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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]
  • Evaluation of anthropometric indicators in malnourished children at
           Nutritional Rehabilitation Center, Gujarat, India

    • Authors: Dhara Patel, Nisha Upadhyay
      Pages: 1410 - 1413
      Abstract: Background: It is very difficult to recognize the cases with mild-to-moderate malnutrition because clinical criteria for their diagnosis are imprecise and are difficult to interpret accurately. The objective of the study was daily weight gain in gram/kg/day in severely malnourished children.Methods: This was a hospital based cross sectional study in which total of 114 consecutive patients of SAM less than 5 years treated for complications of severe acute malnutrition using WHO protocol. The study design included 114 children from the NRC and then followed up the period of 6 months to assess the nutritional status during the period of initial stage and the entire follow up period using available record of anthropometry indicators of the admitted children recruited in the study at the NRC.Results: Mean weight at admission was 6.4 Kg, 6.5 Kg and 6.2 Kg of overall, boys and girls respectively. Mean weight at discharge was 6.8 Kg, 6.7 Kg and 6.6 Kg of overall, boys and girls respectively. Mean MUAC at admission was 10.7 cm, 10.9 cm and 10.6 cm of overall, boys and girls respectively. Mean MUAC at discharge was 10.9 cm, 10.9 cm and 10.8 cm of overall, boys and girls respectively.Conclusions: For treatment of severe acute malnutrition, systematic guidelines required, thus this study indicates that following WHO guidelines, it has become easier to manage SAM in hospital settings, with least possible stay at hospital. The objective of the study was to know the effect of nutritional intervention measures on selected anthropometric indicators of severe acute malnourished children.
      PubDate: 2019-06-27
      DOI: 10.18203/2349-3291.ijcp20192747
      Issue No: Vol. 6, No. 4 (2019)
       
  • Iron deficiency anemia as a risk factor for simple febrile seizures in
           pediatric patients

    • Authors: Bharath Kumar T., Kanimozhi Thandapani, Vinod Babu S.
      Pages: 1414 - 1420
      Abstract: Background: Febrile seizure (FS) is the most common cause of seizure in children, occurring between 6-60 months. It coincides with peak age of incidence for Iron deficiency anemia (IDA). Iron is required for optimal growth and development and its deficiency is associated with numerous problems including persistent cognitive and motor delays. The objective was to study the role of IDA as a risk factor for simple febrile seizure and its recurrenceMethods: A case control study was conducted among 90 febrile children - 45 cases with simple febrile seizure and 45 cases with febrile illness, between the age group of six months to five years of age at Sri Manakula Vinayagar Medical College and Hospital, Pondicherry, between September 2013 and June 2015. The hematological parameters like Hemoglobin, Serum ferritin and RDW were compared between the two groups with respect to fever and different temperature intervals, recurrence of FS.Results: Hb and Serum Ferritin levels were found to be significantly associated with simple febrile seizure, with p value of <0.002 and 0.001 respectively. Similar association was found at different temperature intervals. However, there was no association of hematological parameters with FS recurrence.Conclusions: IDA is a significant risk factor for FS in children while same may not have any effect on the recurrence of FS.
      PubDate: 2019-06-27
      DOI: 10.18203/2349-3291.ijcp20192126
      Issue No: Vol. 6, No. 4 (2019)
       
  • Study on peak expiratory flow rate in school children from Madurai
           district, Tamil Nadu, India

    • Authors: Thangavel A., Vairamuthu G. S.
      Pages: 1421 - 1427
      Abstract: Background: Data on peak expiratory flow rate (PEFR) for Madurai district, Tamil Nadu, India, school children is not available. Hence, this study aims to construct predicted equations for PEFR in both sexes in the age group of 5 - 12 years according to the height as a reference.Methods: About 961 healthy children (493 boys and 468 girls) were randomly selected from six schools of Madurai district. PEFR readings were repeated thrice and the  highest value of these 3 readings was taken as the observed PEFR. Linear regression analysis was performed using age, weight, height and body surface area (BSA) as independent variables and PEFR as the dependent variable.Results: Statistical correlation is found between height, age, BSA, weight and PEFR in both sexes. The variables which show significant positive relationship with PEFR are height (r=0.78), age (r=0.74), BSA (r=0.73), weight(r=0.67) of which height shows the most significant correlation. The regression equation for PEFR with height is: boys: PEFR =3.12 x (height)-211.85, girls: PEFR = 3.07 x (height)- 212.3.Conclusions: BSA needs further formula-based calculation and age may be falsely given in the school records or may be forgotten by uneducated parents. Weight is having less correlation coefficient compared to other parameters. So, this study recommends deriving predicted equation for PEFR based on height for both genders. The prediction equations for PEFR obtained in this study can be used as local reference for the follow up of children with respiratory disorders in and around Madurai district, Tamil Nadu, India.
      PubDate: 2019-06-27
      DOI: 10.18203/2349-3291.ijcp20192602
      Issue No: Vol. 6, No. 4 (2019)
       
  • Prevalence of anemia in school children in the age group of 8 to 14 years
           in Thiruvarur, Tamilnadu, India

    • Authors: P. Raja, R. Rajaselvan
      Pages: 1428 - 1431
      Abstract: Background: Iron deficiency is responsible for most of the nutritional anemia. Hemoglobin concentration is a reliable indicator of anemia at the population level, as opposed to clinical measures which are subjective and therefore have more room for error. Measuring Hemoglobin concentration is relatively easy and inexpensive, and this measurement is frequently used as a proxy indicator of iron deficiency. To study the association of certain risk factors with the prevalence of anemia in school children in the age group of 8-14 years.Methods: The study was conducted from April 2017 to March 2018 in Department of Paediatrics, Government Thiruvarur Medical College, Thiruvarur. The study population consisted of school children in the age group of 8 to 14 years fulfilling the inclusion and exclusion criteria. The sample size was 250. Complete hematological investigations was done to each child for differential diagnosis of anemia.Results: Majority of the children studied had a normal BMI 38.4% (n=96), 16.8% (n=42) were classified as overweight, 9.2% (n=23) were classified as obese. 22.8% (n=57) were classified as having thinness. 12.8% (n=32) were classified as having severe thinness. Of the 132 children with anemia, majority had mild anemia 64.39% (n=85) followed by moderate 28.03% (n=37) and severe anemia 7.58% (n=10). Of the 132 children with anemia, majority had mild anemia 64.39% (n=85) followed by moderate 28.03% (n=37) and severe anemia 7.58% (n=10).Conclusions: The prevalence of anemia was significantly higher in female children (64.91%) compared to male children (42.65%). The prevalence of anemia is highest in children with severe thinness (78.13%) followed by children with obesity (73.91%). The most common type of anemia in our study was iron deficiency anemia. Majority of the children were suffering from anemia of mild severity. There was no statistically significant correlation between the prevalence of anemia in children and age and socioeconomic status.
      PubDate: 2019-06-27
      DOI: 10.18203/2349-3291.ijcp20192168
      Issue No: Vol. 6, No. 4 (2019)
       
  • Risk factors for childhood refractory epilepsy in a tertiary care centre,
           Chennai, India

    • Authors: Thannoli Gowthami Gowrinathan, Senthil Kumar A.
      Pages: 1432 - 1438
      Abstract: Background: Intractable epilepsy is the pragmatic problem during the treatment of active epilepsy in children. Several risk factors are associated with incidence of intractable/recurrent epilepsy. The current study was done to identify the risk and prognostic factors associated with recurrent epilepsy (RE).Methods: This descriptive study was conducted on 152 children with idiopathic or symptomatic epilepsy who are on two or more AEDs and who were in follow up in Neurology OPD and inpatients in medical ward at ICH&HC, Chennai. All patients underwent relevant investigations to identify the possible risk factors for incidence of RE in study population. Karyotyping was done for idiopathic cases.Results: Male preponderance was seen in the study (M:F-2:1). Risk factors such as male sex, age onset of seizures, type of seizures, developmental delay, CNS congenital anomalies, h/o perinatal injury, neuroabnormality, abnormal MRI and EEG was found to have statistically significant association with incidence of RE. No significant association was observed for the factors microcephaly, behavioural abnormalities, h/o febrile seizures and h/o status epilepticus with incidence of RE. No chromosomal abnormalities were detected in idiopathic cases.Conclusions: Early identification, risk factor analysis and understanding in the dynamics of the disease helps the physician in initiating the appropriate treatment, thereby avoiding the wrong therapy, low dose therapy and infrequent therapy. Above all identification of the risk factors helps in parental counseling and prepare them for expected outcome.
      PubDate: 2019-06-27
      DOI: 10.18203/2349-3291.ijcp20192624
      Issue No: Vol. 6, No. 4 (2019)
       
  • A study of risk factors and clinical outcome of stroke in children

    • Authors: Shruti Vyas, Rajwanti K. Vaswani
      Pages: 1439 - 1444
      Abstract: Background: Stroke is a significant cause of neurological morbidity and mortality in children. Early recognition permits timely therapeutic intervention aimed at preventing recurrence and improving long-term outcome. The objective of this study was to determine the risk factors, clinical outcome of stroke in children and to evaluate any association between them.Methods: This was a prospective, observational study, conducted over one and a half year at a tertiary care centre. Children between 1 month to 12 years and diagnosed to have stroke were enrolled. The clinical profile, investigations and outcome of stroke were studied. Data collected was analysed using Pearson chi-square test.Results: Of 55 children enrolled, definite etiology could be determined in 44 (80%) children. The common risk factors identified were vasculitis (30.9%), vasculopathy (23.6%), hypercoagulable states (18.1%), cardiac diseases (12.7%) and bleeding diathesis (7.2%). Focal neurologic deficits (69%), convulsions (58%), altered sensorium (41.8%), fever (45.4%) and aphasia (34.5%) were the chief presenting features. The overall mortality was 30.9% and neurologic deficits were observed in 54.5%. Children with undetermined etiology had a favorable outcome compared to those with definite etiology (p=0.007). Poor outcome was witnessed with vasculitis and cardiac diseases; recurrence was common with Moyamoya disease. Presence of either of altered sensorium (p=0.0005) or convulsions (p=0.046) or visual complaints (p=0.032) or headache (p=0.042) were associated with poor outcome whereas presence of focal neurologic deficits alone predicted a better outcome (p=0.036).Conclusions: The nature of risk factor and the clinical presentation significantly influence the outcome of stroke in children.
      PubDate: 2019-06-27
      DOI: 10.18203/2349-3291.ijcp20192574
      Issue No: Vol. 6, No. 4 (2019)
       
  • Clinical profile and renal complications among cases of malaria in
           children attending a tertiary care hospital of South India

    • Authors: Tenali Ravi Kumar, Sai Lakshmi Ananya Tenali
      Pages: 1445 - 1449
      Abstract: Background: Malaria is one of the major vectors borne disease globally responsible for 1 million deaths a year. Changing trends in the causative species and epidemiological distribution have identified icterus and renal involvement as an emerging complication associated with severe mortality in children. The objectives of this study were aimed to study the clinical profile of malaria cases admitted in a pediatric ward. The study also highlights the involvement of renal manifestations in the cases with regard to species distribution and associated complications in the study group.Methods: A prospective study for 14 months was conducted, and all positive cases of malaria admitted in paediatric unit were enrolled and socio demographic data, clinical history were collected, and biochemical investigations were performed and analyzed. SPSS software version 12 was used for analysis. Statistical significance was set at p ≤0.05.Results: About 278 subjects with 55.4% males, 44.6% females and with 5-10 years was most common age group. 102 cases of vivax malaria, 152 cases were falciparum and 24 were mixed cases. Cerebral malaria, hyperparasitemia was identified in 28 cases, DIC in 5.04% of cases. Renal involvement was observed in 38.16% of falciparum infections and 27.45% of vivax infections. 68 cases developed acute renal failure as a severe complication.Conclusions:  Renal involvement is more in falciparum and mixed infections than vivax malaria. Early diagnosis and prompt treatment help in early recovery of cases and halts to progression to renal failure. An urgent need for a biomarker for early identification of renal involvement in malaria before biochemical involvement is detected.
      PubDate: 2019-06-27
      DOI: 10.18203/2349-3291.ijcp20192056
      Issue No: Vol. 6, No. 4 (2019)
       
  • Clinical profile of children with tuberculosis from a semi urban referral
           centre in South India: a prospective observational study

    • Authors: Anuradha G., Muraleetharan G.
      Pages: 1450 - 1455
      Abstract: Background: Global TB report 2018 reports that in India, an estimated 2.2 lakh children become ill with tuberculosis (TB) each year. In spite of new rapid diagnostic methods, lack of gold standard test for confirming childhood tuberculosis remains an obstacle for the effective reporting of childhood TB and hence these cases often remain under diagnosed. The main objective was to study the clinical profile of childhood tuberculosis with relevant laboratory investigations aiding in early diagnosis.Methods: A prospective observational hospital-based study was conducted in IRT-Perundurai medical college hospital from April 2016 to March 2018. Children less than 18 years of age with tuberculosis were included in the study. Demographic details, presenting symptoms, family history of TB contact, nutritional status and clinical examination findings were documented. Complete blood count, ESR, Mantoux test, chest X-ray and sputum analyses for AFB were done for all patients.Results: Out of the total 124 children studied, the most common age of presentation of tuberculosis was >10 years of age (n=58, (46.8%)). There was a female preponderance (n=71 (57.25%)). Pulmonary tuberculosis (n= 87, (70.16%)) was the most common form followed by extra pulmonary (n=32, (25.80%)) and disseminated type (n=5, (4%)).  Lymph node TB was the most common manifestation (n=20, 62.50%) among extra pulmonary form. Cough (n=75, 60.5%) with sputum (n=55,44.4%) were the predominant symptoms noted followed by fever (n=53, 42.7%). Bacteriological diagnosis was possible in 19.5% (n=17) patients only.Conclusions: This study reinforces that the diagnosis of childhood tuberculosis is based on the constellation of symptom evaluation, contact history, clinical examination, with relevant laboratory investigations.
      PubDate: 2019-06-27
      DOI: 10.18203/2349-3291.ijcp20192127
      Issue No: Vol. 6, No. 4 (2019)
       
  • Clinical profile and short-term outcomes in neonates with septic shock

    • Authors: C. Sai Sujana, R. J. Meshram, B. B. Lakhkar
      Pages: 1456 - 1460
      Abstract: Background: Neonatal sepsis is a syndrome causing severe organ dysfunction triggered by a dysregulated host in response to an infection, affecting millions of neonates. In such situations, early identification and management in the initial hours dramatically improves the outcome. Hence, it was taken up to study the incidence, clinical profile and short-term outcomes of neonates with septic shock.Methods: Hospital based prospective observational study on 95 neonates admitted to neonatal intensive care unit in the department of Paediatrics at Acharya Vinobha Bhave rural hospital, Sawangi, Wardha from 1st August 2016 to 31st July 2018.Neonates diagnosed with septic refractory shock were enrolled after taking IEC approval and assent form and those with non-septic aetiology shock were excluded. Statistical analysis was done to establish correlation between neonatal variables and outcome.Results: 95 neonates fulfilled the inclusion criteria and were recruited. Out of these, 37 and 53 were outborn and inborn respectively. Maximum neonates were preterm and males. Neonates with birth weight 1000-1499 grams to those less than 1000 was 4.2:1. Normal vaginal delivery was more common as compared to lower segment caesarean section (LSCS). Blood culture positivity was in 44.2%. Age of presentation with shock ranged from 1 to 20 days and duration of shock ranged from 2 hours to 192 hours. Most infants were ventilated (84%) and it was more among those who died.Conclusions: Septic shock is the most common type, carrying high morbidity and mortality (more than 60%). Laboratory and clinical parameters (TLC, Platelet count, CRP, Blood culture, duration of shock, HR, RR, BP or arterial blood gas) (p>0.05) did not carry a prognostic value in predicting the outcome of such neonates. Early identification and intervention remains the key in managing such a challenging neonatal condition.
      PubDate: 2019-06-27
      DOI: 10.18203/2349-3291.ijcp20192171
      Issue No: Vol. 6, No. 4 (2019)
       
  • Pediatric risk of mortality III score in predicting mortality in children
           with altered sensorium in pediatric intensive care unit

    • Authors: S. Vijayaraghavan, R. Sasivarathan
      Pages: 1461 - 1465
      Abstract: Background: The Pediatric Risk of Mortality (PRISM) Score has been devised to predict outcome and risk of mortality. The PRISM III score is one of the most recent scoring systems of pediatric mortality. This was developed involving 32 PICUs. Physiological data included the most abnormal values from the first 12 and second 12 hours of the PICU stay. To evaluate the mortality rate in children with altered sensorium by applying PRISM III (pediatric risk of mortality) score.Methods: This study was done in the paediatric intensive care unit of the Department of Paediatrics, Government Mohan Kumaramangalam Medical College Hospital, Salem, Tamil Nadu, India on 100 children of both sexes aged between 1 month and 13 years. The study was carried out for a period from December 2017 to July 2018. PRISM III scoring scale was applied for every child in his/her first 24 hours of PICU admission and their calculated score was recorded into the proforma. The clinical details at admission, laboratory data were recorded into the proforma.Results: Three major groups that contributed to the bulk of the admissions were acute CNS infection, seizure disorder and, bites and stings. They constituted to around 54% of our total admissions. As PRISM III Score increases there is a steady increase in the mortality rate. This table shows that the mortality rate is 0% for the 0-9 group and that it increases to 100% for 20-29 and 30 and above groups as the PRISM III score increase.Conclusions: PRISM III score provides an objective assessment of the severity of illness. PRISM III, when performed well, is good to predict mortality in an Indian PICU. Scoring systems with fewer laboratory parameters will be more useful in author’s context. Larger studies are needed to develop/validate a mortality prediction score for our country.
      PubDate: 2019-06-27
      DOI: 10.18203/2349-3291.ijcp20192604
      Issue No: Vol. 6, No. 4 (2019)
       
  • Assessment of existing referral system of newborn in Madhya Pradesh, India

    • Authors: Avadhesh Verma, Ajay Gaur, Ravi Ambey
      Pages: 1466 - 1471
      Abstract: Background: Objectives of present study was to assess receiving system of newborns, bed occupancies of referring facilities and receiving facility and assessment of rationality of referrals made by referring facilities to receiving facility leading to congestion at receiving facility. The study was conducted in Department of Pediatrics, Special Newborn Care Unit, Kamla Raja Hospital, Gajra Raja Medical College, Gwalior, Madhya Pradesh.Methods: This study was a prospective observational study which was conducted for a period of one year. Referred newborns fulfilling inclusion criteria were enrolled in study, and their receiving characteristics, bed occupancies of referring facilities and receiving facility, number of rationale and irrational referrals at receiving facility were statistically analysed.Results: Total referred newborns enrolled in the study was 2000. As receiving SNCU, of institute caters not only its nearby places, but also to distant districts of Madhya Pradesh, Rajasthan and Uttar Pradesh. SNCU wise receiving was in order of SNCU Morar (20.60%), Morena (19.40%), Bhind (5.70%), Dholpur (5.35%), Shivpuri (4.40%), Chattarpur (3.10%), Datia (1.20%), Sheopur (0.40%) and Jhansi (0.30%). Referring SNCU wise bed occupancy was in order of SNCU Guna (189.16%), Shivpuri (154%), Morena (72.33%), Bhind (71.63%), Sheopur (69.32%), Morar (64.15%) and Datia (62.11%). Referring SNCU wise case fatality was in order of SNCU Jhansi (100%), Sheopur (100%), Chattarpur (56.45%), Bhind (38.59%), Shivpuri (35.22%), Morena (33.76%), Dholpur (27.10%), Datia (25%), Morar (22.08%).Conclusions: Discordant bed occupancy at referring SNCU and receiving SNCU and low rationality of referrals are reason for congestion at receiving SNCU. Optimum utilization of beds and cordant bed occupancy between referring and receiving SNCU may improve the working conditions in SNCU and newborn outcome. Referral system should be close loop systemwith the provision of Down Referral.
      PubDate: 2019-06-27
      DOI: 10.18203/2349-3291.ijcp20192632
      Issue No: Vol. 6, No. 4 (2019)
       
  • Demography, clinical profile, morbidity and mortality pattern of snake
           bite cases in children: a study at tertiary teaching hospital

    • Authors: Vishwanath B., Ganesh P.
      Pages: 1472 - 1475
      Abstract: Background: Snake bite is one of the important health problems in tropical and sub-tropical countries including India. Most snake bites present without envenomation as most bites are usually due to non-poisonous snakes and even poisonous snakes can control amount of venom injected. Even though mortality is under reported, India accounts for most of deaths due to snake bite.Methods: A hospital based descriptive case study was conducted at Pediatric ward of VIMS Ballari. All children with definite history of snake bite with fang marks or features of local/systemic envenomation were included in study. Demographic parameters, symptomatology and complications were noted down as per pro forma and data was analyzed.Results: Most bites occurred in lower limbs in older children while playing outdoors. Most cases were from rural area. Majority presented with local toxicity followed by hemotoxicity and neuroparalysis. Two children died, one because of respiratory paralysis and other by acute kidney injury.Conclusions: Snake bite is a preventable health problem. By wearing protective shoes and avoiding outdoor sleep many snake bites can be avoided. Early, aggressive but judicious use of antisnake venom is a cornerstone of management.
      PubDate: 2019-06-27
      DOI: 10.18203/2349-3291.ijcp20192575
      Issue No: Vol. 6, No. 4 (2019)
       
  • Study on therapeutic effectiveness of continuous positive airway pressure
           compared to mechanical ventilation in preterm babies with respiratory
           distress

    • Authors: Kirankumar Harwalkar, Babalala Kadegaon
      Pages: 1476 - 1479
      Abstract: Background: Previously mechanical ventilation was primary modality of treatment in preterm neonates with respiratory distress. With the introduction of continuous positive airway pressure (CPAP), the need of mechanical ventilation is reduced. The present study was done to know the therapeutic effects of CPAP as compared to mechanical ventilation in preterm neonates with respiratory distress. To study the duration of oxygen requirement and duration of hospitalisation in preterm neonates treated with CPAP compared to invasive mechanical ventilationMethods: Hospital based prospective study was conducted from November 2013 to November 2014 in Dr. B. R. Ambedkar medical college, Bangalore. All the preterm babies admitted in neonatal intensive care unit with respiratory distress requiring CPAP or mechanical ventilation during study period were included. Total 50 cases were included, out of which 20 (40%) were on CPAP treatment and 30 (60%) were on mechanical ventilation. Outcome was assessed by reduction of respiratory distress with SpO2 more than 88% with FiO2 of 21%.Results: Out of 50 preterm neonates studied, 20 (40%) were on CPAP treatment and 30 (60%) were on mechanical ventilation. Mean duration of oxygen treatment was less in neonates on CPAP (4.8±0.9 days) compared to mechanical ventilated neonates (7.12±0.8days) and it is statistically significant (p value<0.05). Mean duration of hospitalisation was less in neonates on CPAP (19.3±0.76 days) compared to mechanical ventilated neonates (21±1.2 days) but it was statistically not significant (P value >0.05).Conclusions: CPAP as a mode of treatment for preterm babies with respiratory distress reduces the duration of oxygen dependency compared to invasive mechanical ventilation. Difference in duration of hospital stay was statistically not significant in these neonates treated with CPAP and mechanical ventilation.
      PubDate: 2019-06-27
      DOI: 10.18203/2349-3291.ijcp20192585
      Issue No: Vol. 6, No. 4 (2019)
       
  • Serum zinc levels in children with simple febrile seizures

    • Authors: Malavika P. Santappanawar, Habeeb U. Khan, Jaidev M. Devdas, Sujonitha John, Pavan Hegde
      Pages: 1480 - 1484
      Abstract: Background: Febrile seizures are the most common seizures in childhood and are often associated with nutritional deficiencies. The present study was done to find any correlation of serum zinc levels in children with simple febrile seizures.Methods: This study was a hospital based prospective case control study, involving 60 children (30 cases and 30 controls) aged between 6 months to 60 months. Serum zinc level was measured in all subjects by atomic absorption spectrophotometer. Data was analysed by using frequency, percentage and Pearson’s chi square test..Results: Most cases (80%) had serum zinc levels <90 mcg/dl, in comparison with children in the control group where only 30% had serum zinc levels <90 mcg/dl. The mean serum zinc level was 78.9±14.26 mcg/dl in cases with simple febrile seizures and 96.7±12.12 mcg/dl in the control group.Conclusions: The mean serum zinc level was significantly lower in children with simple febrile seizures in comparison with controls.
      PubDate: 2019-06-27
      DOI: 10.18203/2349-3291.ijcp20192173
      Issue No: Vol. 6, No. 4 (2019)
       
  • A study of neonatal morbidity and mortality in government general
           hospital, Srikakulam Andhra Pradesh, India

    • Authors: Gunasekhar Raju S., Somasekhara Rao S.
      Pages: 1485 - 1490
      Abstract: Background: Four million newborn babies die in the neonatal period, India 1.2 million neonatal deaths every year. India contributes for a quarter of global neonatal deaths and thus faces the biggest newborn health challenge of any country in the world. The aims of the study were done with the objective to conclude the morbidity and mortality pattern of neonates admitted to a neonatal intensive care unit (NICU).Methods: Hospital based prospective study was conducted at NICU Government Medical Collage, Srikakulam, Andhra Pradesh, India. Neonates from admission to discharge flowed, LAMA or death collecting the data by using a predesigned standardized preform.Results: Neonates were admitted in the NICU during period April 2014 to March 2019. The data analysis for the morbidity showed that the neonatal jaundice (NNJ) were 765(10.57%) , septicemia were 1110 (15.34%), prematurity were 593 (8.19%), birth asphyxia were 963 (13.30%), respiratory distress syndrome (RDS) were 184 (2.54%),hypoxic ischemic encephalopathy (HIE) were 984 (8.46%), meconium aspiration syndrome (MAS)were 612 (8.46%),transient tachypnea of neonate (TTN) were 634 (8.76%), low birth weight (LBW) were 418 (5.77%), intra uterine growth retardation (IUGR) were 179 (2.47%), congenital anomalies were 131 (1.81%), meningitis were 83 (1.15%), seizure disorder were 49 (0.68%) and others. The disease wise mortality among the neonates admitted to NICU was studied and were found that prematurity 212 (35.75%), septicemia were 74 (6.67%), birth asphyxia were 91 (21.70%), meconium aspiration syndrome were 70 (11.44%) and respiratory distress syndrome were 66 (35.87%), low birth weight were 102 (24.40%) congenital anomalies were 31 (23.66%) the top major contributors to the neonatal mortality.Conclusions: The commonest causes of admission were neonatal jaundice (NNJ), sepsis, prematurity, meconium aspiration syndrome, birth asphyxia, low birth weight, congenital anomalies. The most common cause of case fatality was prematurity, meconium aspiration syndrome, birth asphyxia, low birth weight, congenital anomalies in NICU in a tertiary care teaching hospital, government medical college, Srikakulam, Andhra Pradesh, India.
      PubDate: 2019-06-27
      DOI: 10.18203/2349-3291.ijcp20192573
      Issue No: Vol. 6, No. 4 (2019)
       
  • Epidemiological and clinical profile of dog bitten children and side
           effects of anti rabies vaccine

    • Authors: P. Ramkumar, S. Balamurugan
      Pages: 1491 - 1495
      Abstract: Background: Rabies is one of the commonest zoonotic diseases due to Lyssa virus. Rabies is a 100% fatal disease. Understanding the epidemiological and clinical profile of the victims helps in the prevention of dog bite. But rabies is 100% preventable by pre and post exposure prophylaxis vaccination. Evaluation of side effects of anti-rabies vaccine (ARV) is helpful in the pre and post exposure prophylaxis.Methods:
      Authors did a descriptive study of 1450 dog-bitten children. Using the pro-forma, authors interviewed the parents, examined the children. Using W.H.O classification, authors classified the dog bite wounds. Anti-rabies vaccination was administered to category 2 dog bite wounded children. Side effects of vaccination are recorded.Results: Out of 1450 children, significantly more number of boys (67%) in the age group of 10-12 years (31%), from class IV socioeconomic category (52%), nuclear families (80%), sustained category III dog bite (52%) in the lower limb (48%) by unvaccinated (82%) stray dogs (60%) while playing or walking (52%) in the street (60%) during night (72%). Purified Vero cell culture rabies vaccine is having rare mild local side effects (2%), rare mild systemic side effects (4.16%) and very rare systemic allergic reaction (0.14%) but no major side effects.Conclusions: Dog bites can be prevented by not allowing the children to play or walk alone in the street especially during night. The severity of wound can be minimized by wearing fully covered extremities. Vaccination of dogs and population control of stray dogs will reduce rabies. There were no major side-effects or adverse events following vaccination (AEFI) with anti-rabies vaccination. Rare mild local side effects and very rare mild systemic side effects may happen.
      PubDate: 2019-06-27
      DOI: 10.18203/2349-3291.ijcp20192167
      Issue No: Vol. 6, No. 4 (2019)
       
  • Etiological factors and clinical profile of acute respiratory distress in
           children age group 2 months to 2 years and prevalence of respiratory
           syncytial virus in the study population

    • Authors: A. Logesh Anand, S. Vijayaraghavan
      Pages: 1496 - 1500
      Abstract: Background: Acute lower respiratory tract infections are a common cause of morbidity and mortality in children. Respiratory infections in infants and small children are of great importance because of small airways. Infection may cause a further narrowing and may lead to respiratory distress. To evaluate the etiological factors, clinical profile and outcome of acute respiratory distress in the age group 2 months to 2 years.Methods: This study was conducted in the Paediatric department of Government Mohan Kumarmangalam medical college hospital, Salem, Tamil Nadu, India in the year September 2017-March 2018. Totally 183 cases of acute respiratory distress children were included in the study. A thorough clinical examination was done at the time of admission and management details were recorded into the proforma. Respiratory distress is defined as per WHO protocol as respiratory rate more than 50/minute in infants from 2 months to 12 months of age, and more than 40/minute in children from 13 months to 24 months of age.Results: Of the 72 cases of bronchiolitis, 32 cases (44%) tested positive for IgM at the time of admission and no cases in the control population tested positive for IgM. Of the 72 cases of bronchiolitis in the study population, 52 cases (72%) tested positive for ELISA IgG at the time of admission and 2 cases among the controls tested positive for ELISA IgG.Conclusions: Pneumonia was the most common cause of respiratory illness in the study population. Overcrowding was the major risk factor contributing to acute respiratory illness. Incidence of acute respiratory distress was high among undernourished children.
      PubDate: 2019-06-27
      DOI: 10.18203/2349-3291.ijcp20192603
      Issue No: Vol. 6, No. 4 (2019)
       
  • Prevalence of hearing loss among preschool children in Hanoi, Vietnam

    • Authors: Nguyen Tuyet Xuong, Van Dinh Tran
      Pages: 1501 - 1505
      Abstract: Background: Hearing loss in children is a common entity worldwide. This study examined the prevalence of hearing loss among preschool children in Hanoi, Vietnam.Methods: A cross sectional was conducted among pre-schoolers aged 2-5 years in Hanoi, Vietnam to determine the prevalence of hearing loss according to the method recommended by the Joint Committee on Infant Hearing (JCIH): a two-step Automated Oto-Acoustic Emissions (AOAE) program, completed by an Auditory Brainstem Response (ABR) for the positive diagnosis of hearing impairment.Results: In total, there were 7,191 preschoolers and kindergarten screened. Three hundred and thirty-seven (4.7%) of children screened failed and were referred for further testing. The percentage of children with true hearing loss was 4.4% confirmed by ABR test. Majority of the hearing loss children was conductive hearing loss (70.4%). Mild hearing loss (21–≤40 dB) accounted for almost half of the children with hearing loss.Conclusions: This study provides the first estimates of audiometrically measured hearing loss prevalence among preschool children in Hanoi, Vietnam. The study found that hearing loss is common among pre-primary school children in the country. Routine hearing screening of school-age children should be included in annual school health programs in Vietnam.
      PubDate: 2019-06-27
      DOI: 10.18203/2349-3291.ijcp20192623
      Issue No: Vol. 6, No. 4 (2019)
       
  • A study on clinical profile of tuberculosis in HIV children

    • Authors: M. Nirmala, V. Narmadha
      Pages: 1506 - 1509
      Abstract: Background: Children born to Human immunodeficiency virus (HIV) positive parents who are not infected with tuberculosis (TB) themselves, are also at higher risk of acquiring TB because of exposure. The source of transmission of TB to a child is usually an adult with sputum-smear positive PTB. To evaluate the clinical, bacteriological and radiological pattern of TB in HIV seropositive children in correlation with CD4 count.Methods: This study was conducted over a period of 12 months from May 2008- April 2009 at GMKMCH Salem. 100 children screened positive for HIV at voluntary counselling and testing centers (VCTC) in Antiretroviral therapy (ART) center and diagnosed to have TB infection as per Revised national tuberculosis control programme (RNTCP) guidelines.Results: Out of the 100 children with HIV and TB infection 62 were males and 38 were females. The ratio was 1.63:1. The sputum positivity in our study shows that only 9% of the children are sputum positive. Sputum culture for M. Tuberculosis remains the gold standard for the diagnosis of Pulmonary TB. In resource-poor countries, the diagnosis is heavily dependent on the sputum AFB smear. In our study CD4 cell count, less than 300 was observed in 33 children. In these children the predominant X-ray lesions were Hilar adenopathy, lower lobe infiltrations, diffuse infiltrates and miliary mottling. Upper lobe infiltrates was common with higher CD4 count mean 350.Conclusions: With the conventional sputum positivity and Tuberculin test not providing an adequate diagnostic help, familiarity with clinical radiological spectrum of TB and HIV co-infection will help in early diagnosis and improve survival among HIV seropositive children.
      PubDate: 2019-06-27
      DOI: 10.18203/2349-3291.ijcp20192169
      Issue No: Vol. 6, No. 4 (2019)
       
  • Correlation of decayed, missing and filled teeth with risk factors for
           dental caries in children attending outpatient department in tertiary care
           hospital

    • Authors: V. Arunagirinathan, P. Venkatesh
      Pages: 1510 - 1514
      Abstract: Background: Oral health is of vital importance to humans’ general health. Despite the marked improvement in oral health, caries occurs in both developed and developing countries worldwide. The patient’s age is important for determining caries risk. Special attention must be paid to children’s oral health when deciduous teeth start erupting and occlusion has formed in 2 to 3-year-old children. To assess the correlation of decayed, missing and filled teeth (dmft/DMFT) with risk factors for dental caries in children and with knowledge, attitude, and practices of parents regarding dental caries.Methods: Cross-sectional study included 96 children with dental caries attending paediatric outpatient department of Government Stanley Medical College, Chennai, Tamil Nadu, India between 2018 March to November. Clinical evaluation, dmft score, and knowledge, attitude and practices of parents were assessed using pre-formed questionnaire.Results: Patients with high dmft score were found to have low practice score with the Pearson correlation coefficient(r) value -0.41 and P value was 0.01. Corresponding values of knowledge and attitude were not statistically significant. Children who nap/sleep with bottle/pacifier have increased risk (P value-0.01).Conclusions: An oral health risk assessment should be done periodically by Paediatrician who has regular contact with children for early identification of dental caries, to impart healthy oral practices and make them aware of preventive measures.
      PubDate: 2019-06-27
      DOI: 10.18203/2349-3291.ijcp20192172
      Issue No: Vol. 6, No. 4 (2019)
       
  • Etiological factors, clinical profile and outcome of meconium aspiration
           syndrome babies

    • Authors: R. Sasivarathan, A. Logesh Anand
      Pages: 1515 - 1518
      Abstract: Background: Meconium staining of amniotic fluid has for long been considered to be a bad predictor of the fetal outcome because of its direct correlation of fetal distress, and increased the likelihood of inhalation of meconium, resultant deleterious effects on the neonatal lung. To evaluate etiological factors and severity of MAS in the study group.Methods: This study was done in the Neonatal intensive care unit of the Department of Paediatrics, Government Mohan Kumaramangalam Medical College Hospital Salem, Tamil Nadu, India in the year 2018. Complete maternal and neonatal details were recorded in to the proforma. Delivery details, resuscitation did were also recorded.Results: In present study, fetal distress was found to be the most common (42.5%) factor associated with MAS followed by PIH (21.6%) and PROM (17%). 22 (9.1%) cases were associated with Postdatism, 18 (7.5%) cases were associated with placental insufficiency. 88 babies had fetal distress (36.6%) prior to delivery. 138 babies had no fetal distress (57.5%).Conclusions: MAS is known to cause severe respiratory distress and Downe’s score ranging between 4-8, usually a few hours after the onset of respiratory distress. Nearly 73.3% of the cases with MAS had birth asphyxia, out of which 30% had severe birth asphyxia. This indicates that passage of meconium can occur in utero, often considered a feature of the stressed fetus. Undoubtedly aspiration had occurred before delivery in these babies.
      PubDate: 2019-06-27
      DOI: 10.18203/2349-3291.ijcp20192605
      Issue No: Vol. 6, No. 4 (2019)
       
  • Clinico-hematological study of abnormalities of platelet count in children
           with iron deficiency anemia

    • Authors: Sanghamitra Ray, Jagdish Chandra, Sunita Sharma
      Pages: 1519 - 1523
      Abstract: Background: Iron deficiency anemia is a major cause of morbidity in developing countries like India. The aim of the study was to assess abnormalities of platelet count in iron deficiency anemia and to relate the severity of thrombocytosis with severity of anemia and its association with erythropoietin (EPO) level.Methods: A prospective observational study comprising of 200 children below 18 years confirmed to have IDA. Erythropoietin (EPO) level was done in patients who had thrombocytosis. Degree of thrombocytosis was correlated with EPO and also with ferritin, haematological indices like hemoglobin and MCV (mean corpuscular volume) and blood counts were followed up while on iron therapy for one month.Results: Thrombocytosis was noted in 24.5%. In 75.5% thrombocytosis was mild. Platelet had negative correlation with Hb (hemoglobin). EPO was elevated in 67.35% of thrombocytosis. EPO showed negative correlation with Hb and Ferritin and positive correlation with platelet however, these were non-significant. All patients were treated with standard preparation of ferrous fumarate (33mg elemental iron every 5 ml) in a dose of 3mg/kg/day of elemental iron along with appropriate dietary advice.  On one month follow up 92% of the study population showed normalization of platelet count.Conclusions: Nearly One-fourth of children had thrombocytosis. Platelet count was inversely related to Hb and ferritin level. EPO was increased in two-third cases of thrombocytosis and showed positive correlation with platelet count. As authors excluded patients with severe IDA requiring blood transfusion, authors did not get any thrombocytopenia in present study.
      PubDate: 2019-06-27
      DOI: 10.18203/2349-3291.ijcp20192748
      Issue No: Vol. 6, No. 4 (2019)
       
  • Correlation of risk factors with Glasgow coma scale to predict the
           severity and outcome of children with non-traumatic coma

    • Authors: A. Manikanteswara Reddy, G. Sreedhar, Gangadhar B. Belavadi
      Pages: 1524 - 1528
      Abstract: Background: Non-traumatic coma is the problem of pediatric group, accounts 10-15% in hospital admissions. Assessment of the severity of coma is useful to speculate the survival. The aim was to assess outcome in pediatric non-traumatic coma with role of Glasgow coma scale and modified Glasgow coma scale.Methods: Total of 80 cases of non-traumatic coma between 1 month to 12 years, coma severity was assessed by using Glasgow coma scale. A score of less than 8 and more than 8 were used for analysis of outcome.Results: The maximum number of patents with non-traumatic coma were in the age group of 1 month-5 years, 40 children (50%). On neurological examination 42 (52.5%) children has GCS score of >8, 38 cases (47.5%) has GCS <8, 20 children had meningeal signs, 7 children had cranial nerve deficit (7th nerve), 9 children had decebrate posture. Out of 80 cases, 8 cases expired (10%), 4 cases were discharged against medical advice (4%), 68 cases were improved and discharged (85%), among these, 8 cases were discharged with complication (11.7%). Overall mortality was (10%) (8/80), males outnumbered females in frequency with ratio of 1.28:1. CNS infection accounted for almost about 66%.Conclusions: Children with GCS and MGCS scores of less than 8 have poor prognosis and a very high probability of death. Those with GCS score of more than 8 have good prognosis. Identification of these cases at the outset can help prepare the treating physician to plan critical care referral and to give a preliminary assessment of outcome to the family.
      PubDate: 2019-06-27
      DOI: 10.18203/2349-3291.ijcp20192749
      Issue No: Vol. 6, No. 4 (2019)
       
  • Effect of music therapy intervention in pain reduction during venepuncture
           in neonates

    • Authors: S. Ragasivamalini, N. S. Ragupathy
      Pages: 1529 - 1532
      Abstract: Background: Neonates in a neonatal intensive care unit are exposed to a high number of painful procedures. Since repeated and sustained pain can have consequences for the neurological and behavior‐oriented problem in the future. Non‐pharmacological treatment methods are being increasingly discussed with regard to pain prevention and relief during mild or moderate procedures. The aim of this study was to identify effectiveness of music therapy interventions on pain reduction during venipuncture in neonates.Methods: Total of 60 neonates undergoing venepuncture in the postnatal ward was included in this study. They were divided into the music group (n-30) and control group (n-30) by convenient sampling method. The neonates in music group were exposed to pre-recorded lullaby 5 minutes before starting the venepuncture and during the procedure of venepuncture. The NPASS was done 5 minutes before, during and 5 minutes after the procedure.Results: Compared to the control group neonates, music group neonates showed significantly (P <0.05) less pain perception during intravenous needle puncture. The results showed that music group neonates have significantly less score of NPASS than control group neonates (P<0.001) all five domains.Conclusions: Hence for routine painful procedures like venepuncture, music therapy could be helpful in neonates in reducing the pain perception. Further studies are needed to validate our findings in large sample with proper study design in future.
      PubDate: 2019-06-27
      DOI: 10.18203/2349-3291.ijcp20192750
      Issue No: Vol. 6, No. 4 (2019)
       
  • Changes in the physiological parameters of newborns in the first one hour
           of life

    • Authors: Shasidhar Reddy Y., Abdul Mohid Syed, Gangadhar B. Belavadi
      Pages: 1533 - 1544
      Abstract: Background: The transition from a fetus to a newborn is the most complex adaptation that occurs in human experience. This study assessed three physiological parameters viz. temperature (core and peripheral), oxygen saturation and heart rate so as to avoid the delay in normal transitional adaptation.Methods: This cross-sectional observational study was done at Narayana Medical College Hospital, Nellore, Andhra Pradesh, India. A total of 150 neonates born from June 2017 to February 2018 were monitored for heart rate, oxygen saturation, core and peripheral temperature from birth to 60 minutes.Results: Most of the mother’s (45.33%) were aged between 22 to 25 years and the mean age was 23.75±3.64 years. History of consanguineous marriage was noted in 33.33%. The mode of delivery was vaginal in 70.67% of the babies. The mean gestational age was 38.74±1.36 weeks. The birth weight among 62% of the babies was between 2.5 to 3.49 Kgs and mean birth weight was 2.81±0.49 kgs. The meconium stained liquor and requirement of resuscitation was noted in 9.33% and 10.67% respectively.Conclusions: Significant difference was noted with regard to heart rate in babies with active resuscitation, low birth weight (<2.5 kg), meconium stained liquor and warmer care compared to normal babies. There was variation in oxygen saturation in babies who required resuscitation and warmer care, and those who had low birth weight. The mean peripheral and core temperature were different in babies with abdominal care compared to warmer care.
      PubDate: 2019-06-27
      DOI: 10.18203/2349-3291.ijcp20192751
      Issue No: Vol. 6, No. 4 (2019)
       
  • Efficacy of gene xpert over other diagnostic modalities of tuberculosis
           among children

    • Authors: Deepmala Pandey, Ankur Yadav
      Pages: 1545 - 1551
      Abstract: Background: Diagnosis of tuberculosis is a challenge especially among children. GeneXpert has been recommended as a diagnostic test in children. Objectives of this study was to efficacy of GeneXpert over other diagnostic modalities of Tuberculosis like Sputum smear microscopy, Mantoux testing, X-ray chest among children.Methods: A cross sectional hospital-based study was conducted over a period of 24 months among 150 children. All the patients who were having suspicion of Tuberculosis on the basis of History & Examination (fulfilling inclusion criteria) had been enrolled in the study. After doing all preliminary investigations clinical diagnosis has been made and Gene X’pert was carried out for all the samples collected. Pearson chi square test and Fishers exact test was applied wherever appropriate.Results: There was statistically no significant (p >0.05) difference of GeneXpert positivity within different age groups of Suspected TB patients. GeneXpert was positive in 80% with symptom of Cough lasting more than 2 weeks, in 78.8% with fever more than 2 weeks, in 88.9% with FTT, in 76.5% with H/O Koch’s contact, in 77.8% with H/O convulsion, in 69% with significant lymphadenopathy. GeneXpert was positive in all suspected TB patients having ZN staining positive for AFB. In clinically TB diagnosed patients, 86.5% were positive for GeneXpert.Conclusions: GeneXpert is a novel diagnostic modality of choice in all suspected Pulmonary & Extra-pulmonary TB cases among children. It can be used as a primary tool in Pulmonary TB with smear negative samples in pediatric age group.
      PubDate: 2019-06-27
      DOI: 10.18203/2349-3291.ijcp20192752
      Issue No: Vol. 6, No. 4 (2019)
       
  • Splenomegaly in children

    • Authors: Milind B. Kamble, Kunj Bihari Meena, Vimla Kumari Meena
      Pages: 1552 - 1556
      Abstract: Background: Splenomegaly occurs when the size of the spleen is increased by cells or tissue components or by vascular engorgement. In childhood, it is generally first suspected upon physical examination. The aim of the present study was to find out the prevalence and possible cause of splenomegaly in children admitted in pediatric ward and NICU at tertiary care center.Methods: In this study, total 124 children of age between 0-12 years with clinically palpable splenomegaly, admitted to the wards were studied during the period of 18 months. A detailed history, thorough clinical and all relevant investigation was done. The enlargement of the spleen was graded as per Hacketts and conventional classification. The prevalence, cause of splenomegaly and outcome of the study was noted.Results: The prevalence of splenomegaly was 1.46%. Most common grade of splenomegaly was grade III (33%) of Hackett’s classification. The most common presenting symptom was fever (75%) and sign was pallor (97%). Most common cause of splenomegaly was hemolytic anemia (80.64%) among which thalasemia was 50% followed by sickle cell anemia 30.64%. Out of 124 patients, 123 (99.1%) received medical treatment while only one patient (0.9%) underwent surgical treatment. Among medically treated patients 18 (14.5%) were recovered completely while 100 (80.6%) improved and 4 (3.2%) stable and two patients were (1.6%) died.Conclusions: In patient with grade III, IV, and V of splenomegaly is more likely to have hemolytic anemia as common etiology and hematological investigation should be given more emphasis in a case of splenomegaly.
      PubDate: 2019-06-27
      DOI: 10.18203/2349-3291.ijcp20192753
      Issue No: Vol. 6, No. 4 (2019)
       
  • Pattern of adverse drug reactions in paediatric patients reported to
           adverse drug reaction monitoring centre in a tertiary care hospital

    • Authors: Veereswara Rao Kurma, Triveni Manchu, Meena Kumari Amancharla, Kalyani Manchu, Pavan Kumar Kandula
      Pages: 1557 - 1562
      Abstract: Background: Adverse drug reactions (ADRs) are an important cause of morbidity and mortality across the world and contribute to a significant economic burden on healthcare resources and community. In children, monitoring ADRs is essential as adequate clinical trials are lacking in this group. So, this study was undertaken to assess the ADR pattern in a paediatric population in a tertiary care hospital.Methods: A cross sectional, retrospective study was done at ADR monitoring centre (AMC) for a period of 3 years in a tertiary care hospital. All the ADRs reported by the Department of Paediatrics to AMC were collected and analyzed for age group affected, demographic profile, ADR pattern, drug group, systems affected, causality and severity of the ADR.Results: During the study period, a total of 102 ADRs were reported to the AMC from the paediatric department. Out of 102 ADRs reported, males represented 60.8% and females represented 39.2%. Maximum number of ADRs were seen in the age group of 1-5 years (43.3%). Most common ADR reported was maculopapular rash (27.5%) followed by diarrhoea (14.7%). The most common drug class causing ADRs are antibiotics (36.3%) followed by anticonvulsants (18.6%). Vaccines contributed to 14.7% of all reported ADRs. Majority of the ADRs were of probable (70.6%) causality and moderate (52%) in severity.Conclusions: ADRs were reported more among under 5 years of age and antibiotics were the common implicated causative agents. Most of the reactions were of moderate severity. Information acquired through ADR reporting may be useful in identifying and minimizing preventable ADRs and augmenting the knowledge of the prescribers to deal with ADRs more efficiently.
      PubDate: 2019-06-27
      DOI: 10.18203/2349-3291.ijcp20192754
      Issue No: Vol. 6, No. 4 (2019)
       
  • Association of gestational age, Apgar score and neonatal outcomes in
           newborns with meconium stained amniotic fluid

    • Authors: Preeti Garg, Devendra Barua, Shruti Saxena
      Pages: 1563 - 1566
      Abstract: Background: Infants born with meconium stained fluid are at increased risk of fetal hypoxia, evidenced by increased rates of abnormalities indicated by fetal monitoring in labor, low neonatal Apgar scores, and fetal deaths. The study is conducted to determine association of gestational age, Apgar score and neonatal outcomes in newborn born with meconium stained amniotic fluid in tertiary care centre of central India.Methods: The study was conducted over a period of 2 years from January 2012 to January 2014 in Department of Pediatrics, Sri Aurobindo Medical College and Hospital, Indore, Madhya Pradesh, India. One hundred newborns with meconium stained amniotic fluid (study group) and one hundred newborns with clear amniotic fluids (control group) were studied in this period. Gestational age, Apgar score and neonatal outcomes were compared among two groups.Results: The mean gestational age in study group was 38.89±1.14 weeks and in control group was 38.59±0.99 weeks. The mean Apgar score at 1 min was 5.80±1.59 in study group and in the control group was 7.86±0.35. 32 babies in meconium stained liquor had hypoxia of which 11 had respiratory distress, 11 required mechanical ventilation (MAS 08, sepsis 03), 2 newborns had HIE stage 2 and 5 patients died. The above findings suggest higher gestational age, lower Apgar score and poor neonatal outcomes are associated with meconium stained liquor.Conclusions: The study depicts significant co-relation with higher gestational age, lower Apgar at 1 and 5 minutes and poor neonatal outcome in babies with meconium stained amniotic fluid.
      PubDate: 2019-06-27
      DOI: 10.18203/2349-3291.ijcp20192755
      Issue No: Vol. 6, No. 4 (2019)
       
  • Analysis of complete blood counts in rotaviral gastroenteritis with
           special emphasis on platelet indices

    • Authors: Mahesh B. Maralihalli, Kavan R. Deshpande, Pallavi k Deshpande
      Pages: 1567 - 1570
      Abstract: Background: The objectives of this study was to analyze complete blood counts in rotaviral gastroenteritis with special emphasis on platelet indices.Methods: Children diagnosed as rotavirus gastroenteritis and healthy controls were enrolled in this study. Severity of acute gastroenteritis was classified into mild, moderate and severe grades using Vesikari score. Rotavirus was determined in fresh stool samples using rapid diagnostic rotavirus antigen test. Hemoglobin, leukocyte, neutrophil to lymphocyte percentage ratio, platelet counts, mean platelet volume (MPV), platelet distribution width (PDW) and platelet crit (PCT) levels were assessed for all children. It’s a case control study conducted at Pediatric Speciality Hospital.Results: There were 30 cases with mean age 1.58 years. Healthy controls were 30 with mean age 2.10 years. Mean Hb was lower in cases. Mean of platelet counts was higher in cases. Mean MPV levels was lower in cases. Mean PCT value was higher in cases. Mean MPV to platelet ratio value was lower in cases. All parameters values showed no significant difference among mild, moderate and severe groups of rotaviral gastroenteritis cases. Platelet count was negatively correlated with Hb, MPVP and positively correlated with TLC and PCT. MPV was positively correlated with MPVP and PDW. PCT was negatively correlated with Hb, MPVP and positively correlated with TLC and platelet count.Conclusions: MPV can be used as negative acute phase reactant in rotavirus gastroenteritis and so is the MPV to platelet ratio. Platelet count is acute phase reactant in rotavirus gastroenteritis and so is the platelet crit value.
      PubDate: 2019-06-27
      DOI: 10.18203/2349-3291.ijcp20192756
      Issue No: Vol. 6, No. 4 (2019)
       
  • A study on prevalence of symptomatic not confirmed pulmonary tuberculosis
           under 5 to 15 years of age in protein energy malnutrition children in a
           tertiary care centre

    • Authors: Sudhanshu Kumar Das, Monalisa Subudhi
      Pages: 1571 - 1574
      Abstract: Background: Tuberculosis (TB) and malnutrition are important causes of morbidity and mortality in  children, in developing countries. Tuberculosis  can be a  cause of  malnutrition in children and also a common cause of pneumonia  in such malnourished children. In the present study ,our aim is to know the  prevalence and early clinical diagnosis of symptomatic not confirmed TB, in recent challenging environment,  in protein energy malnutrition  children, this information would certainly help clinicians in early detection, diagnosis and management of PTB (Pulmonary Tuberculosis) in such populations ,to reduce morbidity and mortality.Methods: We prospectively investigated protein energy malnutrition children, with clinical features of tuberculosis, between 5 to 15 years of age , admitted during 18 months of study period. Clinical and demographic data  of studied children were collected. Anthropometric (Height and Weight) measurement and physical examination were made. PEM (Protein energy malnutrition) children were classified according to Indian academy of pediatric classification. History of BCG vaccination and exposure to contact were inquired. Chest radiography was done for all  children in our study.Results: A total of 150 protein energy malnutrition children, between 5 to 15 years, admitted over 18 months  period were  studied. Majority of children were female as compared to male and under 5 to 10 years of age. Out of these, symptomatic not confirmed pulmonary TB 93 (62%) and Extra pulmonary TB 18 (12%) and Non TB cases were 39 (26%). According to Grade of PEM, symptomatic not confirmed pulmonary TB cases under grade III were 45 (48.5%) and 35 (37.6%) were under grade II .Conclusions: Pulmonary tuberculosis may be a common cause of pneumonia in malnourished children and  the cause of death in these population. So  Its frequency and early clinical detection ,even without microbiological confirmation and supportive evidence and treatment guideline should be made by more further study. So that, it  will help clinicians to treat these population to reduce morbidity and mortality.
      PubDate: 2019-06-27
      DOI: 10.18203/2349-3291.ijcp20192757
      Issue No: Vol. 6, No. 4 (2019)
       
  • A study of growth pattern in regularly transfused thalassaemic children of
           age group of 2 years to 12 years

    • Authors: Shriharsha Badiger, Aditi Baruah
      Pages: 1575 - 1581
      Abstract: Background: ß-thalassemia is an autosomal recessive single gene disorder. Physical growth failure is one of the most important complications of thalassemia. Very few data regarding growth pattern of thalassemic children is available from India especially North East part. Keeping this in mind, present study was undertaken. To study the growth pattern of transfusion dependent thalassaemic children and to compare growth pattern between regularly and irregularly transfused children.Methods: A cross-sectional observational study was done on 38 thalassaemic patients (aged 2 years-12 years) who attended Department of Pediatrics, Assam Medical College Dibrugarh. History, physical examination and investigations were done and filled in predesigned proforma.  Anthropometric measurements like weight and height were taken from all patients. Sexual maturity rating was done in girls ≥10 years and boys ≥11 years. Lab parameters included pre-transfusion hemoglobin (Hb), serum ferritin, LFT, RFT, Thyroid profile. Percentile for weight, height and body mass index were calculated using WHO (2007) reference data. Collected data were compared with age and sex matched normal children.Results: About 34.21% transfusion dependent children had under-nutrition and 50% had stunting. 42% had thinness. Stunting was more in irregularly transfused children (81.25%) as compared to regularly transfused children which was highly significant (p<0.001). Under-nutrition among irregularly transfused children was more (40%) compared to regularly transfused children (28.57%). Pubertal spurt was delayed in 66% children. Those who had Hb <5 gm/dl had 100% stunting and under-nutrition.Conclusions: Regular blood transfusion with growth monitoring and appropriate iron chelation (Sr. Ferritin >1000 ng/ml) is of utmost importance in transfusion dependent thalassaemic children.
      PubDate: 2019-06-27
      DOI: 10.18203/2349-3291.ijcp20192758
      Issue No: Vol. 6, No. 4 (2019)
       
  • Morbidity and mortality of low birth weight babies in early neonatal
           period in a rural area teaching hospital, Telangana, India

    • Authors: Jayalakshmi Pabbati, Preethi Subramanian, Mahesh Renikuntla
      Pages: 1582 - 1587
      Abstract: Background: A baby’s weight at birth is a strong indicator of newborn health and nutrition. Low birth weight (LBW) babies are more susceptible to morbidities and mortality in early neonatal period than normal birth weight (NBW) babies. Among neonatal deaths, 80% occurs in LBW / preterm babies and 75% of total neonatal deaths occur in early neonatal period. The present study was undertaken to know the incidence and early neonatal outcome of LBW babies in rural area.Methods: Prospective observational study was conducted in babies born with <2.5 kg (LBW) birth weight.Results: The incidence of LBW babies was 25.07% with almost an equal contribution from preterm (50.46%) and Term Intra Uterine Growth Restricted (IUGR) (49.53%) babies. The most common morbidity found in LBW babies was Jaundice (40.09%) followed by respiratory distress (18.16%), sepsis (8.72%) and apnea (4.48%). Preterm-LBW babies had more morbidities in terms of apnea (100%), birth asphyxia (88.88%), respiratory distress (87.01%%), sepsis (80.55%) and jaundice (67.64%). Early neonatal mortality was 21.22 per 1000 live births. Mortality was 100% for babies <1 kg in birth weight, 16% in 1-1.499 kg group and 0.75% in 1.5-2.499 kg group in early neonatal period. According to gestational age, mortality in preterm-LBW babies was 88.88% and 11.11% in Term IUGR-LBW babies. The most common cause of death in LBW babies was birth asphyxia (44.44%) followed by hyaline membrane disease (HMD) (33.33%).Conclusions: The present study revealed that preterm babies contributed 50% to incidence of LBW babies. Morbidity and mortality in LBW babies were inversely related to birth weight and gestational age.
      PubDate: 2019-06-27
      DOI: 10.18203/2349-3291.ijcp20192759
      Issue No: Vol. 6, No. 4 (2019)
       
  • Study on cartridge based nucleic acid amplification test in children with
           Neurotuberculosis at RNT Medical College, Udaipur, Rajasthan, India

    • Authors: Shashi Bala, Suresh Goyal
      Pages: 1588 - 1591
      Abstract: Background: The aim was to determine utility of Cartridge based nucleic acid amplification test (CBNAAT) in diagnosis of mycobacterium tuberculosis in children with neurotuberculosis diagnosed on the basis of clinical evaluation, CSF findings and neuroimaging.Methods: A prospective randomized controlled trial was conducted in Pediatric Department of RNT Medical College, Udaipur, Rajasthan, India from July 2017 to June 2018. Total 110 children of age group of 6 months to 18 years with the diagnosis of tubercular meningoencephalitis (TBME) on the basis of clinical evaluation, CSF examination and neuroimaging were included in the study.Results: A total 110 children were enrolled. Maximum number of cases admitted with TBME were among 1-5 years of age group (60.91%). CSF and gastric aspirate were examined by CBNAAT for MTB. 5 (4.55%) children had CBNAAT positivity in CSF. Gastric aspirate was positive among 16 (14.55%) children. None of the patient had CBNAAT positive result both in CSF and gastric aspirate.Conclusions: TBME is a major health problem in children below 5 years. Gene Xpert assay has the potential to significantly improve and escalate the diagnosis of smear-negative body fluid specimens. CBNAAT for mycobacterium tuberculosis was positive in 5 (4.55%) children from CSF and 16 (14.55%) from gastric aspirate. Negative CBNAAT should not prevent any patient with suspected features of TBME from starting anti tubercular treatment (ATT) as sensitivity of this test remains low. Final judgement to start ATT should be based on clinical, biochemical and radiological profile especially in CNS tuberculosis.
      PubDate: 2019-06-27
      DOI: 10.18203/2349-3291.ijcp20192760
      Issue No: Vol. 6, No. 4 (2019)
       
  • Comparative efficacy of IV phenytoin, IV valproate and IV levetiracetam in
           childhood seizures

    • Authors: Sheeraz A. Dar, Wasim A. Wani, Mudasir Nazir, Zul Eidain Hussan
      Pages: 1592 - 1597
      Abstract: Background: Seizures are the most common pediatric neurologic disorder, with 4% to 10% of children suffering at least one seizure in the first 16 years of life objectives to compare efficacy of IV phenytoin, IV valproate, and IV levetiracetam in childhood seizures between 2months to 16 years of age.Methods: This prospective, randomized, study was done on pediatric patients in the age group of 2 months to 16 years who present actively convulsing to the emergency department of pediatrics.Results: At 24 hours seizures were controlled in 44 (88%) patients out of 50 patients in phenytoin group, 39 (78%) out of 50 patients in levetiracetam group and 46 (92%) out of 50 patients in valproate group (p-value 0.115). The relative risk of seizure recurrence for levetiracetam and phenytoin groups when compared to valproate was 2.75 and 1.5, respectively.Conclusions: Present study demonstrates that IV levetiracetam and IV valproate were comparable to IV phenytoin in terms of seizure control in acute setting. All the three are safe and efficacious. Time to regain consciousness was less in valproate group and long-term seizure control too was also better.
      PubDate: 2019-06-27
      DOI: 10.18203/2349-3291.ijcp20192761
      Issue No: Vol. 6, No. 4 (2019)
       
  • Risk factors for necrotizing enterocolitis in neonates:a prospective study

    • Authors: Manas Ranjan Sahoo, Pydi Nagasree, Lanka Swetha, Arigela Vasundhara
      Pages: 1598 - 1602
      Abstract: Background: Necrotizing enterocolitis (NEC) is mostly limited to preterm babies due to immaturity of gut. NEC is one of important cause of neonatal mortality and morbidity in the neonatal intensive care units all over the world.Aim of study is to find the antenatal and post-natal risk factors associated with necrotizing enterocolitis in neonates admitted to NICU.Methods: A prospective study was conducted on 45 neonates with necrotizing enterocolitis fulfilling the predetermined inclusion criteria. A detailed antenatal history including all maternal risk factors, birth history including the need for resuscitation and type of resuscitation was recorded. The gestational assessment was done by the New Ballard Score.Results: Pregnancy induced hypertension accounts as a risk factor to most of the cases of NEC 18 (40%), followed by setting for sepsis 12 (26.6%), least being gestational diabetes mellitus 1 (2.2%).Conclusions: Prematurity is found to be the most common risk factor followed by patent ductus arteriosus and sepsis. Most common antenatal risk factor was PIH (Pregnancy induced hypertension).
      PubDate: 2019-06-27
      DOI: 10.18203/2349-3291.ijcp20192762
      Issue No: Vol. 6, No. 4 (2019)
       
  • Incidence of congenital anomalies in newborn in tertiary care hospital

    • Authors: V. Narmadha, M. Nirmala
      Pages: 1603 - 1608
      Abstract: Background: Just about three decades ago (1976) congenital malformations comprised 8% of perinatal deaths, from available data and ranked fifth as a cause of perinatal mortality. But the trend is rapidly changing over the years. perinatal death was due to congenital malformation, is the second commonest cause. This changing trend over years warns us that with the control of nutritional and infectious diseases, congenital malformations will come to the forefront as it is in India. To find out the incidence of congenital anomalies in stillbirth. And the probable etiology of congenital anomalies.Methods: The study was conducted at Government Mohan Kumaramangalam Medical College Hospital, Salem in the year 2017 August- September 2018. Totally 5000 babies born of consecutive deliveries were taken for the study, over the period of one year. All mothers were interrogated within 48 Hours of delivery as per the proforma prepared, which contains the following particulars like, maternal and paternal age, consanguinity, detailed antenatal history with reference to exposure to teratogens, especially during 1st Trimester.Results: Of the five thousand consecutive deliveries 48 deliveries were multiple delivers and a number of stillbirths were 108. The incidence of congenital anomalies was 30.4 per 1000 live birth (152 cases). Major malformations were present in 20.8 per 1000 (104 cases) while minor malformations were 9.6 per 1000 (48 cases).Conclusions: Incidence of malformation were higher in preterm babies 6.31%. Incidence of malformations were higher in male babies, especially genitourinary system anomalies. Antenatal events in the 1st trimester like fever, drug intake could be implicated in the etiology of malformations especially neural tube defects in our study.
      PubDate: 2019-06-27
      DOI: 10.18203/2349-3291.ijcp20192170
      Issue No: Vol. 6, No. 4 (2019)
       
  • Study on etiological organisms in a suspected case of sepsis in the
           children admitted to paediatric intensive care unit

    • Authors: Chaitra K. M., Anil H., Varshini P., Avinash Agrawal, Shruti L. Talewad
      Pages: 1609 - 1613
      Abstract: Background: Identifying common etiological organisms among cases of suspected sepsis and their sensitivity pattern for common antibiotics will help in initiating appropriate therapy. Finding association of positive culture with other markers of infection like total leucocyte count, haemoglobin, C-reactive protein.Methods: Descriptive and an observational study conducted in Kempegowda Institute of Medical Sciences, hospital paediatric intensive care unit, Bangalore, Karnataka, India. Data was collected prospectively. Duration of study was for 1 year from February 2018 to February 2019.Results: During the study, 52 cases admitted to paediatric intensive care unit were suspected to have sepsis and 91 samples were sent for culture. Out of these, 46 were blood, 34 were of urine and 11 others (pleural, CSF, ET). Among these samples tested 26% (18) of blood, 23.5% (8) of urine and 45.45% (5) of other samples showed organisms.Conclusions: In this study, author were able to know the common etiological agent involved in sepsis. Author were able to identify the antibiotic sensitivity patterns among various organism which provide valid data for initiation of appropriate treatment.
      PubDate: 2019-06-27
      DOI: 10.18203/2349-3291.ijcp20192763
      Issue No: Vol. 6, No. 4 (2019)
       
  • A study to assess the practices of mothers of under-five children in
           childhood diarrhoea in a tertiary care hospital of Northeast India

    • Authors: Nilratan Majumder, Dipak Kumar Dhar
      Pages: 1614 - 1619
      Abstract: Background: Diarrhoea is one of the major causes of morbidity and mortality in under-five children. The incidence of diarrhoea has remained almost unchanged over the past few decades. A mother is the primary care-giver of a child. Therefore, one of the key factors that determine the survival of a sick-child is her attitude and practices in the event of diarrhoea. The present study was therefore undertaken to understand the different aspects of their care-giving behaviour.Methods: A hospital-based cross-sectional study was carried out in the Department of Paediatrics, Agartala Government Medical College and G. B. Pant Hospital, Agartala, Tripura, India over a period of two months. 700 mothers of under-five children attending the OPD were interviewed with a pre-designed and structured interview schedule.Results: The usage of ORS was about one-fourth. And only one-fifth out of all the participating mothers could show how to prepare ORS solution correctly. Correct practices regarding various aspects of administering ORS solution like duration of usage, frequency of administering, duration of the therapy, etc were not observed in majority of the participating mothers. A preference for home-made fluids was also noted in most of the participants. Educational level and past experience of managing a child with diarrhoea significantly affected their practices.Conclusions: Even though ORS is widely and easily available, easy to use and cost-effective, considerable work needs to be done in the context of adequate practices in its administration to a child affected by diarrhoea and increase its acceptability.
      PubDate: 2019-06-27
      DOI: 10.18203/2349-3291.ijcp20192764
      Issue No: Vol. 6, No. 4 (2019)
       
  • Social characteristics associated with outcome of paediatric human
           immunodeficiency virus admissions

    • Authors: Olusola Adetunji Oyedeji, Olasunkanmi Oladapo Olubanjo, Gabriel Ademola Oyedeji
      Pages: 1620 - 1626
      Abstract: Background: Information on social characteristics in human immunodeficiency virus (HIV) infected Nigerian children is scarce. The association between social characteristics such as single parenthood, low socio-economic status, polygamy and lack of parental education on the outcome of paediatric HIV admissions has been under studied.Methods: Information was obtained from the case notes of HIV infected children between the year 2006 and 2012 at a Nigerian tertiary hospital. Details of the information extracted include socio-demographics, diagnoses and outcome of management. Data was analysed with the SPSS 18 software.Results: Fifty (1.73%) of the total 2897 paediatric admissions were due to HIV disease. The mean age of the children studied was 3.7±2.9years and the 50 children were made up by 27 boys and 23 girls, giving a male to female ratio of 1:0.9. The mean age of the mothers and fathers were 28.7 and 36.7 years respectively. Pneumonia, septicaemia and tuberculosis accounted for more than 60% of admissions. Five (10.0%) children were from the upper, 12 (24.0%) from the middle and 33 (766.0%) from the lower socioeconomic classes. Twenty-four parents (couples) were both sero-positive for HIV and 7 discordant. Nineteen (38.0%) could not be classified because the status of the father was unknown. Of the 7 sero-discordant parents, 3 sero-negative fathers neglected their families. Thirty-nine children were from monogamous homes, nine from polygamous and two were raised by single parents. There were two discharges against medical advice and eleven deaths. The average number of siblings of the children studied was 2.57±2.1. Mortalities on admission were significantly associated with, parental financial constraints and the admitted HIV infected child having more than one sibling (p<0.05).Conclusions: It was concluded that appropriate interventions to manage these associations will most likely improve the outcome of admissions. Strategies of improving disclosure and prevention of negative outcome of disclosures, such as family neglect in sero-discordant couples also need to be identified. 
      PubDate: 2019-06-27
      DOI: 10.18203/2349-3291.ijcp20192765
      Issue No: Vol. 6, No. 4 (2019)
       
  • Study of risk factors for severe pneumonia among children between 2 months
           to 5 years of age

    • Authors: Vijay B. Shah, Kirti Mehta
      Pages: 1627 - 1631
      Abstract: Background: Acute respiratory illness is responsible for 19% of all deaths in children in below five years of age and 8.2% of all disability as measured by DALY. Recent studies have added other risk factors to the list including large family size, poor socioeconomic status, family history of bronchitis, advanced birth order, crowding, young age, air pollution, and the use of non-allopathic treatment in early stages of illness. Also, indoor air pollution is one of the major risk factors for acute lower respiratory tract infection in children in developing countries. The objectives of this study were to identify and compare the risk factors associated with severe and very severe pneumonia.Methods: A prospective observational study. Children between 2 months to 5 years with clinical features of severe pneumonia were included in the study. Socioeconomic history like the type of house, family size, sanitary facilities and fuel-based cooking was recorded. Detailed history about immunization, feeding practice and degree of malnutrition was recorded. Chi Square test was used to determine significant differences between two groups.Results: Total 150 patients could be included in the study. Immunization status shows that 74% were completely immunized, 9% were unimmunized and 17% were partially immunized. Most of the children were breast fed 95.33% and only 4.67% were bottle fed. 30% of the cases were grade 3 and 4 PEM and anemic. The socioeconomic status showed 84% were belonged to grade 3,4 and 5 and 16% belonged to grade 1 and 2. 96.67% were living in ill ventilated kutcha house with poor sanitation facilities and nearly 94% were living in house with fuel other than LPG.Conclusions: Factors like previous history of similar illness, inappropriate immunization for age, anemia, PEM grade 3 and 4, poor housing condition, and indoor air pollution were significantly associated with severity of pneumonia. While severity of illness, PEM grade 3 and 4 and associated illness were the important risk factors for mortality.
      PubDate: 2019-06-27
      DOI: 10.18203/2349-3291.ijcp20192766
      Issue No: Vol. 6, No. 4 (2019)
       
  • Effect of Vitamin A supplementation on preventing recurrent acute lower
           respiratory tract infections in children

    • Authors: Murthy Kanakala, Karunakar Pediredla, Natarajan Pachiappan, Rajendran Ramachari Ramayi, Tanveer Rehman
      Pages: 1632 - 1637
      Abstract: Background: Acute Lower Respiratory Tract Infections (ALRTI) remains the major cause of increased morbidity and mortality in under-five children. Vitamin A has a protective role against infections in children. Vitamin A supplementation is given to under-five children as part of the National Immunization Programme in India. The aim of this study was to find out the effectiveness of vitamin A supplementation in preventing the recurrent ALRTI (≥3 episodes per year) in under-five children.Methods: A cross-sectional analytical study was conducted to find out the role of vitamin A supplementation in reducing recurrent ALRTI in under-five children who were enrolled in Anganwadi centers (AWC’s) in Villupuram district, Tamil Nadu, India. Two hundred children of 1-5 years of age were selected by random systematic sampling. History was elicited and documents about vitamin A supplementation and previous episodes of ALRTI were verified. The association between recurrence of ALRTI and vitamin A supplementation was analyzed using chi-square test.Results: The mean age of the children in this study is 24±8 months. The median number of episodes of ALRTI per year is 2 (1-3). Among 200 children enrolled in the study, 127 (63.5%) children received vitamin A supplementation and 73 (36.5%) did not receive it. There is a significant decrease in the number of ALRTI episodes (less than 3 episodes per year) in the children who received vitamin A supplementation (p <0.001).Conclusions: Vitamin A supplementation along with the National Immunization Programme had shown reduced  ALRTI episodes. Since, the number of ALTRI episodes are directly proportional to mortality due to pneumonia, reduction in number of episodes can decrease the Under-five mortality. Vitamin A supplementation is an important programme in this regard and needs to be scrupulously carried out.
      PubDate: 2019-06-27
      DOI: 10.18203/2349-3291.ijcp20192767
      Issue No: Vol. 6, No. 4 (2019)
       
  • Culture sensitivity and antibiotic profile in urinary tract infection in
           children between 1-15 years

    • Authors: Nisar Ahmad Ganie, Mohsin Rashid, Syed Muneeb Mohammad, Riyaz Ahmad Malik, Mohd Rafiq Lone
      Pages: 1638 - 1641
      Abstract: Background: The aim was to study the antibiotic resistance in children with urinary tract infection and to observe any difference between antibiotic resistance rates.Methods: It was a prospective study carried out in SKIMS Medical College Hospital, Srinagar over a period of two years from January 2017 to January 2019. The study included 210 children between 1 year and 15 years who had presented with complaints of urinary tract infection and whose urine cultures were positive for the growth of an organism. These children were analyzed in order to find the frequency of organisms grown on culture, sensitivity of organisms isolated on culture and the rates of developed resistance to the antibiotics.Results: A total of 210 patients aged were included in the study, encompassing 66 (31.4) males and 144 (68.6%) females. Out of 144 female children 108 were under 6years of age while as out of 66 male children 48 were under 6years of age. As per the growth on urine culture,  the commonest organism that grew on culture were Escherichia coli (E. coli) was observed in 156 (74.3%), enterococcus in 18 (8.57%), Proteus mirabilis in 11 (5.2%), Acinetobacter spp. in 7 (3.3%), Pseudomonas spp. 5 (2.4%), Staphylococcus aureus in 4 (1.9%), Morganella spp. in 3 (1.4%) patients.
      Authors found imipenem, aminoglycosides and nitrofurantoin as the most effective antibiotics for urinary tract infections in pediatric age group.Conclusions: From this study, they concluded that parenteral antibiotics to be started empirically for the treatment of UTIs in all pediatric age groups are  aminoglycosides. In contrast for outpatient management of urinary tract infections, our results suggest that nitrofurantoin should be used for children aged beyond 1 year of age due to the low rate of resistance to nitrofurantoin in patients aged over 1 year.
      PubDate: 2019-06-27
      DOI: 10.18203/2349-3291.ijcp20192768
      Issue No: Vol. 6, No. 4 (2019)
       
  • Asymptomatic hypernatremia in exclusively breastfed neonates

    • Authors: Babalala Kadegaon, Jyoti B. Sarvi
      Pages: 1642 - 1645
      Abstract: Background: The aim of study was to identify the asymptomatic hyparnatremia in exclusively breastfed neonates and to study the factors associated with it.Methods: A cross-sectional study was conducted from November 2010 to October 2012 in Jawaharlal Nehru Medical College and Hospital, A. M. U., Aligarh. Consecutive term appropriate-for-gestational age and asymptomatic neonates who were exclusively breastfed since birth were enrolled.Results: A total of 1360 term neonates were screened, out of which 145 neonates in each early and late neonatal group were enrolled. Prevalence of hypernatremia in 290 patients was 4.48% (n=13) with mean serum sodium level of 156.6±5.5 mmol/L, ranging from 151 to 167 mmol/L. It was 16 times more common in early compare to late neonates (adjusted odds ratio=16.074, P=0.001), 6 times more common in primi mothers (adjusted odds ratio=6.037, P=0.010) and 7 times more common during summer season (May-August) (adjusted odds ratio=6.566, P=0.017). Other variables like sex, mode of delivery and blood urea levels do not show significant association with hypernatremia. There was a significant positive correlation of serum sodium level with blood urea (r=0.123, P=0.037) and serum creatinine levels (r=0.157, P=0.007), and a negative correlation with blood sugar levels, but it was not significant (r=-0.072, P=0.224).Conclusions: The prevalence of hypernatremia in exclusively breastfed term asymptomatic neonates is 4.8%, and is more common in early neonatal period, in summer season and in babies born to primi mothers. There was a significant positive correlation of serum sodium with blood urea and creatinine levels.
      PubDate: 2019-06-27
      DOI: 10.18203/2349-3291.ijcp20192769
      Issue No: Vol. 6, No. 4 (2019)
       
  • The fate of antenatal renal pelvis dilatation: a prospective postnatal
           cohort study

    • Authors: Pradyumna Pan
      Pages: 1646 - 1651
      Abstract: Background: To assess the outcome of fetal hydronephrosis, based on antenatal sonography and to find the best cutoff APD of renal pelvis which lead to surgical outcome.Methods: All patients diagnosed with isolated fetal renal pelvic dilatation (RPD) were prospectively followed between January 2016 and December 2018. RPD was classified according to SFU grading into four grades and by APD classification to 3 groups. Group I (5-9.9 mm), group II (10-14.9 mm) and group III (≥15 mm).Results: Among a total of 57 patients, group I had 32 renal units, none required surgery; group II had 19 renal units, 5 (7.04%) required surgery; group III had 20 units, 11 (15.49%) required surgery. The difference in outcome between the groups was statistically significant (p=0.001). The causes of fetal hydronephrosis was transitional in 33.33%, pelvi ureteric junction obstruction in 33.33%, vesico ureteral reflux in 29.82%, and 3.5 % had posterior urethral valves. Of the 38 infants with RPD, urinary tract infection was seen in 36.84%. Thirty-four patients had MCUG of whom 29.82% had VUR. In 38 patients DTPA was performed with following results: 10.53% had partial obstruction and 14.04% showed complete obstruction.Conclusions: Fetal hydronephrosis less than 5mm runs a benign course. In APD greater than 15 mm and bilateral disease thorough postnatal evaluation and regular follow-up is necessitated for timely intervention. The best cutoff point of anteroposterior renal pelvis diameter that led to surgery was 15 mm, with sensitivity 91% and specificity 73.5%.
      PubDate: 2019-06-27
      DOI: 10.18203/2349-3291.ijcp20192770
      Issue No: Vol. 6, No. 4 (2019)
       
  • Outcome and clinical efficacy of bleomycin and doxycycline percutaneous
           sclerotherapy for treatment of paediatric lymphatic malformations in a
           limited resource setting

    • Authors: Rashi ., Kalyani Saha Basu, Sankha Subhra Ganguly, Kaushik Saha, Shamshad Ahmad
      Pages: 1652 - 1657
      Abstract: Background: The aim was to study the role of bleomycin and doxycycline as a cheap and readily available sclero-therapeutic agent in the treatment of lymphatic malformations in paediatric populations of poor resource setting.Methods: It was a longitudinal study. A total of 23 paediatric cases with distinct types of lymphatic malformations were treated with injection sclerotherapy. Bleomycin and doxycycline used for microcystic and macrocystic lesion type respectively. The patient was followed up to complete remission. The level of evidence was Level II and type of evidence was prognosis study.Results: Commonest site of lesion was neck (78.3%), followed by cheeck (8.7%), chest, shoulder and suprapubic region. Only 21.7% of patients had good reduction (50-89%) in their lesion volume on first follow up. Overall 43.4% of patients showed a reasonable reduction in lesion volume during the follow-up period. Almost 3/4th of patients improved symptomatically on the first follow up visit. Macrocystic lesion showed an excellent response to treatment (50-89% volume reduction) in 33.3% of cases while only 16.7% of microcystic ad 12.5% of the mixed lesion showed a similar response to treatment.Conclusions: Doxycycline sclerotherapy can be a primary treatment modality in macrocystic and mixed macrocystic lesions. It is inexpensive and widely available and has minimal side effects. In contrast, bleomycine as a sclero-therapeutic agent showed an inadequate response in size reduction of microcystic lesions.
      PubDate: 2019-06-27
      DOI: 10.18203/2349-3291.ijcp20192771
      Issue No: Vol. 6, No. 4 (2019)
       
  • Prediction of neonatal hyperbilirubinemia by cord blood analysis to
           diagnose subsequent hyperbilirubinemia

    • Authors: S. K. Mahammad Rafi, Vani Gandikota, Gangadhar B. Belavadi
      Pages: 1658 - 1663
      Abstract: Background: the study was aimed to determine the predictive value of cord bilirubin and 24th hour serum bilirubin levels in identifying newborn babies at risk of developing significant hyperbilirubinemia.Methods: A total 300 term neonates with a mean birth weight of 2.58±0.23 kg ranging from 1.92 kg-4.1kg were included in this study. Under strict aseptic precautions cord blood sample were collected from all newborns for analysis of serum bilirubin levels, and haemoglobin levels.Results: The incidence of significant hyperbilirubinemia in this study was 14%. Among jaundiced newborns sex ratio M/F:1.6:1(male female ratio 1.1:1). Mean Cord bilirubin levels in babies who subsequently developed hyperbilirubinemia was 2.798±0.5559 mg/dl and in others were 1.511±0.3260 mg/dl and the difference was statistically significant. There was a statistically significant correlation between cord bilirubin and neonatal jaundice. Cord bilirubin ≥2 mg/dl had good predictive value in identifying newborns who are likely to develop significant hyperbilirubinemia later.Conclusions: Babies with cord blood bilirubin ≥2 mg/dl can be followed up in the hospital for 5 days, the time of peak neonatal hyperbilirubinemia to prevent the babies discharged early and later readmission for neonatal hyperbilirubinemia.
      PubDate: 2019-06-27
      DOI: 10.18203/2349-3291.ijcp20192772
      Issue No: Vol. 6, No. 4 (2019)
       
  • A retrospective longitudinal study on the effect of ultra short course of
           steroid therapy on clinical and hematologic parameters of secondary
           hemophagocytic lymphohistiocytosis in children

    • Authors: Jayant K. Muduli, Meenakshi Mitra, Swapan K. Ray
      Pages: 1664 - 1667
      Abstract: Background: The aim was to study the effect of ultra-short course of injectable steroid followed by oral steroid therapy for cumulative 14 days on clinical and hematologic parameters of secondary hemophagocytic lymphohistiocytosis in children.Method: A retrospective longitudinal study was conducted by collecting data from case records. Cases diagnosed with secondary hemophagocytic lymphohistiocytosis had been included. The cases with malignancy were excluded. Remaining cases had been given injectable methyprednisolone (30 mg/kg/day) for three days followed by oral prednisolone (1 mg/kg/day) for 11 days. The time  to cessation of fever and organomegaly were noted. The changes in mean hematologic parameters, ferritin and triglycerides were noted at the time of suspicion of HLH or MAS, after therapy and on follow up.Results: About 96% of children were afebrile within five days of therapy. There was regression of hepatospleenomegaly in all 100% surviving children by day seven of therapy. Improvement in hemoglobin (mean value 8.1 mg/dl to 8.7 mg/dl) and platelet count (mean value 0.89 lakh to 1.47 lakh) was seen by day seven of therapy. Fall in serum ferritn (mean value 1419 ng/ml to 298 ng/ml) and serum triglycerides (mean value 307 mg/dl to 176 mg/dl) was seen at one-month follow-up. 96% survival was observed. None of the survivors had any recurrence at 6 months follow up.Conclusion: Ultra short course of injectable methyprednisolone for 3 days followed by oral prednisolone for 11 days was successful in 95% survival in our study. This cost-effective regimen, with use of less toxic drugs leading to a shorter hospital stay maybe helpful in resource limited settings.
      PubDate: 2019-06-27
      DOI: 10.18203/2349-3291.ijcp20192773
      Issue No: Vol. 6, No. 4 (2019)
       
  • An observational study on anaemia in children admitted to a tertiary
           teaching hospital with first episode of febrile seizures

    • Authors: Ashish Pradhan, Prerna Choudhury
      Pages: 1668 - 1672
      Abstract: Background: The association between anaemia and iron deficiency anaemia with febrile seizures is still not very well understood. The purpose of this study was to describe the occurrence of anaemia in children admitted with first episode of febrile seizures.Methods: This was a hospital based prospective study conducted at Central Referral Hospital, Gangtok, Sikkim, India from December 2012 to May 2014 on 50 children in the age group of 6 to 60 months admitted with first episode of febrile seizures. Detailed history and physical examination were performed and findings recorded and complete blood count, serum electrolytes and random blood sugar were done in all children. Mentzer Index was calculated from the haematological data.Results: The mean age in this study was 24.88±13.22 months. 74% of the cases were males. Twenty-eight children (56%) had anaemia out of which twenty-seven had Iron deficiency anaemia. The statistical analysis of qualitative data using Chi-square test with Yate’s correction revealed no statistically significant difference between number of children with anaemia and no anaemia (p value=0.1493) and also between number of children with Iron deficiency anaemia and children with no Iron deficiency anaemia (p value=0.4478).Conclusions: This study did not reveal a higher occurrence of anaemia as well as iron deficiency anaemia in children admitted with first episode of febrile seizures.
      PubDate: 2019-06-27
      DOI: 10.18203/2349-3291.ijcp20192774
      Issue No: Vol. 6, No. 4 (2019)
       
  • Parental perception of quality of life in children following cardiac
           surgery

    • Authors: Neha N. Pilankar, Mariya Prakash Jiandani, Amita Anil Mehta, D. V. Kulkarni
      Pages: 1673 - 1679
      Abstract: Background: Congenital heart disease (CHD) is one of the major causes of mortality in the pediatric population of both the developing and developed countries. Along with medical and surgical treatment, access to quality care is equally essential in children operated with CHD. This study aims at assessing how the parents perceive quality of life in the child post-operatively and the impact on family.Methods: About 185 parents of children operated for CHD were interviewed using Pediatric Quality of Life Inventory™ 3.0 Cardiac, Paediatric Quality of Life Inventory™ (PedsQL™) Family Impact Module scale and Participation Measure using International Classification of Functioning, Disability and Health-Child Youth by World Health Organization-2007 (ICF-CY) after three months of surgery.Results: CHD was found to be more common among males (57.8%) with commonest surgery being ventricular septal defect (36.8%) followed by tetralogy of fallot and others. Overall 44.8% parents perceived their child had problem following surgery, cognition being the most affected domain. Problems in communication were perceived by 47.6% parents and were worried about the future. Using ICF-CY, 55.1% perceived complains of mild difficulty in mobility and moderate difficulty in self-care and schooling for the child.Conclusions: The overall quality of life of children operated for congenital heart disease was perceived as not affected by parents except for cognitive problems. Parental worry and communication were the most affected domains. As far as schooling and self-care is concerned there was moderate difficulty. There is need for parental counselling and rehabilitation to function for children operated for cardiac surgery post operatively.
      PubDate: 2019-06-27
      DOI: 10.18203/2349-3291.ijcp20192775
      Issue No: Vol. 6, No. 4 (2019)
       
  • Survival outcomes of trachea esophageal fistula in infant

    • Authors: S. Prabkaran, K. Kasthuri Thilagam
      Pages: 1680 - 1684
      Abstract: Background: Tracheo-esophageal fistula (TEF) is a rare congenital abnormality often associated with several other anomalies including renal, vertebral column, gastrointestinal or cardiovascular defects. This study was carried out to evaluate the outcome of trachea esophageal fistula among patients who underwent various surgeries for the anastomosis of trachea esophageal fistula.Methods: This study was conducted as a record based cross sectional study among 88 patients who were diagnosed and treated for trachea-esophageal fistula in tertiary care hospital between 2015 and 2018. Data regarding the type of anomaly, presence of associated anomalies, type of surgery and outcomes were documented. Findings of echocardiography and ultrasonography were also documented. Data was analyzed using SPSS software. Chi square test was used to evaluate the outcome of the surgical procedures for management of TEF.Results: Majority of the participants in our study belong to <1 month of age and were males (56.8%). Type 3 tracheo esophageal fistula (80.7%) was the most common type. Associated cardiovascular anomalies were present in 50% of the participants. Thoracotomy with TEF repair was most preferred surgery (76%). Present study demonstrated that surgical techniques improve the physical and physiological outcome of the patients (p <0.05).Conclusions: Trachea esophageal fistula needs to be corrected with surgical procedure. Modern techniques like thorocoscopic anastomosis, thorocosopic techniques to achieve an anastomosis can also be explored. Future studies may be directed in detecting congenital anomalies during the pre-natal period with the help of genetic techniques.
      PubDate: 2019-06-27
      DOI: 10.18203/2349-3291.ijcp20192776
      Issue No: Vol. 6, No. 4 (2019)
       
  • Diagnostic utility of fine needle aspiration cytology in pediatric age
           group in a tertiary care centre

    • Authors: Ritu Bhagat, Roopali Jandial
      Pages: 1685 - 1689
      Abstract: Background: Fine Needle Aspiration Cytology (FNAC) is a simple, cost effective, minimal invasive and a rapid diagnostic technique. The present study was designed to study the role of fine needle aspiration cytology and its utility in paediatric lesions. It also specifies the spectra of different lesions in the paediatric age group.Methods: The present study was performed in the Department of Pathology, in a tertiary care centre of Jammu, Jammu and Kashmir, India. All pediatric patients aged 0-17 years with palpable or deep-seated lesions were included in the study over a period extending from January 2017 to December 2018. The aim was to study the utility of FNAC in paediatric age group.Results: A total of 200 cases of FNAC in pediatric age group were studied. Out of total 200 cases maximum number of patients i.e. 59% were between 11-17 years. Male to female ratio was 1.7:1. A preponderance of lymph nodes over other sites i.e. 129/200 (64.5%) was noted.Conclusions: FNAC is a safe, rapid, accurate and cost-effective procedure with good patient acceptance with no essential morbidity and can be used as an initial screening tool in superficial and deep-seated lesions in pediatric age group.
      PubDate: 2019-06-27
      DOI: 10.18203/2349-3291.ijcp20192777
      Issue No: Vol. 6, No. 4 (2019)
       
  • Incidence of rifampicin resistance, HIV status and efficacy of fluid
           analysis among tuberculosis suspect pediatric cases

    • Authors: Deepmala Pandey, Ankur Yadav
      Pages: 1690 - 1694
      Abstract: Background: Body fluids are commonly used for diagnosis as sputum is not reliable in children. Hence it is essential to study efficacy of body fluids in comparison to GeneXpert which is a new diagnostic modality. Objectives of this study was to incidence of rifampicin resistance, HIV status and efficacy of fluid analysis among tuberculosis suspect pediatric cases.Methods: Present study was hospital based cross sectional study carried out over a period of two years at Department of Pediatrics, ACPM Medical College and Hospital from February 2016 to January 2018 among children with suspected tuberculosis. Rifampicin resistance was determined by using GeneXpert. Body fluids like CSF, pleural fluid, gastric aspirate etc were analyzed and compared with GeneXpert results.Results: Rifampicin resistance was present in 5 cases i.e. 3.3%. 15.15% Patients were HIV positive and in them 12 were GeneXpert positive with 1 Rif resistance. Different Fluid analysis showed maximum positivity with pleural fluid >TB Lymphadenitis >TBM. GeneXpert done on different body fluids showed extra case detection in different fluid analysis negative patients i.e. 28.6% extra case detection in CSF (2 cases), 87.9% in gastric aspirate (25 cases), 85.4% in induced sputum (35 cases), 14.3% in Lymph node aspirate (1 case), 50% in pleural fluid (2 case).Conclusions: : Rifampicin resistance found in present study is alarming. Among body fluids, FNAC, CSF and pleural fluids can be used reliably for diagnosis of tuberculosis where GeneXpert is not available.
      PubDate: 2019-06-27
      DOI: 10.18203/2349-3291.ijcp20192778
      Issue No: Vol. 6, No. 4 (2019)
       
  • Clinical study of meningitis in children and role of adenosine deaminase
           in differentiating tubercular from non-tubercular meningitis

    • Authors: Deepmala Pandey, Ankur Yadav
      Pages: 1695 - 1700
      Abstract: Background: In diseases where cell mediated immunity plays an important role like in tuberculosis, CSF (Cerebrospinal fluid) adenosine deaminase (ADA) activity is increased. Hence, this testing is done especially among children with suspected tubercular meningitis. The objective of this was to study role of Adenosine Deaminase in differentiating tubercular from non-tubercular meningitis.Methods: This was a hospital based cross sectional study was carried out among 50 children of proven meningitis for a period of two years. CSF ADA levels were done for all cases. They were divided into tubercular meningitis and non-tubercular meningitis group and compared.Results: Incidence of tuberculous meningitis (TBM) was found high in the age group 5-8 years. Male:female ratio was 2.3:1. Fever was present in all cases followed by vomiting and neck rigidity. CSF AFB was positive in 3 cases (6%). Neuroimaging was done in all cases in which 3 patients had basal exudate in which 2 patients had TBM and 1 patient was Non-TBM. 3 patients had hydrocephalus in MRI in which 2 had TBM diagnosed and 1 had non-TBM. As per ADA levels, 10 were diagnosed as TBM out of which 8 patients had ADA level ≥10 IU/L and 2 had ADA level <10 IU/L which was missed by ADA and later confirmed by other modalities.Conclusions: It was concluded that if ADA level in CSF is ≥10IU/l the diagnosis of TBM should be considered.
      PubDate: 2019-06-27
      DOI: 10.18203/2349-3291.ijcp20192779
      Issue No: Vol. 6, No. 4 (2019)
       
  • Double surface light emitting diode phototherapy versus double surface
           compact florescent light phototherapy in neonatal non-haemolytic
           hyperbilirubinemia: a randomized controlled trial

    • Authors: Sham B. Lohiya, Tarsem Jindal
      Pages: 1701 - 1706
      Abstract: Background: The aim of the study was to evaluate whether light-emitting diode (LED) phototherapy is as efficacious as compact fluorescent tube (CFT) phototherapy for the treatment of non-hemolytic jaundice in healthy term and late preterm neonates.Methods: Study design was open label randomized controlled trial conducted at tertiary care NICU. Healthy term and late preterm neonates with non-haemolytic jaundice included in the present study. Intervention was double-surface LED or CFT phototherapy. Primary outcome variable was duration of phototherapy.Results: A total of 60 neonates were randomized to receive LED (n=30) or CFT (n=30) phototherapy. The baseline demographic and biochemical variables were similar in the two groups. The median duration of phototherapy (Mean±SD) in the two groups was comparable (26.7±7.0) h vs (24.8±6.05) h, P=0.0.241). The rate of fall of serum total bilirubin (STB) during phototherapy in initial 6 hours was significantly more LED group (n=30), 3.43±0.65 versus (n=30) 2.22±0.55 with P-value of <0.001.Conclusions: LED and CFT phototherapy units were equally efficacious in the management of non-haemolytic hyperbilirubinemia in healthy term and late-preterm neonates.  Side effects were rare, comparable in the two groups and included only rash.
      PubDate: 2019-06-27
      DOI: 10.18203/2349-3291.ijcp20192780
      Issue No: Vol. 6, No. 4 (2019)
       
  • Knowledge, attitude and practice regarding diarrhoea and its prevention
           and the use of oral rehydration therapy among mothers of children under
           the age of five visiting a tertiary care hospital in Mangalore, India

    • Authors: Radhika Renjith N., Prakash Saldanha, Sahana K. S.
      Pages: 1707 - 1711
      Abstract: Background: Diarrheal diseases remain the second most leading cause of mortality and morbidity next to pneumonia among under-five mortality globally, contributing to 1/5th of child deaths.Methods: Cross sectional hospital based questionnaire study conducted among 200 mothers of children within the age group of 6-60 months with diarrhoea attending the paediatric outdoor or treated in the paediatric indoor (OPD) at YMCH hospital using personal interview method. Filled up questionnaires was collected and was attached along with the filled up proforma.Results: Of 200 mothers, 24.3% knew the correct meaning of diarrhoea, with 73.8% of them not knowing the correct cause of diarrhoea. Only 44.3% knew that it could be prevented. Majority 88.7% did not know to look for signs of dehydration. Less than half of the mothers had only heard of ORT. By using c2-test, preparation ORS was found to be associated with the mother’s education (p=0.04) proving that knowledge is better among those mothers with formal education. No association was found between ORS preparation and age of the mother (p=0.229), religion (p=0.342), and gender of the child (p=0.061).Conclusions: The findings of this research indicate that only 73.8% of the mothers had knowledge regarding the cause of the diarrhoea and less than half 11.3% has only heard and used ORT properly.
      PubDate: 2019-06-27
      DOI: 10.18203/2349-3291.ijcp20192781
      Issue No: Vol. 6, No. 4 (2019)
       
  • Study of sexual maturity rating among female adolescents who have attained
           menarche

    • Authors: Srinivasa S., Nisar Ahamed A. R., Bhavya S.
      Pages: 1712 - 1717
      Abstract: Background: Adolescence is an important stage in the growth and development of girls. There has been a change in sectorial trend in the onset of puberty menarche. Thus, this study is designed to study the change in sectorial trend. In this background the study has been framed with these objectives, to correlate the attainment of menarche among the subjects in relation to their mothers and to study the sexual maturity rating among the study subjects.Methods: This is a cross sectional observation study involving 70 female adolescent girls. Data was collected from study subjects admitted in the department of Pediatrics, KIMS Hospital and those visiting KIMS OPD during September 2018 to February 2019. Study Subjects were examined by the female investigator and data on anthropometry, Tanner SMR staging, and other examination findings were collected using a pretested standardized questionnaire, after taking the consent. Subjects were divided based on the age into six groups.Results: The mean age of attainment of menarche is 12.36 years and mean age at menarche in mothers was 14.18 years. In this study the earliest age of attainment of menarche is 10 years. In our study most of the subjects attained menarche between 12-13 years, which is earlier than the age of attainment of menarche in the mothers which was 14-15 years. All the subjects who attained menarche were in SMR Breast stages 3, 4 and 5 and pubic hair stages 2, 3, 4 and 5.Conclusions: There is a positive correlation between the ages of attainment of menarche in the mothers and the subjects in this study it is found that there is a positive correlation between age, weight, height and SMR Stages.
      PubDate: 2019-06-27
      DOI: 10.18203/2349-3291.ijcp20192782
      Issue No: Vol. 6, No. 4 (2019)
       
  • Clinical and aetiological profile of Pneumonia in age group between 1
           month to 1 year: a hospital based prospective study

    • Authors: Vamsee Krishna Polepalli, Naveen Kumar Banda, Y. Venu Gopal Sarma, K. V. Siva Rama Krishna, M. Hima Bindu
      Pages: 1718 - 1724
      Abstract: Background: Pneumonia is one of the leading causes of morbidity and mortality in children under five years of age across the world. The present study was designed to clinically evaluate the children of age 1 month to 1 year with pneumonia, correlate it with bacteriological, radiological findings and to study the risk factors.Methods: Clinical, bacteriological, radiological features and risk factors of community acquired pneumonia in children of age group 1 month to 1 year were noted and analysed.Results: As per WHO ARI control programme, 72% had pneumonia, 25.3 % had severe pneumonia and 2.6% had very severe pneumonia. Bacterial pneumonia was detected radiologically in 4.6% and viral pneumonia in 88.6% of cases. Chest X-ray was normal in 6.6% of cases. Tachypnoea, chest retractions, crepitations alone and crepitations with rhonchi correlated well with positive radiological findings. Inappropriate immunization for age, lack of breast feeding, preterm birth, smoking in family were significant risk factors for severe Pneumonia. 39.3% had leucocytosis and 24% had positive CRP. Culture was positive in 23 cases (15.3% culture positivity).Conclusions: Radiologically confirmed Pneumonia should be treated with antibiotics because, in clinical practice, it is virtually impossible to distinguish exclusively between viral pneumonia and bacterial pneumonia. As the viruses are most common causative agents of Pneumonia in 1 month to 1 year, PCR kits should be used to identify viral etiological agents. Early and exclusive breast feeding should be promoted to decrease the risk of pneumonia.
      PubDate: 2019-06-27
      DOI: 10.18203/2349-3291.ijcp20192783
      Issue No: Vol. 6, No. 4 (2019)
       
  • Iron deficiency and febrile seizures: a retrospective analysis

    • Authors: Bharat Gajare, Madhuri Engade, Anuj Khatri, Pooja Sharma
      Pages: 1725 - 1730
      Abstract: Background: Febrile seizures (FS) are the commonest cause of seizures in children, with 2-5% of neurologically healthy children experiencing at least 1 episode. Iron deficiency is reported to be one of the most prevalent nutritional problems in the world today, especially in developing countries, with an estimated 46%-66% people affected. Our study is an attempt to clarify the relation between iron deficiency and first febrile seizure.Methods: The present study was a case control study carried from December 2016 till June 2018 in a tertiary care hospital at Aurangabad, Maharashtra, India. The study was done after obtaining approval from Institutional ethical Committee.Results: 77 cases and equal number of controls were included. Males were most commonly affected (>50%) as compared to females in both groups. Highest number of cases and controls were in the age group 0.5 to 1 year group, followed by 1-2 and 2-3 years group. Upper respiratory tract infection was most common etiological factor. Anemia (Hb<11 gm/dl) was seen in in 84% of the cases and 65% of the controls. Serum iron and total iron binding capacity (TIBC) was reduced in cases as compared to controls and this difference was highly statistically significant.Conclusions: Iron deficiency is a modifiable risk factor for first episode of febrile seizures in Indian children of age group 6 months to 5 years its early detection and timely correction may be an important determinant for prevention of febrile seizure in children.
      PubDate: 2019-06-27
      DOI: 10.18203/2349-3291.ijcp20192784
      Issue No: Vol. 6, No. 4 (2019)
       
  • Effect of education and socio-economic status on parenting among
           pre-school and school going children

    • Authors: Devendra Barua, Shruti Saxena
      Pages: 1731 - 1736
      Abstract: Background: Parenting is the process of promoting and supporting the physical, emotional, social and intellectual development of a child from infancy to adulthood. Parenting is a complex activity that includes much specific behavior that works individually or together to influence child’s outcomes.Methods: It is prospective observational study carried out in the Department of Pediatrics, Shyam Shah Medical College and associated Gandhi Memorial Hospital, Rewa, Madhya Pradesh, India during the period from July 2008 to June 2010. Parents were interviewed with predesigned proforma. Parenting was graded in to three grades (1, 2 and 3) according to the performance of parents in various aspects of parenting.Results: In this study, 60 parents had 155 children constituting 2.5 children per family and male to female ratio was 1.18:1. We observed that literate parents performed well in all aspects of parenting (i.e. behavioral, physical, emotional, mental, spiritual, nutritional), but illiterate parents could not score on these points especially in spiritual and nutritional aspects. 33% graduate parents fulfilled the criteria for grade 3 parenting in nutritional aspects, 55% intermediate passed parents in nutritional aspects were in grade 3, whereas there were more than 50% parents in behavioral, physical and emotional aspects who had education level up to primary class.Conclusions: Educational status of parents has a positive impact on almost all aspects of parenting and the educational status of mothers appeared to be even more influential. Socioeconomic status of parents and residential area have a great influence on all aspects of parenting.
      PubDate: 2019-06-27
      DOI: 10.18203/2349-3291.ijcp20192785
      Issue No: Vol. 6, No. 4 (2019)
       
  • Kangaroo mother care for low birth weight babies: supportive factors and
           barriers

    • Authors: Dinesh Mekle, Amit Kumar Kumar Singh, Jagdamba Dixit
      Pages: 1737 - 1742
      Abstract: Background: Kangaroo mother care (KMC) is skin-to-skin contact between mother and low birth weight (LBW) baby. It keeps the baby warm, increases accessibility to breast feeding, and protects the baby from infections. This study was done to identify supportive factors and barriers in practicing KMC as perceived by mothers of LBW babies and health care personnel (HCP).Methods: It was a questionnaire based descriptive study. Mothers of LBW babies and HCP were enrolled in study. Mothers and HCP were sensitized regarding KMC and after practicing KMC for 3 days, mothers were interviewed with the help of a predefined proforma. Feedback from the HCP was also taken. Data analysis was performed by using IBM SPSS ver. 20 software.Results: Most common factor in initiation and practice of KMC were, knowledge regarding KMC after training (100%), environmental factors (privacy and resources) (87.27%) and support from HCP (94.54%). Most common barriers perceived during performance of KMC were lack of knowledge about KMC during pregnancy (80%), pain due to LSCS/episiotomy (64.54%) and lack of support from family members (51.81%). Majority of the HCP strongly agree that parents must be encouraged to adopt KMC (82.92%), KMC is hampered due to presence of visitors in the ward (73.17%). KMC needs separate room (68.29%) and it is difficult due to LSCS (51.21%).Conclusions: To increase KMC practice, mother’s knowledge about KMC can be improved by educating them in antenatal clinics and all HCP should receive training on KMC.
      PubDate: 2019-06-27
      DOI: 10.18203/2349-3291.ijcp20192786
      Issue No: Vol. 6, No. 4 (2019)
       
  • Early veno-venous Extra Corporeal Membrane Oxygenation with prone
           positioning in the treatment of severe Acute Respiratory Distress syndrome
           in a pediatric patient: a case report

    • Authors: Md Nawad Azam, Senthil Kumar S. P.
      Pages: 1743 - 1746
      Abstract: Aim of the study was to discuss effectiveness and outcome of Extra Corporeal Membrane Oxygenation (ECMO) therapy with prone positioning while on ECMO in a child with severe Acute Respiratory Distress Syndrome (ARDS). Veno-venous ECMO (VV-ECMO) and prone position on ECMO are relatively newer modalities of treatment in severe ARDS in pediatric age group and to our experience very few cases has been reported in paediatric age group. A 5 year old male child presented with fever with respiratory distress. He deteriorated in next 48 hrs leading to severe hypoxemia with ARDS following which he was put on conventional ventilation. In view of worsening critical lung parameters, veno-venous ECMO was initiated. Child had persistent hypoxemia inspite on high positive end expiaratory pressure (PEEP), adequate flow and adequate Post oxygenator PO2. Recirculation and other possible causes were excluded. Prone positioning (PP) was done for 8 hrs a day with chest physiotherapy while on ECMO. Patient showed considerable improvement in next few days and ECMO was weaned on day 7 and child was discharged on day 16 with good lung recovery. Although studies on VV-ECMO with PP has proven effectiveness in severe ARDS in adult population, overall studies in paediatric ARDS are very limited. Prone positioning on ECMO may decrease duration of ECMO support. Prone positioning on VV ECMO is safe and can be considered in Persistent hypoxemia with poor respiratory compliance.
      PubDate: 2019-06-27
      DOI: 10.18203/2349-3291.ijcp20192128
      Issue No: Vol. 6, No. 4 (2019)
       
  • Lingual thyroid with hypothyroidism in a child

    • Authors: Ramya Ramanathan, Jennifer Priscilla Veerapandian, Sundari S.
      Pages: 1747 - 1749
      Abstract: Ectopic thyroid is an uncommon embryological abnormality characterized by the presence of thyroid tissue in a site other than its usual pretracheal location. Of all ectopic thyroids 90% are found to be lingual. Lingual thyroid is estimated to occur in 0.2 per cent of normal children, being more common in females. It is a rare congenital anomaly appearing with prevalence of 1:100000. This embryological anomaly originates from failure of thyroid gland to descend from foramen caecum to its normal pre laryngeal site. Interestingly, only 0.01% of these patients present with any overt symptoms. If symptomatic: dyspnoea dysphagia, dysphonia and stomatolalia are some common clinical features associated with it. In females these symptoms manifest during stress as in pregnancy, puberty and menstruation. Some rare clinical presentations reported in literature are hyperthyroidism, malignancy and hemoptysis. Hereby authors are reporting a 7-year-old female child who presented to our department with dysphagia who on evaluation diagnosed to have lingual thyroid with hypothyroidism.
      PubDate: 2019-06-27
      DOI: 10.18203/2349-3291.ijcp20192787
      Issue No: Vol. 6, No. 4 (2019)
       
  • A rare presentation of chikungunya in an infant

    • Authors: Vindhiya K., Selvendran C.
      Pages: 1750 - 1752
      Abstract: Chikungunya is an arboviral disease caused by chikungunya virus which belongs to the genus Alpha virus and Togaviridae. It is transmitted by Aedes aegypti and Aedes albopictus mosquitoes. The important reasons for the outbreaks are genetic adaptation of the virus and adaptation of the mosquitoes to the cold climate which lead to increased infectivity and dissemination. The clinical manifestations of disease in infants are different from that of older children and adults. Various dermatological manifestations of chikungunya include generalized erythema, maculopapular rash, vesicular lesions, hyper pigmentation and peeling of skin.
      Authors hereby report a case of 10 month old infant with fever and vesiculobullous lesion which was diagnosed as chikungunya infection.
      PubDate: 2019-06-27
      DOI: 10.18203/2349-3291.ijcp20192788
      Issue No: Vol. 6, No. 4 (2019)
       
  • Meconium pseudocyst revisited

    • Authors: Bhavana Malhotra, Nishant Mittal, Abhishek Jha, N. K. Mittal
      Pages: 1753 - 1756
      Abstract: Meconium peritonitis is defined as a sterile chemical or foreign-body peritonitis that is caused by escape of meconium from the intestinal tract into the peritoneal cavity during the fetal or perinatal period. Although meconium peritonitis is indicative of intrauterine perforation of the intestine, it may occur as early as the 4th to 6th month of INTRA NATAL life and as late as several hours after birth. It can be classified into three pathological variations: fibro-adhesive; cystic and generalized. The cystic type has a meconium filled pseudocyst that may rupture in the peritoneal cavity. Intra-abdominal calcification is pathognomonic for the diagnosis. Here, author reported a classical case of meconium peritonitis with pseudocyst formation, which was treated successfully conservatively.
      PubDate: 2019-06-27
      DOI: 10.18203/2349-3291.ijcp20192789
      Issue No: Vol. 6, No. 4 (2019)
       
  • Rett syndrome: a neurodevelopmental disorder

    • Authors: Setu Dagli, Arpita Thakker Adhikari, Mona Gajre
      Pages: 1757 - 1759
      Abstract: Rett Syndrome is a rare genetic disorder caused by a mutation on the MECP2 gene on the X chromosome. It classically presents with neuroregression, loss of purposeful hand use, stereotypical involuntary hand wringing movements, an ataxic gait and acquired microcephaly with a large proportion of patients developing seizures. The authors present the case of a 3.5 year old girl with severe global developmental delay and regression, loss of purposeful hand use and an ataxic gait for 2 years and seizures since 5 days along with microcephaly with involuntary hand movements but no classic wringing movements with no significant findings on MRI and EEG and diagnosed with Rett Syndrome on the basis of genetic testing.
      PubDate: 2019-06-27
      DOI: 10.18203/2349-3291.ijcp20192790
      Issue No: Vol. 6, No. 4 (2019)
       
  • Acute kidney injury in a critically ill influenza: a H1N1 infected child

    • Authors: Dinesh Kumar Jayapalan, Sangeetha Geminiganesan, Shruthi Parthasarathy, Niranjana Varadharaju, Nithya Bhaskar
      Pages: 1760 - 1763
      Abstract: Influenza H1N1 infection is a globally recognized epidemic and is known for several extra-pulmonary complications. Here, for the first time we report a case of a six-year old male child with severe H1N1 infection with acute kidney injury. The child was referred to our center with fever, chills, cough and cold for 2 days. Investigations revealed H1N1 infection with deranged LFT and RFT with anuria. Child was subjected to mechanical ventilation and received higher antibiotics in addition to oseltamivir. The child underwent 13 cycles of hemodialysis and renal profile normalized after a period of 35 days. Our case highlights the importance of recognizing extra-pulmonary complications of H1N1 infection in the pediatric population and the preparation required by healthcare practitioners to reduce the associated mortality.
      PubDate: 2019-06-27
      DOI: 10.18203/2349-3291.ijcp20192791
      Issue No: Vol. 6, No. 4 (2019)
       
  • A case of diabetic fetopathy: caudal regression syndrome and associated
           anomalies

    • Authors: Somnath Pal, Syamal Kumar Sardar
      Pages: 1764 - 1766
      Abstract: Uncontrolled periconceptional diabetes in mother  can give rise to severe malformation in the offspring. Author describe a case of  diabetic fetopathy  presenting as a case of  Caudal regression syndrome along with cardiovascular, gastrointestinal and genitourinary anomaly. Though most cases of Caudal regression syndrome are sporadic, it is the most specific lesion of diabetic fetopathy. Clinical presentation varies depending on the severity of the neurological lesion along with the presence of other anomalies, most commonly genitourinary malformation. The index case described here had a type IV lumbosacral agenesis with severe bilateral motor and sensory deficits along with D-Transposition of great arteries and Pyloric atresia. Such cases arise due to inadequate prenatal care of diabetic mother, which is not uncommon in developing country like India.
      PubDate: 2019-06-27
      DOI: 10.18203/2349-3291.ijcp20192792
      Issue No: Vol. 6, No. 4 (2019)
       
  • Unna Thost syndrome: a case report

    • Authors: Geetha M., Rajeswari Bhat, Kiran B., Madhusmitha Jena, Libni D. Angel
      Pages: 1767 - 1770
      Abstract: Unna thost syndrome is Palmo Plantar Keratoderma (PPK) of diffuse non epidermolytic type inherited in autosomal dominant fashion.
      Authors had a seven-year-old boy born to second degree consanguineous parents had palmoplantar keratoderma with hyperhidrosis with positive family history. He was promptly diagnosed and treated with acitretin and showed improvement.
      PubDate: 2019-06-27
      DOI: 10.18203/2349-3291.ijcp20192793
      Issue No: Vol. 6, No. 4 (2019)
       
  • An unusual presentation of biotinidase deficiency in infant: High anion
           gap metabolic acidosis and Burkholderia cepacia sepsis

    • Authors: Ravi Sharma, Anupam Chaturvedi, Sandeep Yadav, Rateesh Sareen
      Pages: 1771 - 1772
      Abstract: Biotinidase deficiency (BD) is an inborn metabolic disorder caused by low enzyme activity giving rise to impaired biotin release from dietary proteins. The first symptoms may be seen at first week following birth until 1 year of age. The goal of the therapy is to increase biotin bioavailability by daily 5-20 mg lifelong biotin replacement. Three-month-old girl born to nonconsanguineous parents, admitted to pediatric intensive care with multiple seizures, breathing difficulty and posturing. Blood investigations showed thrombocytopenia and high anion gap metabolic acidosis (HAGMA). Enzyme assay for biotinidase revealed low activities. Urinary organic acid analysis was normal. Enzyme activity is <10% in severe cases whereas between 10-30% in partial deficiency. BD can cause metabolic ketoacidosis, Hyperammonemia and organic Aciduria. BD behaves like immunodeficiency. Rarely bacterial infection can be seen. Treatment is lifelong biotin replacement.
      PubDate: 2019-06-27
      DOI: 10.18203/2349-3291.ijcp20192794
      Issue No: Vol. 6, No. 4 (2019)
       
  • Ketogenic diet: a promising alternative nonpharmacology treatment for
           pediatric epilepsy

    • Authors: Bella Kurnia
      Pages: 1773 - 1781
      Abstract: Epilepsy is a syndrome of brain dysfunction induced by the aberrant excitability of certain neurons. Despite advances in surgical technique and anti-epileptic drug in recent years, recurrent epileptic seizures remain intractable and lead to a serious morbidity in the world. The ketogenic diet (KD) is a nonpharmacologic treatment that has been used for refractory epilepsy since 1921. The KD is a high-fat, low-carbohydrate, and restricted protein diet, which is calculated and weighed for each individual patient. The goal of the KD treatment is to bring the brain into a state of ketosis to control seizures. Many studies have shown that ketogenic diet was very useful in controlling refractory epilepsy.
      PubDate: 2019-06-27
      DOI: 10.18203/2349-3291.ijcp20192795
      Issue No: Vol. 6, No. 4 (2019)
       
 
 
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