shreedhara Avabratha Kadke
      Pages: 191 - 194
      Abstract: Background: Wheezing is the most common chronic health problem in childhood. Many studies have found protective effect of breastfeeding on wheezing, while few others have not. Hence this study was taken up to find out the correlation between breastfeeding and wheezing in children.Methods: Case control study done in a Medical College Hospital. Cases were children of 2-5yrs age with history of wheezing or who had received nebulisation. Controls were children without history of wheezing or nebulisation. Mothers were interviewed with a predesigned proforma. Results were analysed by Chi square test and Odd’s ratio and p value <0.05 was considered significant.Results: There were 92 cases and 184 controls. Sixteen (53.4%), 48 and 27 cases were breastfed less than 1year, till 2yrs and beyond 2yrs respectively. 14 (46.6%), 128, and 40 were the numbers in control group. Breast feeding duration till 1 year of age is statistically correlated with wheezing with p value of 0.02, higher proportion of children who were breastfed for less than 1 year had wheezing when compared to controls. 26 cases out of 69 were not exclusively breast fed till 6 months and 66 cases out of 207 were exclusively breastfed. Higher proportion of cases who were not exclusively breastfed had developed wheeze although it was not significant statistically. 45 cases (36.8%) were initiated on cow’s milk before 1yr of age, 47 cases (30.5%) were initiated after 1year. Higher proportion of children who were initiated on cow’s milk early had developed wheeze but was not significant statistically. 34 cases and 24 controls had family history of asthma. With family history wheezing episodes were 3.72 times more likely irrespective of breast-feeding duration.Conclusions: Breast feeding gives protection against wheezing in children. Mothers should be encouraged to breast feed their children.
      PubDate: 2018-12-24
      DOI: 10.18203/2349-3291.ijcp20185207
      Issue No: Vol. 6, No. 1 (2018)
       
  • A study of prevalence of obesity among adolescent students and its
           correlation with risk factors in Udaipur city, Rajasthan, India

    • Authors: Indira Subhadarshini Paul, Bhagirath Singh
      Pages: 195 - 199
      Abstract: Background: The present study was aimed to determine the prevalence of obesity among adolescent students (11-17 years) and to study the correlation between the behaviors related eating, sedentary activities, dietary pattern and physical activities and obesity.Methods: The study was conducted among1007 students as a case control study. Prevalence of obesity was calculated using centres for disease control and prevention (CDC) growth chart. Risk factors for obesity were assessed by using questionnaires which include 18 questions in four broad categories. And association of risk factors and obesity has been analysed by using multivariate logistic regression model.Results: A total of 1007 school going adolescents were included in present study, out of this 50.94% were boys and 49.06% were girls. The prevalence of obesity in present study population was 4.27%. Prevalence of obesity was more among boys than girls. (53.49% vs 46.51%). On multivariate logistic regression factors V5, V6, V8, V10, V12, V13, and V14 are associated with obesity and risk factors V3, V4, V7, V11 are not associated with obesity, factors V15, V16, V17, V18 are associated with onset of adolescent obesity.Conclusions: Adolescent obesity is a major health problem in Udaipur, Rajasthan and it requires timely intervention to prevent the complication and co morbidities.
      PubDate: 2018-12-24
      DOI: 10.18203/2349-3291.ijcp20185208
      Issue No: Vol. 6, No. 1 (2018)
       
  • Clinico-laboratory profile of dengue fever in children

    • Authors: Gowhar Wani, Ayesha Imran
      Pages: 200 - 203
      Abstract: Background: Dengue is rising globally. It presents with varied clinical manifestations. This study was done to describe the salient clinical as well as laboratory findings of serologically confirmed cases of dengue fever.Methods: This was a prospective study conducted at Government Multispeciality Hospital-16 Chandigarh from July 2017 to December 2017. All children below 17 years of age that had clinical features of dengue and who were antigen or antibody positive were included in this study.Results: Age group most commonly affected was 5-10 years with maximum number of dengue cases with warning signs(72.94%). Fever was present in all cases followed by headache(89.41%) and myalgia(78.82%). Thrombocytopenia was the commonest hematological abnormality(97.6%).Conclusions: Dengue presents with varied clinical features. Community awareness, early diagnosis and management and vector control measures needs to be strengthened in order to reduce the increasing number of dengue case.
      PubDate: 2018-12-24
      DOI: 10.18203/2349-3291.ijcp20185209
      Issue No: Vol. 6, No. 1 (2018)
       
  • Risk factors of pediatric urinary tract infections: an epidemiologic study

    • Authors: Maryam Esteghamati, Seyedeh Elaheh Mousavi, Shervin Haj Alizadeh
      Pages: 204 - 208
      Abstract: Background: Urinary tract infection (UTI) is the second most prevalent pediatric infection, and if it is not recognized and treated properly, it can cause severe irreversible complications such as renal failure and hypertension. In this research, some of the risk factors of UTIs were compared in children with urinary tract infections.Methods: This is a cross-sectional study, with the urinary tract infection as the dependent variable and gender, circumcision status, history of urinary catheterization, family history, history of renal stone, hypercalciuria, constipation history, reflux, neurogenic bladder, phimosis, posterior urethral valves (PUV), ureteropelvic junction obstruction (UPJO), and ureterovesical junction obstruction (UVJO) as the independent variables. A total of 405 children were studied in this research. The data was collected using questionnaires, checklists, and examinations. Data analysis was also carried out using descriptive and analytical statistics method in SPSS.Results: This research revealed the prevalence of urinary tract infection among children with several risk factors, and the common factors were positive family history, history of urinary catheterization, constipation, and other non-anatomical disorders (history of renal stone and hypercalciuria. The most common risk factors regardless of gender and age were non-anatomic disorders that were observed in 147 cases (43.7%) (p-value<0.001). Among the non-anatomical factors, constipation was the most common factor observed in 66 cases (16.3%). A higher rate of urinary infection was observed in the uncircumcised male patients than the circumcised patients, and there was a significant relationship between circumcision and UTI.Conclusions: In this study, urinary tract infection staged a significant relationship with gender, circumcision status, urinary catheterization history, family history, renal stone history, hypercalciuria, history of constipation, reflux, neurogenic bladder, phimosis, PUV, UPJO, and UVJO.
      PubDate: 2018-12-24
      DOI: 10.18203/2349-3291.ijcp20185210
      Issue No: Vol. 6, No. 1 (2018)
       
  • Non-rhabdomyosarcoma soft tissue sarcoma in a neonate, a rare and
           aggressive disease: case report

    • Authors: Tanvi Khanna, Kunal Das, B. P. Kalra
      Pages: 209 - 211
      Abstract: Neonatal soft tissue sarcomas are a rare group of tumors. The behavior and aggressiveness of neonatal STS is variable. Surgical excision has been noted to be most important factor affecting outcome. However, when non-mutilating surgery is not possible, or resection is incomplete, chemotherapy and radiotherapy have been tried with variable success. We encountered a case of a neonate having large soft tissue mass at anterior abdominal wall. Biopsy and immunohistochemistry confirmed it as undifferentiated soft tissue sarcoma. Surgical excision was incomplete with margin positivity. His disease showed recurrence in short duration of time and despite adjuvant chemotherapy, progression was noted. The child abandoned the treatment and died within 3 months of life.
      PubDate: 2018-12-24
      DOI: 10.18203/2349-3291.ijcp20185211
      Issue No: Vol. 6, No. 1 (2018)
       
  • Female child presenting with Duchenne muscular dystrophy like phenotype:
           severe childhood autosomal recessive muscular dystrophy: a rare case
           report

    • Authors: Shaik M. Rafi, Sravya S. Sreekantham, Kedarnath R. Tumati
      Pages: 212 - 214
      Abstract: Severe Childhood Autosomal Recessive Muscular Dystrophy (SCARMD) is a variant of sarcoglycanopathy resulting from mutation in the sarcoglycan genes. SCARMD is a rare form of muscular dystrophy characterised by severe DMD like phenotype occurring at early ages and affecting boys as well as girls. Here we are reporting a case of 7year old female child born to 3rd degree consanguineous parents presented with proximal muscle weakness beginning in both lower limbs since4 years of age. On thorough clinical examination and laboratory evaluation child turned out to be SCARMD. Hence this case report emphasizes that suspicion of SCARMD has to be made when female children presented with features of DMD, and genetic counselling and prenatal diagnosis should be done to reduce the burden of the disease in the community.
      PubDate: 2018-12-24
      DOI: 10.18203/2349-3291.ijcp20185212
      Issue No: Vol. 6, No. 1 (2018)
       
  • Typhoid fever with multiorgan involvement: pulmonary, hepatic and renal
           complications with dyselectrolytemia

    • Authors: Manish Verma, Jaisingh Jat, Khushboo Agarwal
      Pages: 215 - 217
      Abstract: Typhoid fever is an important health problem in developing countries like India, especially among young children. It may involve a number of systems and may present with various complications specially if untreated. We report a rare case of typhoid fever with multiple complications in 4 years young female who presented with fever, toxemia, bronchopneumonia, icteric hepatitis and also developed AKI, hyponatremia. Enteric fever with its complications has been reported previously but mostly reported with surgical complications, pulmonary complication, Myocarditis, hepatitis, hepatitis with renal failure etc but this seems to be unique case as presented with multiorgan involvement e.g. bronchopneumonia, icteric hepatitis, AKI and dyselectrolytemia. Previously reported cases were usually adolescents while this case is just 4 years young child. Despite multiple complications, patient responded well to treatment of enteric fever and discharged successfully.
      PubDate: 2018-12-24
      DOI: 10.18203/2349-3291.ijcp20185213
      Issue No: Vol. 6, No. 1 (2018)
       
  • Congenital lobar emphysema: a rare cause of respiratory distress in a
           neonate

    • Authors: Nishant Mittal, Ankit Parakh, Prashant Jain, N. K. Mittal
      Pages: 218 - 220
      Abstract: Congenital lobar emphysema (CLE) is a congenital condition characterized by distension and air trapping of the affected lobe of the lung. It is one of the causes of infantile respiratory distress, which may require surgical resection of affected lobe. Case characteristics: 3-day-old neonate with ventilation refractory respiratory distress. Imaging was suggestive of decreased lung tissue on the right side with ipsilateral mediastinal shift. Intervention/ outcome: Early surgical lobectomy was done to improve lung functions and the child improved dur to early intervention. Message: An early diagnosis with high index of suspicion helps patients with this rare congenital anomaly. Early intervention is the key to good long-term outcome. More awareness about the entity and treatment options available would greatly help improving the outcome and disease burden.
      PubDate: 2018-12-24
      DOI: 10.18203/2349-3291.ijcp20185214
      Issue No: Vol. 6, No. 1 (2018)
       
  • A case of pediatric leukemia with multi drug resistant bacterial
           infections

    • Authors: Saravanan Murugesan, Parthiban Rudrapathy, Sajani Samuel
      Pages: 221 - 223
      Abstract: Infections still remain a major cause of therapy-associated morbidity and mortality in pediatric cases with acute myeloid leukemia (AML). Down syndrome (DS) children have an approximately 10-20 fold higher incidence of acute leukemia and approximately 150 fold increased risk of developing myeloid leukemia of DS (ML-DS).  Multi-drug resistant (MDR-GNB) Gram-negative bacterial septicaemia is an emerging global challenge.
      Authors are reporting a 4 and half year old boy with diagnosis Acute Megakaryocytic Leukemia (AMKL) who developed septicaemia and diaper rash. MDR E. coli was isolated and he was treated with fosfomycin followed by colistin. The boy developed cardiac arrest with chest compression and expired.
      PubDate: 2018-12-24
      DOI: 10.18203/2349-3291.ijcp20185215
      Issue No: Vol. 6, No. 1 (2018)
       
  • Type IV jejunal atresia in a newborn: a rare birth defect presenting with
           bilious vomiting

    • Authors: Pushwinder Kaur
      Pages: 224 - 226
      Abstract: Background: Type IV jejunal atresia is a rare birth defect, which occurs due to late intrauterine vascular accidents that results in complete obstruction of intestinal lumen. There is no genetic predilection. It occurs most commonly in proximal jejunum. Clinical presentation includes bilious vomiting, abdominal distension, feeding difficulties, failure to pass stools and/or absence of bowel movements after birth. Here author report a case of premature newborn, who was admitted in NICU at birth in view of prematurity. As the baby had bilious vomiting and bilious NG aspirate on day 3 of life, possibility of intestinal obstruction was kept. It was diagnosed as a case of jejunal atresia by abdominal radiograph displaying dilated stomach, duodenum and proximal jejunum with gasless abdomen. Further jejunal atresia confirmed by the upper GI study exhibiting the level of obstruction. Surgical resection of the atretic segment and primary anastomosis was done. This case emphasizes the need of rapid identification of jejunal atresia and its adequate management to prevent morbidity and mortality associated with fore shortened intestine.
      PubDate: 2018-12-24
      DOI: 10.18203/2349-3291.ijcp20185216
      Issue No: Vol. 6, No. 1 (2018)
       
  • Femoral hypoplasia-unusual facies syndrome: a rare clinical entity

    • Authors: Vinaya Lichade, Poonam Wade, Prachi Gandhi, Shruti Saxena, Sushma Malik
      Pages: 227 - 229
      Abstract: Femoral hypoplasia-unusual facies syndrome (FH-UFS) is a disorder with multisystem involvement comprising predominantly of craniofacial dysmorphism with bilateral hypoplastic femurs. The exact etiology of this disorder is unknown, however maternal infections, drug and radiation exposure, oligohydramnios has been implicated. In affected children born to non-diabetic mothers, a genetic contribution is suspected; however, no chromosomal or gene mutations have been identified so far. The syndrome closely resembles with caudal dysplasia or syringomyelia which occur due to insufficient mesoderm in the caudal part of the embryo leading to lumbosacral defects, renal agenesis, and dysplastic lower limbs, however they lack craniofacial dysmorphism. The pathogenesis of FH-UFS involves poor development of subtrochanteric portion of the femoral cartilage. This results in shortening of proximal femur. Maternal diabetes justifies the teratogenic effect of hyperglycemia and ketones on fetus leading to dysmorphic features in fetus. Here, we are reporting a female neonate with characteristic phenotypic features of FH-UFS. She had cleft lip and palate, low set ears, retrognathia and micrognathia, dolichocephaly with bilateral femoral hypoplasia with talipes deformity of both feet. Karyotype was normal (46XX). Renal and cranial ultrasounds were normal. The 2D Echo revealed small 0.3mm PDA.
      PubDate: 2018-12-24
      DOI: 10.18203/2349-3291.ijcp20185217
      Issue No: Vol. 6, No. 1 (2018)
       
  • Comparative study of rise of vitamin D in hypovitaminosis D babies after
           two different dosage recommendations

    • Authors: Bijal Shrivastava, Rashi Aryan, Abhinav Tiwari, Lekha Tiwari, Nimmkayala Pravallika
      Pages: 230 - 232
      Abstract: Background: There are currently two different guidelines for treatment of Vitamin D deficiency in infants, one is that of American Academy of Pediatrics and the other being Clinical Practice Guidelines of the Endocrine Society. This study was done to compare the two guidelines for treatment of Vitamin D deficiency in infants.Methods: A hospital based, longitudinal interventional study was conducted for 2 years and 115 babies having vitamin d deficiency (Vitamin D less than or equal to 20ng/dl) were divided into group A and group B. Group A babies were treated as per American Academy of Pediatrics Guidelines whereas Group Cases were treated as per International Endocrine Society guidelines. All babies were followed up after 3-4 months when repeat Vitamin D levels were checked and then compared.Results: In present study, Vitamin D level had increased by 0.6 times in Group A whereas it had increased by 1.3 times in group B and it was significant.Conclusions: Study results were in favour of the guidelines recommended by the International Endocrine Society.
      PubDate: 2018-12-24
      DOI: 10.18203/2349-3291.ijcp20185218
      Issue No: Vol. 6, No. 1 (2018)
       
  • The world of synbiotics: a review of literature and clinical evidence in
           diarrhoea from the lens of a paediatrician

    • Authors: Pramod Jog
      Pages: 233 - 242
      Abstract: The use of synbiotics in the management of acute diarrhoea in children is becoming a common practice in India. However, since this is an upcoming modality of treatment, it is essential to review the scientific rationale and evidence on clinical efficacy and safety in the context of paediatric diarrhoea. In addition, most synbiotics contain a combination of multiple probiotics along with a prebiotic. Thus arises, a parallel need to understand whether a combination of probiotics performs better than single probiotics, hence justifying the rationale for such combinations. A review of available evidence suggests that synbiotics are indeed safe and superior in efficacy to single probiotics (like Bacillus clausii, Lactobacillus rhamnosus GG etc) and that there is a good body of evidence to support the efficacy and tolerability of synbiotics in the management of paediatric acute gastroenteritis. There is also evidence to suggest that combination probiotics have superior benefits compared to single probiotics, thus justifying their use as part of synbiotics. The overall benefits of synbiotics reported in various clinical trials on paediatric diarrhoea include, a rapid normalization of the gastrointestinal flora, a reduction in the duration of diarrhoea, quicker improvement in stool consistency, lesser administration of additional medications like antibiotics, antiemetics and antipyretics, higher physician reported treatment satisfaction scores and enhanced overall efficacy against gastrointestinal pathogens, including diarrhoea of rota virus origin. Hence, synbiotics put up a strong case to look beyond probiotics and single probiotic formulations in paediatric diarrhoea.
      PubDate: 2018-12-24
      DOI: 10.18203/2349-3291.ijcp20185219
      Issue No: Vol. 6, No. 1 (2018)
       
 
 
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