bluuebunny/crossref_metadata_2025_split huggingface dataset:
Factors Associated with Exclusive Breastfeeding among Working Mothers Attending Maternal and Child Health Clinic
Authors: Sigdel Narayani Devi , Sapkota Sochana , Acharya Sharada 
Published: September 2023

Introduction: Breast milk is a natural and perfect food that protects against illness and death by acting as the baby’s first immunization. The employment of the mother is considered to be one of the most important barriers to exclusive breastfeeding (EBF).
Methods: A hospital-based descriptive cross-sectional study was done to find out the associated factors with EBF among working mothers. A total of 150 working mothers having children six to 24 months were selected. Self-developed semi-structured interview schedule was used. Pre-testing was done on 15 (10%) of the total sample and necessary modifications were done. Data were analyzed by using descriptive (Frequency, percentage) and inferential statistics (Chi-square and odds ratio).
Results: A total of 52 (34.66%) working mothers reported to have practice of EBF for six months. Majority (80%) of the working mothers fed colostrum. Majority (92.85%) of the working mothers gave powdered milk due to inadequate milk secretion. Regarding Expressed Breast Milk (EBM) storage, more than 50% had no idea about EBM and 47 (31.33%) of the mothers had a breastfeeding room at their workplace. 80 (53.33%) mothers had allowed children in their workplace while 47 (88.0%) had family support. EBF was associated with mode of delivery (OR = 0.440, 95% CI: 0.214 - 0.903), child hospitalization in the past (OR = 0.139, 95% CI: 0.031 - 0.618), facility of express breastmilk (OR = 4.087, 95% CI: 0.978 - 17.079) and flexible working environment (OR = 4.2, 95% CI: 1.789 - 9.863).
Conclusions: About only one-third of working mothers had given EBF to their child. Vaginal delivery, child hospitalization in the past, a facility of EBM at home, and a flexible working environment were associated factors with EBF among working mothers.
Feasibility of Telemedicine for Follow up of Children with Established Seizure Disorder- A Tertiary Care Center Prospective Study
Authors: Bajracharya Luna , Shrestha Merina 
Published: September 2023

Introduction: Medical information exchanged via electronic communications to improve a patient’s clinical health status by a physician without in-patient visit is telemedicine. Control of seizures with antiepileptic drugs, reassurance for compliance to drugs, regular monitoring of adverse effects of drugs in patient with established seizure can be possible through telemedicine. The main objective of this study was to evaluate feasibility of telemedicine for follow up of children with established seizure disorder.
Methods: This study was conducted among children of age one to 16 years with an established seizure due to any cause presenting to the Paediatric Neurodevelopmental OPD of Tribhuvan University Teaching Hospital (TUTH) between October 1, 2018 and September 30, 2020. Mobile phone as a modality of telemedicine was used to inquire about seizure every month for 12 months and whenever necessary.
Results: When parameters as seizure control, total cost and time spent per hospital visit, distance to TUTH were analyzed, more than 75% caregivers were satisfied with telemedicine. Greater age, appropriate development, focal onset of seizure, normal electroencephalogram and seizure adequately controlled by single antiepileptic drug were the favorable factors in better seizure control in children using telemedicine.
Conclusions: Telemedicine for follow up of children with established seizure disorder seems to be a feasible and satisfactory option when implemented with caution and proper patient selection as it decreases unnecessary high expenses and time to hospital visit
Hand Washing – its Awareness and Practices Among School Children and Facilities Available in Rural Government Schools of District Rohtak, Haryana
Authors: Anvesha  , Vashisht B M , Saha Arup , Jyotsana  , Pratibha  
Published: September 2023

Introduction: Hand washing with soap (HWWS) is one of the single most cost-effective public health interventions. HWWS is effective in reducing diarrhea and can reduce its risk up to 48% and acute respiratory infections by more than 20%. Government of India launched Swachh Bharat Swachh Vidyalaya program, which also provided guidelines for hand washing i.e., availability of soap at hand washing stations, hand washing to be done before mid-day meal and also after use of toilet or urinal. The objective of the study was to assess knowledge and practices of hand washing among school children along with adequacy of available hand washing facilities and contributors responsible for it.
Methods: A descriptive cross-sectional study was carried out in all Government schools of Lakhan Majra block, Rohtak, Haryana, India. Thirty-Eight schools for provision of facilities and 613 students for assessing knowledge, practice and behavior change were included in the study employing stratified random sampling technique. Semi-structured interview schedule was used for data collection.
Results: All schools had hand washing facilities. Soap was available in 63.2% and 97.2% students knew benefits of hand washing while 88.9% of them were promoting it also. Less than one fifth of the students could demonstrate the correct steps of hand washing.
Conclusions: Majority of students were aware of washing hands before and after critical times. Soap availability in schools was inadequate
Impact of Quality Improvement (QI) Initiatives on Neonatal Mortality in NICU: A Retrospective Analysis in Tertiary Care Centre in Western India
Authors: Hasbi Prabhudev Basavaraj , Jain Jitendra Kumar , Ajmera Mohit , Sharma Gopikishan , Meena Chetan , Mayanger Amrita 
Published: September 2023

Introduction: The global “under-five mortality” has dropped 60% from 93 deaths per 1,000 live births in 1990 to 37 in 2020 in the last three decades. It is vital to adopt proven quality improvement initiatives to provide quality care to improve neonatal mortality and morbidity. Aim of the study was to assess the impact of the quality improvement interventions and strategies in reducing the neonatal mortality statistics.
Methods: The study was conducted in a 500 bedded Government Hospital in India. The management implemented various tactics, such as enhancing the existing infrastructure, upgrading equipment, augmenting the workforce, and implementing established clinical protocols, to enhance the quality of intensive care services provided in the NICU. The QI points were identified based on the shortcomings that were identified and shortlisted based on the working of NICU pre QI implementation. The outcome was measured as neonatal mortality indicators and the data was compared between pre and post implementation period.
Results: After implementing quality improvement measures, there were notable enhancements in the total floor area, availability of skilled personnel, and equipment. The number of total admissions to the NICU increased by 79%, and mortality reduced from 20.93% to 7.82%. There was a statistically significant decrease in disease-specific neonatal mortality rates, with a p-value of less than 0.001.
Conclusions: This study concludes that implementation of proper and comprehensive QI interventions and strategies in NICUs can help in decreasing the neonatal mortality.
Incidence of Acute Kidney Injury in 1 - 14 years old Critically ill Children in a Tertiary care Center
Authors: Pooja Vijaykumar , John BM , Kalra Suprita , Devgan Amit 
Published: September 2023

Introduction:Acute Kidney injury (AKI) is associated with poor outcomes in critically ill hospitalized children. There are very few studies on incidence of AKI based on urine output criteria of KDIGO (Kidney Disease: Improving Global Outcome) and time lag between the fall in urine output and rise in serum creatinine. This study was therefore aimed at determining the same.
Methods: A prospective study was conducted in the Department of Paediatrics of a tertiary care hospital. 171 critically ill children between one to 14 years who were admitted in PICU were enrolled. Hourly urine output and eight hourly serum creatinine levels were measured and incidence of AKI was calculated along with lag time between fall in urine output and rise in serum creatinine. Outcome of children with AKI was also studied. Data analysis was done using SPSS software version 25.0 and Microsoft excel 2007.
Results: The mean age + SD of children in the study was 5.5 years ± 3.76 with a range of one to 14 years, with 62.6 % of them being boys. The incidence of AKI in the study population was 14.62%. The mean lag time between fall in urine output and rise in serum creatinine was found to be 13.21 hours. AKI had a significant association with mortality, use of nephrotoxic drugs, inotropes and mechanical ventilation.
Conclusions: A significant number of critically ill children develop AKI and its occurrence portends a poor outcome. Utilization of the KDIGO reduced urine output criteria as a marker of AKI allows for early detection and intervention
Modified Sick Neonatal Score (MSNS) in Predicting the Outcome of Neonates in Tertiary Care Hospital
Authors: Twanbasu Sajal , Amatya Puja , Shah Ganesh 
Published: September 2023

Introduction: Neonatal disease severity scoring systems are widely used to predict severity of illness. Existing scoring systems contain variables like pH, PO2 / FiO2 ratio, and base excess, which are difficult to obtain in resource-limited settings. Modified sick neonatal score (MSNS) is based on eight clinical variables which are easy to calculate and are also accurate enough at the same time. This study was done to evaluate MSNS for predicting the outcome of neonates in our settings.
Methods: This was prospective observational study done at neonatal intensive care unit (NICU) of tertiary care hospital in Nepal from February 2021 to January 2022. The parameters required for the score were recorded at admission. Total score was calculated and outcome was noted. Data collected was analyzed using SPSS Statistics for Windows, v21.0. Chi square test, Mann-Whitney U test and ROC analysis were used for statistical analysis.
Results: Total of 195 neonates were discharged and 37 expired. The mean MSNS score among expired was 8.16 ± 1.625 and discharged was 10.99 ± 1.753. For a cutoff score of ≤ 10, sensitivity and specificity; Positive and negative predictive value were 89.2% and 60.5%; 30.7% and 98.3% respectively. The area under the curve (AUC) of MSNS was 0.875 (CI 95%; 0.817 - 0.934). Lower MSNS score was also associated with requirement of iontrope and ventilator support.
Conclusions: MSNS can be used as an important clinical tool for predicting the severity of disease in neonates in resource limited settings.
Parental Satisfaction with the Care of Admitted Children in a Tertiary Level Hospital
Authors: Pandey Kabita , Shrestha Sanjana , Shrestha Sarala 
Published: September 2023

Introduction: The quality care is an essential aspect of hospital service in improving health outcomes. Quality of children’s care can be assessed by measuring the parental satisfaction.
Methods: A descriptive cross-sectional design was used. Non-probability purposive sampling was used to select 167 parents of children who were admitted in Kanti Children Hospital. Data were collected by interviewing either the father or mother as roomed-in by using the Pediatric family satisfaction questionnaire (PFSQ) containing three domains as modified to suit to local context. Data were entered, cleaned and analyzed in statistical package for the social sciences SPSS version 22. Chi-square test and Spearman rank correlation coefficient were used to analyze the data.
Results: Findings revealed that the overall satisfaction among majority (59.9%) of the respondents was low. However, domain wise, almost all (94.6%) respondents were satisfied in medical care followed by 89.2% in nursing care and lowest proportion (42.5%) was satisfied with hospital services and accommodation. Parental overall satisfaction was significantly higher among those admitted in surgical unit (p = 0.00) and among those with days of hospitalization as more than 6 days (p = 0.01). Findings also showed a moderate correlation between the satisfaction with nursing care and medical care (r = 0.64).
Conclusions: Parents tend to have low satisfaction with the care provided to the admitted children whereas domain wise satisfaction is high in medical and nursing care and low in hospital services. Therefore, in order to increases the parental satisfaction, more focus should be given to improve the quality of hospital services and accommodation.
Prevalence and Associated Factors of Malnutrition in Under Five Children in Eastern Nepal: A Hospital Based Study
Authors: Shrestha Manju , Rai Basant , Agrawal Jyoti , Chaudhary Shipra , Shrestha Kala , Bhandari Singh Rupa Raj 
Published: September 2023

Introduction: Malnutrition among children remains one of the most important causes of morbidity and mortality in the developing countries like Nepal. Multiple interrelated determinants are involved in causing malnutrition that needs to be catered. This study aims to assess the prevalence and associated factors of malnutrition among under-five children in eastern Nepal.
Methods: This is a hospital-based correctional study. The enrolment occurred between Jan 2018 and Dec 2019 among children who visited nutrition clinic in our hospital. The data analyses were performed using Logistic regression and 95% confidence interval along with p-value. A p-value < 0.05 was considered statistically significant.
Results: A total of 310 children were analyzed for malnutrition. Among them, the prevalence of underweight, stunting and wasting was 34.10, 32.45, 17.54 % respectively. Among them, majority of the mother belonged to young age group between 18- 25 years, 216 (69.68%) were females and 120 (38.71%) and Majority of malnutrition fell in the age group of 12 – 23 months. Mother’s age, mother’s education, family size, economic status, child’s age and sex, exclusive breast, ethnicity, mother’s occupation and total family size were found to be significantly associated with malnutrition.
Conclusions: This study highlights serious concern of malnutrition among under five years old children in eastern part of Nepal. Multiple hierarchically interrelated determinants associated with child, mother and the social environmental factors were found significant in malnutrition among the children.
Spectrum of Paediatric Dermatoses in a Private Medical College
Authors: Bhatia Ravi , Bhardwaj Shivani , Anandh Sarat , Rajwaniya Dinesh 
Published: September 2023

Introduction: Dermatoses in children puts a huge burden on the parents as well as their development. Severity of these dermatoses vary from location to location. Environment plays an important role, especially in children and presentation of these dermatoses maybe quite different than those in adults.
Methods: This is a six months prospective study. All children who presented to the Paediatrics / Dermatology OPD with any skin ailment were included. Diagnosis was done clinically, investigations if required were done. Based on age, cases were divided into six groups. Skin disorders were categorized into 17 groups. The demographic data and other clinical details were recorded on a pre-designed performa.
Results: 206 children were included in our study. Males were 136 (66.01%) and females were 70 (33.98%) with M:F ratio 1.94:1. The spectrum of skin diseases were infections and exanthems (40.29%), eczematous diseases (19.41%), disorders of sebaceous and sweat glands (13.10%), papulosquamous diseases (6.31%), hypersensitivity syndromes (5.82%), disorders of pigmentation (5.33%), disorders of hair and nail (3.39%), cutaneous tumor and tumor syndromes (1.94%), vascular disorders (1.45%), disorders of cornification (0.97%), photo-dermatoses(0.97%), histiocytosis and malignant skin tumors (0.48%), and miscellaneous (0.48%). Dermatoses according to age were neonatal (0.97%), infant (4.36%), toddlers (9.70%), preschool (18.44%), school-age-children (30.58%), and adolescents (35.92%).
Conclusions: Skin infections and infestations being the majority explains the status of developing countries like India. This study can help identify (or diagnosing) and treating common dermatological conditions in children and this would also sensitize our fellow paediatricians to this common but often neglected aspect of childcare.
Stretched Penile Length in Boys - A Cross-sectional Single Centre Study
Authors: Lakshmanapillai Ramuppillai Saranya , Krishnamoorthi Rangasamy , Ravichandran Saranya , Kumar Somasundaram Jithesh , Rengarajan Dhanalakshmi Naveen 
Published: September 2023

Introduction: Stretched penile length is the most relevant measurement to define the size of the penis, which varies in various ages, geographical regions and ethnicities. Thus, a population specific normative data on stretched penile length helps in early diagnosis of penile abnormalities and endocrine disorders in children.
Methods: A cross sectional study was done in 501 healthy boys from neonatal period till 12 years of age. Boys with abnormalities of external genitalia, suspected endocrine disorders, suspected syndromes, chronic diseases were excluded from the study. Stretched penile length was measured with a transparent ruler from the pubic ramus till the tip of the glans penis excluding the foreskin. Height and weight of the boys were also recorded. Spearman’s rank correlation coefficient test was used to find the correlation of stretched penile length vs height and weight of the boys. P < 0.05 was considered significant.
Results: The median, 5th, 95th percentiles of stretched penile length were calculated. The median stretched penile length of the boys ranged from 3.01 (2.32, 3.06) cm in infancy to 6.33 (6.04, 6.62) cm by 12 years. The correlation of stretched penile length vs height and weight showed a statistically significant positive correlation. (rs = 0.979, p < 0.001; rs = 0.971, P < 0.001 respectively).
Conclusions: Our study provides normative data on stretched penile length from neonatal period till 12 years of age. There was a significant positive correlation between stretched penile length and height and weight of the boys.
Validation of the Paediatric Asthma Score (PAS) in Evaluation of Acute Exacerbation of Asthma in Children
Authors: K Jose Joswin , Namboodiripad Aparna 
Published: September 2023

Introduction: Assessing the severity of acute asthma objectively is important to guide treatment. Peak Expiratory Flow Rate (PEFR) is used for this. Paediatric Asthma Score (PAS) is a user-friendly asthma score in children. Our aim was to validate the efficacy of PAS in comparison with PEFR for assessing severity of acute asthma.
Methods: The study included 32 children in the age group of five to 14 years, with mild to moderate asthma exacerbation. The PEFR and the PAS were measured before treatment, 15 min, 30 min, and one hour after treatment, and at discharge. Paired t-test was used to establish construct validity by comparing pre-and post-treatment PEFR and PAS. The criterion validity was calculated by correlating pre-and post-treatment PASs with PEFRs.
Results: The mean predicted PEFR improved with treatment by 22.35% (p < 0.001) by one hour. Pre- and post-treatment PASs significantly correlated with PEFRs. The correlation of pre-treatment PEFR and PAS was r = -0.491 (p = 0.004), that for post-treatment at 1hour was r = -0.505 (p = 0.003).
Conclusions: The study validities the PAS as a measure of severity of asthma. The PAS is thus a simple alternative to the PEFR to estimate airway obstruction in children within the age group to five to 14 years with acute asthma exacerbations.
Germination of True Shallot Seed (TSS) of Onion Cultivars and Mixing of Planting Media
Authors: Sopiana Rina , Suwignyo Rujito Agus , Harun M. Umar , Susilawati Susilawati 
Published: September 2023

In Indonesia, onion cultivation uses bulbs, which disrupts stocks of consumtion and trade quite significantly. One way to reduce the need for bulbs from onions is to use True Shallot Seed (TSS). Onion of TSS can reduce production costs, and is practical in shipping compared to bulbs. One of the activities in the cultivation of TSS is the preparation of strong, uniform and healthy of seedling. This study aims to examine the appropriate composition of organic matter as a planting medium to accelerate the germination time of various cultivars of TSS. The planting medium tested was a mixture of soil, rice husk, cocopeat and sawdust. This study used a complete randomized block design which was arranged in factorials. The first factor was the variety and the second factor was mixing of organic matter. Mixing organic matter with the soil before planting onion seeds led to an increase in soil pH from 0.77 to 1.51. Mixing soil with organic matter before implementation increased the pH of the media, CEC, WHC, and decreases the bulb density. After germination, the husk and cocopeat mixture showed a pH (5.9), CEC (1.62 mS.cm-1), bulb density (0.3 g/cm3) and WHC (162%). The combination of rice husk and cocopeat as the growing medium (4,9 days), the Sanren cultivar (7,3 days) exhibited the fastest germination and seedling growth rate compared to other cultivars and mixed growing media.
Growth response of corn due to application of simple mixed compound fertilizer derived from urea - azolla (azolla sp.) - coal fly ash
Authors: Hermawan Agus , Budianta Dedik , Warsito  
Published: September 2023

Mixing urea with natural materials that can reduce the rate of urea dissolution is known to increase the N availability replenished by inorganic fertilizers which absorbed by plants for growth and production.This study aimed to examine the effective of application of pellet N fertilizer prepared by coal fly ash- azolla and urea on the response of corn planted in acidic Ultisol. This pot experiment was performed in the greenhouse and soil analysis was conducted in the Laboratory of Chemistry, Biology and Soil Fertility, Soil Science Department, Faculty of Agriculture, Sriwijaya University. The research was arranged using a completely randomized design with nine treatments and three replications. The treatments applied were a mixed composition materials (w/w) of 50% coal fly ash + 50% azolla, and 40% coal fly ash + 60% azolla respectively. Each composition (w/w) of 70% coal fly ash- Azolla mixture was then incorporated by 30% urea and compacted as pellets using a manual screw extruder. In addition, to compare the effect of pellet, it was done the other treatment by granular urea fertilizer only applied by immersing and sowing on the soil surface. The results showed that the application of N slow release using the pellet forms significantly increased N availability, plant N uptake, plant height and dry weight of corn. The N slow release as a pellet can reduce the dose of N inorganic fertilizer as urea by 25%. The response of corn at a dose of 0.75 times is not significantly different from the dose of 1 times the recommended dose of N.