bluuebunny/crossref_metadata_2025_split huggingface dataset:
Postnatal growth and short-term complications in very low birth weight neonates receiving total parenteral nutrition
Authors: Purkayastha Jayashree , Soundaram V , Lewis Leslie Edward , Bhat Y Ramesh 
Published: June 2020

Objective: To study the postnatal growth and short-term complications in very low birth weight preterm neonates receiving total parenteral nutrition (TPN). Methods: This prospective, observational study was conducted in the neonatal intensive care unit of a tertiary care hospital in South India. All neonates with birth weight <1250 g and <32 weeks of gestation who received TPN and survived at least 7 days were studied prospectively. Amino acid infusion was started at 1 g/kg/day on day 1 and graded up to 4 g/kg/day. Lipids were started on the day 2 of life at 1 g/kg/day and graded up to 3 g/kg/day. Enteral feeds were introduced within3 days of life. TPN was stopped once enteral feeds reached 100 ml/kg/day. Postnatal growth and biochemical and hematological parameters were also monitored. Results: Time to reach full enteral feeds was 11.3±4.5 days, cumulative weight loss proportion (in %) was 8.5±4.7, and number of days to regain birth weight was 11.1±4.5 days. Mean growth velocity (GV) at 30 days of life and 40 weeks of postmenstrual age (PMA) was 16.37±4.8 g/kg/day and 20.03±5.8 g/day, respectively. Mean GV of appropriate for gestational age (AGA) infants was 3.13 g/kg/day, lower compared to small for GA (SGA) infants at 30 days PMA (p=0.01). However, there was no statistical difference in GV between AGA and SGA infants at 40 weeks of PMA. There was no correlationbetween energy intake on the day 7 and weight and head circumference at 40 weeks of PMA. Hyponatremia was observed in 40.6% infants receiving TPN, and there were no other significant complications. Conclusion: Conventional TPN was associated with favorable postnatal growth until 30 days of postnatal life. However, catch-up growth at 40 weeks of PMA was not satisfactory. Mean GV of AGA infants was found to be lower compared to that in SGA infants at 30 days of postnatal life. Besides hyponatremia, there was no major complication due to TPN in this study.
Maternal anthropometry in relation to birth weight of newborn: A prospective hospital based study
Authors: Shrivastava Jyotsna , Agrawal Amit , Giri Ashish 
Published: June 2020

Background: Birth weight of neonate is probably the most important factor that affects the future survival and quality of life of the neonates. Objective: To study the maternal anthropometric parameters in relation to birth weight of neonate. Methods: This observational case-control study was conducted in a tertiary care teaching hospital in central India from March 2013 to September 2014. Low birth weight (LBW) neonates (<2.5 kg) and their mothers were taken as cases, and normal birth weight (NBW) neonates (?2.5 kg) and their mothers were taken as controls. Data regarding demographic profile, maternal and neonatal anthropometry, antenatal, and natal events were recorded. Results: Of total 600 subjects, 300 neonates were LBW (cases) and 300 were NBW (controls). Mean birth weight was 2.05±0.252 kg (in cases) and 2.9±0.295 kg (in control). The weight of 59.3% mothers in the case group was below 50 kg (odds ratio [OR] - 3.4) and height was <150 cm (OR - 1.22). Mean maternal body mass index (BMI) in study and control group was 21.73±0.25 and 22.06±0.87, respectively (p<0.0677). BMI ranged from 21.5 to 22 in 85% of NBW and 19% of LBW neonates, and from 22.1 to 22.9 in 81% of LBW and 15% of NBW babies. Mean maternal mid-upper arm circumference (MUAC) in this study and control group were 20±2.13 cm and 25.5±1.36 cm, respectively (p<0.0001). Maternal MUAC was 19-23 cm in 81% of LBW babies and 23-27 cm in mothers of NBW babies (OR - 24). Conclusion: MUAC can be used as an easy cost-effective tool to identify mother at risk of delivering LBW babies so that they can be subjected appropriate care intervention at hospital and home to improve the perinatal outcome.
Cross-sectional study of risk factors associated with neonatal sepsis in a tertiary care teaching hospital
Authors: Kumar G V , Rahman Hareesh Fazulu , - Vatsalakumari , Viswanathakumar H M 
Published: June 2020

Background: Neonatal sepsis is the term that has been used to describe the systemic response to infection in newborn infants during the first 28 days of life, which can be affected by multiple risk factors. Objectives: We planned this study is carried out to determine the various risk factors associated with neonatal sepsis in the neonatal intensive care unit (NICU) of this institution. Materials and Methods: This cross-sectional study was carried out in the NICU of Sri Siddhartha Medical College and Hospital, Tumkur, Karnataka, India. All neonates up to the age of 28 days with clinical signs and symptoms, and risk factors of suspected neonatal sepsis wereincluded in the study. Various risk factors, clinical data and investigation findings were collected and recorded on a pretested proforma. Results: Out of 60 newborn babies, 35 were male and 25 were female, and 28 cases were culture positive. Pregnancy-induced hypertension, anemia during pregnancy, and premature rupture of membranes were the most common risk factors observed in our study. The most commonly associated risk factors seen in neonates with culture positive sepsis were low birth weight (89.3%) and prematurity (89.3%) (p=0.0001) followed by respiratory distress syndrome (42.8%). Conclusion: Neonatal sepsis is quiet common, especially when associated with neonatal and maternal risk factors. Prevention of risk factors, early detection of sepsis and accurate treatment go a long way in the good outcome of neonates with sepsis.
Cold abscess of thigh following inadvertent vaccination in an infant
Authors: Verma Sanjay , Didel Siyaram 
Published: June 2020

Localized abscess in the same site of bacillus Calmette-Guerin (BCG) vaccine is a known complication. However, the occurrence of such abscess at other sites is uncommon. We, hereby, report a case of 4-month-old female child who developed a swelling at left thigh following intramuscular injection at 6 weeks vaccination. Aspiration cytology of abscess showed granulomatous inflammation and positivity for acid-fast bacilli. The exact etiology for this presentation is unknown; however, wrongful inoculation of the BCG vaccine in place of DPwT vaccine at 6 weeks could be suspected. Mycobacterium should be considered in any unexplained soft tissue abscessin areas of the world where tuberculosis is prevalent.
Progressive pseudo rheumatoid dysplasia mimicking juvenile idiopathic arthritis
Authors: Vajpayee Shailja , Gupta R K 
Published: June 2020

Progressive pseudo rheumatoid dysplasia (PPRD) is an autosomal recessive skeletal dysplasia with an underlying mutation in WISP 3 gene. Clinical, it is frequently misdiagnosed as juvenile idiopathic arthritis (JIA), particularly the seronegative polyarticular JIA. It is the characteristic radiological feature which helps in the early recognition of this disease. Here, we report a case of PPRD which has been previously diagnosed as JIA and was on antirheumatoid drugs with no improvement rather a progressive course. Because of its resemblance, PPRD should be kept in mind in the differential diagnosis of inflammatory joint diseases and metabolic bone diseases to prevent inappropriate treatment and unnecessary investigation.
Procalcitonin as marker of the severity of sepsis in critically ill children
Authors: Deepashree G , Rao Chandrika , Rau A T K 
Published: June 2020

Objective: To assess the role of procalcitonin (PCT) in the diagnosis and prognosis in children with sepsis. Design: Prospective, observational study. Setting: Tertiary care center in South India. Participants: Children, 1 month to 15 years of age, admitted with the diagnosis of sepsis excluding children with chronic systemic/inflammatory disease, degenerative neurologic disease, primary/ acquired immune deficiency, on steroids and children who had trauma/burns. Intervention: None. Main Outcome Measures: SerumPCT levels, grades of sepsis and mortality. Results: Respiratory tract infection was the most common source of sepsis (71%). Of the 53 patients studied, PCT was >2 ng/ml in 42 (79.2%) patients. Mean PCT values were 9.63, 17.72, and 84.68 ng/ml in sepsis, severe sepsis, and septic shock, respectively. PCT was found to be 86.36% sensitive, 55.56% specific with a positive predictive value (PPV) of 90.48, and negative predictive value of 45.45. 79.2% of patients in the study were discharged and 18.9% died. PCT levels were high in children who died subsequently. Conclusions: There is a positive association between PCT levels and the severity of sepsis as reflected by high sensitivity and PPV. High PCT levels also indicate increased chances of mortality.
Current antibiogram pattern of Salmonella typhi and paratyphi isolates and response to treatment in a tertiary care centre
Authors: Udayakumar S , Swathi P M , Pushpalatha K , Ravi G S 
Published: June 2020

Objective: The objective of this study is to study the current antibiotic sensitivity pattern of Salmonella typhi and paratyphi isolates and the clinical response of children with culture positive enteric fever (EF) to the specific antibiotic used as suggested by the sensitivity pattern. Materials and Methods: This is a retrospective study analyzing the records of 197 children treated for blood culture positive EF during 3 years from January 2013 to December 2015. Antibiogram pattern of S. typhi/paratyphi and response pattern to the antibiotic used as per antibiogram were analyzed. Kirby Bauer’s disc diffusion method was used for antibiotic sensitivity using closed-loop stripping analysis standards. Temperature charts of the patients analyzed for response patternof fever to the antibiotic started. Results: 197 culture positive cases were included in the study (S. typhi=190 and paratyphi=7). Sensitivity pattern to 9 out of 10 antibiotics tested was high and was low only to nalidixic acid (6.3%). There were 184 (93.4%) children whose antibiogram showed high sensitivity to cephalosporins and were treated with intravenous ceftriaxone (Group 1). The majority of children in this group (172/184, 93.5%) became afebrile by 7 days of therapy. 13 (6.6%) children whose antibiogram showed resistance to cephalosporins were treated with intravenous ciprofloxacin (Group 2). 9 of this group became afebrile by 7 days. 12 children from Group 1 and 4 children from Group 2 were considered as either reduced susceptibility or resistance torespective antibiotics and were treated with either azithromycin or piperacillin-tazobactam over the next 5-7 days successfully. Conclusion: Appropriate diagnosis using blood cultures and using 3rd generation cephalosporins as the first line of the drug in treating children with EF can reduce the duration of treatment, promote better compliance, reduce relapse rates, and may help decrease multi-drug resistant S.typhi/partyphi strains in the community..
Predictors of neonatal mortality referred to a tertiary care teaching institute: A descriptive study
Authors: Sachan Ravi , Singh Aaradhana , Kumar Durgesh , Yadav Rajesh , Singh D K , Shukla K M 
Published: June 2020

Objective: To assess the predictors of neonatal mortality transported to our institution from other hospitals. Methods: In this descriptive study, neonates who were delivered outside of the hospital premises and were referred to our tertiary care teaching institute were enrolled in the study and the following information were recorded - gestational ages in completed week, place of birth, stabilization of newborn before and during transportation, and clinical parameter on hospital arrival. Management of neonatal illness was performed as per the standard protocol. Predictors of neonatal mortality were assessed. Results: Out of 245 referred neonates included in the study, 45 expired. Number of babies delivered at home and conducted by unskilled birth attendant was 46 (18.8%) and at private hospitals was 82 (33.5%). Government ambulance facility for neonatal transport was used only in 80 (32.6%). Among the expired neonate, 73.3% of the babies were delivered by unskilled birth attendants (odds ratio [OR]: 16.60, 95% confidence interval [CI]: 4.57-60.19, p=0.0001). Neonatal mortality was significantly less when baby referred or admitted early, i.e. <24 h age at the time of admission (p=0.02) and total duration of transport <1 h (OR: 0.01, 95% CI: 0.001-0.05, p=0.001). Conclusions: Significant predictors of neonatal mortality were birth weight <1.5 kg, gestational age <28 weeks, duration of transport > 1 h, delivery by traditional birth attendants, oxygen saturation <90%, poor perfusion (capillaryrefill time), and cyanosis at the time of admission. The most common cause of mortality was birth asphyxia, followed by sepsis and prematurity.
Clinical study of external dysmorphism in congenital heart disease
Authors: Dharmendar V G , - Natesh , Vijayalakshmi I B , Manjunath C N 
Published: June 2020

Background: To study the clinical profile and dysmorphism associated in patients presenting to tertiary referral hospital with congenital heart disease (CHD). Materials and Methods: This prospective study was conducted in the Pediatric Cardiology Unit of Sri Jayadeva Institute of Cardiovascular Sciences, Bengaluru, between March 2013 and February 2015. Study subjects include children referred for investigation of suspected heart disease to the Pediatric Cardiology OPD during the study period. Children found to have some type of CHDs were included in the study. All recruited subjects were examined and worked up at outpatient follow-up clinics. Results: A total of 450 subjects were found to have CHDs; out of these, 183 (40.6%) were male and 267 (59.4%) were female. Mean age was 3.34 years (range - 4 days to 24 years) and mean weight was 11.15 kg (range - 2-60 kg). History of maternal diseases and intake of drugs during pregnancy was present in 99 (22%) cases (Odds ratio [OR]=7.4, p=0.0090) and maternal fever in 59 (15%) cases (OR=6.5, p<0.0001). Distribution of CHD cases includes cyanotic CHD in 162 (36%) cases, obstructive lesions in 111 (24.6%), and left to right shunt lesions in 288 (64%) cases. 79.4% cases have shown external dysmorphic features, and main dysmorphic features associated with CHDs were eye anomalies, ear anomalies, upturned nose, clinodactyly, and chest deformity. Conclusion: Eye and ear anomalies, clinodactyly, and chest deformity were the dysmorphic features significantly associated with CHDs. Consanguinity was found to be linked to CHD. Maternal drug intakes and maternal fever during pregnancy also have bearing on CHDs.
Evaluation of testicular volume in children aged 8-17 years in south India
Authors: Boben Gissy Elizabeth , Umapathy P , Ravichandran Latha , Godfrey D A , Ramani Gokul , Srinivasan V 
Published: June 2020

Background: The standard five-stage clinical systems of Tanner and Marshall for assessing pubertal development are limited by observer variations. The measurement of testicular volume, in addition, will make assessments objective. It is important to determine the mean testicular volumes (MTVs) for a given population as reference standards. Aim: To determine the MTVs in children between 8 and 17 years and to compare the MTV with Tanners staging. Methods: A cross-sectional study was conducted on 750 healthy school boys from 2 schools in Chennai between 8 and 17 years of age by a single observer to reduce the observer variation. Tanner’s staging and testicular volume measurement were done using a Prader’s orchidometer. Results: Of the 750 boys studied, the MTV of both the right and left testes was found to increase from 2.47±0.70 cc at 8 years of age, to 3.84±1.91 cc at 12 years, to 15.93±6.65 cc at 17 years of age (p=0.0001). The mean age was found to be increased from 12.69 years at sexual maturity rating (SMR) Stage-2, to 15.66 years at SMR Stage-5. We found a significant positive correlation between SMR and height (p=0.0001), weight (p=0.0001) and body mass index (p=0.0001). The average size of both the right and left testes was found to be increased from 2.86±1.12 cc at SMR Stage-1 to 12.51±4.67 cc at SMR Stage-3 to 18.90±4.64 cc at SMR Stage-5. In our study, 0.5% (n=4) had an MTV of 4 cc at the age of 8, 0.4% (n=3) had an MTV of <4 cc by the age of 14. Conclusion: The measurementof MTV along with Tanner’s SMR staging makes the assessment of male genital development more objective and acts as a measure of testicular growth and spermatogenesis. Generating a baseline data on age appropriate testicular volume in a population or ethnic group is essential to assess sexual developmental disorders among males.
Myocardial performance index in children with ?-thalassemia major
Authors: Suman Rameshwar Lal , Sanadhya Anuradha , Singh Jaskaran , Meena Pradeep 
Published: June 2020

Background: Cardiac complications are the major cause of mortality and morbidity in thalassemic children. Iron deposition in myocardium is the key factor leading to poor cardiac functions. Myocardial performance index (MPI) by echocardiography (ECHO) can be used for an early recognition of ventricular dysfunctions. Objectives: To assess the MPI in children with ?-thalassemia major and to establish their relationship with serum ferritin. Methods: Fifty-five children of Thalassemia major in age group of 4-20 years who were on regular blood transfusion and on oral iron chelators from thalassemia unit of tertiary hospital were enrolled.After blood transfusion, serum ferritin estimation was done. Two dimensional ECHO with color Doppler was done to estimate the cardiac functions and then MPI by various parameters was calculated. Results: Out of 55 children, most were in the age group of 4 to 8 years. Mean rate of blood transfusion in subjects was 157.01 ± 21.33 ml/kg/year and mean duration of chelation therapy was 2.34 ± 1.86 years. Mean serum ferritin of subjects was 2130 ± 859.5 ng/ml. Mean ejection fraction was 61 ± 6.2%. Mean MPI of subjects was 0.60 ± 0.14. The MPI was abnormal at all levels of more than 1000 ng/ml serum ferritin (p=0.001). There was a positive correlation between MPI and serum ferritin (Pearson’s bivariate correlation coefficient r=+0.93). Conclusion: In poorlychelated thalassemic children, MPI was abnormally high despite normal ejection fraction, which can be used as an early marker of ventricular dysfunction.
Assessment of speech and language delay among 0-3 years old children attending well-baby clinics using Language Evaluation Scale Trivandrum
Authors: Kondekar Santosh Venketraman , Shree V Sudha 
Published: June 2020

Objectives: To assess the prevalence of language delay in children aged 0-3 years and to evaluate the association of sociodemographic, perinatal, and home environment factors with language delay. Materials and Methods: A total of 200 children aged 0-3 years attending the well-baby clinic or the outpatient department were included in the study, with exclusion of children with severe illnesses or those with known developmental delays. The parents of the children were asked to fill a risk factor analysis questionnaire consisting of questions related to the socio-demographic, perinatal factors, and home environment. Children were screened for developmental delay using Language Evaluation Scale Trivandrum for children aged 0-3 years. Results: Prevalence of language delay in our study was 13%. Positive home environment was significantly associated with no language delay in children (p=0.0481); the association was also seen with the parental habit of reading and the happy nature of children (p<0.05). Language delay was more common in the age group of 13-24 months, and other socio-demographic or perinatal factors did not have a statistically significant association with language delay. Conclusion: Positive home environment is significantly associated with less language delay in children aged 0-3 years. Association of different socio-demographic, perinatal, and home environmental factors with language delay needs to be evaluated with further research.
To compare the effectiveness of oral azithromycin versus intravenous ceftriaxone for treating uncomplicated enteric fever
Authors: Sreenivasa B , Manjunatha B , Joseph Nivil 
Published: June 2020

Objectives: To compare the clinical effectiveness of oral azithromycin versus intravenous (IV) ceftriaxone for treating uncomplicated enteric fever. Methods: Children aged 2-17 years with uncomplicated enteric fever and positive blood cultures for Salmonella typhi were included in the study. These were grouped as Group A (50 cases) and Group B (50 cases). Group A was given oral azithromycin 10 mg/kg/day once a day (azithromycin group) and Group B was given IV ceftriaxone 100 mg/kg/day in 2 divided doses (ceftriaxone group) for 6 and 7 days, respectively. Every day the child was examined, and the study results were assigned as a clinical and microbiological cure or failure. Results: A total of 100 patients in sex ratio of 1.2:1 (male:female) with uncomplicated enteric fever were enrolled in the study. Mean duration to become afebrile was less with azithromycin (2.72 days) as compared to ceftriaxone (5.52 days) treatment (p=0.000). 96% of the cases treated with azithromycin attained defervescence by the 5th day of treatment, but only 27% of cases treated with ceftriaxone attained defervescence by the 5th day of treatment. A clinical cure was earlier with azithromycin than with ceftriaxone treatment (p=0.027). Microbiological cure was achieved in 100% and 98% cases treated with azithromycin and ceftriaxone, respectively (p=0.5). Conclusion: Oral azithromycin was more efficacious in the treatment of uncomplicated enteric fever in children as compared to IV ceftriaxone.
Assessment of prevalence of acute respiratory tract infection and risk factors in under five children in anganwadi of Kota city
Authors: Temani Kuldeep , Mayenger Amrita , Bairwa A L 
Published: June 2020

Background: Acute respiratory tract infection (ARI) is a major cause of morbidity and mortality in developing countries. Objective: To find out the prevalence and risk factors related to ARI among children between 0 and 5 years attending anganwadi centers in Kota city. Materials and Methods: A community-based, prospective, cross-sectional study was carried out in 14 Integrated Child Development Services center (seven zones) of Kota city covering 406 under five children during March 2015-February 2016. Results: The overall prevalence of ARI was 32% (130/406). Winter season, illiterate mother, >2 under five children at home, overcrowding, smoker in house, family member suffering from cough and cold in last month, smoky chullhas, low birth weight (LBW), partial immunization, inappropriate breastfeeding were significant risk factors for ARI. No associationwas found between prevalence of ARI and age, sex, religion of child, geographic location of house in terms of main road, place of birth (home or hospital), and birth order of the child. Conclusion: The prevalence of ARI was 32%. Significant risk factors were illiterate mother, more than two under five children at home, overcrowding, LBW, partial immunization, lack of exclusive or short duration of exclusive breastfeeding, use of biomass fuel, smoker in house, family history of cough and cold in last month, and kitchen attached to living room.