bluuebunny/crossref_metadata_2025 huggingface dataset:
Readiness for self-directed learning among King Abdulaziz University medical students
Authors: Al-Basri Samera Fahad , Al-Afari Reem , Al-Hibshi Amro M. , Al-Sayes Faten , Soo Park Yoon , Tekian Ara
Published: December 2016

Background: To determine readiness for self-directed learning (SDL) among medical students enrolled at King Abdulaziz University (KAU) in Jeddah, Saudi Arabia, as well as identify demographic characteristics that might affect or control such readiness.Methods: Medical students at all levels of training were asked to participate in a study in the form of a self-response questionnaire via emailed link (Gugliemino’s Self-Directed Learner Readiness Scale [SDLRS]). This instrument was designed to measure the complex attitudes, skills and characteristics that comprise an individual’s current level of readiness to manage his or her own learning. Data were analysed using SPSS, and mean, median and total scores were calculated and compared.Results: Of more than 1900 medical students at the KAU Faculty of Medicine, 192 students responded to the self-response questionnaire (see appendix). Results suggested that readiness for SDL is below average for more than 99% of medical studentsConclusions: Our study showed that further evaluation of our students' readiness for SDL is required, as well as exploration and implementation of tools for improving skill and knowledge development, to enable students to develop a lifelong learning attitude.
Morbidity associated with sickle cell trait carriers
Authors: Seck Moussa , Soubaiga Yannick , Faye Blaise Félix , Sy Diariétou , Touré Sokhna Aissatou , Dieng Nata , Sall Abibatou , Touré Awa Oumar , Diop Saliou
Published: December 2016

Background: Sickle cell trait carriers has long considered asymptomatic. This affirmation is now challenged because many patients complain of osteoarticular pain and several organic degenerative complications in particular; renal, eye and sudden death have been described. The objective of this study was to evaluate the morbidity of sickle cell trait and identify risk factors associated.Methods: This is a prospective study with duration of 16 months including 50 patients with sickle cell trait received regular visits (every 6 months) for painful events. Biological assessment was carried out systematically to eliminate rheumatic disease (CRP, ASLO, latex Waler Rose) or metabolic disorders (serum calcium, serum magnesium, and serum uric acid). A correlation between clinical and laboratory data was performed to study the relationship between morbidity observed and biological abnormalities.Results: Mean age of patients was 32 years (12-59) and mean age at diagnosis was 24 years (12-55 years). Sex ratio M/F was 0.16. Clinical symptoms were osteoarticular pain (88%), headache (86%), abdominal pain (76%), muscle cramps (70%), dizziness (56%), biliary lithiasis (6%), femoral head osteonecrosis (2%) and gross haematuria (2%). Seventeen patients (34%) had abnormal metabolic or rheumatic analysis. No risk factor associated with morbidity of patients was identified.Conclusions: This work has allowed us to find that the symptoms presented by sickle cell trait patients are dominated by painful events. This morbidity associated with porting sickle cell trait was not secondary to inflammatory or metabolic disorders or physical activity.
Changes in homocysteine levels during normal pregnancy and preeclampsia and its relation with oxidative stress
Authors: A. V. Shilpa , P. A. Zubaida , G. Rajalekshmi
Published: December 2016

Background: Preeclampsia is a pregnancy specific disorder characterised by vasospasm and endothelial dysfunction. One of the most favoured hypotheses is the endothelial dysfunction secondary to the peroxidation of membrane lipids resulting in altered vascular reactivity, loss of vascular integrity and activation of the coagulation cascade. Elevated circulating homocysteine is a risk factor for endothelial dysfunction and vascular diseases and is found to be associated with preeclampsia. Hyperhomocysteinemia increases the risk of atherosclerosis through a mechanism involving oxidative damage. Malondialdehyde, (MDA) a metabolite of lipid peroxides detectable in plasma is used as an indicator of lipid peroxidation.Methods: The present study was undertaken to find out the alterations in the circulating levels of serum homocysteine and malondialdehyde (MDA) in normal pregnancy and preeclampsia when compared to normal nonpregnant women. The case control study was conducted by taking a statistical sample size of 30 subjects (18- 35 years) in each group. Data were analyzed using ANOVA. Significance level was fixed at p<0.05.Results: The mean serum levels of homocysteine were higher in preeclampsia patients than normal pregnant women. The mean serum levels of MDA in preeclampsia patients were higher than that of normal pregnant women.Conclusions: The increased homocysteine levels in preeclampsia results in endothelial dysfunction and vasospasm. Also oxidative stress plays an important role in the pathogenesis of preeclampsia. Thus identifying the risk factors and aggressive management may prove to be beneficial in these women.
Lymphatic filariasis: the importance of screening all peripheral blood smears in low power for detection of asymptomatic cases
Authors: Chavarkar Sneha P.
Published: December 2016

Lymphatic filariasis caused by the mosquitoborne, lymphatic-dwelling nematodes Wuchereria bancrofti and Brugia malayi is still a common tropical parasitic disease and 120 million people are affected in the world, of which two-third are in Asia. They cause high morbidity and mortality among humans. Irreversible “elephantiasis” is the major clinical manifestation for LF. Detection of microﬁlaria in peripheral blood is important. In addition to simple thick and thin blood smear tests, concentration techniques are used: mainly density gradient centrifugation, haemolysis and ﬁltration of the blood through a polycarbonate membrane, which retains the parasite. Diagnosis has been revolutionized with the availability of circulating filarial antigen (CFA) tests which are easy to perform but are costly. Diethylcarbamazine (DEC) is the drug of choice for treating lymphatic filariasis. In the light of this information, hereby presenting a case series of 4 asymptomatic patients who were diagnosed with filariasis on peripheral blood smear examination. The article emphasizes the importance of low power scanning of every peripheral blood smear, especially when the laboratory is not facilitated with costly methods to detect microfilaria.
Rectus sheath haematoma complicating dengue haemorrhagic fever-a case report
Authors: Kaur Harharpreet , Girgila Kawalinder
Published: December 2016

Dengue hemorrhagic fever manifests in various forms, ranging from petechial skin hemorrhages to life threatening hemorrhages. However it is very rare to have muscle hematomas in this condition. We report a case of spontaneous Rectus sheath hematoma complicating dengue hemorrhagic fever. Our patient was a 55 year old female positive for NS1antigen and anti-dengue IgM. She had thrombocytopenia with platelet counts as low as 12000 in the beginning. There was evidence of plasma leakage and acute dyspnoea during the course of illness. On the 5th day though the platelet count had recovered she developed haematoma in the left rectus sheath which was diagnosed on ultrasound and aspirated leading to relief of symptoms. This complication needs to be recognized so that it can be treated early.
Complaints box as a measurement of quality improvement in Institute of Health Science Faletehan, Indonesia
Authors: Fatoni . , Syukrowardi Delly Arfa , Lukman Muhammad
Published: December 2016

One of indicators in quality improvement in private college was student's satisfaction. Whether or not student satisfies to the college, complaints box can be uses as a tool of it. The purpose of this study was to report the student complaints box that has been used as a tool of quality improvement in Institute of Health Science (IHS) Faletehan, Indonesia. The student complaints from December 2014 to October 2016 have been gathered. All complaints were written by student in a blank of submission form with the requirement of student number as identity (ID). Total of 250 complaints were collected and were investigated by a single trained staff member of the Quality Assurance (QA) Department of IHS Faletehan, who reviewed statements related to the complaints. Each complaint was classified as operational, educational, and student service-related. In analyzing process, data were re-written and were analyzed by using QDA Miner Lite. Here we present the total 250 complaints of student that addressed on the individual, unit and organizational levels. This study showed that the sustainable of quality improvement in IHS Faletehan is effective through complaints box.
5 Cases of traumatic double acute extradural hematoma in M. D. M hospital Jodhpur, Rajasthan, India
Authors: Agay Ashuvi Kunjan , Garg Sunil , Thanvi Sharad , Hedaoo Ketan
Published: December 2016

Double acute EDHs are extremely rare. It is an uncommon consequence of closed head injury and the reported incidence ranges from 2 to 25% in different series.5. It may be unilateral or bilateral. Bilateral EDH may be symmetrical (same region on opposite site) or asymmetrical (different region on opposite site).
Assessment of developmental outcome of neonatal seizures at NICU of tertiary care centre hospital
Authors: Saral Swati , Ghanghoria Pawan
Published: December 2016

Background: Seizures are relatively common among first month of life. New-born with neonatal seizures are at risk of developmental delay. The objective of this study was to assess the developmental outcome of neonatal seizures and to study the factors associated with delayed developmental outcome in neonatal seizures.Methods: A prospective observational Study was conducted in 71 term and preterm neonates with documented seizure admitted in Medical college hospital, Jabalpur. A predesigned pretested questionnaire was used. The face to face interview technique was used for collection of data by mother, followed by clinical examination of newborn and investigations were done. DDST II was used for developmental assessment of neonates. Results: Neonates with delayed developmental outcome are 42.62%. Delayed developmental outcome is significantly associated with male sex, low birth weight, prematurity and multiple frequencies of seizures.Conclusions: The delayed developmental outcome was high among neonatal seizures.
Clinical profile and outcome of acute lower respiratory tract infection in children aged between 2 months to 5 years
Authors: M. K. Alok Kumar , Badakali Ashok V. , Mirji Gangadhar , Vanaki Raghavendra N. , Pol Ramesh
Published: December 2016

Background: Acute respiratory infection is a leading cause of morbidity and mortality in under five children in developing countries. Hence, the present study was undertaken to study the clinical profile and factors predicting the outcome.Methods: Hospital based case series study conducted at HSK hospital & Research centre. The study conducted from 01 March 2014 to 31 August 2015. 200 ALRI cases in the age group of 2 months to 5 years as per WHO criteria for pneumonia fulfilling the study criteria were evaluated for clinical profile and outcome as per predesigned proforma. Data collected was analyzed using chi square test. Results: We found higher incidence of ALRTI cases among infants (53.5%) and male (58%) children. Majority had PEM (60.5%) and anemia (73.5%). Parental smoking, period of EBF and gestation at delivery were significantly associated with severity of pneumonia (p <0.05). 1.5%, 77.5% and 21% had pneumonia, severe and very severe pneumonia with mean duration of hospital stay of 5, 7.43 and 10.36 days. Need of change in antibiotics and duration of stay were significantly associated with pneumonia severity (p <0.05). 56.5% cases required oxygen and 4.5% required mechanical ventilation. Bronchopneumonia (33.5%) was the most common diagnosis and sepsis (6%) was the most frequent complication. Mortality was 3%.Conclusions: Present study has identified prevalence of various risk factors among ALRI cases and predictors of severity and outcome. ARI burden and severity can be reduced by promoting EBF and immunization, effective management of malnutrition, improving the living standards and educating parents about hazards of smoking.
Clinical and laboratory profile of dengue fever in children during an outbreak - one year study at tertiary care hospital, Chennai, Tamilnadu, India
Authors: Sharma Natwar Lal , Balasubramanyam Vasuki , Kandati Jithendra , Ponugoti Munilakshmi
Published: December 2016

Background: Dengue fever is a mosquito borne arboviral disease which is of global concern. It is endemic in tropical countries with annual incidence of 7.5 to 32.5 million cases. It commonly affects the young adults and paediatric cases of Dengue haemorrhagic fever has high mortality. The objective of this study was to assess the clinical and laboratory profile and outcomes of dengue fever in children of less than 18 years of age. The study was conducted for a period of one year during an outbreak, in a tertiary care hospital of Chennai, Tamilnadu, India.Methods: This was a prospective cross sectional study and 200 cases of dengue fever were enrolled and classified as per WHO guidelines. The clinical profile and demographic profile was recorded in a structured questionnaire form. Haematological parameters were recorded and followed till the day of discharge. The duration of stay was recorded and outcomes were noted.Results: A total of 200 cases with 113 males and 87 females, 177 non severe dengue cases and 23 severe cases of dengue fever were classified. The mean age of admission was 9 years and mean duration of stay in hospital was 4.61 days. Fever was most common presenting symptom (100%) and hepatomegaly (58.5%) was common clinical finding. Bleeding manifestations were seen in severe dengue cases. Statistical significance was seen in rise in SGOT levels, rise in haematocrit and pleural effusion with severe dengue cases and non-severe dengue cases. The case fatality rate was zero.Conclusions: Understanding the knowledge of presentations and associated features would help to predict the severity of the disease. In children, if symptoms like fever, pain, rashes, and vomiting are associated with Hepatomegaly and elevated SGOT in context of low total platelet count, a strong possibility of dengue fever is present, especially in an epidemic setting. Early suspicion and effective management can reduce the severity.
To compare the efficacy of two probiotics in acute non bloody diarrhea
Authors: Kumar Mohitesh , Ahmed Minhajuddin , Vohra Pankaj , Warsi Sumbul
Published: December 2016

Background: According to WHO watery diarrhea is defined as passage of 3 or more loose stools without blood during preceding 24 hrs. End point of diarrhea was defined as passage of 3 stools of formed consistency. The objective of this study was tocompare the efficacy of two groups of commercially available probiotics in treating children hospitalized with acute non-bloody diarrhea on the basis of duration of stay in hospital, frequency of stool per day and duration of requirement for intravenous fluid. And to compare the results of probiotics in Rotavirus antigen positive children.Methods: A prospective interventional study was conducted in Holy Family Hospital, New Delhi in children aged between 6 months - 5 years hospitalized with acute non bloody diarrhea with 30 children in each group.Results: Total 123 children (6 months - 5 years) admitted in hospital with acute diarrhea, out of which 6 turned out to be bloody, 5 could not be followed up and 3 went LAMA. Finally 109 children with 68 males (62%) with male:female ratio of 1.65. Total 109 children (68 males) were included - Group A (33), 48 in Group B (48) and 28 in Group C (28). In a lateral study, Group A (11), Group B (23) and Group C (10) were Rotavirus positive. 49 children (45%) admitted with stool frequency of 5-10 times per day. Majority of children presented with symptoms like vomiting (68%), fever (55%), decrease oral intake (45%), decrease urine output (25%). Majority of patients 92 children (84%) were between 6 months to 2 years. 44 children (40%) were Rotavirus antigen positive.Conclusions: There is no statistical significant advantage of adding probiotics for treating acute non bloody diarrhea including Rotaviral.
Validation of language evaluation scale Trivandrum in children aged 3 -6 years attending well baby clinic in a tertiary care hospital
Authors: Singraiah Avinash , Hegde Pavan , Mendonsa Hazel D.
Published: December 2016

Background: Delay in language development is often an early and most sensitive indicator of intellectual disability. Language delay should be detected in early stages for early intervention, so our study is to validate a simple screening tool to assess language and speech delay in a tertiary care setting. Present study was conducted to validate LEST to use in pediatric clinics to identify delay in language development among children of 3-6years, and to compare LEST and extended receptive expressive emergent scale (Extended REELS).Methods: This was a cross sectional descriptive study done in children aged 3-6 years attending well baby clinic at a tertiary care hospital. Total sample size was 100. After the written informed consent, LEST was applied to all children initially and then extended REELS was administered in the department of speech and hearing.Results: The prevalence of language and speech delay in the present study was 16%. When one item delay was taken as ‘LEST delay’ (test positive), the sensitivity and specificity of LEST was found to be 25% and 80% respectively with a negative predictive value of 85% and Likelihood ratio (LR - negative) of 0.9. When two item delay was taken as ‘LEST delay, sensitivity and specificity, was found to be 44% and 99% respectively with a negative predictive value of 91% and LR (negative) of 0.5.Conclusions: The 16% prevalence of language delay in the children indicates the need for an early identification and for it a simple screening tool like LEST is a must during the routine evaluation of young children in pediatric clinics.
Clinico-etiological pattern of upper gastrointestinal bleeding in children
Authors: Dubey Shiv Ram Krishna , Bhadauria Neha , Shukla Mukesh , Mittal Purvi , Arya Arun Kumar , Singh R. P.
Published: December 2016

Background: Upper GI bleeding (UGIB) is defined as bleeding occurring proximal to ligament of treitz. Upper gastrointestinal bleeding (UGIB) can lead to potentially serious and life-threatening clinical situation in children. Globally, the cause of UGIB differs significantly depending on variations in patient population and the presence of comorbid conditions. The objective of this study was to understand the clinico-etiological pattern of upper gastrointestinal bleeding in children in the age group 5-18 years, at a tertiary care centre in central India.Methods: This prospective study was carried out at a tertiary health care centre between January 2011 and August 2012. We consecutively enrolled all patients in the age group 5-18 years who came to our centre with hematemesis or hematemesis and malena both. Blood sample for CBC, stool sample for occult blood was taken and Ultrasonography of abdomen for liver echotexture, portal vein diameter/pressure and splenomegaly, done. Then, all patients underwent upper gastro intestinal endoscopy (Olympus GIF-V70 upper GI video endoscope).Results: Total 112 patients were included in the study during the study period. UGIB is most common in the age group 5-10 years (71.4%), followed by 10-14 years (26.8%). Hematemesis is the most common presenting symptom (75%) followed by both hematemesis and melena (25%). The most common causes of UGIB on EGD were oesophageal or gastric varices (91.1%) followed by erosive gastritis (5.3%), gastric ulcer (1.8%) and esophagitis (1.8%). Most common finding on ultrasonography (USG) abdomen was extra-hepatic portal venous obstruction (EHPVO) 75%, followed by liver cirrhosis (16.1%). No abnormality was detected on USG in 8.9% of patients.Conclusions: We conclude that Upper GI bleeding is more common in 5-10 years age group with hematemesis as the main presenting symptom. The causes of upper GI bleeding in children in developing countries are different from those in developed countries (variceal bleeding due to extra hepatic portal venous obstruction is the most common cause and peptic ulcer is rare).
To study the frequency, etiology and predisposing factors of urinary tract infection in children with nephrotic syndrome in Eastern Odisha Region: a hospital based study
Authors: Dash Dillip Kumar , Bisoi Swarup Kumar , Mohanty Mamata Devi , Dash Mrutunjaya , Acarya Naresh Chandra
Published: December 2016

Background: The increased prevalence of infection in nephrotic syndrome is due to immunoglobulin loss, defective T cell function, and presence of ascites, relative malnutrition, and immunosuppressive therapy and associated with other factors. The objective of this study was to study the incidence, aetiology and the antibiotic sensitivity pattern of urinary tract infections (UTI) in children at presentation of nephrotic syndrome (NS).Methods: A retrospective hospital-based study carried out in IMS and SUM Hospital, Bhubaneswar, India. Seventy six children aged between two to twelve years with a diagnosis of NS at the time of were studied from April 2014 to March 2016.Results: The mean age of males was 5.9±0.5years and females are 6.2±0.8years. Pyuria was noted in 44 (57.89%) of the patients. Boys were more commonly affected with urinary tract infection than girls with a ratio of 1.9:1. UTI is the most common encountered infection and was predominantly caused by E. Coli in 18 (39%), Klebsiella species 7 (15.21%) and culture negative in 8 (17.28%) cases. There was high in vitro resistance of these organisms to cefixime and ampicillin but sensitive to cefotaxime, amikacin, ceftriazone , piperacillin- tazobactum and vancomycin.Conclusions: It is recommended that UTI should be sought for in patients with nephrotic syndrome and treatment should be prompt and appropriate taking into account of etiology and predisposing factors. UTI is one of the most common infections accompanying NS due to many factors. A high index of suspicion and early institution of appropriate antibiotics will help in reducing morbidity and mortality.
Clinical profile of children presenting with acute abdomen in a tertiary care centre of South Tamilnadu: a retrospective observational study
Authors: Rajma Jenish , A. C. Arun , R. V. Jeyabalaji , S. Natarajarathinam , G. Mathevan
Published: December 2016

Background: Acute abdominal pain is a common presentation in both outpatient visits and emergency room. It can be organic or functional, medical or surgical. We did an observational study to evaluate the clinical profile of children presenting with acute abdominal pain <7 days duration and analyse the various medical and surgical causes for this clinical presentation.Methods: Children <15 years presenting with acute onset pain abdomen <7 days with or without fever, vomiting, loose stools or urinary symptoms and admitted in pediatric ward were included in the study. Out of the 205 children enrolled in the study, 120 were males and 85 were females.Results: Only 15.6% of cases were of surgical etiology requiring elective or emergency surgical interventions. Among the 173 children diagnosed with variety of medical conditions, the most common condition presenting with pain abdomen was acid peptic disease (16%) followed by acute gastro enteritis(14%) and Urolithiasis(13%). Increasing prevalence of acute pancreatitis and type 1 diabetes mellitus (13 cases each) in children were observed.Conclusions: Long term follow up of children presenting with mesenteric adenopathy without other significant pathology is warranted to avoid unnecessary empirical antituberculous treatment. Our study helped us to identify the different spectrum of etiologies across the three age groups (1-5 years, 6-10 years, 11-15 years) and some diseases were showing male or female predilection.
Clinico-epidemiological profile of acute respiratory infections and malnutrition in urban and rural population of central India
Authors: Jawade Pranav G. , Sukhsohale Neelam D. , Jawade Gayatri G. , Khan Binish Z. A. , Kakani Pratik K. , Aklujkar Saurabh P. , Dudhe Rajkumar K. , Bhagwat Aditya S.
Published: December 2016

Background: Acute respiratory infections (ARI) and Malnutrition in children have tremendous burden on the health care sector of developing nations including India. The intensity with which these conditions are holding grip in the community is indeed a matter of concern and hence developing nations should develop an insight to assess the severity of it has become a necessity.Methods: A hospital based cross sectional study was carried out in children aged 0-14 years. Children were clinically assessed and diagnosis was made as URTI or LRTI Also anthropometry was performed and accordingly children were divided into categories of no malnutrition (NM), severe acute malnutrition (SAM) and moderate acute malnutrition (MAM) in ‘under 5’ years age children according to WHO guidelines, whereas children aged ‘above 5’ years were categorized as per the IAP guidelines.Results: It was observed that most of the mothers of children were illiterate with inadequate or absent ventilation and use of biomass fuels (chulha) for cooking purpose in households of rural children. The proportion of malnutrition was found to be equal in Under 5 children. In ‘above 5 years’ age study subjects, 52.4% of urban study subjects were normal as compared to 16.7% of rural study subjects.Conclusions: Our study implies that ARI and Malnutrition definitely is more prevalent in the pediatric population. Prevalence of URTI was found to be on a higher side in the rural population and LRTI prevalence was found to be higher in the urban population. Similarly, the prevalence of malnutrition was almost similar in ‘Under 5’ aged children, whereas the prevalence of malnutrition in ‘Above 5’ aged children was higher in the rural population than urban population.
How good are the examination findings in predicting the chest radiographic abnormalities amongst children with LRTI?
Authors: Goel Ishank , Kher Anjali , Vagha Jayant
Published: December 2016

Background: Acute lower respiratory tract infections are an important cause of mortality and morbidity in children below five years of age. Plain chest radiograph remains the most accessible and commonly used radiological tool. The present study is thus designed to clinically evaluate children with pneumonia, to identify the risk factors and correlate them with the X-ray findings.Methods: Our study was an observational and Analytical study. A total of 250 patients from the age group of 2 months to 5 years, admitted in paediatrics wards with respiratory complaints suggestive of involvement of lower respiratory tract whose X-rays were done were included in our study. All the patients were examined by the clinical experts every day and the findings were being confirmed by at least two experts. Radiologists/residents in the department made the first assessment during their daily practice through online database. The radiologist, who was not informed about the results of the first assessment, re-examined the radiographs. X-ray findings were then compared with clinical features.Results: Out of 250 children, 137 patients had normal radiographs and 113 had abnormal radiographs. Pallor, intercostal retractions, subcostal retractions, grunt, nasal flaring, decreased breath sounds and crepts had a sensitivity of 80.53%, 84.07%, 76.99%, 70.80%, 76.99%, 73.45%, 62.83% and specificity of 30.66%, 35.77%, 67.88%, 82.48%, 36.50%, 88.32%, 49.64% respectively, in predicting the chest X-ray abnormalities in LRTI.Conclusions: Tachypnea, pallor, retractions, grunt, nasal flaring, decreased breath sounds and crepitations were the main indicators of ALRI confirmed by X-ray. Inspection and Auscultation were two more important pillars of Respiratory system examination in children, where we could predict abnormal X-ray findings.
Study of perinatal factors in children with developmental delay
Authors: Charan Goli Sri , Vagha Jayant
Published: December 2016

Background: Birth history gives important information in children with developmental delay. Developmental challenge in children is an emerging problem across the globe, which is largely associated with improved neonatal survival. The present study highlights the importance of birth history in children with developmental delay in our hospital. The objective of this study was to study the perinatal events in children with developmental delay.Methods: Observational descriptive study was conducted on children between 6 months to 5 years who were admitted in Pediatric wards with suspected history of developmental delay. DDST II scale was performed on these children and children who failed on Denver II scale were recruited into the study. Birth history was noted in detail, if available, documentation of birth events was asked for and noted. Developmental history with developmental quotient (DQ), were noted in detail.Results: 135 children had developmental delay, 113 (83.70%) were born by vaginal delivery and 22 (16.30%) were born by caesarian section, 46 (34.18%) had no cry at birth and remaining 89 (65.92%) had normal cry at birth. 104 (77.04%) were born by term gestation and 31 (22.96%) were born preterm. Birth weight was normal in 78 (57.7%) children, LBW was seen 47 (34.81%) and 5 children each with VLBW and ELBW and 35 (25.93%) were IUGR. On comparing the children born gestational age and birth body weight with all four domains, there was no significant difference.Conclusions: Global developmental delay was more common in children born at preterm, low birth weight, IUGR and children who had birth asphyxia. Birth weight and gestational age did not significantly affect any particular domain of development.
Study of ecology of malnutrition with respect to infection, infestation pattern, immunization and feeding practices in children attending tertiary care hospital
Authors: Kabbin Gautam M. , Chavan Vinod P.
Published: December 2016

Background: It often quipped that half of the world is starving and other half is tyring to lose weight!!.Unfortunately India is in the former half of the world. Out of 667 million children under age five worldwide, 151 million children are stunted and 50 million children are wasted.Methods: The present study showed a very poor immunization status of malnourished children only 7.26% were completely immunized and 74.39% and 8.47% of malnourished children were partially immunized and unimmunized respectively. Study also showed a high incidence of wrong feeding practices like early weaning, prolonged exclusive breast feeding without adequate supplementation, and top feeding in the malnourished cohort. Study also showed a high prevalence of bronchopneumonia, UTI, GI infections in the study group. Tubercular meningitis, pyogenic meningitis, aspiration pneumonia contributed to majority of deaths. Malnourished children are more likely to have anemia, xerophthalmia, bacteremia, bacteriuria, pneumonia, GI infection and tuberculosis. The study was conducted in the Department of Pediatrics, VIMS and Head Quarters Hospital Bellary from December 2006 to December 2007.Results: In this study out of 8 HIV positive children 6 children had been breast fed and 2 were top fed. Study also showed a high prevalence of bronchopneumonia, UTI, GI infections in the study group. Tubercular meningitis, pyogenic meningitis, aspiration pneumonia contributed to majority of deaths. Malnourished children are more likely to have anemia, xerophthalmia, bacteremia, bacteriuria, pneumonia, GI infection and tuberculosis. In cases with severe malnutrition, screening for HIV infection must be done.Conclusions: Education regarding early initiation of breast feeding within one hour of birth, exclusive breast feeding for 4 to 6 months and continued breast feeding for 2 years or beyond with adequate supplementation must be emphasized. Last but not the least, the importance of immunization in breaking the vicious cycle of infection and malnutrition should be made known to the community at large through effective usage of mass media.
A study on the awareness of the weaning practices and the determinants affecting them in a rural hospital based pediatric outpatient clinic of Maval Taluka, Maharashtra
Authors: Ambike Deepali , Bhavari Vijay , Poker Faisal , Ahmed Kaenat
Published: December 2016

Background: Malnutrition and micronutrient deficiencies is a very common cause of late weaning and improper weaning practices. There are many factors affecting the weaning practices in developing countries like India which may act as hindrance to the proper weaning methods. The objective of this study was to know the awareness about weaning or complementary feeding practices in the mothers of children attending the pediatric OPD. And to study the various determinants affecting the weaning or Complementary feeding practices in this rural population.Methods: This study is a cross-sectional study conducted in pediatric immunization outpatient clinic of M.I.M.E.R medical college, Talegaon (D) during the period from May to September 2016.About 300 parents were interviewed with a semi open questionnaire.Results: Out of total 304 respondents, total unawareness regarding weaning was the reason for not starting complimentary feeding at 6-months in 64 respondents (21.1%). Majority of the respondents (210, 69.1%) revealed that they prefer home based complimentary feeding. A total of 125 respondents (41.1%) admitted that they stopped the feeding in the event of illness.Conclusions: Incorrect weaning practices, withholding breastfeeding and improper feeding during illnesses are the major deterrents which can hamper proper weaning techniques and are major contributory factors in increasing Malnutrition.
Etiological profile of respiratory distress in first day of life of a newborn baby
Authors: Rao Gavara Chinna , Rao Marpi Surya Prasada
Published: December 2016

Background: Respiratory distress in neonates is one of the important clinical manifestations of a variety of disorders of the respiratory system and non-respiratory disorders. It has been estimated that 40-50% of all the perinatal deaths occur following respiratory distress. The objective of this study was to estimate the proportion of respiratory distress in the new-born period. And know the etiological factors of respiratory distress in first day of life and to study the first day of life morbidity and mortality of respiratory distress in NICU.Methods: All newborn babies admitted to King George Hospital NICU during a period of 1 year from July 2014 to July 2015 who developed respiratory distress in first day of life were studied.Results: The present study is descriptive in nature where clinical spectrum of respiratory distress in neonates and its outcome were studied. 1500 Neonates were admitted in NICU during the study period, among them 200(13.3%) Developed respiratory distress in first day of life. In the overall study 97.5% Survived with 5 deaths. 3 Deaths were due to preterm with RDS, 2 due to CDH. Most of the deaths were due to RDS.Conclusions: MAS was the main cause of respiratory distress followed by RDS in first day of life. Immediate clinical outcome of new-born respiratory distress in term of mortality rate is variable.
Serum sodium as a prognostic marker in dengue fever cases admitted to PICU in Navodaya hospital, Raichur, India
Authors: Reddy A. Akshay , Reddy T. Prashanth , G. M. Pranam , Pranam Usha , Manjunath G. A.
Published: December 2016

Background: Dengue fever is an arboviral infection which is mosquito transmitted, most common in tropical and subtropical countries. Worldwide around 2.5 billion population are at the risk of developing dengue infection.Methods: The study was carried out in a 5 bedded (high dependency unit) PICU of Navodaya Medical College and Hospital, Raichur, Karnataka, India. The study was approved by the ethical committee of the hospital. The study was performed over a period of 12 months from August 2015 - August 2016. The study group included individuals from the age group of 1 month to 18 years, who were diagnosed with dengue fever. Results: Out of the total 99 cases, 36 cases had no variation in serum sodium levels, 33 cases were mild hyponatremic, 12 cases were moderate hyponatremic and 18 cases were severely hyponatremic. Out of the 36 cases with normal serum sodium levels, only 1 case progressed to bleeding complications. Out of the 33 cases with mild serum sodium levels, 2 cases progressed to complications out of which 1 case having bleeding manifestations and 1 case having both bleeding and central nervous system (CNS) complications.Conclusions: Hyponatremia is the most common electrolyte disturbance in dengue fever as well as dengue associated complications. The lower the serum sodium levels the higher is the incidence of complications associated with dengue fever. The incidence of CNS and bleeding complications is more as compared to the RS and hepatobiliary complications. The incidence of RS and hepatobiliary complications is high with moderate and severe hyponatremia. Thus serum sodium plays a most important role in the prognosis of dengue fever and associated complications.
Retrospective study of clinical profile and outcome of pediatric dengue cases in a teaching hospital
Authors: M. K. Alok Kumar , Patil Timmangouda R. , Veerabadhraiah Santhosh
Published: December 2016

Background: Dengue fever is an acute febrile illness caused by 4 closely related viral serotypes of the genus Flavivirus. Dengue has a broad range of clinical manifestations and often with unpredictable clinical evaluation and outcome. So this study has been done to see the wide range of clinical presentation of dengue and its outcome.Methods: It is a retrospective study done in tertiary hospital during the period of 8 months. Study was done by collecting the previous records from hospital record section. There were 48 cases of serologically confirmed cases of dengue which satisfied the inclusion and exclusion criteria were included in the study. Results: In our study there were 52% of the cases of dengue fever, 16.6% of cases were dengue fever with warning signs and remaining 31.4% of patients were severe dengue. Common Clinical symptoms at admission were fever (100%), vomiting (77%), respiratory distress (56.25%), generalised weakness (54.1%) and pain abdomen (33.3%). Less common symptoms were loose stools (6.25%), periorbital puffiness (6.25%), altered sensorium (4.1%), oliguria (2%) and bleeding manifestations (2%). Out of these dengue children 70.8% of these children improved without complication, 20.8 % of children improved with complication, in the form of ARDS, acute liver failure, DSS, meningitis, 6.25 % of these children went DAMA and  2 % of children expired.Conclusions: In our study atypical presentations like respiratory distress, loose stools meningitis were commonly noted and bleeding manifestation at admission was rare in our study. Platelet transfusions have little role in management of dengue patients. Early diagnosis, careful monitoring and proper fluid management goes a long way in reducing the mortality due to dengue hemorrhagic fever and shock syndrome.
Clinical profile and gram negative bacterial profile of urinary tract infection in children attending a tertiary care hospital of Tamilnadu, India
Authors: Balasubramanyam Vasuki , Sharma Natwar Lal
Published: December 2016

Background: Urinary tract infection (UTI) is one of the most common infections caused by bacterial pathogens seen mostly in developing countries. This study was done to assess the clinical and gram negative bacterial profile of pathogens causing urinary tract infection, which helps the clinician to diagnose early and give presumptive antibiotic to prevent complications.Methods: Specimen was collected in sterile, leak proof container by clean catch mid-stream technique. Isolation of uropathogens was performed by a surface streak procedure on both blood agar and Mac Conkey Agar (Himedia, India) using semi quantitative method by using standard loop technique and Identified as per standard CLSI guidelines. Antibiogram of the isolates was performed and read as per standard manufacturer’s instructions.Results: UTI was more common in female children than male, and half were in the age group 1-5 years. Fever is the most common presentation (58.6%) followed by dysuria (46.4%) abdominal pain (45%) and decreased appetite (23.6%). Escherichia coli was the most common (73.6%) isolate followed in order by Klebsiella sps (15.7%), Citrobacter sps (2.1%) Proteus sps (5%) and Pseudomonas sps (3.5%). Nitrofurantoin (86%) was the most sensitive antibiotic followed by cefexime (84.7%), gentamicin (82%) and ciprofloxacin (81%) for E. coli. Klebsiella was sensitive to gentamycin, ciprofloxacin. Greater degree of resistance was noted to ampicillin, cotrimoxazole and nalidixic acid.Conclusions: The common clinical feature assosciated with UTI was fever and commonest causative organism for UTI was E. coli. The appropriate antibiotic in-vitro were cefexime and gentamicin in this study. Higher degree of resistance was found in antibiotics such as amipicllin, cotrimioxazole, cephalexin, nalidixicacid.
Acute kidney injury as a predictor of poor outcome post cardiopulmonary bypass in children
Authors: Alam Shahzad , Shalini Akunuri , Hegde Rajesh , Mazahir Rufaida
Published: December 2016

Background: We objective of the current study was to identify the prevalence of AKI and classify them based on Acute Kidney Injury Network (AKIN) staging system. We also evaluated the outcome of patients developing AKI and identified the associated risk factors.Methods: This retrospective study was conducted in pediatric cardiac ICU of a tertiary care hospital. Patient < 18 years who underwent cardiac surgery on cardiopulmonary bypass (CPB) for congenital heart disease were enrolled in the study. AKI was defined as increase in serum creatinine ≥ 0.3 mg/dl within 48 hours or 1.5 times or more from baseline within the first 7 days post-surgery. Results: Nine hundred and twenty children were enrolled in the study. Three hundred and twelve (34%) children developed AKI with 202 (20%) developing stage I, 92 (10%) stage II and 18 (2%) stage III. Resolution was achieved in all the patients and none developed chronic kidney disease. Risk factors for AKI were higher CPB time, higher aortic cross clamp time, significant arrhythmias and higher inotropic requirement at admission. Children with stage 2 and 3 disease had higher odds for requirement of mechanical ventilation > 24 hours and > 72 hours, length of ICU stay > 5 days and in hospital mortality.   Conclusions: AKI following cardiac surgery is common. Although majority of the cases are mild disease and self-limiting it can significantly affect the outcome of these patients.
Neurocysticercosis: a commonest neuroimaging abnormalitiy in children with first afebrile seizure in central India
Authors: G. Agarwal , M. Lazarus , A. Roy , M. Ajmariya
Published: December 2016

Background: Seizures are the commonest neurological ailments in paediatrics in ~10%, even though the role of emergent neuroimaging in first onset afebrile seizure is not well defined.Methods: A prospective observational study was conducted in NSCB Medical College, Jabalpur, Madhya Pradesh, India to determine the incidence of neuroimaging abnormalities in children with first onset afebrile seizure and to make specific recommendations for use of routine neuroimaging in the new onset afebrile seizure. A total of 75 children (1 month to 14 years of age) with the new-onset afebrile seizure were enrolled and underwent clinical examination & neuroimaging. We defined first seizure using the international league against epilepsy (ILAE). The data were recorded and analysed by Student ‘t’ test for continuous variables, Fisher’s Exact Test or Chi square test for categorical variables. The critical level of significance was considered at P < 0.05 level.Results: Neuroimaging abnormalities were found in 66.7% of the cases, mostly in the children above 2 years of age (72.6 %) (P value <0.05). A significant relationship (P <0.001) was observed between focality (partial seizures (83.8%)) and abnormal neuroimaging, among these neurocysticercosis (26.7%) were in highest proportion with parietal lobe as the commonest involvement. The cases with contact history of tuberculosis /mantoux positivity/abnormal chest radiography were found significantly interrelated with tuberculoma (P <0.05).Conclusions: In developing countries like India the prevalence of neurocysticercosis and tuberculoma is high, hence neuroimaging in all cases of first onset afebrile seizure/ focal seizure with mantoux positive/ history of Contact /abnormal chest radiograph can be kept in a view for better management of child.
Association of azotemia with hypoglycemia in severe acute malnutrition how much concerning?
Authors: Ali Syed Manazir , Meshram Hari Shankar
Published: December 2016

Background: Hypoglycemia is a known complication of SAM which is to be managed early to prevent morbidity and mortality. There is lack of literature regarding hypoglycemia and its associated factors in SAM children. This study aimed to evaluate predicting factors associated with hypoglycemia in children with severe acute malnutrition (SAM) in NRC.Methods: In this case-control design, we compared clinical and laboratory characteristics of children with and without hypoglycemia taken from a population of 299 children with SAM admitted in NRC.Results: Prevalence of hypoglycemia in SAM was 14%. Amongst the association it was found that deranged creatinine (P value of 0.002, odds ratio 2.9, 95% C.I.1.48 - 5.97) and deranged urea (P value 0.0001, odds ratio 3.6, 95% C.I. 1.79 - 7.2) were statistically significant. Diarrhoea (P value 0.7, odds ratio 1.14, 95% C.I. 0.57 - 2.26), leucocytosis (P value 0.23, odds ratio 0.54, 95% C.I. 0.21 - 2.26), leucopenia ( P value 0.6, odds ratio 0.42, 95% C.I. 0.05 - 3.35) were found statistically insignificant.Conclusions: Azotemia in SAM was found significantly associated with hyponatremia.
A rare case of Ehler Danlos syndrome - Progeroid type: a case report
Authors: Anitha G. Fatima Shirly , Shanmugam V. Karthik , Rajendran V. Vignesh
Published: December 2016

Ehler Danlos syndrome (EDS), is a group of genetically heterogenous connective tissue disorder. A very rare type of this syndrome is the Progeroid type which is included in the NIH group of rare diseases list. The prevalence is < 1 / 1000000. Along with the usual clinical features, patients with Ehler Danlos syndrome-Progeroid type have old age appearance. Here we report one such rare case of this syndrome diagnosed in a 8 yr old child with characteristic clinical features and supportive genetic confirmation.
Incidental diagnosis of tuberous sclerosis in a child with falciparum malaria
Authors: Singla Sanjay , Sanadhya Anuradha , Goyal Suresh , Khan Amzad , Chaudhry Chakshu
Published: December 2016

Tuberous sclerosis complex is a rare genetic disorder inherited in autosomal dominant fashion. It is a multisystem disorder involving brain, skin, kidneys, heart, eyes and lungs which becomes apparent only in late childhood, limiting the usefulness of early diagnosis in infancy. Here, we report a case of a 14 year female child presenting with seizure, mental retardation and typical skin manifestations.
Childhood coeliac disease presenting as hepatitis with an associated aplastic anaemia: a case report and literature review
Authors: Krishnasamy Jagannathan
Published: December 2016

Although aplastic anaemia and deranged liver function test are well documented in the adult coeliac literature, this combination is not well recognized in childhood. We report a case of 8 year old girl who presented with jaundice and spontaneous bruising. Initial investigations showed pancytopenia, raised bilirubin and transaminases. On extensive evaluation to look in to the cause of above presentation, she was found to have coeliac disease with aplastic anaemia. She was started on gluten free diet which resolved her liver derangement. The marrow aplasia persisted however, requiring immune therapies.