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Sri Lanka Journal of Child Health
Number of Followers: 0  Open Access journalISSN (Print) 1391-5452 This journal is no longer being updated because: HTTP Error: Unable to connect remote server |
- Open access publications
Abstract: No abstract available Sri Lanka Journal of Child Health, 2023; 52(1): 1-2 Published on 2023-03-05 00:00:00
- Child Health: Navigating through crises
Abstract: No absytact available
Sri Lanka Journal of Child Health, 2023: 52(1): 3-7 Published on 2023-03-05 00:00:00
- Assessment of amblyopia among school going children aged 6-15 years in a
city of West Bengal, India: A cross-sectional study
Abstract: Introduction: Amblyopia is the leading cause of preventable monocular vision loss in children. Refractive error is a common cause of amblyopia, other causes being anisometropia, ocular media opacities, strabismus or a combination of factors. Since amblyopia is avoidable and mostly treatable, early screening and timely treatment are very important.
Objectives: To assess the prevalence and types of amblyopia among 6-15 years old school going children in urban West Bengal, India.
Method: A cross sectional study was conducted for one year among 3882 rural school children aged 6-15 years. A full ophthalmic examination, including refraction, fundoscopy and slit lamp examination was done in children having vision <6/12 without any organic lesion.
Results: Amblyopia was found in 112 (2.9%) children. Common causes of amblyopia observed were anisometropia (33.9%), strabismus (29.5%), meridional amblyopia (14.3%) and combined (13.4%). Amblyopia was found to be higher in males (3.2% vs 2.5%) and in the 11-15-year age group (3.1% vs 2.6%), though it was not statistically significant.
Conclusions: Prevalence of amblyopia was 2.9% in our study population and anisometropia was the commonest (33.9%) type.
Sri Lanka Journal of Child Health, 2023; 52(1): 8-12 Published on 2023-03-05 00:00:00
- Ocular manifestations in paediatric rheumatic diseases: Experience from a
paediatric referral hospital
Abstract: Background: Rheumatic diseases are characterised by inflammation of the joints, muscles, bones and skin. The musculoskeletal system is commonly involved in rheumatic diseases but ocular involvement, which can lead to loss of vision, may be a clue to the diagnosis or may add to the severity of disease. There is paucity of data regarding ophthalmic findings in children with rheumatic diseases, especially in India.
Objectives: To describe the clinical spectrum of ocular manifestations in paediatric rheumatic diseases in a tertiary level paediatric hospital in South India.
Method: A hospital-based cross-sectional, observational study was conducted in which 220 children diagnosed with rheumatic diseases were subjected to complete ophthalmic evaluation between January 2019 and June 2020 and the different ocular manifestations were documented.
Results: Of the 220 children with rheumatic disease, 29 (13.2%) had ocular involvement. Anterior uveitis was the most common ocular finding occurring in 8 (29.6%) cases. Duration of the disease and HLA B 27 had significant association with abnormal ophthalmic findings.
Conclusions: In this study, ocular involvement was present in 13.2% children with rheumatic diseases. Anterior uveitis was the most common ocular finding. Duration of disease and HLA B 27 positivity were significantly associated with abnormal ophthalmic findings.
Sri Lanka Journal of Child Health, 2023; 52(1): 13-20 Published on 2023-03-05 00:00:00
- Survey on screening for inborn errors of metabolism among medical
professionals caring for children in Sri Lanka
Abstract: Introduction: Newborn screening (NBS) is one of the most efficient and effective ways of detecting disorders among neonates who can then be treated and have an improved quality of life. Inborn Errors of Metabolism (IEMs) are a group of rare metabolic diseases that can be diagnosed at birth.
Objectives: To assess the level of knowledge and opinion on IEMs among medical professionals in paediatric and neonatology units in Sri Lanka
Method: An online survey was carried out using an online questionnaire among paediatric / neonatology professionals in Sri Lanka from April to October 2021.
Results: Participants were from the whole of Sri Lanka (n=320), but only 309 were included after excluding incomplete responses. There were 129 consultants, 124 postgraduate trainees, and the remainder were senior house officers. All respondents knew about the existing newborn screening for congenital hypothyroidism in Sri Lanka. The awareness on screening for congenital heart diseases, congenital adrenal hyperplasia glucose-6-phosphate dehydrogenase deficiencyand congenital deafness was 94%, 71%, 34% and 33%, respectively. Of the participants 96% had encountered patients with IEM, and they felt that IEM were underdiagnosed in Sri Lanka. Two hundred and fifty (81%) had heard about expanded newborn screening (eNBS), but only 54% rated average knowledge. Whilst 84% participants have justified eNBS, 67% suggested implementing it immediately. Two out of three participants felt thatit should be voluntary and government-funded. However, over 58% indicated screening only for at-risk babies.
Conclusions: Of the paediatric / neonatology professionals participating in the survey, 96% had encountered patients with IEMs, and they felt that IEMs were underdiagnosed in Sri Lanka. Whilst 81% had heard about expanded newborn screening, over 58% advocated screening only at-risk babies.
Sri Lanka Journal of Child Health, 2023; 52(1): 21-26
Published on 2023-03-05 00:00:00
- Prognostic factors affecting remissions based on minimal residual disease
(MRD) examination in paediatric acute lymphoblastic leukaemia patients
after induction phase treatment
Abstract: Introduction: Acute lymphoblastic leukaemia (ALL) is the most common cancer in children. Remission in the induction phase plays an important role in the prognosis of ALL. Minimal residual disease (MRD) examination can detect cancer cell residues that cannot be detected by conventional morphological examination methods.
Objectives: To identify prognostic factors affecting ALL remissions at the end of the induction phase of chemotherapy treatment using MRD examination as the paediatric gold standard.
Method: This is a retrospective cohort study. Forty-six children diagnosed with ALL aged 1 to 18 years in the paediatric ward of Sanglah General Hospital, Bali, Indonesia were enrolled in this study from 2017 to 2019. Data with categorical variables were analysed using the Chi-Square test. A p-value <0.05 was considered statistically significant.
Results: A total of 46 subjects, aged 1 to 10 years, was included in this study. Twenty-five (54.3%) patients experienced relapse, 21 (45.7%) of them achieving remission by MRD examination at the end of the induction phase. Bivariate test results showed a significant difference in therapeutic response based on L1 type (p = 0.028) and platelet levels (p = 0.017). Multivariate test results showed a platelet level >30,000/ cu mm caused remission in ALL patients (CI 95% 1.486-28.326, p=0.013). The L1 type was significantly associated with treatment response (95% CI 0.013-0.617, p = 0.014).
Conclusions: Platelet levels >30.000/cu mm and L1 type of leukaemia are prognostic factors for remissions based on the examination of MRD in paediatric patients with ALL after the induction phase.
Sri Lanka Journal of Child Health, 2023; 52(1): 27-32 Published on 2023-03-05 00:00:00
- Clinical profile and electroencephalogram characteristics of children with
self-limited epilepsy with centro-temporal spikes attending paediatric
neurology clinic, Teaching Hospital, Karapitiya, Sri Lanka
Abstract: Introduction: Self-limited epilepsy with centro-temporal spikes (SLECTS) is the commonest type of epilepsy in childhood. Though considered a benign condition in the past, there is growing evidence of its multiple neuropsychiatric involvement. Antiepileptic drugs (AEDs) were not recommended in children with SLECTS due to its benign nature.
Objectives: To describe the clinical profile and EEG characteristics of children with SLECTS followed up at the paediatric neurology unit, Teaching Hospital Karapitiya.
Method: A descriptive cross-sectional study, using an interviewer-administered questionnaire, was carried out at the paediatric neurology clinic, THK from December 2021 to February 2022.
Results:A total of 113 children with SLECTS was included in the study. Of them, 61.1% were males. Mean age of the sample was 10 ± 2.8 years. Mean age of onset of seizures was 7 ± 2.5 years. Majority (87.5%) were diagnosed after one seizure episode and 13.3% had a history of febrile seizures. Developmental delay was evident among 5 (4.4%) patients. Speech arrest (91.2%), hypersalivation (74.3%) and hemifacial sensory-motor seizures (56.6%) were the main manifestations; 87.6% had seizures at night. Abnormal EEGs were found in 110 (97.3%) patients and 51.3% had bilateral typical SLECTS changes in the EEG. Twenty-seven (23.9%) parents had concerns about their children's school performance. Behavioural problems were reported in 37 (32.7%). Child psychiatry referrals were done on 12 (10.2%) occasions. AEDs were used on 72.6% of patients and 27.4% had achieved remission. Sodium valproate was the most widely used AEDs (79.6%). Most of the patients were managed with monotherapy.
Conclusions: There was male predominance. Mean age of onset of seizures was around 7 years; 87.5% were diagnosed after one seizure episode and 87.6% had seizures at night. The predominant EEG characteristic was bilateral typical centro-temporal spikes and waves. Speech arrest (91.2%), hypersalivation (74.3%) and hemifacial sensory-motor seizures (56.6%) were the main manifestations of the seizure.
Sri Lanka Journal of Child Health, 2023; 52(1): 33-38 Published on 2023-03-05 00:00:00
- Retrospective comparative study on maternal, fetal, and neonatal outcomes
of symptomatic dengue infection: A study in Teaching Hospital, Peradeniya,
Sri Lanka
Abstract: Introduction: Dengue fever is one of the most important mosquito-borne infections and is considered a major health problem in Sri Lanka. The impact of dengue fever on pregnancy is not very well studied owning to small study cohorts and methodical bias.
Objectives: This is a retrospective comparative study to assess the maternal, fetal, and neonatal outcomes in symptomatic dengue infection in pregnancy
Method: The maternal, neonatal, and fetal outcomes of a cohort of pregnant patients with serologically confirmed dengue fever (n=24) were compared with an age-matched group of healthy pregnant mothers without symptomatic dengue illness (n=72).
Results: There were no statistically significant differences in birth weight (p=0.229), prematurity (p=1.000), peripartum complications (p=0.439) and mode of delivery (p=0.246). Neonates born to mothers with dengue infection needed more premature baby unit (PBU) admissions (p<0.01), and a longer hospital stay (p<0.01). Two maternal deaths were due to multi-organ failure with dengue haemorrhagic fever and one symptomatic case of mother-to-child transmission of dengue infection was noted in the study
Conclusions: In this study there were no statistically significant differences in the fetal or neonatal outcomes between the dengue-exposed and un-exposed groups of pregnant mothers. However, 2 maternal deaths were reported in the exposed group of 24 compared to none in the non-exposed group of 72 which is statistically significant (p<0.001).
Sri Lanka Journal of Child Health, 2023; 52(1): 39-44 Published on 2023-03-05 00:00:00
- Comparison between paediatric risk of mortality III and paediatric
logistic organ dysfunction-2 as mortality predictor in paediatric
intensive care
Abstract: Background: Scoring systems in an intensive care unit (ICU) help in monitoring the patient, evaluating the performance of the ICU and in determining the prognosis of the patient. Pediatric Logistic Organ Dysfunction-2 (PELOD-2) is a new scoring system describing organ dysfunction in paediatric intensive care unit (PICU) which has gained importance as a mortality predictor.
Objectives: To assess the performance of PELOD-2 in predicting mortality and compare it with Pediatric Risk of Mortality-III (PRISM-III) scoring system.
Method: This prospective observational study was carried out in a tertiary care PICU. All consecutive patients with critical illness were scored according to the 2 scoring systems within 24 hours of admission and followed up until discharge or death. Patients admitted for post-surgical care, PICU stay less than 2 hours, death within 8 hours of admission and patients leaving against medical advice were excluded from the study.
Results: A total of 550 patients with critical illness was included in study with a median (IQR) age of 60 (12,132) months and a M: F ratio of 1.6. Predicted mortality using PELOD-2 and PRISM-III score was 62 and 63 patients respectively whereas actual mortality was 67 patients. Area under the ROC was 0.992 for PELOD-2 and 0.98 for PRISM-III with a mean difference of 0.0118 with 95% CI (0.00325 to 0.0204) p value of 0.007. Hosmer and Lemeshow goodness of fit test also showed good calibration in predicting mortality for both scoring systems (PELOD-2: ꭓ2 = 6.051, p value of 0.301, PRISM-III - ꭓ2 = 9.391, p value= 0.153)
Conclusions: PRISM-III and PELOD-2 were found to have excellent discrimination and good calibration in our study.
Sri Lanka Journal of Child Health, 2023; 52(1): 45-51 Published on 2023-03-05 00:00:00
- Effect of dual task activity programme on balance and coordination in a
selected group of children aged 4-16 years with cerebral palsy (gross
motor function classification system levels I and II) using
telerehabilitation: A pre-post experimental study
Abstract: Background: Cerebral palsy (CP) children with gross motor function classification system (GMFCS) levels I and II experience problems in performing daily activities due to impairment in balance and coordination. Telerehabilitation refers to the use of information and communication technologies (ICT) to provide rehabilitation services to people remotely in their homes or other environments. It can prove beneficial to the family by decreasing time and costs related to travelling, family centred service and home-based delivery of care.
Objective: To determine the effect of dual task activity programme (DTAP) on balance and coordination in CP children aged 4-16 years with GMFCS levels I and II using telerehabilitation.
Method: The pre-post experimental study included 20 CP children aged 4-16 years who received DTAP using telerehabilitation with smartphone and internet for 3 days a week, for 6 weeks, each session lasting for 45 minutes. The children were assessed for balance and coordination using BOT-2 and functional mobility using the TUG test before and after intervention.
Results: CP children demonstrated significant improvement in bilateral coordination (p<0.0001), balance (p<0.0001) and functional mobility (p<0.0001) post-intervention. There was no significant change in balance, coordination and functional mobility based on age, gender and GMFCS level.
Conclusions: In this study of a selected group of children aged 4-16 years with cerebral palsy, GMFCS levels I and II, DTAP using tele-rehabilitation was found to be effective in improving balance, coordination and functional mobility.
Sri Lanka Journal of Child Health, 2023; 52(1): 52-58 Published on 2023-03-05 00:00:00
