bluuebunny/crossref_metadata_2025_split huggingface dataset:
Percutaneous cannulation of central veins in neonates: Its safety and feasibility: Audit of 75 neonatal insertions
Authors: Jadhav Vinay , Shankar Gowri , Deepak J , Babu Narendra 
Published: June 2020

Introduction: Central venous catheters (CVC) have become an integral part in the care of children in intensive care settings. However, their use in neonates is limited due to inherent difficulties in insertion and associated complications. Objective: We present our experience in the use of CVC by percutaneous cannulation in neonates. Materials and Methods: A total of 75 cases of neonatal percutaneous central venous cannulation inserted over a period of 6-month from March 2014 to August 2014. Data regarding age, indication for central line insertion, site of insertion, complications related to central line insertion, duration of catheter days, werecollected. Results: Of the 75 neonates, 49 were male and 26 were female. Age group ranged from 14 to 30 days with a median of 21 days. Weight ranged from 750 g to 3.5 kg with an average of 1.9 kg. The internal jugular vein was accessed in 45 (60%), followed by femoral 26 (34.6%) and subclavian in 4 (5.3%) cases. Successful percutaneous cannulation was achieved in all and the median catheter days were 12 days. The longest catheter patency was 46 days in one neonate. The most common indication for placement was failure of peripheral venous access (78%). The main complications encountered were catheter displacement (12%) and catheter malposition (9.3%). Catheter induced sepsis was seen in 7 (9.3%) neonates. Conclusion: Percutaneous cannulation of central veins in neonates is feasible, and safe, with acceptable morbidity. Ultrasound guided central line insertions is becoming the gold standard in neonates, as the entire vascular anatomy is delineated and variations in anatomy clearly identified; hence avoiding multiple attempts and complications.Contrast injected X-rays confirmation even when the catheter is radio-opaque is effective in accurate tip identification and helps in preventing tip related complications.
Oral fenofibrate in neonatal hyperbilirubinemia: A randomized controlled trial
Authors: Chaudhary G S , Chaudhary Vidya , Chaurasiya Om Shankar , Chandrakant Verma , Kumar Vipin 
Published: June 2020

Objective: To evaluate the role of oral fenofibrate for lowering neonatal hyperbilirubinemia as compared to placebo. Design: Doubleblind, randomized, placebo-controlled trial. Setting: NICU of tertiary care hospital of North India. Subjects: 50 neonates with neonatal hyperbilirubinemia. Neonates (?35 weeks of gestation), birth weight (1.5-3.5 kg), jaundice beginning at day 3-11 after birth, total bilirubin level between 15 and 21 mg/dl, and clinically stable vital signs. Intervention: Neonates were assigned randomly to receive either single dose of oral fenofibrate at 10 mg/kg/dose on day 1 of admission and distilled water on the following next day or a singledose of oral glucose solution on day 1 and distilled water on the following next day. Malloy-Evelyn method was used to estimate the serum total bilirubin levels. All newborns enrolled in this study, received phototherapy. The cases were divided into two groups, i.e. study (fenofibrate) group and control group. Measurement of Primary Outcome: Duration of phototherapy. Results: Mean values for total serum bilirubin in fenofibrate group at 36 and 48 h after starting of phototherapy were significantly lower in the study group than those in the control group (p<0.00001). The mean time needed for phototherapy was also shorter in the study group than control group (p<0.0002). No side effects of fenofibrate were observed after a single dose administration. Conclusion: Fenofibrate appears to be an effective and safe drug for the treatment of neonatal hyperbilirubinemia. This decreases the duration of phototherapy and thus shortens the length of hospital stay.
Bedside reduction of gastroschisis: A feasible option
Authors: Deepak J , Aravind K L , Jadhav Vinay , Shankar Gowri , Narendrababu M 
Published: June 2020

Background: Gastroschisis is a common neonatal malformation, with an incidence of 0.4-3 per 10,000 live births worldwide. Objective: This study was planned to assess the feasibility of bedside reduction of gastroschisis (BRG) in the neonatal intensive care unit (NICU) at our institution. Materials and Methods: Retrospective analysis of newborns with gastroschisis managed at our institution between September 2008 and May 2013. Initial bedside reduction in NICU was attempted in all the neonates procedure was done underlocal anesthesia. Incision was extended transversely on the lateral aspect when required. Gradual reduction of bowel loops done with monitoring of parameters. Complete abdominal wall closure in multiple layers/skin closure only was done based on intra-abdominal tension. The final outcome was recorded. Results: During the study period of 60-month, 10 children were treated for gastroschisis at our institution. The sex ratio among them was 8:2 in favor of males. The average age was 23 h (range: 4-72 h). The average birth weight of the babies was 2290 g (range: 1700-2600 g). Six patients were in the high-risk group and 4 in the low-risk group. The BRG was successful in 7 patients and a silo was placed in 3 patients who did not tolerate BRG. General anesthesia was required in 3 patients only for subsequent repair. The overall survival was 70%. Conclusion: BRG is a feasible and safe option. Selective use of silo, gradual staged bowel reduction, and delayed primary closure of the defect can be done on the bedside when attempted BRG is unsuccessful.
To determine the pattern and severity of cardiac valves involvement in children with rheumatic heart disease
Authors: Goel Manjusha , Agrawal Amit , Kumar Pradip , Dwivedi Rashmi , Yadav B S 
Published: June 2020

Background: Rheumatic heart disease (RHD) is the most common cardiovascular disease in children and young adults and is a major public health problem in developing world. Objectives: To determine the relative frequency and severity of the cardiac valve lesions in children, diagnosed as RHD. Materials and Methods: This prospective observational study was conducted from January 2013 to December 2014 in the Department of Pediatrics and Cardiology of teaching institution. Children less than 15 years of age fulfilling the selection criteria of RHD were evaluated by transthoracic echocardiography for pattern and degree of valvular involvement, according to the American Heart Association/American College of Cardiology guidelines. Results: A total of 45 patients (23 males and 22 females) were studied. The most common age group was 10-12 years, 91.11% cases belonged to lower socio-economic class. The most common lesion was mitral regurgitation (MR) (91.11%) with female predominance (51.22%) followed by atrial regurgitation (AR) (51.11%) with female (56.53%) predominance, mitral stenosis (MS) (26.66%) with male (58.33%) predominance, and tricuspid regurgitation (24.44%) with female (63.64%) predominance. Out of 45 cases of RHD, 29 cases (64.44%) had combined valvular lesions, out of which 14 cases (48.28%) had both MR and AR. Conclusion: RHD is stilla common problem in our country. In our study, the most of the patients had combined valvular lesions. The predominant lesion was MR followed by aortic regurgitation and MS. Regurgitant lesions were seen predominantly in females while stenotic lesions were seen in males. Echocardiography should be done routinely for patients with RHD, focusing on younger population, to facilitate diagnosis and definitive treatment before complications set in.
Applicability of pediatric risk of mortality score in predicting mortality in pediatric severe cerebral falciparum malaria cases
Authors: Kondekar Alpana S , Ahmed Maaz , Kondekar Santosh 
Published: June 2020

Introduction: Pediatric risk of mortality score (PRISM-3) has been applied in pediatric intensive care settings for varied diagnoses. We planned to study the outcome when PRISM score is applied to a single clinical diagnosis. Objectives: To study the applicability of PRISM score in predicting mortality in pediatric severe cerebral malaria cases. Methodology: This was a retrospective analysis of severe cerebral malaria cases admitted to the pediatric intensive care unit over 3 years from 2009 to 2012 whose peripheral blood smear was positive for Plasmodium falciparum. Cases that presented with single seizure without altered sensorium were excluded. The PRISM scores, predicted mortality and observed mortality, were studied from demographic and clinical data. Results: Of the total 38 cases, 22 (57.8%) cases were females and 16 (42.10%) cases were males. There were 4 (10.52%) infants, 15 (39.4%) children from 1 to 5 years age and 19 (50%) cases were above 5 year age. A total of 14 cases, 36.84% had PRISM score ?10, whereas 16 cases (42.1%) had score 10-20 and 8 cases had scored above 20. Mean predicted mortality was 17.84%, whereas observed mortality was 21.05%. Observed mortality had statistically significant association with PRISM score and predicted mortality rate. Conclusion: PRISM score and the expected mortality rate were good indicators in expecting the outcome of severe cerebral malaria cases. PRISM score can be effectively applied in severe cerebral malaria cases in predicting the outcome.
Circulating 25-hydroxyvitamin D status in apparently healthy adolescents and its association with body mass index in Puducherry population
Authors: Gandhe Mahendra Bhauraoji , Velu V Kuzhandai , Shyamini R Sree , Saha Subiman , Ramesh R , Babu M Sathish 
Published: June 2020

Background: Several earlier studies were focused on Vitamin D status and insulin resistance in diabetes mellitus in adult population. However, very few studies have been done among the healthy adolescents associating Vitamin D status with body mass index (BMI) (anthropometric marker of central obesity). Objective: To examine the concentration of 25-hydroxyvitamin D (25[OH]D) in apparently healthy adolescent and its association with BMI in apparently healthy adolescents (12-19 years age group) of Puducherry region. Methods: About 60 apparently healthy adolescents were evaluated for anthropometric, physiological, andbiochemical (fasting insulin and glucose, lipid profile, and 25[OH]D) parameters. Correlation between Vitamin D levels and BMI was calculated. Results: Our study demonstrated a significant low level of 25(OH)D level in overweight (BMI=25-29.9) and obese adolescent (BMI?30) compared to non-obese (BMI<25) group. Pearson’s correlation analysis showed strong negative association between BMI and serum 25(OH)D. Conclusion: Overweight or obese adolescents are more prone to Vitamin D deficiency. Hence, major efforts should be undertaken to tackle Vitamin D deficiency in adolescents such as food fortification and micronutrientsupplementation.
Evaluation of efficacy of topical and systemic antihistaminic drugs in children with allergic rhinitis
Authors: Chaudhary G S , Yadav J S , Singh M , Singh A 
Published: June 2020

Objective: To evaluate the efficacy of topical and systemic antihistaminic drugs in children with allergic rhinitis (AR). Methods: This prospective, hospital-based study was conducted on children aged 6-18 years attending pediatric and ENT OPD. The children with a clinical diagnosis of AR were selected for study and were divided into two groups randomly. Group A children received oral second generation antihistamine levocetrizine and Group B children received intranasal antihistaminic drug azelastine. Both groups received medications for 4 weeks. A post therapy response was recorded in the form of symptomatic and histopathological response. Results: There was better symptomatic response for sneezing and rhinorrhea with levocetrizine than azelastine but better response for nasal blockage with azelastine. There was no significant difference in histopathological response of both groups. Conclusion: Levocetrizine was showing better symptomatic response as topical azelastine and also showing better acceptability.
Trends of formula feeding practices among infant and young children in Bhubaneswar city
Authors: Raj Rishav , Behera B K 
Published: June 2020

Objective: To assess the formula feeding practices in Bhubaneswar city and the parameters influencing it. Materials and Methods: A cross-sectional study was conducted from January 1, 2014, to December 31, 2014, in OPD and well-baby clinic of Hi-Tech Medical College, Bhubaneswar and pharmacies in the different Bhubaneswar Municipal Corporation units of this city. 250 mothers having infants and young children were interviewed individually as per pre-designed questionnaire. A separate set of questionnaires for 33 pharmacies were interviewed separately. The data were analyzed by SPSS 16.0 software. Results: About 38% of the mothers were preparing formula with proper dilution. 47% of mothers were adhering to a single brand. Formula sellingconstitutes 15-20% of the average total monthly income of pharmacies. 83% of the formulas were sold without prescription. Pharmacist (30%) and media (20%) were the major influencing factors. Conclusion: Mothers should be clearly explained about the health hazards of formula feeding during antenatal visits and subsequent immunization visits. Infant milk substitute act should include pharmacists, druggists, and chemists.
Thrombocytopenia with bleeding manifestations in childhood malaria
Authors: Mohan Kriti , Omar B J , Singh Rupa D , - Aaradhana , Sachan Ravi 
Published: June 2020

Background: Thrombocytopenia is frequently found in malaria, but its prognostic value has not been addressed in children. Bleeding with thrombocytopenia in malaria is not so common but can be a cause of mortality if left unattended. Objective: To study the occurrence and severity of thrombocytopenia with bleeding manifestations in children with malaria. Materials and Methods: This cross-sectional study was conducted in a pediatric hospital of north India. All positive cases of malaria <15 years of age admittedto the hospital between January 2008 and December 2013 were included in the study, and data were recorded on pre-designed pro forma. Patients were further assessed for thrombocytopenia and bleeding manifestations. Data were analyzed by Chi-square test and independent sample t-test using SPSS version 16. Results: Total 185 cases were included in the study with a median age of presentation of 4 years. Plasmodium vivax was identified in 142 (77%) patients, whereas Plasmodium falciparum in 31 (17%) and mixed infection in 12 (6%) patients. Thrombocytopenia was observed in 79 (43%) cases, of which 35 (44%) cases had mild, 30 (38%) cases moderate, and 14 (18%) cases had severe thrombocytopenia. Total 10 (5.4%) patients had bleeding manifestations,and all of these had thrombocytopenia. The most common bleeding manifestation was gastrointestinal bleeding presenting as malena. No significant association was found between bleeding and severity of thrombocytopenia (p=0.527) or species of malaria (p=0.682). Furthermore, no significant association was found between severity of malaria and thrombocytopenia (p=0.365). Conclusion: Thrombocytopenia and bleeding were not significantly associated with the type of malaria. In an endemic area, if a child presents with acute fever and thrombocytopenia with or without bleeding manifestation, diagnosis of malaria should be strongly suspected.
Comparison of calcium metabolism in different subgroups of nephrotic syndrome in children
Authors: Mehta Poonam , Nanda Sanjiv 
Published: June 2020

Background: Children with nephrotic syndrome are at risk of altered calcium metabolism because of the disease per se as well as steroid therapy even before fall in glomerular filtration rate (GFR). Objective: To compare the pattern of alteration in calcium metabolism in different subgroups (infrequent relapser [IFR], frequent relapser or steroid-dependent nephrotic syndrome [FR/ SDNS], and patients in remission) of nephrotic syndrome in children. Methods: We conducted a cross-sectional study in the Department of Pediatrics, PGIMS, Rohtak. Children between 1 and 8 years of age were divided into three groups, viz., IFR (Group I), FR/SDNS (Group II), and patients in remission (Group III). Serum total calcium, ionized calcium, phosphate, parathormone (PTH), albumin levels, and urinary calcium and phosphate were measured, and X-rays of both lower limbs were done. Results: 10 patients in each group were compared. Serum total calcium, ionic calcium, and urinary calcium levels were decreased in patient with nephrotic syndrome during active disease. No difference was noted in serum phosphate, urinary phosphate, and GFR in all the three groups (p>0.05). Serum calcium and urinary calcium were significantly lower in Group II as compared to Group I (p<0.05),whereas serum PTH levels were significantly higher in Group II as compared to Group I (p<0.05). None of the patients with IFR and in remission had changes of osteopenia while 50% patients with FR/SDNS had features of osteopenia in their X-rays. Conclusion: Hypocalcemia is a common finding in children with nephritic syndrome. These children especially those with FR or SDNS should undergo careful monitoring of calcium, phosphorus, and PTH to prevent bone mineral disease.
Socio-demographic profile of poisoning in children admitted to a tertiary hospital
Authors: Srinivasa B S , Manuprakash S K , Ara Syeda Saltanat , Kumar S R , Prasannakumar D G 
Published: June 2020

Background: Childhood poisoning is a significant public health problem and is very important cause of mortality and morbidity in children. The offending substances used vary from place to place. The pattern of poisoning has been changing with new hazards constantly appearing due to the introduction of new drugs and chemicals. Childhood poisoning is usually accidental making poisoning a preventable problem. Objectives: To determine the socio-demographic and clinical profile and outcome of childhood poisoning in a tertiary care hospital. Materials and Methods: This prospective study was done over a period of 2-year in a tertiarycare hospital. We studied children <15 years of age who were admitted to our hospital with a history of poisoning. Children with history of food poisoning, snake bite, scorpion sting, and insect bites were excluded from the study. The demographic profile of patients, various substances of poisoning, mode of poisoning, and outcome of admitted children with poisoning were studied. Results: Among 200 children admitted with the history of poisoning, 126 (63%) were boys and 74 (37%) were girls. The majority of the poisoning were accidental in nature and found to be common in the age group of 1-5 years, children from rural areas, and areof lower socio-economic status. Kerosene poisoning was the most common (35%) agent followed by organophosphorus poisoning (11%). 4 children died due to various complications of poisoning. Conclusion: Common household products were found to be the main source of poisoning in younger age groups from rural background, and the majority was accidental in nature. Educational programs toward creating awareness among public are necessary to reduce the incidence of poisoning in children.
Rectovestibular fistula: Is treatment always required?
Authors: Raghunath B V , Girish M L , Jade Rajashekhar 
Published: June 2020

The traditional teaching in the management of rectovestibular fistula involves corrective surgery, either in single or multiple stages. Usually, female children operated for the same are advised cesarean section during childbirth to prevent damage to the neoanus. Herein, we report a story of a 68-year-old woman with untreated rectovestibular fistula and has given birth to five children without any sequalae.
Clinical profile and outcome of H1N1 influenza in children- a tertiary care experience
Authors: Pushpalatha K , Sushma C , Udayakumar S , Mridula A M , Archana V 
Published: June 2020

Background: H1N1 influenza pandemic began in Mexico in 2009 and soon spread to the other parts of the globe. The 2009 H1N1 virus contained a unique combination of gene segments that had not previously been identified in humans or animals. Objective: To study the clinical and epidemiological profile and outcome of H1N1 influenza among children admitted to pediatric ward and intensive care unit. Materials and Methods: Prospective data of 82 children with suspected influenza illness were collected, and throat swabs sentfor reverse transcription polymerase chain reaction testing for H1N1. Epidemiological characteristics were analyzed in terms of clinical presentation and outcome. Results: Of the total 82 children with suspected influenza, majority (56.09%) were males, and majority (51.2%) were in the age group of 1-5 years. Throat swab was positive for H1N1 isolate in 22 (26.8%) cases. Clinically, all of them had flu-like illness. All 22 (100%) confirmed H1N1 cases had fever, 21 (95.4%) had cough, 18 (81.8%) had breathlessness, and 15 (68.1%)had running nose. 18 (81.8%) had chest X-ray abnormalities. 1 (4.5%) required mechanical ventilation and 1 (4.5%) succumbed to the illness. Conclusion: Fever, cough, breathlessness, and chest X-ray abnormalities were the most common presentation. A high index of suspicion of swine flu, during epidemics, and early treatment will lessen the mortality rates.
Study of biochemical and nutritional indicators in severe acute malnutrition: A prospective observational study
Authors: Lakshmi M , Sreenivas S K , Pavitra N A , Nath Sudheendra 
Published: June 2020

Background: Malnutrition in children is widely prevalent in developing countries including India. More than 33% of the deaths in 0-5 years are associated with malnutrition. Children with severe acute malnutrition (SAM) are in danger of death from hypoglycemia, hypothermia, fluid overload, electrolyte mismanagement, and undetected infections. Hence, biochemical and nutritional indicators in these children are important for management. Objectives: To study the biochemical and nutritional indicators in children with SAM. Methods: This hospital based prospective study was conducted on children aged 6-59 months admitted at Nutrition Rehabilitation Center attached to a tertiary care teaching institution. 100 consecutive SAM children admitted during 2013-2015 were studied. Children were tested for biochemical and nutritional status like complete blood picture with peripheral smear, liver function tests, renal function tests, serum electrolytes, calcium, phosphorus, and alkaline phosphatase. Results: A total of 100 cases were included, of these 57 were male and female were 43. Mean age of presentation was 18.45±2.37 months. A lack of exclusive breastfeeding was seen in 67% of these children and in 78% children complimentary feeds were initiated either early or later than 6 months. Hypoglycemia was seen in 15% cases, hypokalemia in 22%, and hypocalcemia in 35% of cases. Hyponatremia was seen in 14% and hypernatremia in 19% of the children. The most common type of anemia was microcytic hypochromic type (55%). Conclusion: The observations in this study confirm a significant association between SAM and faulty feeding and early introduction of complementary feeds. It was observed that these children have significant alterations in nutritional indicators at admission.
A rare presentation of shingles (herpes zoster) in an infant
Authors: Nair P M C , James Jemila , Soumya S 
Published: June 2020

Herpes zoster (HZ) in children is very rare. We report a case of HZ in an infant which responded well to the treatment. HZ should also be considered in an infant with vesiculo-bullous lesion in a dermatomal distribution.