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International Journal of Contemporary Pediatrics
Number of Followers: 5  

  This is an Open Access Journal Open Access journal
ISSN (Print) 2349-3283 - ISSN (Online) 2349-3291
Published by Medip Academy Homepage  [12 journals]
  • Demographic variation of electrolyte imbalance in a tertiary care
           pediatric intensive care unit

    • Authors: Mrutyunjay Routray, Kishore S. V., Jyotiranjan Champatiray, Saroj Kumar Satpathy
      Pages: 224 - 229
      Abstract: Background: Electrolyte imbalances are common in critically ill paediatric patients. When present, they can significantly affect the outcome. Critical care provision through Paediatric Intensive Care Units (PICU) is aimed at maintaining ‘homeostasis’ in the body which is vital for the organ’s support and optimal function. This involves fluids and electrolytes balance.Methods: This prospective observational study was conducted in the PICU, SCB MC and Hospital, Cuttack during November 2015 to October 2017. includes Children admitted to PICU (Based on consensus guidelines for PICUs in India, Indian Society of Critical Care Medicine (Pediatric Section) and Indian Academy of Pediatrics (Intensive Care Chapter).Results: Percentage of male children was 65.9%, with male to female ratio 1.9:1, showing male dominance. Most electrolyte imbalances were seen in age group of 1 to 5 years (67.06%). Abnormal serum electrolyte was seen in 37.91% in our study. SIADH was observed in 43.5% of euvolemic hyponatremic patients. SIADH was observed in 27.8% of hyponatremic patients. Respiratory disorder was the most common attributing factor for SIADH followed by CNS disorder.Conclusions: The present study showed high incidence of electrolyte abnormalities in patients admitted to pediatric intensive care unit. Though at times symptoms of electrolyte disorder is indistinguishable from symptoms of primary pathology, so a close monitoring and correction of electrolyte abnormalities is necessary for better outcome. SIADH is recognizable and common cause of electrolyte imbalance in PICU. Thus, this study recommends early routine monitoring of serum electrolytes in all patients admitted to PICU.
      PubDate: 2020-01-23
      DOI: 10.18203/2349-3291.ijcp20200095
      Issue No: Vol. 7, No. 2 (2020)
       
  • Study of parenting styles, family functioning and its relation to coping
           strategies in children of specific learning disorder

    • Authors: Enagandula Rupesh, Shipra Singh, Alka A. Subramanyam, Ravindra M. Kamath
      Pages: 230 - 235
      Abstract: Background: Families of children with disabilities otherwise experience higher stress; and relation between parenting styles and coping of children is well known. Parental factors and family functioning may play a role in shaping the child, especially having issues like SLD. The objective is to study was coping strategies of children with SLD, parenting styles of their parents, their family functioning and relation of these with each other.Methods: It is a cross-sectional study undertaken after Institutional Ethics Committee approval, parent’s consent and child’s assent. Participants were 100 consecutive children, diagnosed with SLD, 9-13 years of age. Tools used were: Semi-structured proforma, Parenting Practices Questionnaire, Family Assessment Device and Children’s Coping Strategies Checklist Revision 1.Results: Authoritarian parenting style was significantly was associated with less use of ‘active’ and ‘support seeking’; and increased use of ‘distraction’ and ‘avoidance’ strategies. High scores on Authoritative style was associated with ‘active’ and ‘support seeking’ strategies. Avoidance coping strategy was associated with poor (high scores) and active coping strategies with higher (low scores) on problem solving, communication, and general family functioning.Conclusions: Parenting practices and family functioning can be pivotal in determining child’s attitude and coping. Assessment of this can be routinely included in child evaluation.
      PubDate: 2020-01-23
      DOI: 10.18203/2349-3291.ijcp20200096
      Issue No: Vol. 7, No. 2 (2020)
       
  • An evaluation of safety and efficacy of nadifloxacin 1% ointment versus
           mupirocin 1% ointment in Indian children with skin and soft tissue
           infection

    • Authors: Swapnil Janbandhu, Sushil Chaudhary, Sunil Chaudhary, Gaurav Puppalwar, Rishi Jain
      Pages: 236 - 242
      Abstract: Background: Although nadifloxacin has been shown to be effective in the treatment of skin & soft tissue infections (SSTI), there is a paucity of data comparing its efficacy and safety with other antibacterials, especially in Indian paediatric population. Therefore, objective of this study was to compare the safety and efficacy of nadifloxacin with mupirocin in children with SSTI.Methods: This was a single-centre, open label, randomized, parallel group, comparative study in 60 children of <12 years of age with SSTI. Test group (n=30) received nadifloxacin 1% ointment and reference group (n=30) received mupirocin 1% ointment, to be applied twice daily. Patients were followed up at day 4, 8 and 15. Efficacy of the study drugs was evaluated by clinical and bacteriological cure rate. Safety was assessed by reporting of adverse events.Results: Baseline characteristics of enrolled patients were comparable between treatment groups and all 60 patients completed the study. At Day 15, 100.0% cases among nadifloxacin group and 96.7% cases among mupirocin group achieved clinical cure (p=0.313). The most common bacteria found in culture were Gram positive cocci in both the groups (86.7% in nadifloxacin and 58.8% in mupirocin group). None of the cases in any of the groups showed bacteriological presence at day 15. No adverse event was reported in any of the treatment groups during the study duration.Conclusions: Nadifloxacin was found to be equally efficacious and safe to mupirocin in the treatment of SSTI in Indian pediatric population.
      PubDate: 2020-01-23
      DOI: 10.18203/2349-3291.ijcp20200097
      Issue No: Vol. 7, No. 2 (2020)
       
  • Optimal feeding practices in Tamilnadu, breast feeding and complementary
           feeding: the reality

    • Authors: Rathisharmila R., Uvaraj P., Saraswathi N., Ilamaran V.
      Pages: 243 - 247
      Abstract: Background: Optimal feeding of infants under two years of age has the greatest potential impact on child survival of all preventive interventions. This study was done to evaluate feeding practices of infants in first two years of life.Methods: In this cross sectional study, 161 mothers with infants 6 mo to 24 mo of age, attending the well-baby clinic of this hospital were selected for study from April 2014 to March 2015 and interviewed using a structured questionnaire.Results: The prevalence of exclusive breastfeeding for 6 mo was 44% with a median duration of 4.9±1.8 mo. The proportion of infants who received continued breast feeding at 1 year of age (12-15 mo) was 67%. The median duration of any breast feeding was 13.6 mo by survival analysis. Early introduction of cow’s milk and bottle feeding were associated with nonexclusive breast feeding under 6 mo and early termination of breast feeding.Conclusions: While rate of exclusive breast feeding was comparable to the state average (48%), there was a higher rate of introduction of cow’s milk and bottle feeding which contributed to early termination of breastfeeding before one year of age. This study emphasis the fact that bottle feeding and inappropriate complementary feeding should be tackled to improve IYCF indicators in Tamilnadu.
      PubDate: 2020-01-23
      DOI: 10.18203/2349-3291.ijcp20200098
      Issue No: Vol. 7, No. 2 (2020)
       
  • A neonatal morbidities and outcomes among late preterm infants

    • Authors: Jyoti B. Sarvi, Sandeep V. H.
      Pages: 248 - 251
      Abstract: Background: Late preterm birth (34-36 weeks) infants are at greater risk of (2-3 fold) compared to near term or term babies. The present study was done with the purpose to examine related morbidities and outcomes among late preterm infants.Methods: The study included all late preterm babies (34 0/7 weeks-36 6/7 weeks) admitted to the Basaveshwar Teaching and General Hospital and Sangameshwar Hospital for a period of one and half year (December 2013-May 2015). Short term outcome was assessed in the form of neonatal morbidities and mortality during the study period.Results: A total of 203 late Preterm neonates comprised the study group. Male preponderance was noticed with a ratio of 1.5:1. This study confirmed that late-preterm infants are a population at risk of increased neonatal morbidity. Neonatal hyperbilirubinemia requiring phototherapy forms the major one followed by sepsis, respiratory distress, and feed intolerance. Majority of late preterm neonates required more than 7 days hospital duration.Conclusions: Late preterm infants suffer a large number of intercurrent medical problems during the neonatal period, especially increased likelihood of resuscitation in the delivery room, hypothermia, hypoglycemia, jaundice requiring phototherapy, respiratory pathologies, sepsis and feeding intolerance. Prolonging pregnancy to the maximum safest gestation will result in decrease in such morbidities.
      PubDate: 2020-01-23
      DOI: 10.18203/2349-3291.ijcp20200017
      Issue No: Vol. 7, No. 2 (2020)
       
  • A quality improvement study on breastfeeding initiation rate within 1 hour
           of life in inborn neonates in a tertiary care centre

    • Authors: C. Renuka Devi, Nalini A., N. S. Raghupathy
      Pages: 252 - 256
      Abstract: Background: Breastfeeding is a well-established key of success to improve the outcome in neonates. Early initiation of breastfeeding in neonates refers to the provision of mother’s milk to their own babies as early as possible after delivery. Despite the established benefits of breastfeeding, early initiation of breastfeeding is found to be suboptimal in our country. Early initiation of breastfeeding has many challenges like no bedding in, availability of lactation counsellors and staff nurses, procedural delay (episiotomy, skin suture) and shifting from the recovery room. Objective of the study was to improve the rate of initiation of breastfeeding stable term and preterm neonates within 1 hour of life in both normal vaginal delivery and caesarean section conducted in our hospital from baseline to 95% over 3 months period by Quality improvement approach.Methods: Eligible inborn mother-infant dyads were enrolled in this study. A team formed, baseline data and rate of early initiation of breastfeeding collected and factors for delayed initiation analysed by Flowchart process, Fishbone analysis and 5 why’s, 3 PDSA cycles were done.Results: Total 50 mother-infant dyads assessed. Rate of early initiation of breastfeeding within 1 hour of life increased from 25% to 100% over 3 months.Conclusions: This quality improvement study was able to accomplish sustained improvement in the rate of breastfeeding the neonates in the first hour of life.
      PubDate: 2020-01-23
      DOI: 10.18203/2349-3291.ijcp20200059
      Issue No: Vol. 7, No. 2 (2020)
       
  • Study of changes noted in the platelet count in cord blood of neonates
           born to hypertensive mothers in a tertiary care hospital, Bangalore, India
           

    • Authors: Vijayalaxmi Gagandeep, Mohinish S., Mallesh K.
      Pages: 257 - 262
      Abstract: Background: Hypertensive disorders of pregnancy pose several problems to both mother and newborn. Complications in new-born like intrauterine death (IUD), intrauterine growth retardation (IUGR), perinatal asphyxia, neonatal sepsis and bleeding disorders are associated with toxemia of pregnancy. To decrease the perinatal morbidity and mortality, babies of hypertensive mothers should be carefully monitored and managed. Aim of this study was to establish the changes in total platelet count in umbilical cord blood.Methods: This is a hospital based prospective observational study which included the babies born to mothers having hypertensive disorders of pregnancy, total cases accounting about 158. Detailed clinical history taken including details of labour and clinical examination done.  In all the subjects, 2 ml of umbilical cord blood anticoagulated with EDTA was collected and haematological tests for total platelet count (TPC) count was done.Results: This study shows that the incidence of neonatal thrombocytopenia is 43.67%. The incidence of sepsis among thrombocytopenia group accounts for about 60% in gestational hypertension, 64.2% in pre-eclampsia and 50% in eclampsia group.Conclusions: With respectively, these findings it can be concluded that the incidence of Neonatal Thrombocytopenia is significantly higher in babies born to HDP mothers and it can be taken as a marker to evaluate Sepsis in such a situation in resource limited setting. As less number of studies is available in this area of interest, this study supports the cause.
      PubDate: 2020-01-23
      DOI: 10.18203/2349-3291.ijcp20195628
      Issue No: Vol. 7, No. 2 (2020)
       
  • Evaluation of factors, associated with defaulting routine immunization in
           children

    • Authors: Gayathri Devi Chinnappa, Chikkanarasa P. S. Reddy, Sarala Sabapathy, Deepthy Alice Varghese
      Pages: 263 - 266
      Abstract: Background: India was one of the first countries to adopt the World Health Organization’s Expanded Programme of Immunization (EPI). The program started globally in 1974 and was initiated in India in 1978. Immunization is considered to be one of the most important cost-effective and a powerful public health intervention. Achieving maximum coverage, however, has been a challenge due to many reasons, including high rates of defaulters from the program. The term ªdefaulterº is used to refer a child who misses the scheduled vaccinations for any reason. The objective of this study was to explore the reasons behind defaulting from the routine immunization program.Methods: A study was conducted in Bowring and Lady Curzon Hospital, Bangalore between January 2012 and December 2012. A total of sixty six children’s’ details were gathered from mothers of defaulted children. Children below 5 years attending OPD were included in the study. Children above 5 years and inpatients were excluded. Observations and review of relevant documents was done.Results: Of the 66 children, in our study, males were more than females. Children in the age group of 2 years to 5 years were 17(25%) as compared to those between 1 to 2 years. Mothers were more literate than fathers. Muslim children had the best immunization coverage. The main determinant of defaulting was lack of knowledge and awareness regarding immunization by the mothers (21/31%) followed by sickness in children (11/16%), causing them to default immunization schedulesConclusions: The main reason for defaulting from the immunization program was lack of awareness, regarding immunization by mothers in the community.
      PubDate: 2020-01-23
      DOI: 10.18203/2349-3291.ijcp20200063
      Issue No: Vol. 7, No. 2 (2020)
       
  • Umbilical cord albumin and serum bilirubin as predictive factors for
           hyperbilirubinemia in term neonates

    • Authors: Manu Shekhar, Vinod Kumar, Santosh Bhalke, Atul Goel
      Pages: 267 - 272
      Abstract: Background: Hyperbilirubinemia is one of the common causes of neonatal admission. As clinical evaluation may cause a delay in identification and subsequent initiation of medical therapy, there is a need for the sensitive and inexpensive predictive marker for hyperbilirubinemia in neonates. Measurement of cord albumin and its correlation with the serum bilirubin is one of the noninvasive predictive markers for Hyperbilirubinemia. The present study carried out to know the significance of umbilical cord albumin level as a predictor of neonatal hyperbilirubinemia.Methods: It is a hospital-based prospective cohort study, total 100 healthy term new-borns admitted in the Neonatal Intensive Care Unit, were included in the study as per study protocol over a period of one year. The blood sample was collected from umbilical cord blood for the analysis of bilirubin and albumin, and post 72 hours of life venous blood obtained for estimation of serum bilirubin and albumin along with direct and indirect Coombs test.Results: In this study most of the patients were in the gestational age of 37-38 weeks (71%) followed by 38-40 weeks (27%) and only 1% are >40 weeks. A positive correlation was observed between cord blood bilirubin, serum bilirubin, serum albumin, and cord blood albumin levels. Cord blood albumin was a better marker for neonatal hyperbilirubinemia with a sensitivity of 83%, and a specificity of 48%; as compared to cord blood bilirubin with a sensitivity and specificity of 73% and 39% respectively.Conclusions: From this study, cord blood albumin level was demonstrated as a good predictive marker for neonatal hyperbilirubinemia with a sensitivity of 83.1%. and specificity 48.8%. Hence, cord blood albumin may be used as a non-invasive predictor for neonatal hyperbilirubinemia.
      PubDate: 2020-01-23
      DOI: 10.18203/2349-3291.ijcp20200012
      Issue No: Vol. 7, No. 2 (2020)
       
  • A study of prevalence and factors associated with language delay among 0-3
           year old children in a tertiary teaching hospital

    • Authors: Arunkumar Raju, Bharanidharan S.
      Pages: 273 - 276
      Abstract: Background: Speech and language are essential components of child development. Delay in language development leads to poor scholastic performance, learning disabilities and poor socialization. Language Evaluation Scale Trivandrum (LEST) is a screening tool for use in office and communities for identifying language delay.Methods: A descriptive study of cross-sectional design was done in 350 children between 0 and 36 months attending well baby clinic. A proforma with demographic details of parents, antenatal, perinatal risk factors were completed. All mothers were asked to complete home screening questionnaire to assess home environment. Language delay was identified using LEST scale. The association of language delay with antenatal, perinatal risk factors, socio economic status and home environment were analyzed.Results: The prevalence of language delay was 6%. No association was found between language delay and type of family, place of residence, antenatal complications, perinatal complications, gestational age, birth weight and socio-economic status. Negative home environment was significantly associated with language delay.Conclusions: The prevalence of language delay was 6%. Negative home environment significantly affects speech and language development
      PubDate: 2020-01-23
      DOI: 10.18203/2349-3291.ijcp20195641
      Issue No: Vol. 7, No. 2 (2020)
       
  • Knowledge on breast feeding and its techniques among health care workers
           in a tertiary health centre

    • Authors: Aril Bhatia, Mithun H. K., Shyam Sudhir, Haleema Nuwera
      Pages: 277 - 281
      Abstract: Background: Breast milk is optimum for a neonate as it is a natural food and the best gift a mother can give to her baby. Breast feeding is an art and skill which need to be learnt and mastered by mothers. As health care workers are the first line of contact for lactating mothers, this study was planned to assess their knowledge on breast feeding.Methods: Hospital based cross-sectional study was performed among health care workers at Yenepoya Medical College and Hospital of Mangalore. 100 health care workers consisting of 60 medical interns and 40 staff nurses were enrolled in the study. Health care workers were given a questionnaire that sought responses pertaining to the knowledge on breastfeeding and its techniques. The data were analyzed using Microsoft Access and Excel software.Results: The present study showed 92% of medical interns and 95% of nursing staff had correct knowledge about initiation of breastfeeding. Knowledge on contents of colostrums and its advantage was more among medical interns (85%) as compared to nursing staffs (30%). Knowledge on prelacteal feeds was good among medical interns as compared to nurses. Both medical interns and nursing have poor knowledge on breastfeeding during maternal illness. Knowledge on correct feeding position and good breast attachment was good among nursing staffs.Conclusions: Study showed there is some substantial knowledge gap on breastfeeding among health care workers. Enhancing their knowledge on breastfeeding and the problems associated with it will be useful for the nurturing mothers as well as themselves.
      PubDate: 2020-01-23
      DOI: 10.18203/2349-3291.ijcp20200024
      Issue No: Vol. 7, No. 2 (2020)
       
  • Incidence of catheter-related bloodstream infections after removal of
           peripherally inserted central catheters in preterm neonates

    • Authors: Rampal Singh Tomar, Ashish Kr Gupta, I. D. Khan
      Pages: 282 - 286
      Abstract: Background: Peripherally inserted central catheter (PICC) have become essential for a safe and reliable long term venous access in all neonatal intensive care units (NICU) for providing long term intravenous fluids and medications. However, they associated with central line blood stream infections (CRBSI) infections and it is postulated that this risk is more on during their removal but the true incidence is not known. The objective was to evaluate the incidence and identify risk factors associated with CRBSI following the PICC removal in preterm neonates.Methods: This was a retrospective cohort study was done on <37 weeks premature neonates. Data included patient particulars, location of PICC placement, days of PICC, antibiotics and TPN through PICC, infections noted during or within 48 hours of PICC removal.Results: A total of 238 PICC removals in 215 neonates were analysed which did not show a significant difference in the prevalence of CRBSI within 48 hours of PICC removal. However, there was an increase in odds for sepsis following PICC removal in less than 29 weeks gestation and if it was not used for antibiotic infusion for more than 48 hours preceding its removal.Conclusions: This study does not support the use of prophylactic antibiotics during PICC removal in neonates as there was no increase in the incidence of CRBSI following PICC removal. However, they may have a role in very low gestation age, low birth weight infants who have not recently received antibiotics prior to PICC removal.
      PubDate: 2020-01-23
      DOI: 10.18203/2349-3291.ijcp20200018
      Issue No: Vol. 7, No. 2 (2020)
       
  • Etiology of cerebral palsy in children below age of 5 years

    • Authors: Mitul Kasundra, Purvi Patel, K. M. Mehariya
      Pages: 287 - 293
      Abstract: Background: Cerebral palsy is the most common and costly form of chronic motor disability that begins in childhood. Aims of the study were to identify etiology and risk factors of CP*, to find correlation between the etiology and clinical type of CP* in children below age of 5 years.Methods: analytical study done in indoor patients at civil hospital, Ahmedabad from October 2014 to September 2016.Results: Overall incidence of cerebral palsy in indoor patients was 0.78 per 100 patients. Most common age of presentation is 1-3 years. Majority of cases have perinatal factors as etiology followed by postnatal etiology. Most common type of CP was spastic type. Most common type of topographical CP was spastic quadriplegic. Major symptom for which they admitted in the hospital was convulsion.Conclusions: Majority of cases had perinatal factors as etiology author can prevent CP* by providing primary prevention, specific prevention and improving antenatal and intra-natal care. Disease progression of CP* can be halted by secondary prevention. Maximization of function can be done by tertiary prevention.
      PubDate: 2020-01-23
      DOI: 10.18203/2349-3291.ijcp20200019
      Issue No: Vol. 7, No. 2 (2020)
       
  • Study to correlate sepsis markers and blood culture in neonatal sepsis

    • Authors: Harshitha M. Swamy, Lakshmi ., Mallesh K., Asima Banu
      Pages: 294 - 299
      Abstract: Background: Neonatal sepsis forms the second most common cause of neonatal mortality resulting in more than one million neonatal deaths per year. Neonatal sepsis, pneumonia and meningitis together result in one- fourth of all newborn deaths. Objectives of the study was to correlate sepsis markers with blood culture in neonatal sepsis.Methods: A cross sectional study was carried out in the NICU unit under department of Pediatrics, between November 2017 and May 2019. Sample size was 50. Babies admitted to NICU with clinical suspicion of sepsis were included in the study. Blood samples from these babies were collected under aseptic precautions and subjected to rapid diagnostic tests- sepsis markers and blood culture.Results: Male were predominant (64%). Important risk factors were preterm and low birth weight. Blood culture positivity was 20% (E. coli being most commonly isolated organism). CRP had a high sensitivity of 90% and low specificity of 47%. Procalcitonin had highest sensitivity of 100% and low specificity of 47.5%.Conclusions: CRP and PCT were found to be statistically significant (p=0.036 and 0.01), can be used as a diagnostic tool in neonatal sepsis.
      PubDate: 2020-01-23
      DOI: 10.18203/2349-3291.ijcp20200043
      Issue No: Vol. 7, No. 2 (2020)
       
  • Demographic and clinical profile of children with severe acute
           malnutrition admitted in a tertiary care hospital in Mahbubnagar, India

    • Authors: Archana Reddy D., Lakshmi Aparnadevi V. V.
      Pages: 300 - 304
      Abstract: Background: All possible efforts are being made by the governments, and other agencies to reduce the burden of these problems of malnutrition and deaths associated with it but still it remains a challenge. Severe acute malnutrition continues to constitute an important risk for mortality and morbidity among the under five children. Objective of the study was to study the profile and risk factors of severe acute malnutrition of the under five children in a tertiary care hospital setting.Methods: Hospital based cross sectional study was carried out among 60 under five children with severe acute malnutrition who were admitted for difference causes in the Pediatric wards of SVS Medical College and Hospital, Mahabubnagar. A detailed history and physical examination were done. Anthropometric indices like weight, length/height, MUAC and weight for height were recorded and analysed using WHO growth charts.Results: Majority of the children with severe acute malnutrition were found in the age group of 1-2 years i.e. 48.3%. Males were more (69%) compared to females (31%) and this can be attributed to the hospital based cross sectional nature of the present study. Only 21.6% of the children were completely immunized for age. Majority of the children were found to have grade IV type of malnutrition i.e. 38.3%. Majority of the children presented with fever in 71.6% of the cases. Majority of the children had gastrointestinal related comorbidity in 54.6% of the cases.Conclusions: Incomplete immunization, low social class, inappropriate feeding practices in young age of <1 year are important risk factors of severe acute malnutrition.
      PubDate: 2020-01-23
      DOI: 10.18203/2349-3291.ijcp20200025
      Issue No: Vol. 7, No. 2 (2020)
       
  • Ultrasound guided hydrostatic enema reduction of acute intussusception:
           guidelines in therapy and review of the institutional experience

    • Authors: Vivek Parameswara Sarma
      Pages: 305 - 310
      Abstract: Background: In this review, author analyzed the cases of Acute Intussusception that underwent Ultrasound guided hydrostatic reduction during a one-year period. Author reviewed this treatment protocol and guidelines of non-operative and surgical therapy. The procedure followed and guidelines of therapy were reviewed and are detailed in the study.Methods: Retrospective analysis of the hospital data of all patients who were treated for acute Intussusception during the period of January 2017 to December 2017 was done. All records including admission data, investigations, procedure records, preoperative details and operation notes, where applicable, post procedure recovery data and incidence of recurrence were studied. Inclusion criteria included confirmed sonological diagnosis of Intussusception verified by the treating paediatric surgeon, availability of all necessary records and absence of other co-morbidities. Exclusion criteria included age more than 2 years, children who had other major systemic disease, doubtful sonological diagnosis and postoperative intussusception. The paediatric surgeon himself performed the procedure in the dedicated ultrasound suite.Results: The study was done in the mother and child wing of a medical college which is a tertiary referral centre catering to more than 200 cases of Intussusception per year. The records of 194 cases of Intussusception were available for analysis, of which only 176 could be included in the study. The age group included is 3 months to 3 years. The mean age was 11 months. The sex incidence was 94 cases in males and 82 in females.Conclusions: Ultrasound guided hydrostatic reduction is a safe, effective and convenient modality for treatment of acute Intussusception, which can be performed by the treating Paediatric surgeon himself with requisite training and exposure.
      PubDate: 2020-01-23
      DOI: 10.18203/2349-3291.ijcp20200099
      Issue No: Vol. 7, No. 2 (2020)
       
  • Clinical profile and outcome of congenital cyanotic heart disease in
           neonatal period: a retrospective study

    • Authors: Janaki B. Pradhan, C. N. Kamalarathnam
      Pages: 311 - 315
      Abstract: Background: Congenital Cyanotic Heart Disease (CCHD) is under reported during neonatal period and mortality rate is high in India. Aims and objectives of the study determine clinical presentation, maternal and neonatal risk factors and outcome of CCHD during neonatal period.Methods: A retrospective study conducted over 15-month period during March 2017 to June 2018 in a tertiary out born NICU. Neonates with echocardiographically confirmed case of structurally abnormal heart disease were analyzed.Results: Among 106 CCHD neonates, 60% neonates were asymptomatic, 22% had persistent cyanosis and 19% had tachypneic at birth. Cyanosis (35%) and tachypnea (30%) were common initial presentation in postnatal period. 22% neonates were readmitted with initial clinical symptom after discharge from birthing centre. CCHD were more common in male and term neonate, 34% were small for age, median age at admission and discharge were 5days (2-12) and 5 days (2.7-9.2) days respectively. Nineteen percent neonates had fetal distress and 6% neonates required aggressive resuscitation at birth. First trimester abortion (16%), maternal diabetes (10%) and hypothyroidism (7%) were common maternal risk factor. Nearly 20% neonates were diagnosed at referring hospital and 4.7% were transported with PGE1 during transport. TGA (17%) was most common lesion noted followed by pulmonary atresia (10%). Fourteen percent neonates died during the neonatal period. Disease specific death rate was highest for Single ventricle (42%) followed by TGA with IVS (37.5%) and aortic arch anomaly (28.5%) in this study.Conclusions: Early diagnosis and management may improve the survival in CCHD neonates.
      PubDate: 2020-01-23
      DOI: 10.18203/2349-3291.ijcp20200100
      Issue No: Vol. 7, No. 2 (2020)
       
  • Clinico-aetiological profile and outcome patterns of neonatal seizures at
           a tertiary care centre

    • Authors: Vijay Agrawal, Dhan Raj Bagri, J. N. Sharma, Roop Singh
      Pages: 316 - 320
      Abstract: Background: Neonatal seizures are a major risk factor for neonatal mortality and subsequent neurological disability. The incidence of seizure varies from 1.5-3.7/1000 live birth; while in NICU it can be up to 5/1000 live birth.Methods: This Descriptive type of observational study aimed to study clinical profile, aetiology in neonatal seizures and short term outcome was done in all Neonatal units attached to paediatric Department of SMS Medical College, Jaipur.Results: In the 100 cases Majority of neonates had onset of seizure <3 days (<72 hours) 53% and remaining 47% neonates had onset of seizure >3 days (>72 hours). Most common type of neonatal seizure was subtle(75%), other types were tonic seizure (17.3%), clonic seizure (5.1%) and least common type was myoclonic (2.5%). Most common cause of neonates seizure noted was birth asphyxia (73%) second common cause is pyomeningitis and third common cause is hypoglycaemia. Most common cause of neonatal seizure both in full term (71.17%) and preterm (25%) is birth asphyxia. Second most common cause of neonatal seizure in full term is pyomeningitis (8.70%) and in preterm is pyomeningitis and hypoglycaemia (25%). Most common cause of neonatal seizure both in onset of seizure <3 days (<72 hours) 53% and in onset of seizure >3 days (>72 hours).Conclusions: Out of total 100 cases, neonates with normal birth weight 92% and low birth weight 8%. Majority of neonates had onset of seizure <3 days (<72 hours) 53% and remaining 47% neonates had onset of seizure >3 days (>72 hours). Majority of neonates with seizure delivered by vaginal route (86%) and remaining 14% neonates were delivered by LSCS.
      PubDate: 2020-01-23
      DOI: 10.18203/2349-3291.ijcp20200101
      Issue No: Vol. 7, No. 2 (2020)
       
  • Impact of effective counselling on management of moderate acute
           malnutrition in a community

    • Authors: Vikas Arya, Ajay Gaur, Neetu S. Agarwal, Harsha Chouhan
      Pages: 321 - 326
      Abstract: Background: Moderate Acute Malnutrition (MAM) is defined as Weight for Height between -2SD to -3SD, and/or Mid Upper Arm Circumference (MUAC) 11.5 cm to 12.5 cm. Effect of not treating MAM has a significant impact on Severe Acute Malnutrition (SAM) burden. Management of MAM is possible through supplementary feeding or Community centre counselling.Methods: Present study was a prospective case control study done in 2013-14 in 200 children in adjacent communities. Community in which intervention (dietary counselling) was planned, it was labelled as case group. For dietary counselling ‘structured group counselling’ method was selected in which at a time parents of six MAM children were involved. Counselling was done by a trained counsellor using all techniques proposed by IYCF. Counselling sessions were scheduled at 0, 1, 3 and 6 months.Results: 60% children of case group moved to improved or well- nourished nutritional status (p-value 0.00001). Amongst improved group, weight for height improvement is statistically significant (p-value 0.001), average weight attained is 2-3 kg in 6 months with average weight gain of 1.5-3 grams/kg/day. MUAC improvement was also found to be statistically significant (p-value 0.003), there was 47% improvement in case group with average MUAC gain is 0.6 cm to 1 cm in 6 months (0.13 cm/month). Also, there is early rise in weight for height then MUAC. Average duration to achieve target weight for height is 4.3 months in case group as compare to 5.3 months in control group.Conclusions: Structured and integrated group counselling using all counselling skills by a trained counsellor should be an integral part of managing MAM in community. Weight for height should be primary indicator in early phase of response as compare to MUAC in measuring impact of counselling.
      PubDate: 2020-01-23
      DOI: 10.18203/2349-3291.ijcp20200102
      Issue No: Vol. 7, No. 2 (2020)
       
  • Need of the hour' does breast milk bank reduces perinatal morbidity
           and mortality: a retrospective observational study

    • Authors: Narayanan E., Mohd Sajjid, Arun Kumar
      Pages: 327 - 332
      Abstract: Background: Human milk bank plays an essential role by providing human milk to infants who would otherwise not be able to receive human milk. The aims and Objectives is to study the morbidity and mortality outcome  profile of babies fed with PDHM (pasteurized donor human milk) comparing data between Pre Human Milk Breast bank (2015) and Post Human Milk Breast bank (2016, 2017 and 2018).Methods: Milk bank collect, screen, store, process, and distribute human milk. Retrospective observational study was done in Department of Neonatology, Institute of Obstetrics and Gynaecology and Women and Children Hospital, Chennai. Data obtained retrospectively comparing data Pre HMB (2015) and Post HMB (2016, 2017 and 2018).Results: In this study authors collected the data comparing Pre human milk bank (Pre HMB) and Post human milk bank (Post HMB).  After starting human milk bank, around 1799 babies were benefitted and 14.45 lakh ml milk was collected from 16000 donor mothers in last 3 years. Bacterial contamination rate of PDHM has reduced to 4.39% (2018) compared to 7.73% (2016) with P Value 0.0042 (statistically significant). CONS and Staphylococcus aureus were the most common Organisms isolated. There was reduction in morbidity profile like sepsis rate, NEC/ Feed intolerance and ROP profile. Mortality profile also reduced to (7.73-9.31%). Duration of hospital and Duration to attain full feeds were improved all GA group babies.Conclusions: In this study, after starting human milk bank there was reduction in mortality, morbidity outcome, sepsis. Duration to attain full feeds  and duration of hospital stay reduced. We concluded that establishment of breast milk bank will be more useful and beneficial for all GA group babies for better outcome.
      PubDate: 2020-01-23
      DOI: 10.18203/2349-3291.ijcp20200103
      Issue No: Vol. 7, No. 2 (2020)
       
  • The predictive accuracy of hypoxic scoring for prediction of adverse
           outcome in neonates born with asphyxia

    • Authors: Muhammad Saqib, Safeer A. Jamil, Usman Arif, Zubda Anwar, Sarosh Waheed, Munibah Bashir, Maham Javed
      Pages: 333 - 337
      Abstract: Background: Birth asphyxia is a major contributor to neonatal mortality. Fetal hypoxia followed by asphyxia is common cause of brain injury in term infants. Hypoxia score has shown to be accurate enough to predict adverse outcome in asphyxiated neonates. But controversies exist regarding predictive accuracy of hypoxia score. So we conducted this study. Objective to assess the predictive accuracy of hypoxic scoring for prediction of adverse outcome in neonates born with asphyxia.Methods: 170 neonates were screed for hypoxia score. Neonates were labelled as positive or negative. Then all neonates were followed-up for 7 days. If neonate died within 7days, then case was confirmed as positive or negative. Data was analysed by using SPSS 20. 2x2 table was developed to calculate sensitivity, specificity, PPV, NPV and predictive accuracy of hypoxia score.Results: The mean Apgar score at birth was 5.01±0.83. The sensitivity of hypoxia score was 87.8%, specificity was 90.9%, PPV was 90%, NPV was 88.9% while predictive accuracy was 89.4% taking actual adverse outcome as gold standard.Conclusions: The predictive accuracy of hypoxia score was high for prediction of adverse outcome in asphyxiated neonates.
      PubDate: 2020-01-23
      DOI: 10.18203/2349-3291.ijcp20200104
      Issue No: Vol. 7, No. 2 (2020)
       
  • A study on breastfeeding initiation in low birth weight and very low birth
           weight babies and their developmental outcome with special reference to
           kangaroo mother care

    • Authors: Bramhini Sura, Gangadhar B. Belavadi
      Pages: 338 - 345
      Abstract: Background: Kangaroo Mother Care (KMC) was developed for caring of low birth weight (LBW) babies in developing countries. Study was done with the objective to evaluate the factors affecting initiation of breast feeding and effect of Kangaroo Mother Care (KMC) on morbidity problems and developmental outcome in Low Birth Weight (LBW) and Very Low Birth Weight (VLBW) babies.Methods: Prospective follow-up cohort study was carried out at Neonatal Intensive Care Unit (NICU) at Narayana medical college hospital Nellore from January 2018 to December 2019 and details of neonates were recorded on prestuctured proforma. Kangaroo mother care was given to one group. ASQ 3 questionnaire was used to assess the developmental outcome of the infants.Results: In this study, 100 babies were divided into two groups, case group consists of 50 babies where KMC is given and another control group consists 50 babies where KMC is not given. Mean gestational age for case and control group babies were 34.5 and 33.7 weeks respectively. Mean Birth weight in cases (1700 gr) and control (1580) grams respectively. Number of Male babies were more in cases (51%) and Group B (53%). Main factors affecting the initiation of breastfeeding in babies are LSCS (62% and 48%), RDS (50% and 40%), Apnea (24% and 25%) and seizures (20% and 14%) respectively in case and controls. Rates of exclusive breastfeeding is significantly increased in cases (90%) when compared to control (72%). Morbidity in cases is comparatively lesser than controls. At 6 months of corrected gestational age, mean weight in cases (5.2 kg) is significantly more than mean weight in control (4.7 kg). Significant development is noticed in communication (p=0.036), gross motor (0.04), and fine motor (0.05) compare to controls. Percentage of babies who acquired better personal social skills are more in cases (80%).Conclusions: The main factors affecting the initiation of breastfeeding in LBW and VLBW babies are LSCS, RDS, not secreted milk and seizures. KMC helps to achieve smooth and early transition to direct breastfeeding, increases the exclusively breastfeeding rate, better growth and developmental outcome and reduces the morbidities in LBW neonates.
      PubDate: 2020-01-23
      DOI: 10.18203/2349-3291.ijcp20200105
      Issue No: Vol. 7, No. 2 (2020)
       
  • A study on role of thrombocytopenia in retinopathy of prematurity

    • Authors: Aswathy Benedict, Mario Joseph Bukelo
      Pages: 346 - 350
      Abstract: Background: Retinopathy of Prematurity (ROP) is one of the causes of avoidable blindness in India. Globally ROP is estimated to affect more than 50,000 infants annually and in India, every year, 500 children are estimated to become blind from ROP. Many a times, lack of trained professionals and lack of timely referral are found to be setbacks in ROP diagnosis and treatment in developing nations. The aim of the study was to study if thrombocytopenia is a risk factor for retinopathy of prematurity and does supplemental oxygen with thrombocytopenia increases the risk of ROP.Methods: It was a retrospective case control study done in a tertiary care hospital. Data was collected from 177 preterm admitted to NICU over a period of 3 years from March 2015-2018.Results: A total of 177 preterm admitted to the NICU was included in this study. 77 had ROP and were taken as cases, while 100 were controls. Out of the cases, 55.6% had thrombocytopenia (OR-2.47, p value: 0.003). 89% (n =69) of cases had significant oxygen exposure (OR-8.65, p value 0.0001; 95% CI: 2.00-10.75). Oxygen exposure and thrombocytopenia coexisted in 57% of cases, with 4 times increased risk of ROP (OR-4.51, p value: 0.0001).Conclusions: Thrombocytopenia is a significant risk factor for retinopathy of prematurity in preterm. The presence of thrombocytopenia with significant oxygen exposure tends to accentuate the risk further. Future prospective studies with long term follow up are warranted to establish other risk factors.
      PubDate: 2020-01-23
      DOI: 10.18203/2349-3291.ijcp20200106
      Issue No: Vol. 7, No. 2 (2020)
       
  • Early hospital discharge and readmission jaundice in term babies

    • Authors: Saleena Saleem, Rekha S. Nair, P. Madhava Chandran Nair
      Pages: 351 - 354
      Abstract: Background: Hyperbilirubinemia is a common and often benign disease in the neonatal period. It is the most common cause of readmission in early neonatal period. Prolonged hyperbilirubinemia can result in chronic bilirubin encephalopathy. Increasing the hospital stay of otherwise healthy neonates is not an acceptable solution for medical, social and economic constraints. So, identifying the risk factors for readmission assumes importance. Aim of our study is to identify the risk factors for readmission jaundice in our hospital.Methods: In this study, authors used a questionnaire to find out the risk factors for readmission in those babies who were readmitted with jaundice within 3 weeks of life to our hospital. During the study period, routine treatment practices were followed and there was no deviation from the standard of care for the purpose of research.Results: Of the 2297 deliveries during this study period, 93 babies (4%) were readmitted with jaundice.Among the 93 babies, prevalence of blood group incompatibility was one of the common causes of neonatal jaundice. 46.2% of the babies had an early discharge. Total Serum bilirubin levels were measured by a hospital-based bilirubin assay. Babies with serum bilirubin level above photozones as per American Academy of Pediatrics practice guidelines 2004 were identified and subjected to photo therapy. All the babies in this study responded to photo therapy. No other interventions were needed.Conclusions: Though an early discharge is the most cost-effective strategy in this era of high medical expenditure, we can identify certain high-risk babies, prone for readmission. Blood group incompatibility, infants of primiparous mothers and GDM mothers are more prone to readmission jaundice. Identifying these high-risk babies and educating the mothers is a more cost-effective strategy than prolonging the hospital stay for all babies.
      PubDate: 2020-01-23
      DOI: 10.18203/2349-3291.ijcp20200107
      Issue No: Vol. 7, No. 2 (2020)
       
  • Nutritional status and age of menarche in adolescent girls in urban and
           rural area schools

    • Authors: Ramamani D., Ramyaa Rajendiran, Iyanar Kannan
      Pages: 355 - 358
      Abstract: Background: There are various factors that influences the age of menarche which includes genetic, nutritional status, socioeconomic status and environmental conditions. Further it has also proved that the malnutrition has delayed the age of menarche. Thus, the present study focuses on the study of relation between the nutritional status and age of menarche among the adolescent girls in a rural and urban area in Tamil Nadu, India.Methods: It is a community based cross-sectional study done in the adolescent girls of age between 11 to 15 years studying in school in the city of Chennai, India and surrounding rural areas. A total of 602 post-menarcheal adolescent girls were included in the study. The participants who were post-menarcheal were asked to recall the year and month of menarche and was noted. To assess the nutritional status, the parameters weight, height and waist circumference were determined.Results: The association between the age of menarche and BMI was studied. The study showed that there was an association with a Pearson coefficient (r) value of - 0.252 which is statistically significant (p˂0.001). The association between the age of menarche and waist to height ratio was studied. The study showed that there was an association with a Pearson coefficient (r) value of - 0.261 which is statistically significant (p˂0.001).Conclusions: This study has confirmed that the nutritional status has association with the age of menarche and is the contribution to the reduction in the mean of age of menarche in this geographical area.
      PubDate: 2020-01-23
      DOI: 10.18203/2349-3291.ijcp20200108
      Issue No: Vol. 7, No. 2 (2020)
       
  • Study on demographic factors of discharge against medical advice in
           pediatric population

    • Authors: Vidya B. U., Anil Shetty K.
      Pages: 359 - 362
      Abstract: Background: Discharge against medical advice (DAMA) is of serious concern among the pediatrics population. Parent(s)/guardians understanding about the disease and various other factors play role in their decision of DAMA. The aim of this study is to know the prevalence of DAMA in a tertiary care center and to observe the gender stratification in DAMA.Methods: A retrospective survey of medical records of children discharge against medical advice during the period January 2017 to January 2019. Demographic data, length of hospital stay, clinical diagnosis and procedure refused was collected.Results: Total 12977 were discharged during the study period of which, 387 children were DAMA, prevalence of DAMA was 2.9%, male to female ratio among DAMA patients is 1.2:1. The mean length of stay was 4.8 days. Among the DAMA patients’ newborns were predominant (61.6 %), p value = 0.0001, highly significant. No significant difference with respect to age and gender (p value = 0.535). Out of 370 DAMA patients, 211 patients who required further investigations and procedure was refused by parents/guardians (p value = 0.0001) highly significant. Phototherapy refusal was most common among newborn (59.7%), followed by neuroimaging and lumbar puncture in children (10.9%).Conclusions: DAMA was observed more among the newborns compared to infants, toddlers and children. Among newborns, phototherapy refusal was most common. In infants and children neuroimaging and lumbar puncture was the most commonly refused procedure. There was no gender bias.
      PubDate: 2020-01-23
      DOI: 10.18203/2349-3291.ijcp20200109
      Issue No: Vol. 7, No. 2 (2020)
       
  • Etiology of short stature in children attending pediatric endocrinology
           clinic of a tertiary care hospital in Bangladesh

    • Authors: Muhammad Rezaul Karim, Kohinoor Jahan Shamaly, Baraka Badrudduja Tithi, Romana Akter, Ismat Jahan, Suraiya Begum
      Pages: 363 - 368
      Abstract: Background: Short stature is a common problem to practicing pediatricians. It results from various etiologies, which are categorized as normal variants and pathological causes. Normal variant short stature consists of Familial Short Stature (FSS) and Constitutional Growth Delay (CGD), while pathological causes are subdivided into endocrine diseases, clinically defined syndromes, chronic diseases, metabolic diseases and others. There are not so much data available in Bangladesh in this respect. So, present study was conducted to know the common causes of short stature.Methods: This cross-sectional study was done in pediatric endocrinology clinic of Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh from January 2017 to August 2018. One hundred children with short stature meeting inclusion criteria were recruited after taking an informed consent. The detailed history, physical examination including anthropometric measurements and relevant investigations were done. Data were recorded on a predesigned questionnaire for final analysis.Results: The common causes of short stature identified were familial short stature (FSS) 51% cases, Constitutional Growth Delay (CGD) 14% cases and hypothyroidism 12% cases. Other less common causes of short stature were Growth Hormone Deficiency (GHD) 8% cases, malnutrition 6% cases and genetic syndrome 5% cases.Conclusions: FSS and CGD were the leading cause of short stature in children. Endocrinological causes were the most common cause of short stature after normal variant while nonendocrine causes were the least.
      PubDate: 2020-01-23
      DOI: 10.18203/2349-3291.ijcp20200110
      Issue No: Vol. 7, No. 2 (2020)
       
  • Study of liver enzyme variation in children with dengue fever

    • Authors: Clara Rilna Joseph, Nitish Kumar P. Nandini, K. Varadaraj Shenoy
      Pages: 369 - 371
      Abstract: Background: Dengue fever continues to be one of the major public health problems in large parts of the world, with an estimated 50 million dengue infections occurring annually. Liver enzyme variation is commonly seen in patients with dengue fever. This study was undertaken to assess the pattern of liver enzyme variation in children with dengue fever and to correlate it with the severity of this disease.Methods: Observational, descriptive hospital-based study involving 100 children who were serologically positive for dengue fever. The cases were classified as Mild, Moderate and Severe Dengue based on National Guidelines of clinical management of Dengue fever, 2015 and severity was assessed in each category. The study assessed the variability of liver enzymes in these children.Results: Aspartate Aminotransferase (AST) was elevated in 56 cases whereas Alanine Aminotransferase (ALT) was elevated in 44 cases. The elevation in liver enzymes in mild cases was 52%, moderate cases was 75% and severe cases was 100%. In cases presenting on day 1 of fever, enzymes were elevated in 0%, on day 2 in 20%, on day 3 in 38%, on day 4 in 51%, on day 5 in 90% and on day 6 in 88%.Conclusions: Liver Enzyme (AST and ALT) elevation in Dengue is a common feature. AST elevation was more common than ALT. Highest elevation in liver enzymes were observed on 5th and 6th day of fever. Liver enzyme elevation was more commonly seen in moderate and severe cases.
      PubDate: 2020-01-23
      DOI: 10.18203/2349-3291.ijcp20200111
      Issue No: Vol. 7, No. 2 (2020)
       
  • Role of peak expiratory flow rate and chest radiography in children above
           5 years of age with acute asthma

    • Authors: Sankeerthana Shankarnarayana, Jaidev M. Devdas, Sujonitha John, Habeeb Ullah Khan, Pavan Hegde
      Pages: 372 - 376
      Abstract: Background: Asthma is a heterogeneous disease characterized by cough, wheeze and shortness of breath that vary in intensity and time with variable expiratory airflow limitation, associated with chronic airway inflammation. Aim of the study was to assess the usefulness of Peak Expiratory Flow Rate [PEFR] and oxygen saturation in determining severity of acute asthma, to measure objective change in PEFR and oxygen saturation following bronchodilator therapy and the role of chest X-rays in acute asthma.Methods: A prospective study of 50 children above 5 years with acute asthma who presented to the emergency department in a tertiary care hospital were included. PEFR and oxygen saturation before and after bronchodilator therapy was measured. Indication for chest X-rays, its clinical correlation and change in standard treatment of acute asthma based on X-ray reports was noted.Results: The mean PEFR and PEFR % of expected was lower in severe asthma when compared to moderate asthma and was statistically significant (p<0.001). The % of expected PEFR before salbutamol therapy was 48.78±14.36, which improved significantly to 67.13±14.22 after treatment (p<0.001). Oxygen saturation before and after salbutamol therapy was 94.96 ± 4.11 and 96.96±2.87 respectively with the change being significant (p value <0.001). Chest X-rays were performed in 12 (24%) children as per standard guidelines, of which 1(9%) was abnormal showing right basal consolidation. Chest X-ray correlated with clinical findings in 1 child and the findings on chest X-ray altered the ongoing treatment by addition of antibiotic.Conclusions: PEFR and oxygen saturation is useful in the emergency department to objectively assess the severity of acute asthma and the response to initial bronchodilator therapy. Chest X-rays are not routinely indicated in the standard treatment of acute asthma.
      PubDate: 2020-01-23
      DOI: 10.18203/2349-3291.ijcp20200112
      Issue No: Vol. 7, No. 2 (2020)
       
  • Life style effects on hypertension and obesity in adolescents

    • Authors: Sonia Bhatt, Shehraz Firoz
      Pages: 377 - 381
      Abstract: Background: Studies based on effects of lifestyle on hypertension and obesity in adolescent age group are lacking in India. The present study was conducted to evaluate the prevalence of lifestyle associated risk factors in school going adolescents of Kendriya Vidyalaya in district Firozabad and their effects on hypertension and obesity.Methods: The study was carried out among 200 students of classes 9th and 11th in the age group of 13 to 17 years. Students were given a pre-designed questionnaire and feedback was taken about dietary practices and physical activity along with family history of hypertension and obesity. Height, weight, waist circumference, hip circumference, blood pressure was measured in all children. Effects of lifestyle associated risk factors were determined on obesity and hypertension.Results: The study documents that inappropriate dietary practices (fast food consumption, low fruit intake) and less physical activity were strongly associated with high prevalence of obesity and hypertension in the adolescents. The study also showed that adolescents with positive family history of obesity and/or hypertension are also at higher risk. There was a positive correlation between high BMI and hypertension.Conclusions: School based interventions are required to educate the adolescent children about lifestyle modifications to reduce the morbidity associated with non-communicable diseases.
      PubDate: 2020-01-23
      DOI: 10.18203/2349-3291.ijcp20200113
      Issue No: Vol. 7, No. 2 (2020)
       
  • Clinico-laboratory profile and outcome of dengue fever among children
           attending a tertiary care hospital of rural Telangana, India

    • Authors: V. Shekar, K. Praveen Kumar, C. Soren, K. Venkataramana Reddy, N. Dharani
      Pages: 382 - 386
      Abstract: Background: Dengue is a self-limiting, vector-borne disease transmitted by Aedes mosquito, causing a major public health threat globally. The objective of this study is to assess the clinical profile and outcome of the dengue infection in children less than 14 years of age September 2018 to August 2019 at the Pediatric Department of S.V.S. Medical College, the tertiary care hospital in Mahabubnagar, Telanagana.Methods: Prospective study of 82 hospitalized children of <14 years with the diagnosis of dengue illness. Children with diagnosis of dengue were classified further in to two groups as per WHO guidelines, Non-severe dengue fever (probable dengue, dengue with warning signs) and ‘Severe Dengue’ (Dengue Haemorrhagic Fever and/or Dengue Shock Syndrome (DHF/DSS). A separate questionnaire form used for documenting clinical history, laboratory parameters. Haematological parameters were noted, chest x-ray, ultra-sonogram in required cases was done. Children were managed as per WHO protocol. The outcomes of the cases were mentioned as discharge, left against medical advice and death.Results: A total of 82 children with dengue were divided in to 55(67%) non severe dengue and 27(33%) severe dengue with males 56(68.2%) and females 26(31.7%). The most common age of presentation was between 6-10 years 34(41.5%). Fever 73(89%) was the most common presenting symptoms. Pleural effusion and hepatomegaly were the commonest clinical findings 28(34.1%) each, which were more among the severe dengue patients. Gall bladder edema 29(35.3%) was the most common ultra-sonogram finding. Significant elevation of transaminases (SGOP, SGPT) was seen in 39(47.5%). Severe thrombocytopenia was observed in 22(26.8%) children. Management was by administration of colloids and crystalloids.Conclusions: Dengue is a global problem. Presenting features include high grade fever, vomiting, abdominal pain, skin rash. Early recognition of symptoms and proper management can reduce the mortality.
      PubDate: 2020-01-23
      DOI: 10.18203/2349-3291.ijcp20200114
      Issue No: Vol. 7, No. 2 (2020)
       
  • A study on vitamin D levels in preterm and term neonates and their mothers

    • Authors: Deepa J. Thomas, Habeeb U. Khan, Saritha Paul, Jaidev M. D., Pavan Hegde
      Pages: 387 - 392
      Abstract: Background: Vitamin D is a fat-soluble vitamin which has immunomodulatory and anti-inflammatory effects. Vitamin D deficiency is a worldwide problem and yet is one of the most under diagnosed and under treated nutritional deficiency. Despite India being in the tropical zone with plentiful sunlight, there is a wide prevalence of vitamin D deficiency.Methods: Cross sectional descriptive study done in a tertiary care hospital involving 30 mother baby dyads equally divided into term and preterm babies. Maternal vitamin D levels (before delivery) and cord blood vitamin D levels (after delivery) were estimated.Results: All the mothers had low vitamin D levels, 93% having deficiency and 7% having insufficiency. The maternal vitamin D levels correlated with cord blood vitamin D levels. There was significant correlation between maternal vitamin D levels and cord blood vitamin D levels with maternal age and parity. There was no correlation between maternal vitamin D levels with gestational age, sociodemographic profile or neonatal anthropometry.Conclusions: Vitamin D deficiency is widely prevalent even in well-nourished mothers. Vitamin D supplementation may be helpful in antenatal mothers. Larger studies are needed to study the prevalence of vitamin D deficiency in mothers and babies and look for effectiveness of supplementation.
      PubDate: 2020-01-23
      DOI: 10.18203/2349-3291.ijcp20200115
      Issue No: Vol. 7, No. 2 (2020)
       
  • Study on peak expiratory flow rate and its influencing factors in healthy
           school children in Kancheepuram district of Tamil Nadu, India

    • Authors: Ramamani D., Iyanar Kannan
      Pages: 393 - 396
      Abstract: Background: The Peak Expiratory Flow Rate (PEFR) is useful to screen and monitor the severity of asthma in children. Many studies have documented that age, height and weight are some of the main factors that affect the PEFR. Thus, the present study was done to find the PEFR values among the school children and to find the factors that influences the PEFR values in our geographical area.Methods: It was a cross sectional study conducted in school children belong the rural area of Kancheepuram district, Tamil Nadu, India. A total of 378 students of both the gender at the age group of 5-10 years were selected for the study. The PEFR was measured by making the participant seated comfortably. One peak flow meter was used for 25 children and mouthpiece was changed for each student.Results: The PEFR value among and male and female participants was analyzed statistically (Table 2). The mean value of male and female study population was 169.53±37.38 and 146.24±33.01 respectively. The difference in the mean values were statistically significant (p=0.001) and found to be high in male participants. The Pearson correlation r between PEFR with height is 0.463, thus showing a positive correlation with the p˂0.001 which is statistically significant. The Pearson correlation r between PEFR and chest circumference is 0.335 thus indicating a positive correlation between PEFR and chest circumference.Conclusions: From the present study, the normal values of PEFR has been deduced for the healthy school children in our geographical area. Further, it was found that the height and chest circumference are influencing factors for PEFR. Further regression equation has been derived that can help us to find the approximate PEFR values with the help of height and chest circumference of the children.
      PubDate: 2020-01-23
      DOI: 10.18203/2349-3291.ijcp20200116
      Issue No: Vol. 7, No. 2 (2020)
       
  • Congenital hypothyroidism screening by umbilical cord blood: thyroid
           stimulating hormone

    • Authors: Gaddam Eluzai Zion, Raheemunnisa .
      Pages: 397 - 404
      Abstract: Background: Congenital hypothyroidism (CH) is one of the common preventable cause of intellectual disability. Most cases of CH result from thyroid dysgenesis. CH is often asymptomatic in early infancy, and any delay in treatment can affect the child in terms of delayed cognitive milestones. NSCH (newborn screening for congenital hypothyroidism) has been universally accepted and it is one of the most cost effective screening programs in the field of preventive medicine and public health.Methods: A cross sectional study was conducted in Sri Venkata Sai Medical College and Hospital from 28th August to 28th February 2019 (1.5 years), this study was done on 73 newborns (70 deliveries, three mothers gave birth to twins). All data was collected prospectively. Mothers with known thyroid disease or on thyroid medication were excluded from the study. Under sterile aseptic conditions blood sample is collected from the umbilical cord soon after delivery.Results: In the present study Cord blood TSH level of >20 mIU/L was present in 10% (7) of neonates. When the blood TSH levels were repeated (on day 3) among those with high cord blood TSH levels (>20), the blood TSH levels was also high (>20) in 6 (85.7%) neonates and low (<20) in 1 (14.2%). In Neonates with cord blood TSH >20, 6 neonates also had Low T4 (T4<7) levels (85.7%) and 1 neonate (14.2%) had T4 >7. In the present study 6 neonates (85.7%) had Congenital Hypothyroidism. The present study finds that Cord blood TSH as a diagnostic tool has Sensitivity of 100% and specificity of 98.5% in diagnosing congenital hypothyroidism.Conclusions: The current study concludes that Cord blood TSH is a sensitive and specific marker to predict the presence of congenital hypothyroidism in neonates.
      PubDate: 2020-01-23
      DOI: 10.18203/2349-3291.ijcp20200117
      Issue No: Vol. 7, No. 2 (2020)
       
  • Cord blood albumin as predictor of neonatal hyperbilirubinemia

    • Authors: Chandan M. V., Praveen B. K.
      Pages: 405 - 407
      Abstract: Background: Measuring the Cord blood Albumin level and predicting neonatal hyperbilirubinemia.Methods: Prospective study was performed on 160 healthy term neonates. Relevant maternal history was collected. Cord blood was collected from the healthy term neonates at birth and cord serum albumin measured. Neonate was assessed for jaundice every day using transcutaneous bilirubinometer. Total Serum Bilirubin (TSB) was assessed if the Transcutaneous Bilirubin (TCB) values were found high and treated according to NICU protocol.Results: Study cohort was grouped as Group A, Group B and Group C based on Cord Serum Albumin (CSA) level ≤3.3 g/dl, 3.3-3.8 g/dl and ≥3.8 g/d respectively. Statistical analysis was done for correlation of CSA with Neonatal Hyperbilirubinemia (NH). It showed that cord serum albumin level ≤3.8 g/dl is critical, as it was seen in 9.1% of neonates who developed neonatal hyperbilirubinemia (p value-0.032).Conclusions: There is a correlation between cord serum albumin level and neonatal hyperbilirubinemia. Cord serum albumin level of ≤3.8 g/dl is a risk indicator in predicting the development of neonatal hyperbilirubinemia.
      PubDate: 2020-01-23
      DOI: 10.18203/2349-3291.ijcp20200118
      Issue No: Vol. 7, No. 2 (2020)
       
  • A prospective observational study to describe magnetic resonance imaging
           findings in perinatal asphyxia in terms of severity, outcome and
           neurological sequel in term and preterm babies

    • Authors: Tanushree Mondal, Gargi Gayen, Arijit Bhowmik
      Pages: 408 - 412
      Abstract: Background: Perinatal asphyxia is a significant cause of neonatal mortality and morbidity. MRI is useful for assessing the severity and pattern of brain injuries. There is less data of MRI findings of perinatal asphyxia from India and the subcontinents. This prospective observational study was done to describe MRI brain findings in neonates with perinatal asphyxia with respect to various determinants.Methods:  Initial MRI brain was done when babies were stable after fulfilling inclusion criteria. Immediate outcome was assessed at the end of hospital stay. They were followed up for presence of any sequel up to 1 year. Repeat MRI brain was done in few selected babies. Data was collected and statistically analyzed.Results: Total 55 babies were included in the study (term 27, preterm 28). There were 9 babies in stage 1, 17 babies in stage II and 22 babies in stage III. MRI brain findings were normal in 8 and abnormal in 47 patients. There were Deep gray matter injury (DG) in 22, Para Sagittal subcortical white matter injury (PS) in 6, Germinal matrix haemorrage (GMH), intraventricular haemorrage (IVH) and Periventricular leucomalacia (PVL) in 12 and Mixed pattern of injury in 7 babies. Findings among 9 expired babies were: 4 (44.4%) DG, 2 (22.2%) GMH+IVH and 3 (33.3%) mixed. There was neurological sequel in 13 babies (48.1%).  Babies with normal MRI initially had no sequel.Conclusion: Brain injury due to perinatal asphyxia follows several patterns according to gestational age and severity. Early and accurate recognition of these patterns with the help of MRI brain helps in managing the baby and predicting the prognosis.
      PubDate: 2020-01-23
      DOI: 10.18203/2349-3291.ijcp20200119
      Issue No: Vol. 7, No. 2 (2020)
       
  • Serum immunoglobulin E and absolute eosinophil count as markers of
           severity in childhood asthma

    • Authors: Pinakin P. Trivedi, Ami H. Patel
      Pages: 413 - 418
      Abstract: Background: Asthma is a chronic inflammatory condition of the airways resulting in increased airway reactivity to a variety of stimuli like allergens, irritants, viruses and exercise. There is a strong association between the exposure of allergens and development of asthmatic symptoms. A hypersensitivity reaction initiated by immunologic mechanisms mediated by Immunoglobulin E (IgE) antibodies occurs in allergic asthma. IgE and eosinophils play an important role in the inflammatory process resulting in bronchial hyperresponsiveness. The aim of this study was to evaluate serum total IgE levels and Absolute Eosinophil Count (AEC) as markers of disease activity and study their association with the severity of bronchial asthma in children.Methods: A prospective study was conducted in the paediatric department of a tertiary care hospital in Ahmedabad, Gujarat, India from July 2017 to December 2018. Children between 4-14 years of age diagnosed as having bronchial asthma were included in the study. Serum total IgE levels and absolute eosinophil count were done in all the study participants and their correlation with the severity of asthma was assessed.Results: Of the total 109 patients of asthma, 44(40.4%) had intermittent asthma, 30(27.5%) mild persistent, 25(22.9%) moderate persistent and 10(9.2%) severe persistent asthma. Serum total IgE levels were raised above the normal limits for age in 94(86.2%) patients and increased AEC was found in 61(56 %) patients. Both serum total IgE levels and AEC increased significantly (p<0.0001) with increasing severity of asthma.Conclusions: Serum total IgE levels and AEC can be used to predict the severity of asthma in children.
      PubDate: 2020-01-23
      DOI: 10.18203/2349-3291.ijcp20200120
      Issue No: Vol. 7, No. 2 (2020)
       
  • Detection of red cell alloantibodies in thalassaemia patients

    • Authors: Ansuman Sahu, Pankaj Parida, Smita Mahapatra, Binay Bhusan Sahoo
      Pages: 419 - 423
      Abstract: Background: β-thalassaemia patients receive regular blood transfusion to thrive. Due to antigen disparity between the blood donors and these patients they develop red cell alloantibodies due to alloimmunization.  The objective of this study is to predict the frequency of red cell alloimmunization amongst β-thalassaemia major patients receiving regular blood transfusion.Methods: This study including 106 patients with β-thalassaemia was conducted in the department of Transfusion Medicine, S. C. B. Medical College, Cuttack for a period of 12 months. Alloantibodies to different red cell blood group antigens in multi-transfused thalassaemia patients were detected using the glass bead technology for blood group serology in the present study.Results: Out of 106 β-thalassaemia major patients included in the study, 7.5% of patients developed alloantibodies, all being clinically significant. The alloantibodies were anti-E, anti c, anti e and anti-D. The rate of incidence of these alloantibodies was 3.8%, 1.9%, 0.9% and 0.9% respectively.  There was a significant association between alloantibody formation with number of transfused packed red cells (Mann-Whitney Test: p value = 0.035) and age at first transfusion (p value = 0.001). The factors having no association with alloimmunization to red cell antigens are age and gender.Conclusions: Alloimmunization to various erythrocyte blood group antigens is a common problem in multi-transfused β-thalassaemia patients. There is an association between number of transfused packed red cells and age at first transfusion with alloantibody formation in the study.
      PubDate: 2020-01-23
      DOI: 10.18203/2349-3291.ijcp20200121
      Issue No: Vol. 7, No. 2 (2020)
       
  • Yale observation scale for bacterial infection in febrile children

    • Authors: Shiwani Mangla, Hemant Jain
      Pages: 424 - 427
      Abstract: Background: Sepsis is one of the leading causes of mortality in children under 5 years by UNICEF statistics which is difficult to diagnose because of nonspecific initial clinical presentation and potential for rapid deterioration. In this regard use of Yale Observation Scale assists in early recognition of serious bacterial infection than other laboratory investigation as it is simple, quick, easy to apply and cost-effective bed side scale.Methods: All eligible young febrile infants and children were consecutively enrolled in the study. Axillary temperatures of the cases were documented. Yale observation scoring was done. Blood sample were sent for culture and sensitivity. Colonies were identified morphologically by Gram stain and biochemically. The collected data was analyzed using ROC curve for finding cut off scores of Yale Observation Scale for prediction of severe bacterial illness and final outcome. Statistical analysis was performed using the Statistical Packages for Social Sciences (SPSS) version 14 for MS Window.Results: Bacteremia was found in 23(15.3%) out of total 150 young febrile children enrolled in the present study. It shows that in lower YOS score blood culture was sterile and in higher YOS score blood culture was positive for bacteremia, which is statistically significant with p value (<0.05). As per ROC curve analyses the best cut off value of YOS for prediction of bacteremia was 17.5 with sensitivity 91.3%, specificity 81.9%, PPV 47.7% and NPV of 98.1%.Conclusions: YOS of  >17.5 has a good predictive ability for prediction of bacteraemia in young febrile children.
      PubDate: 2020-01-23
      DOI: 10.18203/2349-3291.ijcp20200122
      Issue No: Vol. 7, No. 2 (2020)
       
  • Study on ultrasound observations in children with typhoid fever in a
           tertiary care hospital

    • Authors: Zubair Ahamed Md., Gangadhar B. Belavadi
      Pages: 428 - 431
      Abstract: Background: Enteric fever continues to be endemic in poor countries globally, although it has been eradicated from the developed nations due to their well-organized sanitation and protected water supply. The five Fs most concerned with spread of typhoid disease are fingers, food, fomites, flies, and feces. Enteric fever is predominantly caused by Salmonella typhi and next in frequency is Salmonella paratyphi. Very less literature is available on radiological manifestations of typhoid fever in children on the basis of age difference in India. Hence, a study was conducted to observe the radiological findings and to correlate with laboratory manifestations in typhoid fever. Objectives of the study was to observe the ultrasound abdomen changes in Typhoid fever at rural area.Methods: The current study was conducted at Department of pediatrics of Narayana Medical College Hospital, Nellore, Andhra Pradesh state in a period of one year. All patients presenting with fever having positive for Widal test were included. In total 50 patients were included and divided into 2 age groups, <5 years and >5years. The laboratory results and abdominal ultrasound were conducted in the two groups and compared.Results: Total 20 patients in <5 years age and 30 patients in >5 years were enrolled. Male to female ratio was 2:1 in both groups. Common laboratory findings showed 32 patients (64%) with Anemia, elevated liver enzymes in 40 patients (80%), and elevated ESR in 42 patients (84%). 45 patients have Splenomegaly and hepatomegaly with normal parenchymal echotexture. Gallbladder sludge and biliary sludge was seen in 6 patients. Thickened gall bladder in 34 patients (68%) was observed. Bowel wall thickening seen in 32 patients (64%). mesenteric lymphadenopathy in 36 patients (68%) observed. All were recovered by treatment.Conclusions: On ultrasound, splenomegaly, hepatomegaly, and thick-walled gallbladder were observed in most of the childrens with typhoid fever. Therefore, ultrasound can also be used as supportive diagnose along with laboratory parameters due to it is a non-invasive and economical tool of diagnosing typhoid.
      PubDate: 2020-01-23
      DOI: 10.18203/2349-3291.ijcp20200123
      Issue No: Vol. 7, No. 2 (2020)
       
  • Gastric residual volume as a measure of feed intolerance/necrotising
           enterocolitis in very low birth weight infants: an observational cohort
           study

    • Authors: RahulRahul M. Kadam, Lakshmi Aparna Devi V. V.
      Pages: 432 - 436
      Abstract: Background: To evaluate the efficacy of Gastric Residual Volume (GRV) as a measure of feed intolerance /Necrotising enterocolitis in Very Low Birth Weight (VLBW) infants.Methods: This prospective observational cohort study was done in a tertiary care hospital located in rural South India for a period of 2 years. All haemodynamically stable infants born between 30-34 weeks of gestation at birth and 1000-1500 grams of birth weight, admitted to Neonatal Intensive Care Unit (NICU) within first 24 hours of life during study period were enrolled in two groups; GRV group, where pre-feed gastric residual volume  was checked and No-GRV group, where pre-feed gastric residual volume  was not checked.Results: Both groups had similar baseline characteristics. In No-GRV group, the days to reach birth weight (12.1) and days to attain full feeds (8.0) were less when compared to GRV group. In No-GRV group, average duration of NICU stay in days (16.60) and parenteral nutrition (5.25) was less when compared to GRV group. No-GRV group does not have increased incidence of sepsis or mortality compared to GRV group. In this study there was increased incidence of NEC noted in GRV group (30%) when compared to No-GRV group (p value-0.02).Conclusions: In hemodynamically stable preterm VLBW infants, it is recommended not to check gastric residual volume routinely prior to the enteral feeding.
      PubDate: 2020-01-23
      DOI: 10.18203/2349-3291.ijcp20200124
      Issue No: Vol. 7, No. 2 (2020)
       
  • Acquired generalized lipodystrophy type 2-lawrence syndrome: a rare case
           report

    • Authors: Dhanalakshmi K., Mohinish S., Dakshayani B., Mallesh K.
      Pages: 437 - 441
      Abstract: Lawrence syndrome (Acquired Generalized Lipodystrophy) is a rare disorder, characterized by various dermatological and systemic manifestations such as lipodystrophy, hypertriglyceridemia, hepatomegaly, acanthosis nigricans and acromegaloid features. Because of its rare occurrence we are reporting a case with similar manifestations in a 10 years old child.
      PubDate: 2020-01-23
      DOI: 10.18203/2349-3291.ijcp20200125
      Issue No: Vol. 7, No. 2 (2020)
       
  • Functioning adrenocortical carcinoma causing virilisation: a case report

    • Authors: Vivek Parameswara Sarma, Sunil S. Menon
      Pages: 442 - 444
      Abstract: Adrenocortical carticnoma (ACC) is an uncommon tumor with an incidence of 1-2 cases/million/year. It has two peak incidences; the first one in the first decade and the second one in the fourth decade. Most patients present with features of steroid hormone excess or abdominal mass effects, but about 15% of ACC are diagnosed incidentally. It is hormonally functional in 80 - 100% patients and the predisposing lesions include congenital adrenal hyperplasia and adenoma. ACC has significant syndromic and genetic association. Surgery offers the best chance of cure, especially in localized disease. Here, we present the case of virilization in a young female child secondary to a functioning ACC. The child had classical hormonal and imaging features of functioning ACC and underwent resection of the tumor (Adrenalectomy) with good outcome.
      PubDate: 2020-01-23
      DOI: 10.18203/2349-3291.ijcp20200126
      Issue No: Vol. 7, No. 2 (2020)
       
  • A rare case of ischaemic stroke following cervical spine manipulation in
           an adolescent girl

    • Authors: Ashitha Judith Paul, Radha Kumar
      Pages: 445 - 448
      Abstract: Stroke in children is associated with a multitude of risk factors compared to risk factors of adult stroke such as hypertension, diabetes or atherosclerosis. A 15-year adolescent girl presented with acute onset weakness involving right upper and lower limb. She complained of neck pain and fever 2 days before the onset of hemiparesis for which her parents took her to traditional healer who performed neck manipulation after which she developed vomiting, tingling numbness and weakness of right upper and lower limb. There was no history of preceding headache, ear discharge or any other contributory history. Clinical examination revealed Glasgow Come Scale 12/15, power of grade 2/5 in right upper limb and 3/5 in right lower limb, exaggerated deep reflexes, extensor plantar reflex, right sided ptosis and right sided upper motor neuron facial palsy. CT scan brain showed right cerebellar and occipital infarct with posterior inferior cerebellar artery territory involvement. MRI Brain and MR Angiogram showed wedge shaped infarct involving right posterior inferior cerebellum, inferior vermis, ventral aspect of superior medulla, paracentral pons, right cerebral peduncle, tectum of both halves of midbrain with no internal hemorrhage and no vessel abnormality and right vertebral artery was not visualized. Her coagulation profile and cardiac work up were normal. She was treated with antiplatelet drugs, anticoagulants and physiotherapy following which the child gradually improved over a period of one month. In this case, with a positive history of neck manipulation authors can conclude that the etiology of young stroke wasinduced byneck manipulation. This case has been reported to increase awareness about the ill effects of neck manipulation and counsel parents against performing such procedures for children. Early recognition of pediatric stroke is critical for immediate diagnosis, imaging and treatment with better outcomes.
      PubDate: 2020-01-23
      DOI: 10.18203/2349-3291.ijcp20200127
      Issue No: Vol. 7, No. 2 (2020)
       
  • Takayasu arteritis presenting with massive cerebral ischemic infarction in
           a 15-year-old girl: a case report

    • Authors: Mohinish S., Dhanalakshmi K., Sushma Veeranna Sajjan, Priyanka K.
      Pages: 449 - 453
      Abstract: Takayasu arteritis is a relatively rare type of large-vessel arteritis that primarily affects the aorta and its major branches, the coronary arteries, and the pulmonary arteries. Depending on the different groups of blood vessels involved in the disease process, the clinical presentation of Takayasu arteritis varies. Here we report a case of a girl presenting with a debilitating massive cerebral ischemic infarct that turned out to be a relatively rare first presentation of Takayasu arteritis. Case report of 15 years old adolescent female hailing from lower socio-economic status with past history of chronic headache, no significant family history, completely immunized presented with sudden onset weakness of right upper and lower limbs, which progressed over 1day with aphasia (recovering) with deviation of angle of mouth to left side On examination left radial ,carotid artery not palpable. Her laboratory results showed an elevated C-reactive protein and erythrocyte sedimentation rate, and subsequent CT angiography demonstrated narrowing and occlusion of the major branches of her aortic arch. We report the case of a patient with Takayasu arteritis presenting with a massive cerebral ischemic infarct and review the current literature on this topic. Conclusion of takayasu arteritis is a relatively rare disease with various and sometimes devastating clinical manifestations, such as massive cerebral ischemic infarction as in our case. Currently, there are multiple diagnostic tools and treatment options available, and more under investigation. Early, appropriate diagnosis and initiation of proper therapy could avoid further progression and reduce complications of the disease.
      PubDate: 2020-01-23
      DOI: 10.18203/2349-3291.ijcp20200128
      Issue No: Vol. 7, No. 2 (2020)
       
  • Neonatal ovarian cyst complicating as subacute intestinal obstruction: a
           case report

    • Authors: Goutam Chakraborty, Anwesa Chakraborty, Nidhi Sugandhi, Amit Jadhav, S. K. Acharya, Deepak Bagga
      Pages: 454 - 457
      Abstract: Congenital Ovarian cysts are among the commonest intra-abdominal masses encountered in foetuses on antenatal screening, mostly during the third trimester of pregnancy. Though the etiology remains unknown, the most prevalent hypothesis holds maternal hormonal stimulation responsible for the pathology. Most are asymptomatic but potential complications can be life-threatening. A case of a 7 day old female baby was reported with normal antenatal scans and complaints of abdominal distension and vomiting since day 1 of life. Imaging included a Ultrasonographic diagnosis of suspected ovarian lesion and an MRI diagnosis of omental cyst. Due to progressive abdominal distension, authors proceeded with laparotomy. Left salpingo-oophorectomy was done as no ovarian tissue was salvageable. Post-operative period was uneventful. The histopathological picture was that of benign follicular cyst of ovary.
      PubDate: 2020-01-23
      DOI: 10.18203/2349-3291.ijcp20195629
      Issue No: Vol. 7, No. 2 (2020)
       
  • Neonatal presentation of Joubert syndrome

    • Authors: Rahul Choudhary, Garima Sachdeva, Gaurav Katoch, Sanjeev Choudhary
      Pages: 458 - 461
      Abstract: Joubert syndrome is a rare genetic disorder with autosomal recessive or rarely X-linked recessive inheritance.
      Authors are reporting a case of a newborn girl with Joubert syndrome who presented with respiratory distress, hypotonia, hyporeflexia, abnormal eye movements, and facial dysmorphism. Brain MRI revealed vermian hypoplasia, “molar tooth sign” with “bat wing appearance” of the fourth ventricle, deepened interpeduncular fossa, and elongated superior cerebellar peduncles. The clinical diagnosis of this syndrome is difficult due to its variable presentation and non-specific presentation. Magnetic Resonance Imaging (MRI) has an important role in the diagnosis of Joubert syndrome. This not only helps in early diagnosis but also helps in appropriate counseling and proper rehabilitation of the baby.
      PubDate: 2020-01-23
      DOI: 10.18203/2349-3291.ijcp20200129
      Issue No: Vol. 7, No. 2 (2020)
       
  • Severe haemoptysis in a 5 year old child with Kartagener’s syndrome:
           case report

    • Authors: Mohinish S., Mallesh K., Prashanth H. K., Ravichandra K. R.
      Pages: 462 - 465
      Abstract: Kartagener`s syndrome, a rare autosomal recessive disorder is a type of Primary Ciliary Dyskinesia (PCD) associated situs inversus, bronchiectasis, sinusitis and male infertility. We present a case of a 5-year-old girl who came with features of bilateral glue ear, recurrent sinusitis, recurrent hemoptysis and dextrocardia. She was diagnosed to have Kartagener`s syndrome and was evaluated for recurrent hemoptysis.
      PubDate: 2020-01-23
      DOI: 10.18203/2349-3291.ijcp20200130
      Issue No: Vol. 7, No. 2 (2020)
       
 
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