bluuebunny/crossref_metadata_2025 huggingface dataset:
A study on reliable diagnosis of allergic respiratory diseases by using eosinophil count in nasal and blood smear: a prospective study in tertiary care centre
Authors: Ankireddy Korisipati , M. Mallikarjuna
Published: February 2019

Background: Allergic rhinitis and asthma are two very common allergic diseases of respiratory tract in pediatric patients. In this geographical area, where the prevalence of allergens exists, the role of allergens as the etiological factor is higher in allergic respiratory disorders. Confirmation of allergen as etiologic agent is cumbersome in a small setup, where IgE estimation and allergy tests are not accessible. In this study, the simple test of peripheral smear and nasal smear eosinophil count as a reliable diagnosis to solve the above problem and establishing allergy as etiological agent has been tried.Methods: A present study which was conducted over 2 years in children between 2 to 12 years who visited tertiary health care centre, Kurnool medical college and general hospital. The allergic respiratory cases based on typical history and clinical features were included in the study and investigated for nasal and blood eosinophilia. Children with TB, recurrent and chronic pneumonia, malnutrition, malignancy, collagen vascular disorders and those who are on steroid therapy were excluded from the study. The clinical profile of allergic rhinitis with or without asthma and nasal and blood eosinophils are studied.Results: Out of 120 patients, there was male predominance and incidence was increasing as age increases. Dust is the most common risk factor for allergic rhinitis followed by weather changes, whereas in allergic rhinitis with bronchial asthma, weather change is common risk factor followed by dust and family history.Conclusions: In children with allergic rhinitis with or without bronchial asthma, there is positive relation between nasal and peripheral smear eosinophil count.
A study on clinical correlation of EEG in neonates with perinatal asphyxia
Authors: Shinde Rajendra , Haridas Kiran , Shelke Madhavi , Deshmukh L. S. , Patil P. S.
Published: February 2019

Background: Perinatal asphyxia is the most common and important cause of preventable cerebral injury occurring in the neonatal period. The WHO has estimated that 4 million babies die during the neonatal period every year. According to WHO, perinatal asphyxia is defined as the failure to initiate and sustain breathing at birth. The objective is to study the electroencephalographic changes and correlation between severity of Perinatal asphyxia with EEG changes.Methods: It is prospective observational study, which includes 40 term neonates admitted in NICU with perinatal asphyxia in GMCH Aurangabad. EEG analysis focused on background activity and classified into four categories.Results: The EEG was normal in 45%, mild abnormal in 25%, intermediate in 15%, and severely abnormal in 15%.  Outcome at discharge was normal in 19(47.5%) and abnormal in 21(52.5%) including 1 death. Abnormal outcome was seen in 27% of newborns with normal EEG and 72% of abnormal EEG.Conclusions: Severity of perinatal asphyxia correlated well with abnormality of EEG. EEG changes and severity showed good correlation with immediate outcome of newborn in terms of duration of hospitalization and normal neurological examination.
Study of foot length as an alternate measurement for assessment of gestational maturity in neonates
Authors: Tenali Ananya S. L. , Tenali Ravi Kumar
Published: February 2019

Background: The aim was to study neonatal foot length as a simple method for quick gestational age assessment which can be done by basic healthcare personnel overcoming the technicality required by other assessment methods.Methods: Prospective descriptive study was done. Live born neonates at Saveetha Medical College, Kanchipuram from June 2016 to June2017 were enrolled. Gestational age was assessed by New Ballard’s Scoring and footlength was measured using the paddle blades of automated digital Vernier calipers within 24 hours while birth weight was taken within 72 hours of birth. Based on gestational age, babies were grouped into preterm, term and post term and were subclassified as small for gestational age (SGA), appropriate for gestational age (AGA) and large for gestational age (LGA) based on Lubchenco’s intrauterine growth chart. Correlation and regression analysis and Scattergram was done.Results: Out of 300 neonates, term, preterm and post-term were 70.3%,28.3% and1.3% while SGA, AGA, and LGA babies were 9%, 88% and 3%. Mean foot length was 7.728cm±0.59 with a range of 5-8.8cm. Foot length strongly correlated with gestational age in Preterm AGA, SGA and Term AGA babies (<0.001). Correlation coefficient of foot length with gestational age was higher in preterms (r=0.95). Gestational age in 54% of study population could be calculated with the derived regression equation derived.Conclusions: Foot length maybe useful for quick estimation of gestational age in preterm and term neonates for early referral of newborns requiring special care and can even be done by basic healthcare personnel.
A study on efficacy of oral administration of colostrum fortified lactoferrin in the weight gain of low birth weight infants
Authors: Jayaseelan Raghul , Sivaprakasam Chidambaranathan , Palanisamy Logesvar
Published: February 2019

Background: Low birth weight babies is the result of being small for gestational age (i.e. under 10th percentile of the reference population) and preterm (i.e. before 37 weeks of gestation. Preterm infants have higher protein, calorie requirement, which cannot be met with unfortified breast milk feeds.Methods: This study was conducted prospectively in the Department of Pediatrics, Rajah Muthiah Medical College and Hospital, Chidambaram from October 2016 to April 2018. 20 low birth weight babies were selected by randomization technique and they were administered with 2 grams of oral colostrum fortified lactoferrin daily for 4 weeks. The rate of weight gain, length gain and head circumference gain were assessed prospectively for a period of 4 weeks. They were analysed statistically by ANOVA and tabulated. Babies weighing less than 2.5 kg and on exclusive breast feeding, were included. Babies more than 2.5kg and less than 1kg, at risk for neonatal sepsis, congenital heart disease, necrotizing enterocolitis were excluded from the study.Results: In the present study, 20 low birth weight babies were included. 11 maternal risk factors were identified. Out of which anemia stands as a single risk factor. The rate of weight gain in oral colostrum fortified lactoferrin, is 320 grams with P value of 0.703 which is not statistically significant. The rate of length gain is 3.3cm, p value is 0.093 which is statistically insignificant. The rate of head circumference gain in oral colostrum fortified lactoferrin is 2.8cm, with the p-value of 0.001 which is statistically significant.Conclusions: The rate of weight and length gain was normal, but the rate of head circumference gain is significantly increased in oral colostrum fortified lactoferrin supplementation.
Blood culture positive sepsis and sensitivity pattern in a tertiary care neonatal centre in eastern India
Authors: Rath Soumini , Panda Santosh Kumar , Nayak Manas Kumar , Pradhan Deepti Damayanty
Published: February 2019

Background: The objective of this study is to evaluate sensitive pattern of causative organisms of neonatal sepsis with its clinical outcome in a tertiary neonatal care unit of eastern India.Methods: This retrospective observational cohort study was done in a tertiary care hospital of Odisha. All the blood culture positive neonatal sepsis cases, excluding neonates with multiple congenital malformations, diagnosed during January 2017 to December 2018 were analysed using descriptive summary statistics.Results: A total of 73 neonatal sepsis cases were diagnosed by BacT/Alert and VITEK-2 blood culture method. Among them, 50 (68%) babies had gram negative sepsis,14 (19%) cases of gram-positive sepsis and nine (13%) cases of fungal sepsis. In present study 38 (52%) cases were early onset sepsis, 38(52 %) babies were term, 55(75%) were male and 44 (60%) babies were out born. Klebsiella pneumonia and Acinetobacter were the most common organism in early onset and late onset sepsis respectively. Among gram negative organism (GNB), 66% were multi drug resistant. A fifty percent of gram-negative organism were sensitive to meropenem and 28% were sensitive to piperacillin/tazobactam. The sensitivity of GNB to colistin, ciprofloxacin, amikacin was 76%, 64% and 56% respectively. The sensitivity of gram-positive organisms to linezolid, vancomycin, teicoplanin and penicillin were 92%, 85%,85% and 20% respectively. Survival rate among culture positive sepsis was 83%.Conclusions: Multi drug organisms are emerging in modern neonatal care practice. Practice of antibiotic stewardship may save the babies from multidrug resistance organism in future.
Clinical study of babies born through meconium stained amniotic fluid
Authors: Y. M. Shilpasri , B. Madhurya
Published: February 2019

Background: Meconium stained amniotic fluid has been considered a sign of fetal distress and associated with poor fetal outcome, but others considered meconium passage by fetus is physiological phenomena and produce environmental hazards to fetus before birth. Such magnitude of different opinion was the object behind taking up of this study and aim was to find out incidence and effect of meconium in terms of morbidity and mortality.Methods: Two hundred babies born with meconium stained amniotic fluid considering the inclusion and exclusion criteria from December 2012 to June 2013 in the Department of Paediatrics, Cheluvamba hospital attached to Mysore Medical College and Research Institute, Mysore. Fetal monitoring, mode of delivery, Apgar score, birth weight, resuscitation of baby are noted. All babies followed-up up to 1st week of neonatal life.Results: In present study 200 babies born through meconium stained amniotic fluid was randomly selected-thin 37% and thick 63%. Major complications like birth asphyxia, meconium aspiration syndrome, early neonatal death seen in 5.5% (11 cases), morbidity in 37%, 12.5% in thin and 24.5% in thick MSAF. Causes of death were meconium aspiration syndrome in 3 cases, sepsis in 1 case, pneumonia in 1 case and birth asphyxia in 6 cases.Conclusions: Immediate airway management, need for suction and intubation should be guided by state of newborn rather than presence of meconium. Timely diagnosis and management of meconium stained amniotic fluid may improve fetal outcome. From present study authors conclude that MSAF adversely affect fetal outcome mostly by thick meconium.
A prospective study to determine etiology, clinical profile and neurodevelopmental outcome of neonatal seizures admitted in newborn unit of Chengalpattu Medical College and Hospital, Tamil Nadu, India
Authors: Kolkar Yalaguraswami B. , Sailavasan Madhivannan
Published: February 2019

Background: Newborn with neonatal seizures is at risk of neurodevelopmental delay. The aim of this study was to determine the factors affecting the adverse outcome of neonatal seizures and to study the significant factors associated with poor neurodevelopmental outcome in neonatal seizures.Methods: This was a prospective study done at neonatal intensive care unit (NICU) in Chengalpattu Medical College during the period from June 2017 to September 2018. A total of 110 neonates with seizures admitted in NICU from first hour of life to 28 days of age were included in the study. Detailed history was collected in preformed proforma, and followed up to one year and neurological assessment done at 4th month, 8th month and 1 year. The Hammersmith infant neurological examination (HINE) was done at 4 and 8 month and the Bayley–III assessment was done at 1 year of age to determine the neurodevelopment outcome.Results: Out of 110 newborns with seizures, 86 cases were followed up to 1 year of age. Neurological assessment done by HINE determined abnormal neurodevelopment in 33.6% neonates. Bayley-III scale assessment found cognitive delay in 10.9%, language delay in 20%, motor delay in 5.55%, socio-emotional delay in 30%, and adoptive delay in 31.8% cases. Delayed developmental outcome is significantly associated with onset of seizures, frequency of seizure, poor 5 minute Apgar score, abnormal EEG, and hypoxic ischemic encephalopathy (HIE).Conclusions: The delayed developmental outcome high among the neonates with subtle and myoclonic seizures. Mortality and neurological impairment was after neonatal seizure is associated with Onset and frequency of seizures, low Apgar score at 5 min, findings of USG cranium, CT brain, EEG, and HIE.
A study on symptoms of children mechanically ventilated in a paediatric intensive care unit of a minimum resource setting in tertiary care centre
Authors: Ankireddy Korisipati , Jyothi K. Aruna
Published: February 2019

Background: Mechanical ventilation, a lifesaving intervention in a critical care unit is under continuous evolution in modern era. Despite this, the management of children with invasive ventilation in developing countries with limited resources is challenging. The study analyses the clinical profile, indications, complications and duration of ventilator care in limited resource settings. Methods: A retrospective study of critically ill children mechanically ventilated in an intensive care unit of a tertiary care government hospital.   Results: A total of 120 children required invasive ventilation during the study period of 1 year. Infants constituted the majority (70%), and males (65%) were marginally more than female children (35%). Respiratory failure was the most common indication for invasive ventilation (55%). The major underlying etiology for invasive ventilation was bronchopneumonia associated with septic shock (30%); and the same also required a prolonged duration of ventilation of >72 hours (35%). Prolonged ventilator support of >72 hours predisposed to more complications as well as a prolonged hospital stay of >2 weeks and above, which was statistically significant. Upper lobe atelectasis (50%) and ventilator associated pneumonia (25%) were the major complications. The mortality rate of present study population was 40% as opposed to the overall mortality of 10%.   Conclusions: Present study highlights that critically ill children can be managed with mechanical ventilation even in limited resource settings. The child should be assessed clinically regarding the tolerance to extubation every day, to minimise the complications associated with prolonged ventilator support.
Clinical characteristics of childhood vitiligo in Nigeria
Authors: Anaba Ehiaghe L. , O. O. Adebola
Published: February 2019

Background: Literature specifically documenting clinical characteristics of childhood vitiligo are few when compared to the documentation in adults in Nigeria. This study aims to document the clinical characteristics of childhood vitiligo.Methods: This was a retrospective cross-sectional study of 35 children diagnosed to have vitiligo from January of 2005 to December of 2010 at the dermatology outpatient clinic of the University College Hospital, (UCH) Ibadan. A proforma was used to extract socio-demographic variables and clinical features from the chats. Ethical clearance for the study was given by the research and ethics committee of the hospital.Results: Over the 5 year period, 35 out of 264 children were diagnosed to have vitiligo giving an incidence of 13.3 %. The children were made up of 34.3% males and 65.7% females. At presentation, 71.4% of the children were aged 0-10 years. In 80% of the children, age at onset of vitiligo was before age 10 years especially at age 6-10 years. The commonest area of onset was the face/scalp (51.4%) and the commonest type of vitiligo was segmental. Severity of vitiligo was <9% in 97.1% of cases. Vitiligo was in an exposed part of the body in 88.6% of the children. Only females had the genitalia as area of onset of vitiligo.Conclusions: Childhood vitiligo is mainly segmental, re-pigments well and occurs more in females. Only females have the genital area as the area of onset.
Clinical profile of type 1 diabetes mellitus among children in eastern part of Nepal
Authors: Muktan Dipak , Tamang (Ghising) Lisa , Singh Rupa Rajbhandari
Published: February 2019

Background: The objective of this study is to determine the clinical profile of Type 1 diabetes mellitus (T1DM) among children.Methods: Descriptive cross sectional study was conducted at B.P. Koirala institute of Health Sciences (BPKIHS), Dharan, Nepal, the eastern part of Nepal. A total of 42 diabetic children of less than 20 years old diagnosed with T1DM were included in the study. Data were collected via semi-structured interviews and medical records of patients attending diabetic clinic at the time of follow up.Results: The mean age at diagnosis of disease was 11.1±4.9 years. Polyuria 33 (78.6%) was found to be the commonest symptom followed by polydipsia 27 (64.3%), weight loss 23 (54.8%) and polyphagia 13 (30.9%). The mean duration of symptoms before diagnosis was 14.3±9.7 days. DKA was present in 25 (59.5%) children at the time of diagnosis. Mean Glycosylated hemoglobin (HbA1c) value was 10.6±2.7. Obesity was observed in 9 (21.4%) children. Nine (21.4%) children had family history of diabetes. In most of the cases, primary caregiver was mother, among them only 24 (57.2%) had formal education. Almost half of the caregivers were using FRIO, an insulin cooling case, for insulin storage.Conclusions: Polyuria was the most common presenting symptom followed by polydipsia, weight loss and polyphagia. Moreover, most of the children had landed up in diabetic keto-acidosis (DKA) at the time of diagnosis. Therefore, community awareness programs should be emphasized among parents and primary health care workers especially in rural areas regarding T1DM for early recognition and prompt treatment.
A comparative study of morbidity pattern among term and late preterm infants in a tertiary care hospital
Authors: Haridas Kiran , Shinde Rajendra , Nagar Pritesh , Parakh Hemant
Published: February 2019

Background: The incidence of preterm birth, defined as delivery before the end of the 37th week of pregnancy from the first day of the last menstrual period, is increasing. India accounts for the 40% of the global burden of low birth weight babies with 7.5million babies born with a birth weight of <2500g. The objective of the study is to compare the morbidity suffered by the late preterm infants with that of term infants.Methods: This was a retrospective study and the data for this study came from the medical records of maternal and neonatal case sheets and discharge summaries. The data was collected for the period between January 2014 and December 2014. All the late preterm infants born and admitted during early neonatal period were compared with term infants who were born and admitted during early neonatal period to the Aditya Hospital on the basis of maternal, infant and clinical characteristics.Results: A total 292 infants including LPTI and term infant records were obtained. LPTI group had significant problems compared to term infants. The predominant clinical problems at birth and during the early neonatal period are neonatal jaundice, transient tachypnea of newborn, feeding difficulty and probable sepsis.Conclusions: LPTI are at increased risk of morbidity compared to term infants and hence require special attention and care for possible complication during their early neonatal period.
Study of serum calcium, phosphorus and vitamin D status in multitransfused β-thalassemia major children and adolescents of Jharkhand, India
Authors: Ahmed Zeeshan , . Pushpanjali , Kausar Md. Shahnawaz , Sinha Doyel
Published: February 2019

Background: The pattern of levels of calcium, phosphorous and vitamin D levels among the patients with thalassemia major undergoing repeated blood transfusions remain unexplored. Only very few studies have been undertaken among Indian population. The present study was an attempt to determine the levels of calcium, phosphorous and vitamin D levels among thalassemia major patients undergoing repeated multiple transfusions.Methods: In a prospective observational study, 65 patients suffering from β-thalassemia major, aged 2-18 years, having undergone regular blood transfusion and chelation therapy, were evaluated for the levels of serum calcium, phosphorus and vitamin D and the values were compared to the standard values of the same.Results: The mean values of serum calcium (6.72±0.66), phosphorous (5.51±1.07) and vitamin D (13.12±2.9) were significantly lower in our patients as compared to that of standard population values, the difference in each being statistically significant (p<0.05).Conclusions: It is evident from the present study that the levels of calcium, phosphorous and vitamin D are deficient among β-thalassemia major patients on repeated blood transfusion. The deficiencies may be due to iron overload or due to nutritional deficiency. Frequent monitoring and supplementation in deficient states is recommended.
Study to determine gender variation in severe acute malnutrition at nutrition rehabilitation centre
Authors: S. Suguna , V. Vidyasagar
Published: February 2019

Background: The objective of this study is to know the gender variation in number of admissions, severity of malnutrition at the time of admission, gaining of weight and adherence to follow up in children admitted to nutrition rehabilitation center and during follow up.Methods: This is a retrospective study involving the review of existing programme records. Children who were admitted to nutrition rehabilitation centre, district hospital, Chamarajanagar, Karnataka, India, between January 2017 to December 2017 with severe acute malnutrition were involved in the study. The programme included 2 weeks of in-patient care, and four follow-up visits to the NRC subsequently as follows; 1st visit at 7 days, 2nd at 14 days, 3rd at 1 month and 4th at 2 months after discharge.Results: Among 57 children who admitted to NRC females were 30 (52.6%) and males 27 47.4%). 25 among 57 children (43.9%) could sustain weight gain of >5grams/kg/day as per one of the discharge criteria. 13 (52%) were females and 12 (48%) were males. 32(56%) among 57 admitted children to NRC, could achieve <-1SD during entire programmed. 15(46.8%) were females and 17 (53.1%) were males.Conclusions: There was no gender variation in either number of admission or severity of malnutrition at the time of admission or weight gain during NRC programme.
The outcome of resurgence of diphtheria in older children in a tertiary care hospital
Authors: K. R. Sachin , H. Ramesh , K. G. Sachin , E. S. Siddharth
Published: February 2019

Background: Diphtheria is a fatal bacterial infection which affects the mucous membranes of oropharyngeal and nasal cavity, caused by aerobic gram-positive bacteria Corynebacterium diphtheriae. With the advent of universal immunization against diphtheria the incidence of this infectious disease has declined dramatically with few developed nations having eradicated the disease. No large outbreaks have been reported in India in recent times.Methods: In present study, authors reviewed an outbreak of diphtheria in Davangere between the months of June 2017 and July 2018. Case records of children suspected to have diphtheria, admitted to hospitals affiliated to JJM Medical College, Davangere were retrospectively analysed.Results: 15 cases were suspected to have diphtheria on clinical examination. The mean age of presentation was 7.5 years. Fever, sore throat, difficulty in swallowing, neck swelling and patch in oral cavity were the common signs and symptoms. Airway compromise, myocarditis and neurological complications were noted. Antidiphtheritic serum (ADS) was tried in all 15 cases. Case fatality rate was 40%.Conclusions: Diphtheria is a resurgent problem in India. Prompt identification and early appropriate treatment is essential to prevent morbidity and mortality. Strict adherence to the national immunisation schedule should also be emphasized.
A study on sleep patterns and sleep problems in children aged 6 to 15 years as perceived by their parents
Authors: Tharakan Riya Mary , Shenoy K. Varadraj
Published: February 2019

Background: The objective is to study the sleep pattern and occurrence of sleep problems in children aged 6 to 15 years, visiting the Outpatient clinic at a tertiary care hospital, as perceived by the parents and to establish the common causal association as perceived by the parents for developing sleep problems.  Methods: The study design was based on the descriptive study. The duration of the study was from 1st June to 31st July. Data was collected from all the children visiting the Pediatric OPD and those who are admitted, Department of Pediatrics, Father Muller Medical College. Sample size: convenient sampling. Considering the prevalence of sleep disturbance in children as 10%, estimated error of 5% and confidence interval of 5%, sample size was 139. Children who followed the inclusion and exclusion criteria were considered for the study. Informed consent was taken from the parent. Relevant details were asked to the parents of the child and a pre-designed proforma was filled by the investigator accordingly. SDSC questionnaire was used and a cut off score of 39 was considered.Results: Out of the 140 children who completed the survey, 48% of the children had sleep disturbances.  The most common was disorder of initiating and maintaining sleep. The most common association was with need for accompaniment, followed by use of gadgets. The prevalence of sleep disorders is underestimated, and it is important to recognize them early.Conclusions: The increasing use of electronic gadgets could be a possible cause of sleep disturbances, which suggests that the exposure of children to these gadgets maybe reduced.
A qualitative study on experiences of mothers about control of diarrhoea of their children
Authors: Barik Kanai Lal , Paul Uttam Kumar
Published: February 2019

Background: Diarrheal disease poses a significant problem to the health, wellbeing and survival of children of less than five-year age group and is the second leading cause of mortality.  Most of the deaths are due to dehydration and it can be preventable by proper and timely use of oral rehydration salt solution (ORS). There is lack of awareness among the mothers about the appropriate use of ORS during diarrhea of children. So, authors have tried to find out the experiences of the mothers about the management of diarrhea of their children.Methods: The study is one of qualitative descriptive type involving 27 mothers of children who are suffering from diarrhoea in face to face in depth interviews (IDI).Results: The mothers of children were within the age group of 21 to 34 years of age group. On the basis of qualitative data analysis, the present study shows the data related to childhood diarrhea can be classified under six themes. The themes are : 'Perception of the participant mothers about the diarrhea of their babies', 'Measures taken by the mothers to combat diarrhea at home', 'How Oral rehydration salt solution is applied by the mothers', 'How Oral rehydration salt solution is beneficial', 'How Oral rehydration salt solution is causing undesirable effects on the baby' and 'What additional measures taken to control diarrhea of the baby'.Conclusions: There are several misconceptions and lack of awareness of the mothers about management of diarrhoea. However, it is possible to create awareness among them so that they can take all suitable measures to control diarrhoea.
Study of antenatal and postnatal factors affecting catchup growth in intrauterine growth retarded babies during first year
Authors: Polepalli Vamsee Krishna , Sarma Venu Gopala , D. Suresh Reddy
Published: February 2019

Background: The burden of IUGR is concentrated mainly in Asia with the proportion of IUGR 54% in India. Higher rates of IUGR should be a cause of concern because they signal high risk of malnutrition, morbidity and mortality for the new born. This study was done to see the factors affecting catchup growth (CUG) of IUGR babies during first year.Methods: The study was done in 120 SGA babies for a period of 18 months from October 2013 to March 2015. Antenatal, postnatal factors and anthropometry at 1st, 2nd, 3rd, 6th, 9th and 12 months were noted and analysed.Results: 78.3% babies showed CUG with in the first year. Preterm IUGR infants showed better CUG than full term. Asymmetric IUGR infants showed better CUG than symmetric. Teenage pregnancy, hypertensive disorders, multiple pregnancies, cardiac disease, anemia, type of IUGR, NICU stay, type of feeding, socioeconomic status, mother age, mother height, mother hemoglobin, gestational age, multiple gestation, birth weight, birth length, head circumference at birth all influenced CUG.Conclusions: Teenage pregnancies should be avoided. In SGA babies of pregnancy induced hypertension and preeclampsia, failure in CUG occurred more, these babies need to be followed in high risk clinics. SGA infants of mothers with low haemoglobin failed to show CUG, so antenatal nutrition improvement of mother should be done. Breastfed babies had higher CUG rates than formula fed babies, so exclusive breastfeeding should be promoted.
Clinicoepidemiology, clinical profile and outcome of venomous snake bite in children in Konaseema region of Andhra Pradesh, India
Authors: Rao K. Visweswara , Ramesh G. , Acharya Anand
Published: February 2019

Background: Venomous snake bite is an acute medical emergency, and children are more quickly and severely affected than adult. Venomous snake bite is responsible for 28.5 deaths per 1000 snake bite death among 5-15years old children. Most of them used to be from rural India and is more common in school going children. But there is no study regarding clinic epidemiology and treatment outcome among pediatric age group in this part of Andhra Pradesh. This retrospective descriptive has been conducted to evaluate the clinic epidemiology, clinical presentation, complication and treatment outcome in snake bite in pediatric patients in our set up.Methods: Present study is a retrospective, descriptive study conducted in the department of paediatrics Konaseema institute of medical science Amalapuram Andhra Pradesh, between 2006 to September 2018. This study protocol is approved by the institutional ethics committee. All the clinical parameters like, age, sex, season of bite, time of bite, socio economic statue, region, site, common clinical presentation, complications, reaction to ASV outcome of treatment were obtained from patient’s case record and was analysed.Results: In present study total 166 snake bite patient case records were evaluated, out of this 166 snake bite cases, 28 bites were by unknown snakes. Demographic profile of patient shows that out of 70 cases, 49 cases were in male child and 21 cases were in female child. Regarding clinical profile of the children with snake bite as mentioned in Table 3, local pain was present in (n=70) 100 % patients. Local blending was presenting symptom in 64.28 %(n=45) patients.Conclusions: From present study authors conclude that snake bite in children is more common among school going children, during monsoon and post monsoon, and in rural area. In our region vasculotoxic snake envanomation is more common and presented with cellulitis which required surgical intervention in most of circumstances. In neurotoxic envenomation some patient developed respiratory paralysis which required ventilatory support.
Estimation of coverage of pulse polio immunization round on 28th January 2018
Authors: Mahajan Zubin Ajay , Mehta Sameera Rajendra , Bafna Tanvi Ajay , P. S. Narula A.
Published: February 2019

Background: India accounted for more than 50% of polio cases globally. India therefore started the intensive pulse polio immunization (IPPI) in 1995. The national immunization days (NID) were on 28th January and 11th March 2018. The objectives of this study were to determine the completeness of pulse polio immunization round on 28th January 2018, to evaluate the reasons for non-compliance of the community towards the vaccination round, to assess the demographic profile amongst the unvaccinated children.Methods: A cross-sectional descriptive study was conducted among 570 children of zero-five years were checked in major areas of Pune that is Katraj Zoo, Swargate, Saras baug and a school in Dhankawadi. The data was collected after the first round of PPI by viewing the ink mark on the left little finger nail of the child or by interviewing the parents. SIA monitoring chart was used to assess the completeness of immunization campaign. Statistical analysis: Microsoft Excel were used to calculate percentages.Results: Out of 570, 69 (12.1%) were unvaccinated with the highest number seen in nursery that is 28 (40.6%). Amongst the unvaccinated (n=69), 40 (57.9%) were males. In the unvaccinated children (n=69), 13 (18.84%) and 56 (81.15%) belonged to age group of  zero-two years and two-five years respectively. Reasons for being unvaccinated were 29(42%) parents were unaware of time and place of PPI, 21 (30.4%) were outside Pune and 19 (27.5%) were unwilling due to false beliefs..Conclusions: Awareness should be increased about benefits of PPI through mass media, local leaders and teachers to enhance community participation. The authorities’ in charge of the PPI should be informed regarding areas lacking significant coverage so that they can be concentrated upon during subsequent PPI rounds ultimately contributing to eradicate poliomyelitis.
Correlation of cord blood albumin values with neonatal jaundice in health new-borns: a prospective observational study
Authors: Bhat Jehangir Allam , Ara Roshan
Published: February 2019

Background: The objective of the present study was to investigate the predictability of pathological jaundice on cord blood albumin values.Methods: It was a prospective observation study conducted in Kurji holy family hospital on 289 healthy new-borns. Babies were divided into two groups. Group A who developed physiological jaundice and group B who developed pathological jaundice. Cord blood albumin was estimated in all new-born who were then followed up-to 5th day of life. Babies who developed jaundice requiring treatment were admitted in NICU for phototherapy. Rest where checked regularly up-to 5th day of life and value recorded on 5th day by estimation of serum albumin.Results: Incidence of pathological hyperalbuminemia in present study was 11.2%. There was statistically significant correlation between cord blood albumin and development of pathological jaundice. Gender, age, mode of delivery and birth weight has no correlation with cord albumin and the subsequent development of jaundice. Cord blood albumin <3.5mg/dl when compared with subsequent development of jaundice has high specificity (83.92%) and negative predictive value (87.35%). Cord blood value of >2.5mg/dl has high sensitivity (97.06%), specificity (99.22%), Positive predictive value (94.29%) and negative predictive value (99.61%) in predicting future development of pathological jaundice.Conclusions: The 87.35% negative predictive value in the present study suggests that in healthy term babies (Cord blood albumin ≤3.5mg/dl) cord serum albumin can help to identify those new-borns who are unlikely to require further evaluation and intervention. These new-borns can be discharged with assurance to parents. Babies with CBA level <2.5mg/dl should be followed more frequently. Thus, this study concludes that cord blood total albumin levels reliably predict the occurrence of pathological hyperalbuminemia.
Neurological outcome of high-risk neonates at 40 weeks of gestational age and at three months of corrected gestational age
Authors: Khan Ameer , Galwa Anil
Published: February 2019

Background: Infants born <30 weeks’ gestation is at increased risk of long-term neurodevelopmental problems compared with term born peers. The predictive value of neuro behavioral examinations at term equivalent age in very preterm infants has been reported for subsequent impairment. Therefore, this study aims to attempt to study incidence of neurological abnormality in high risk neonates in our neonatal intensive care unit.Methods: A prospective cohort observational study was conducted at centre for comprehensive child health, division of neonatology, Pushpanjali Crosslay hospital (Max super speciality hospital, Vaishali), Vaishali, Ghaziabad, Uttar Pradesh, India. Duration of study was October 2014 to September 2015. Seventy-five high risk neonates fulfilling the inclusion criteria admitted at NICU were recruited after taking informed consent from mothers /fathers.Results: Total 75 high risk newborns were studied. Their clinical data was noted, neurodevelopmental, neurosensory examination done at 40 weeks of completed gestational age and also at 3 months on follow up. The data was collected according to pre-decided proforma. Neuro developmental assessment was done by updated Amiel-Tison manual of neurological examination. On follow up at 3 months all the newborns who were normal (54) at 40 weeks were found to be normal (100%) and also all those who were definite abnormal (4) at 40 weeks were found to be definite abnormal (100%). But out of the 17 who were moderately abnormal at 40 weeks, 13 (76.5%) have become normal and 4 (23,5%) remained moderately abnormal and none progressed to definite abnormality.Conclusions: There is lack of awareness regarding dog bite and its management among the rural population.
Neonatal sepsis due to coagulase negative Staphylococci: a study from Kashmir valley, India
Authors: Nazir Asifa
Published: February 2019

Background: Neonatal sepsis is a leading cause of neonatal mortality and morbidity. Early diagnosis and treatment with appropriate antibiotics are important to improve the prognosis of neonatal sepsis. Coagulase-negative Staphylococci (CoNS) have emerged as prominent pathogens in the neonatal intensive care unit. These infections are rarely fatal, but they cause significant morbidity, especially among very low birth weight infants. This study was done to know the prevalence of Coagulase-negative Staphylococci in neonatal sepsis and to determine their antibiotic susceptibility pattern.Methods: A prospective study was conducted on blood samples of suspected neonatal septicaemia between August 2017 and May 2018 received at Department of Microbiology, Government Medical College, Srinagar. Blood culture was done by automated blood culture system, (BacT/Alert) and identification and antibiotic susceptibility was done by VITEK2 method.Results: Out of 356 neonates screened, there were 185 (53.4%) positive blood cultures. Among the culture positive cases, 107 (57.83%) were male and 78 (42.16%) were female. Early Onset Septicaemia cases (130 [70.27%]) were found to be three times higher than late onset Septicaemia (55 [29.72%]). Coagulase-negative Staphylococci (CoNs) (30.27%) were the most common organisms isolated followed by Acinetobacter sp (15.1%), Klebsiella sp (5.4%) S. aureus (4.8%) and E. coli (4.8%). All the isolates of CoNS were sensitive to linezolid and vancomycin and tigecycline. Methicillin resistance was seen in 84% isolates.Conclusions: Present study highlights the emergence of Coagulase-negative Staphylococci (CoNS) as predominant cause of neonatal septicaemia. Most of the isolates were resistant to methicillin which is alarming and a cause for concern.
Clinical profile of children with pneumonia admitted at KIMS hospital, Bangalore, India: a prospective study
Authors: S. Srinivasa , E. Nithya , Reddy Varsha Monica , Devraj Shiva
Published: February 2019

Background: In India acute respiratory infections are an important public health problem accounting for 15-30 % of under-five mortality. Early detection, timely intervention, standard management and a proper early referral service can reduce the mortality rate. The objective of this study was to study the sociodemographic and clinical profile of children admitted with pneumonia, to study its relation to the duration of stay at the hospital.Methods: The study was conducted in KIMS hospital, Bangalore from September 2016 to August 2017. Sociodemographic and clinical features of children aged from 2 months to 18 years of age were studied. A total of 92 children who fulfilled the inclusion criteria for community-acquired pneumonia were studied. The patient population comprises mainly of the low-income group from rural areas, urban slums, referred patients from surrounding rural areas, and other centres.Results: A total of 92 children were studied, 52 boys and 40 girls. 45% children were breastfed for <6 months, and 28% were incompletely immunized. Majority of children belonged to lower socioeconomic group. Passive smoking was present in 38 % of the patients and overcrowding was seen in 50% of children studied. There is a significant association between passive smoking, delayed hospital care, and length of stay.Conclusions: Present study concluded that ARI was more common in LES children and incompletely immunised children. And children who got early medical attention i.e. <4 days had a lesser duration of hospital stay i.e. <7 days.
Clinicopathologic study of Kikuchi’s disease in children in a tertiary hospital in South India
Authors: Punnen Anu , . Kanagalakshmi , Manipadam Marie Therese , Verghese Valsan Philip , Mathew Leni Grace , Kumar Sathish
Published: February 2019

Background: The aim of this study was to evaluate the clinical and laboratory characteristics, treatment modalities and outcome of children with Kikuchi’s disease.Methods: A retrospective cross-sectional study was conducted among all children, histopathologically diagnosed with KFD.  Clinical, laboratory data and treatment outcomes were analysed.Results: During the study period, 53 children histopathologically confirmed as KFD were enrolled in the study. There were 36 males and 17 females. The lymph node involvements were mostly cervical with bilateral predisposition (63.5%), firm (88%), matted (30.8%) and tenderness (38.5%). Fever, headache, vomiting, chills, myalgia and rash were other common presentations other than cervical lymphadenopathy. The associated laboratory findings include anemia (71.2%), leukopenia especially lymphopenia (31.4%), monocytosis (21.6%), thrombocytopenia (16.3%), elevated CRP (53.1%), ESR (83.7%), LDH (100%) and elevated liver enzymes. Most of the children were managed conservatively (49.1%). Corticosteroids were administered for (22.6 %) of patients. Recurrence occurred in 4 children (7.5 %) and 13 children (24.5%) had other associated diseases.Conclusions: KFD should be suspected in well children with febrile cervical lymphadenopathy, especially with leukopenia, monocytosis, and elevated CRP, ESR, LDH, Liver enzymes. KFD in children can have rarely atypical presentations and coexist with other diseases.
Prediction of significant hyperbilirubinemia by estimating cord blood bilirubin in neonates with ABO incompatibility
Authors: Singh Ruchika , Jain Hemant
Published: February 2019

Background: Neonatal hyperbilirubinemia is a common condition that may occur in 60-70 % of term babies and the most common pathological cause leading to hyperbilirubinemia is ABO incompatibility. ABO incompatible newborns are reported to be at greater risk of significant hyperbilirubinemia and are associated with significant morbidity like development of kernicterus.  So early intervention, at proper time, is mandatory to prevent this sequel.Methods: A prospective study included 240 term new-borns with gestational age of >37 weeks and birth weight >2.5 kg born to ‘O’ blood group mothers. Soon after delivery, cord blood was sent for blood group, total bilirubin and direct coombs test. All enrolled new-borns were assessed clinically daily till day 5th for appearance of hyperbilirubinemia using Kramer method. The data was analysed using descriptive analysis, ROC curve in SPSS version 14.Results: Among two hundred forty ABO incompatible newborns, 40 (17%) had developed hyperbilirubinemia and among them most common blood group associated was B+ve (75%). Association between cord bilirubin content and maximum serum bilirubin content among newborn who developed hyperbilirubinemia was found to be significant (P value <0.01). As per ROC curve analysis, cord blood total bilirubin cut off value of 1.79mg/dl had sensitivity (82.5%), specificity (55.5 %), PPV (27.04%) and NPV (94.06).Conclusions: Cord blood total bilirubin levels ≥1.79mg/dl has a good predictive ability for prediction of significant hyperbilirubinemia among ABO incompatible new-born. DCT is neither specific nor sensitive screening tool for development of Neonatal hyperbilirubinemia in ABO incompatibility.
Burden of central nervous system infection in cases of fever with seizure and its association with outcome: an experience in a tertiary care center of Uttarakhand, India
Authors: Chand Ramesh , Sharma Yuvraj , Rakholia Ritu
Published: February 2019

Background: CNS infections have been linked to adverse neurological sequelae notably seizures and mortality. Although, various etiologies of AFE have been studied, but the mystery still remains untangled for the substantial risk factors for the diagnosis and outcome.Methods: This prospective study was carried out on 67 children between 2 months to 15 years, from (May 2016 to April 2017) tertiary care centre of Uttarakhand. Patients were analysed for demographic variables, haematological parameters, CSF analysis, neuroimaging and their outcome was assessed at one month of follow up.Results: This study showed, 70% (n=47) of the cases presented in acute febrile encephalopathy. Most cases were diagnosed with pyogenic meningitis (40%, n=27) and More commonly occur during rainy season (39%; n=26) radiologically meningeal enhancement (28%; n=18) as the most common finding. Cases of acute febrile encephalopathy with GCS ≤5 had significant association with mortality. (Fischer exact value of 0.005; significant at p<0.05).Conclusions: Clinical signs of meningitis are not always reliable, and a laboratory support is required to reach early diagnosis hence. Pseudomonas and MRCONS were the major pathogens responsible for the bacterial meningitis among the paediatric age groups, hence antibiotic management should be planned intensively while culture reports are awaited. Cluster of cases with meningoencephalitis were found in rainy season hence suggested possible etiologies are JE/ Scrub/ Enterovirus. Mortality as well as morbidity was high in cases with acute encephalitis syndrome cause? JE/unknown etiology in this era for modern medicine hence vector control strategies be encouraged.