Asian Journal of Clinical Pediatrics and Neonatology http://aijournals.com/index.php/ajcpn <p><strong class="pull-left">Asian Journal of Clinical Pediatrics and Neonatology (AJCPN)</strong>&nbsp;&nbsp;is an open-access; freely accessible, online and print Quarterly peer-reviewed international journal publishes a wide spectrum of advanced research in different fields of pediatrics and neonatology, covering etiology, diagnosis, therapy and prognosis aspects. <br><strong>Online ISSN: 2347-3363 | Print ISSN: 2347-3355</strong></p> en-US dir.aijournals@gmail.com (Dr. Rohit Varshney) Mon, 13 Apr 2020 02:02:47 +0000 OJS 3.1.2.1 http://blogs.law.harvard.edu/tech/rss 60 Cord Blood Albumin as a Predictor of Significant Hyperbilirubinemia in Term and Preterm Neonates http://aijournals.com/index.php/ajcpn/article/view/1354 <p><strong>Background: </strong>Jaundice is the most common condition requiring medical attention and readmission. As neonates are discharged within 48 hours of birth, close follow up is very important to look for jaundice. In developing countries, follow up visits are difficult. Therefore, it is important to identify at risk neonates before discharge. This study helps in identifying neonates at risk for hyperbilirubinemia. This study includes both healthy pre-term and full term neonates.<strong>Aim &amp; Objective:</strong>To find correlation between cord blood albumin level with serum bilirubin level in healthy term and preterm neonates and correlation between maternal serum albumin level with cord blood albumin.<strong>Subject and Method:</strong>This study included 106 neonates (full-term and pre-term) born in Lilavati Hospital, Mumbai during period of March to December 2017. <strong>Result:</strong>Out of 106 neonates, 42(39.6%) developed significant hyperbilirubinemia. 17 (58.6%) neonates with cord blood albumin below 2.8 g/dl required phototherapy against 24 (50%) with cord blood albumin between 2.8-3.3 g/dl. In this study, 11 (73.3%) out of 15 pre-term and 6 (42.9%) of 14 full-term neonates with cord blood albumin below 2.8 g/dl developed significant hyperbilirubinemia and required phototherapy. A significant association wasobserved between maternal and cord blood albumin level. <strong>Conclusion:</strong>Significant association observed between cord blood albuminand tendencies of significant hyperbilirubinemia. So, cord blood albumin can be used as a surrogate marker for screening newborns for development of significant hyperbilirubinemia</p> Anurag Singh Chandel, Ravindra Chittal Copyright (c) 2020 Asian Journal of Clinical Pediatrics and Neonatology http://aijournals.com/index.php/ajcpn/article/view/1354 Sun, 12 Apr 2020 00:00:00 +0000 A Study of Midarm Circumference and Chest Circumference as a Predictor of Low Birth Weight http://aijournals.com/index.php/ajcpn/article/view/1355 <p><strong>Background</strong>: 60–80% of neonatal deaths are due to low birth weight (LBW &lt;2500 g) in developing countries.<strong>Aim &amp; Objective:</strong>The objectives of this study was to identify a suitable anthropometric surrogate and to identify LBW babies in the resource limited settings like rural areas where 80–90% deliveries take place to screen the LBW babies.<strong>Subject and Method:</strong>This is a prospective observational study conducted in department of pediatrics of tertiary care hospital and medical college of western India. A total of 519 newborns were studied by random sampling method. BW and other anthropometric measurements were taken within 24 h of birth. <strong>Result:</strong>Mean birth weight significantlyincreases with increasing value of anthropometric measurement, all key anthropometric parameters were significantly correlated to each other. The correlation with birth weight is more for chest circumference (0.58)than mid upper arm circumference (0.54). <strong>Conclusion:</strong>CC is the better measurement to identify low birth-weight babies. Measurement of both MUAC and CC is of little additional value in predicting LBW babies. Chest circumference is a simple, quick, and valid screening tool for identifying LBW neonates in a community setting where there are problems of nonavailability of weighing scales.</p> Mamta Nikhurpa, Sucheta Munshi, Dipti Shah Copyright (c) 2020 Asian Journal of Clinical Pediatrics and Neonatology http://aijournals.com/index.php/ajcpn/article/view/1355 Sun, 12 Apr 2020 00:00:00 +0000 Study of Clinico-Radiological Profile in Childhood Tuberculosis http://aijournals.com/index.php/ajcpn/article/view/1356 <p><strong>Background</strong>: Tuberculosis still is one of the deadliest diseases in the world killing nearly 2 million people every year. In India, two deaths occur every three minutes from tuberculosis. The actual global disease burden of childhood tuberculosis is not known, as childhood Tuberculosis is notoriously difficult to diagnose because of the absence of a ‘gold standard’ as bacteriologic confirmation is rarely achieved. The present study was designed to study clinical profile of various forms of childhood TB. Objective of this study was to study clinic-epidemiological profile of various forms of childhood TB.<strong>Subject and Method:</strong>Retrospective analysis of clinical profile of 100 patients of childhood TB in the age group of 6 months to 12 years. A detailed clinical history, family history of contact with Koch’s disease, history of BCG vaccination of each child was recorded. A complete examination was carried out and findings regarding the general and systemic examination were recorded. <strong>Result:</strong>Age distribution in our study showed that 51% cases in the age of 5-12 years, 47% cases in the age group 1-5 years and&nbsp; 2 % cases falling in the age group 0-1 years, with male to female ratio of a 1.27:1. 95% of the patients belonged to the lower socio-economic class. The distribution of TB was- pulmonary tuberculosis(42%),TBME(30%),pleural effusion(12%),abdominal TB (12%), TB lymphadenitis(4%), Osteotuberculosis(2%), miliary TB(2%). 12% of the patients had mild to moderate malnutrition (PEM Grade I, II)and 57 % were severely malnourished. 72% of the patients were BCG vaccinated and history of Koch’s contact were present in 21% of all cases. The most frequently seen symptoms were fever (88%), cough (65%), weight loss in 50%, anorexia in 35% of cases and in physical examination cachexia was the most common (50%) followed by hepatomegaly (40%),lymphadenopathy(16%) and Splenomegaly (8%) of&nbsp; cases. <strong>Conclusion:</strong>childhood TB is commonly seen in children more than 1 year, lower socioeconomic class and in severely malnourished children.</p> Triya Malde, Gaurang Pabani, O.P. Shukla Copyright (c) 2020 Asian Journal of Clinical Pediatrics and Neonatology http://aijournals.com/index.php/ajcpn/article/view/1356 Sun, 12 Apr 2020 00:00:00 +0000 Effect of Home Base Glucose Monitoring & Self Dose Adjustment of Insulin on Glycosylated Hemoglobin http://aijournals.com/index.php/ajcpn/article/view/1357 <p><strong>Background: </strong>Type1 Diabetes Mellitus (T1DM) is the most common endocrine metabolic disorder of childhood casing significant mortality and morbidity in childhood. Home Monitoring of Blood Glucose (HMBG) and Supplements of insulin as required depending on the blood glucose level at that time is a very important aspect of management in T1DM. The Goal of this study was to determine whether frequent checking of home base blood glucose (HMBG) levels accompanied with insulin self dose adjustment, will lead to improved metabolic control as assessed by reduction in the Glycosylated hemoglobin values (HbA1c).<strong>Subject and Method:</strong>This study was conducted in G.G.Hospital,,M.P.Shah Medical college,Jamanagar between October 2012 to September 2013 for a period of 1 year including OPD and ward patients. Retrospective analysis of clinical profile of 37patients with T1DM attending our OPD between the age group of 2 to 16 years.A detailed clinical and family history, educational level of parents and insulin regime and insulin dose was recorded. <strong>Result:</strong>Age distribution in our study showed that 62% cases in the age of more than 10 years, 32% cases in the age group 5-10years and&nbsp; 2 % cases falling in the age group 0-2 years, with male to female ratio of a 1:1.7. The most frequently seen symptoms were polyuria (53%), breathlessness (48%),polydipsia (46%), vomiting (29%) of cases and 82%of the patients were ketotic at the time of presentation. In family members most common associated co-morbidity is type 2 DM(21% ) , hypertension(21%) &amp; thyroid dysfunction (19%). split regimen was observed in (70%)and basal bolus regime in (30%). split mix regime 11(42%) had good(&lt;7GHb) wheaeas Basal bolus regime 6(54%) of them had good control p=0.0308(&lt;0.05). <strong>Conclusion:</strong>Regular Home monitoring of Blood glucose(HMBG) along with education on diabetes self management and regular contact with a member of a medical team for insulin dose adjustments with advice on meal planning and physical activity improve the metabolic control (as assessed by HbA1c levels) in children with T1DM.</p> Maulik Shah, Triya Malde, Falgun Gondalia, Sonal Shah Copyright (c) 2020 Asian Journal of Clinical Pediatrics and Neonatology http://aijournals.com/index.php/ajcpn/article/view/1357 Sun, 12 Apr 2020 00:00:00 +0000 Neonates with Jaundice A Clinical Profile http://aijournals.com/index.php/ajcpn/article/view/1358 <p><strong>Background: </strong>In the first week of child birth, neonatal jaundice is the most common problem which leads to delayed hospital discharge and re-admissions. Recognising early neonatal hyperbilirubenemia plays a pivotal role in preventing serious complications. The aim of this study was to study the clinical profile and the aetiological factors leading to neonatal jaundice in rural areas.<strong>Subject and Method:</strong>This study is a prospective observational study&nbsp; conducted in neonatal intensive care unit (NICU) and post natal ward . This study was conducted during the period of February 2017 to July 2017. Total 400 neonates were admitted in NICU and post natal ward during this period. Out of them, 100 newborns were having jaundice (Serum bilirubin &gt; 10 mg/dl). 100 cases in total were enrolled in the study. <strong>Result:</strong>In this study,out of 100 neonates, 70% were males and 30% were females. , 92 were born at term (92%) and remaining 10 were preterm babies (10%). Physiological jaundice constituted 45%, followed by ABO incompatibility constituted 25%, followed by sepsis(1%), Rh incompatibility (8%), idioapathy (8%), prematurity (5%), cephalhematoma (4%), breast feeding (2%), haemolytic anemia (2%) were diagnosed as hereditary spherocytosis. <strong>Conclusion:</strong>Physiological jaundice is the most common cause of neonatal jaundice followed by ABO incompatibility, sepsis, Rh incompatibility and idiopathic cases. Cephalhematoma, breast feeding jaundice and haemolytic anaemia are the less common causes. Hence, it is required to monitor neonates more appropriately and accurately.</p> Davis Manuel, Shajahan R A Copyright (c) 2020 Asian Journal of Clinical Pediatrics and Neonatology http://aijournals.com/index.php/ajcpn/article/view/1358 Sun, 12 Apr 2020 00:00:00 +0000 To Study the Orientation of Anganwadi Workers on Integrated Management of Neonatal and Childhood Illness in Malnutrition http://aijournals.com/index.php/ajcpn/article/view/1359 <p><strong>Background: </strong>Malnutrition is one of the serious health problems in children. Malnourished children are more prone to frequent illness. This adversely affects their nutritional status, faltering growth and diminished learning ability. India adapted the integrated management of childhood illness strategy aiming to reduce its newborn and infant mortality burden and the main objective of the&nbsp; study&nbsp; was the&nbsp; orientation of anganwadi workers on IMNCI in malnutrition.<strong>Subjects and Methods:</strong>The study was observational and conducted jagdalpur Chhattisgarh. Only those who fully satisfied both the inclusion and exclusion criteria were included in the study. Permission from institutional ethics committee was obtained. Selection criteria in the present study were all children in the Anganwadi in a defined area. <strong>Result:</strong>PEM cases are more compared to controls, Malnutrition is seen in below 5 years of age group in children and more in&nbsp;&nbsp; cases group than the control group. In cases group it was 360 and control group it was 240.In 0 – 2 months of age malnutrition is more in cases than controls. <strong>Conclusion:</strong>Anganwadi workers were trained based on IMNCI and asked to educate mothers regarding health, nutrition and care seeking during illness of the children.</p> Tarun Naik, Bhagat Baghel Copyright (c) 2020 Asian Journal of Clinical Pediatrics and Neonatology http://aijournals.com/index.php/ajcpn/article/view/1359 Sun, 12 Apr 2020 00:00:00 +0000 Role of PSOFA-E Score in Predicting the Clinical Outcome of Critically Ill Children http://aijournals.com/index.php/ajcpn/article/view/1360 <p><strong>Background: </strong>Recently pediatric sequential organ failure assessment (pSOFA) score was adapted and validated in critically ill children. This study was aimed to evaluate the feasibility of addition of echocardiographic parameters to paediatric version of SOFA score (pSOFA-E score) and to adapt and validate with reference to pSOFA score in predicting the mortality of critically ill children.<strong>Subjects and Methods:</strong>This hospital based prospective, observational, analytical study was conducted in the Department of Paediatrics, A. J Hospital, Mangalore, Karnataka, from November 2017 to November 2019. A total of 74 cases were studied. <strong>Result:</strong>Most of the children were aged &lt;1 year (41.89%). Majority of the patients (62.16%) improved and 37.84% of the patients expired. The mean and median pSOFA-E scores were 10.53±4.06 and 10 respectively and pSOFA-E score of 5-8 was noted in most of the children (32.43%). Mortality was significantly high in children with pSOFA-E score between 9-12 (39.13%), 13-16 (77.78%), 17-20 (83.33%) (p&lt;0.001). Receiver operating characteristic curve (ROC) yielded area under curve (AUC) of 0.920 and 0.791 with a cut-off value of 11.5 in predicting mortality. Significantly higher number of children with pSOFA-E score of ≥ 11.5 had positive blood culture (30%). <strong>Conclusion:</strong>The findings of the present study validate and emphasize that, addition of score devised by requirement of ionotropes to maintain adequate ejection fraction defy simple bedside echocardiography to pSOFA score is highly useful and accurate in discrimination of PICU mortality, morbidity and cardiovascular status/ compromise of body.</p> Bhaskar Gorla, Vishwas Rao Copyright (c) 2020 Asian Journal of Clinical Pediatrics and Neonatology http://aijournals.com/index.php/ajcpn/article/view/1360 Sun, 12 Apr 2020 00:00:00 +0000 Etiological Study of Short Stature among Children Attending Outpatient Department of Pediatrics in a Tertiary Care Medical College Hospital http://aijournals.com/index.php/ajcpn/article/view/1361 <p><strong>Background: </strong>Short stature is a term applied to a child whose height is two standard deviations or more below the mean height for children of that gender and chronologic age.Familial short stature and Constitutional Growth delay are considered as normal variants, the pathological short stature includes a wide variety of underlying disorders.Chronic systemic disorders, malnutrition, chromosomal or endocrinal disorders lead to a proportionate short stature.While most of the disproportionate short stature are secondary to skeletal dysplasias or resistant rickets.Etiological evaluation plays an important role in identification of physiological as well as pathological causes of short stature.<strong>Subjects and Methods:</strong>All children of age between 2 and 18 years with height below 2 standard deviation of mean for age and gender were included in the study. <strong>Result:</strong>A total of 100 children were studied who fulfilled the criteria of short stature, out of which 61 children were male and 39 were female children.Present study showed that females had more pathological variants (72%) than males (46%) whereas males had more physiological variants (54%) than females (28%) with P-value: 0.011Hypothyroidism was more common in females than males with 28% and 8% respectively. Genetic syndrome was more common in females than males with 10% and 3% respectively. <strong>Conclusion:</strong>Etiological evaluation is of pivotal role in identification of physiological as well as pathological causes of short stature and also helps in modifying the course of stature by means of early intervention.</p> Imthyas Khan V.H, Harshini B P, Ashoka C, Kumar G V Copyright (c) 2020 Asian Journal of Clinical Pediatrics and Neonatology http://aijournals.com/index.php/ajcpn/article/view/1361 Sun, 12 Apr 2020 00:00:00 +0000 Study of Correlation between APGAR Scoreand Cord Blood Glucose Level of Neonates at Tertiary Care Hospital http://aijournals.com/index.php/ajcpn/article/view/1362 <p><strong>Background: </strong>Cord blood biochemical parameter reflects the status of neonate. APGAR score following birth is used for evaluation of the neonate. There is limited data regarding the correlation between APGAR score and cord blood sugar levels.<strong>Subjects and Methods:</strong>Glucose Oxidase Peroxidase method was used for measuring cord blood sugar levels of 250 randomly selected consecutive samples. At 1 minute and 5 minutes of life the APGAR scores of the newborns were assessed by a single person in order to avoid subjective variability. The collected data was analyzed using the SPSS software. Mothers with gestational diabetes mellitus and overt diabetes were excluded from the study. <strong>Result:</strong>The mean age of the mothers in the study population was 22.86 years ± 3.465(SD). The mean blood glucose level in the maternal blood was 88.16 mg/dl ± 10.675(SD). The vaginal deliveries were 60.6% and Lower Uterine Caesarean Sections were 39.4 %. The cord blood glucose level had a mean value of 92.48 mg/dl ±21.005 (SD). The mean APGAR scores after 1 minute and 5 minutes of birth were found to be 4.82 ± 1.42(SD) and 7.01 ±1.68 (SD) respectively. <strong>Conclusion:</strong>The study showed no correlation with cord blood sugar levels and APGAR scores calculated at 1 minute and 5 minutes of life. The study found that neonates were free from complications if the cord blood sugar levels were around 87 mg/dl.</p> Karthik S, Preethi R M, Kumar G V Copyright (c) 2020 Asian Journal of Clinical Pediatrics and Neonatology http://aijournals.com/index.php/ajcpn/article/view/1362 Sun, 12 Apr 2020 00:00:00 +0000 A Study of Serum Electrolytes in Malnourished Children http://aijournals.com/index.php/ajcpn/article/view/1363 <p><strong>Background: </strong>Severe acute malnutrition (SAM) is one of the most common health problems. SAM children are more prone to serious infections that culminate in different co-morbid conditions and result in electrolyte disturbances. <strong>Objective:</strong> To study the electrolyte profile in severely malnourished children. <strong>Subjects and Methods:</strong>This was Hospital based cross sectional study. Duration: 1 year from June 2018 to May 2019. Setting: Department of Pediatrics. Participants: 50 Children.Detailed history and physical examination were made. Anthropometric measurements, such as weight and height, were recorded. On admission, electrolytes were performed and children were classified as either hypo / hypernatramic or hypo / hyperkalemic, which depend on the levels of the electrolytes.<strong>Result:</strong>The Hyponatremia was high with 72% on the day 1, and hypernatremia was 6%, on day 3 hyponatremia was 60% and hypernatremia was 4% and on day 8 Normal sodium was seen in around 68% of the children. The mean sodium significantly improved from day 1 to day 8 with a mean of 135.8±9.9 on the day 8th. The Hypokalemia was highest with 38% on the day 1, Hyperkalemia was seen in 28% of the patients on day 3 and normal potassium was seen in 80% of the children on the day 8th. The mean potassium significantly improved from day 1 to 8 with a mean of 5.5±1.24 on the day 8<sup>th</sup>. <strong>Conclusion:</strong>Most of the children with SAM and electrolyte derangements also had diarrhoea. Therefore determination of the electrolyte profile of all patients with SAM immediately on admission and proceeding days after admission is vital as it helps the clinician to decide on the most appropriate fluids to give to help reduce on the morbidity and mortality associated with life threatening electrolyte derangements.</p> Mohd Zakir Mohiuddin Owais, N.L Sridhar Copyright (c) 2020 Asian Journal of Clinical Pediatrics and Neonatology http://aijournals.com/index.php/ajcpn/article/view/1363 Sun, 12 Apr 2020 00:00:00 +0000 Study of Hypoglycemia in Neonates with Low Birth Weight http://aijournals.com/index.php/ajcpn/article/view/1364 <p><strong>Background: </strong>Glucose metabolism disorders are common in low birth weight (LBW) infants and are associated with high morbidity and mortality. Neonatal hypoglycemia, a common metabolic problem, often goes unnoticed owing to lack of specific symptoms. Hypoglycemia both symptomatic and asymptomatic can lead to long term neurological sequelae. Therefore, it needs early management to prevent brain damage in a developing neonate.<strong>Subjects and Methods:</strong>This study was conducted to evaluate the prevalence and risk factors associated with hypoglycemia in low birth weight infants. Design: A hospital-based prospective longitudinal study. Duration: One year (October 2017 – October 2018). Setting: Niloufer Hospital, Hyderabad. Participants: 50 LBW neonates with birth weight less than 2500 grams. Methods: Blood glucose values were measured at the age of 1 h, 6 h, 12 h, 24 h and 48 h after delivery which was independent of feeding time. Blood glucose value less than 40 mg/dl (2.2 mmol/l) was defined as hypoglycemia. For statistical analysis, SPSS software version 20 was used.<strong>Result:</strong>Out of 50 neonates, 15(30%) had one or more episode of hypoglycemia. Overall 22 episodes were recorded. Out of 15 hypoglycemic neonates 8(53.3%) were small for gestational age (SGA) and 7(46.7%) were AGA. Sepsis was significantly noticed after hypoglycemia. The pattern of blood glucose levels was significantly different among hypoglycemic babies and normoglycemic babies over first 72 hours.<strong>Conclusion:</strong>Hypoglycemia was frequent among low birth weight babies more so in SGA babies in first 24 hours.</p> Abrar Ahmed Siddique, N.L Sridhar Copyright (c) 2020 Asian Journal of Clinical Pediatrics and Neonatology http://aijournals.com/index.php/ajcpn/article/view/1364 Sun, 12 Apr 2020 00:00:00 +0000 Glycosylated Hemoglobin Levels and Lipid Profile in Type 1 Diabetes Mellitus and Precipitating Factorsin Diabetic Ketoacidosis http://aijournals.com/index.php/ajcpn/article/view/1365 <p><strong>Background: </strong>Type-1 Diabetes Mellitus is the most common endocrine-metabolic disorder of childhood and adolescence. The diseases has a prevalence of approximately 1 in 2500 children at age 5 years to approximately 1 in 300 children by age 18 years. A recent study from Madras suggests that diabetes in Indian children is present in a frequency of 10.5 per 1,00,000 patient years. Prevalence of childhood diabetes among urban population in India is 0.26 per 1000. Type-1 diabetes constituted nearly 90 to 100% of all children with diabetes. <strong>Objective:</strong> The objectives of this research were to study the levels of glycosylated hemoglobin and lipid profile in type 1 diabetes mellitus in children attending Gandhi Hospital Secunderabad, Telangana and to study the precipitating factors in Diabetic Ketoacidosis (DKA). <strong>Subjects and Methods:</strong>Design: This was a Cross-Sectional study. Duration: One year and six months i.e. from January 2017 to June 2018. Participants: 50 diabetic children of age less than 18 years attending Gandhi Hospital, Secunderabad, Telangana were included in the study.The diabetic cases were studied using a predesigned and pretested proforma. A detailed clinical examination was carried out with detailed anthropometric measurements and necessary lab investigations were done. Metabolic profile was assessed by investigating for blood sugar levels, glycosylated hemoglobin, and lipid profile. Rates, ratios and percentages of presentations and significance were calculated using Chi-square test.<strong>Result:</strong>48 % cases had onset of diabetes Mellitus at 13-18 years with Male: female ratio of 1.27: 1. 20 % had family history of diabetes. 16 % children had normal nutrition, 20 % children had grade I and grade II, 38% had grade III and 6 % children had grade IV. 54% children had glycosylated hemoglobin level of more than 10% indicating poor glycemic control, 32 % had fair control, and 14 % had good glycosylated hemoglobin levels. 62 % presented with fever , 40 % presented with symptoms of polyuria, polydipsia and polyphagia, 37.5 % presented with vomiting, 18 % children with loose stools, abdominal pain, 20 % children had breathlessness, 6% presented with seizures. 88.9% were diagnosed to have diabetic ketoacidosis as their initial presentation of diabetes mellitus Causes for precipitating factors of diabetic ketoacidosis were associated infections like pneumonia (22 %) and urinary tract infection(16 %), Non availability of insulin doses (25%), non-acceptance by child (16.66 %). Recurrent hospitalization in the patients with 5 years diabetic duration was statistically significant. Common causes being hypoglycemia (38 %) recurrent DKA (24 %), pneumonia (12 %) and urinary tract infections (8 %). 23.52% cases were non-compliant.<strong>Conclusion:</strong>More than half of the cases(54%) had poor glycemic control. Majority presented with classical symptoms of polyuria, polydipsia, polyphagia, fever, breathlessness and diabetic ketoacidosis as clinical presentation. Causes for precipitating factors of diabetic ketoacidosis were associated infections like pneumonia and urinary tract infection, non-availability of insulin doses and non- acceptance by child.</p> Chilumula Monica, Saleem Copyright (c) 2020 Asian Journal of Clinical Pediatrics and Neonatology http://aijournals.com/index.php/ajcpn/article/view/1365 Sun, 12 Apr 2020 00:00:00 +0000 Double Lung Point Vs X-Ray in Transient Tachypnea of Newborn http://aijournals.com/index.php/ajcpn/article/view/1366 <p><strong>Background: </strong>Transient tachypnea of the newborn (TTNB) is one of the most common causes of perinatal dyspnea and is traditionally diagnosed by chest x-ray. Lung ultrasound is an upcoming tool which is being proved in recent studies to have a better diagnostic capability with the main characteristic feature being the Double Lung Point. Aims &amp; objectives: To define ultrasonographic appearance of TTNB, evaluate its clinical relevance for early diagnosis and compare the outcome with xray and to assess the diagnostic ability of Double lung point.<strong>Subjects and Methods:</strong>All newborns presenting with tachypnea within 4 hours of life in 1 ½ years of study period. (November 2017-May 2019) were enrolled for study. Methods of collection of data: All newborns fulfilling the inclusion criteria were included as study subjects, At same time CHEST XRAY and LUS were done. Statistical analysis: Fisher’s exact test was used as test of significance for qualitative data. Continuous data was represented as mean and standard deviation. Mann Whitney U test and Kruskul-wallis test was used for subgroup analysis. P value of &lt;0.05 was considered as statistically significant.<strong>Result:</strong>In study period of 1 ½ years 99 cases which were admitted in NICU with respiratory distress meeting the criteria were included. 60 cases were diagnosed to have TTNB, 34 RDS &amp; 5 Pneumonia. Chest xray and Lung ultrasound (LUS) of these 60 TTNB cases were compared . LUS of TTNB and other cases was also compared for presence of double lung point (DLP). The sensitivity &amp; specificity of DLP in diagnosis of TTNB was noted to be 68 % &amp; 100 % respectively with 100 % Positive predictive value. Thus confirming LUS to be a more reliable diagnostic tool than x-ray.<strong>Conclusion:</strong>Therefore LUS could be used widely in NICU as 1st line of diagnostic medium in diagnosis of various respiratory conditions and early initiation of treatment accordingly.</p> Poorvi, Roshan Ann Oommen, Santosh T Soans Copyright (c) 2020 Asian Journal of Clinical Pediatrics and Neonatology http://aijournals.com/index.php/ajcpn/article/view/1366 Sun, 12 Apr 2020 00:00:00 +0000 A Prospective Study on Retinopathy of Prematurity in a Teritiary Care Center http://aijournals.com/index.php/ajcpn/article/view/1367 <p><strong>Background: </strong>Retinopathy of prematurity (ROP) is a vaso-proliferative retinopathy which occurs mostly in premature babies. The pathological change in ROP is peripheral retinal neovascularisation which may regress completely or leave sequelae from mild myopia to bilateral total blindness. International classification of ROP helped in uniform documentation and staging of ROP. In India, the incidence of ROP is between 38 and 51.9 p.c among low-birth-weight infants. <strong>Aim &amp; Objectives:</strong> To estimate the incidence of ROP among premature and / or low birth weight babies who were born and admitted to neonatal intensive care unit and attending neonatal follow-up clinic.<strong>Subjects and Methods:</strong>A hospital based, prospective analytical cross-sectional study was conducted in Department of Pediatrics at Shadan Institute of Medical Sciences, Teaching hospital and research center, Hyderabad, Telangana for a period of 6 months from 1st October 2018 to 31st March 2019. Prior to the study initiation, ethical clearance was obtained and written consent was taken from the parents of the respective babies. The study subjects included premature babies (less than or equal to 35 weeks of gestation) or low birth weight babies (less than or equal to 1500 grams). A predesigned, pre-tested, semi-structured proforma was used to collected the data. The data was collected, entered in Microsoft excel-2013 and analyzed using SPSS version-22 (trial). Data was presented in percentages, proportions and figures.<strong>Result:</strong>The ROP incidence in the study group was reported among 17.1 p.c of the study subjects.<strong>Conclusion:</strong>Low birth weight and prematurity are important risk factors for ROP.</p> Mahaboob Basha Kallur, K. Muralidhar Copyright (c) 2020 Asian Journal of Clinical Pediatrics and Neonatology http://aijournals.com/index.php/ajcpn/article/view/1367 Sun, 12 Apr 2020 00:00:00 +0000 Comparison of Child Participation and Life Balance and Perceived Stress of Parents of Children on Dialysis with That of Normal Population. http://aijournals.com/index.php/ajcpn/article/view/1368 <p><strong>Background: </strong>Aim: The study compared child participation of children undergoing dialysis with that of normal population. Study design:&nbsp; comparative study design. Place and Duration of Study:&nbsp;&nbsp; This study was conducted in Sparsh Rotary south end charitable trust, Batra Hospital, New Delhi during year 2013-2015.<strong>Subjects and Methods:</strong>In this study design thirty children, fifteen children undergoing dialysis (5-18) years were recruited from Sparsh, Rotary south end charitable trust. And fifteen children without any problem were selected as per inclusion criteria. The participation in home-school and community of these children is measured using Child and Adolescent Scale of Participation (CASP and Life balance and perceived stress in caregivers was measured with Life Balance Inventory (LBI) and Perceived Stress Scale (PSS) respectively. The same scales were used for normal population. The scores was collected from each scale and statistically analyzed for both groups.<strong>Result:</strong>Results revealed that children on dialysis have less participation in home school and community with that of normal population. The perceived stress of caregivers of these children is also very higher and life balance score was found to be lesser when compared with caregivers of normal population.<strong>Conclusion:</strong>Clinical intervention of children undergoing dialysis is narrowed upon only medical intervention and not focuses more on participation. The Occupational Therapy intervention should be given to children undergoing dialysis.</p> Sheeba Parveen, Ruchi Nagar Buckshee Copyright (c) 2020 Asian Journal of Clinical Pediatrics and Neonatology http://aijournals.com/index.php/ajcpn/article/view/1368 Sun, 12 Apr 2020 00:00:00 +0000 Correlation between Clinical Symptoms of Coeliac Disease, Serum IgA Anti TTG and Biopsy in Pediatric Population of Northern India http://aijournals.com/index.php/ajcpn/article/view/1369 <p><strong>Background: </strong>Celiac disease is basically an immune-mediated enteropathic condition produced by permanent sensitivity to gluten in genetically susceptible subjects. There is paucity of data in north India regarding clinical symptoms of coeliac disease, Serum IgA Anti TTG and Biopsy in pediatric population. The present study was conducted with the aim to determine the correlation between clinical symptoms of coeliac disease, Serum IgA Anti TTG and Biopsy in pediatric population of northern India.<strong>Materials and Methods:</strong> The present study was conducted in prospective including 73 pediatric patients at Department of Pediatric Gastroenterology, Institute of Child Health, Sir Gangaram Hospital, New Delhi, India. Esophagogastroduodenoendoscopy and serum anti Ig A tissue transglutaminase were performed. The characteristic scalloping of the folds were looked for in endoscopy followed by four duodenal biopsies performed from second part of duodenum and histological grading was performed as per modified marsh system. Patients with Serum IgA anti tTG&gt;20 U/ml were confirmed to be at risk. Complete histological work up was done including hemoglobin, RBC indices and peripheral blood smear examination. The association of clinical manifestations with disease grade was also established with correlation coefficient. All the data thus obtained was arranged in a tabulated form and analyzed using SPSS software. Probability value of less than 0.05 was regarded as significant.<strong>Results:</strong> There were 4 males and 16 females with marsh grade 1 and 2 and mean age of 7.3±1.9 years. There were 5 males and 8 females with marsh grade 3a and mean age of 6.8±2.3 years. The mean weight of 18.11±3.89, height of 103.17±8.73 and BMI of 16.26±3.78 was observed amongst subjects with Marsh grade 1 and 2. The mean weight of 15.12±3.17, height of 99.28±9.19 and BMI of 15.02±3.20was observed amongst subjects with Marsh grade 3a. Diarrhoea was maximum amongst subjects with grade 3c and 4(70%) and minimum amongst Grade 1 and 2 (40%). There was a significant difference between the frequency of anemia amongst different grades as the p value was less than 0.05.<strong>Conclusion:</strong> The most common presenting signs and symptoms were diarrhea and abdominal pain. The study also concluded that the incidence of anemia increases with higher marsh grades.</p> Sumit Jeena, Jaswinder Kaur, Nishant Wadhwa Copyright (c) 2020 Asian Journal of Clinical Pediatrics and Neonatology http://aijournals.com/index.php/ajcpn/article/view/1369 Sun, 12 Apr 2020 00:00:00 +0000 Etiological and Clinical Profile of Seizures in Late Preterm and Term Neonates - A Retrospective Study in an Intramural Tertiary Care Centre http://aijournals.com/index.php/ajcpn/article/view/1370 <p><strong>Background: </strong>Seizures represents the most distinctive signal of the neurological disease in the newborn period. Neonatal seizures are associated with unfavourable short and long term neurodevelopmental outcome. Objective: Our study was aimed at finding incidence, etiological factors, and clinical profile seizures in late preterm and term infants.<strong>Subject and Method:</strong>A retrospective study was conducted in an intramural tertiary care hospital, IOG, Chennai, India. Detailed antenatal, intrapartum history and baseline characteristics of both mother and infants, clinical details of seizures, investigations and neuroimaging details of 113 late preterm and term neonates with seizures data was collected from January 2018 to December 2018. <strong>Results:</strong>The incidence of seizures in late preterm and term neonates was 0.76% in our study. Hypoxic ischemic encephalopathy(HIE) was the commonest etiology(50.4%) followed by sepsis(24.8%). Majority of HIE neonates presented within 12 hrs of life (89%). Hypoglycemia(21.2%) was the commonest primary metabolic abnormality followed by hypocalcemia(9.7%). Clonic type was the most commonest type (82.3%) of seizure followed by subtle (73.5%) seizure. <strong>Conclusion:</strong>Hypoxic ischemic encephalopathy was the commonest etiology along with clonic seizures most commonest types. Hypoglycemia was the most commonest biochemical abnormality.</p> Venkatesh G, V Prakash, Mohd Sajjid, Elango Copyright (c) 2020 Asian Journal of Clinical Pediatrics and Neonatology http://aijournals.com/index.php/ajcpn/article/view/1370 Sun, 12 Apr 2020 00:00:00 +0000 A study on Effect of Nutrition Supplementation in Children Living With HIV at ART Centre- A Prospective Observational Study http://aijournals.com/index.php/ajcpn/article/view/1371 <p><strong>Background: </strong>The nutritional status of people living with HIV/AIDS is related to morbidity and mortality and may predict the course of HIV infection and the management of these helps in recovery and maintenance of health status.<strong>Aims &amp;&nbsp;objectives:</strong>&nbsp;The main aim of the current study toassess the nutritional status and nutritional supplementation in children with HIV at ART center.<strong>Subjects and Methods:</strong>A prospective observational study was conducted between May 2017 and May 2018 in a total of 100 children aged 1 to 18 years with proven HIV status attending ART centre. Each child included in the study was examined clinically and their anthropometric data was recorded. They were provided with a fixed nutrition supplementation of 2 scoops of protein powder and one serving of peanut chikki per day and they were followed up regularly. At the end of one year, they were examined clinically and their anthropometric data was recorded again. <strong>Result:</strong>In the present study, about 44% of subjects were males and 56% were females. Majority of the children (55%) fell in the age group of 11-15 years. 36% were on pre-ART and 64% were on ART.At the beginning of the study, 59% of children were stunted and 64% of the children had &lt; 2 SD of BMI for age. According to WHO, Z scores could be calculated only for children less than 10 years of age. In this study, 34 children fell in this age group and 24 among them were underweight at the beginning of the study. <strong>Conclusion:</strong>After giving the nutritional supplementation for a period of one year, there was a statistically significant improvement in height-for-age, weight-for-age and the Z scores of height-for-age, weight-for-age and BMI-for-age. Though there was an improvement in the mean values of BMI for age, this was not considered to be statistically significant. Finally, nutritional interventions should be tailored and assessed to improve growth, especially at time of ART initiation that could lead to an optimisation of their clinical response and survival of ART-treated children.</p> Muddana Narasimha Rao, Ashish Ragireddy Copyright (c) 2020 Asian Journal of Clinical Pediatrics and Neonatology http://aijournals.com/index.php/ajcpn/article/view/1371 Sun, 12 Apr 2020 00:00:00 +0000 Candidial Infection in Pre- Term Babies- A Clinical Study http://aijournals.com/index.php/ajcpn/article/view/1372 <p><strong>Background: </strong>Invasive candidiasis in neonates is a serious and common cause oflate onset sepsis and has a high mortality. The present study was conducted to assess candidial infection in pre- term babies.<strong>Subject and Method:</strong>The present study was conducted in the Department of Neonatology. It comprised of 56 low birth weight babies of both genders. In all cases, gestational age, birth weight, length of stay before candidemia, presence of CVC, stay in NICU ≤ 7 days and mechanical ventilation was recorded. <strong>Result:</strong>Out of 56 patients, boys were 32 and girls were 24. Gestational age (weeks) was 30.2, birth weight was 1214.5 grams, length of stay before candidemia was 10.2 days, presence of CVC in 54, stay in NICU ≤ 7 days was seen in 52 and mechanical ventilation was seen in 47. Clinical manifestations was candida endophthalmitis in 13, candida endocarditis in 16 and congenital cutaneous candidiasis in 27. The difference was significant (P&lt; 0.05). <strong>Conclusion:</strong>Authors found that Candidial infection is common in newborn. Clinical manifestations were candida endophthalmitis, candida endocarditis and congenital cutaneous candidiasis.</p> Venkatesh G, Arun Kumar P Copyright (c) 2020 Asian Journal of Clinical Pediatrics and Neonatology http://aijournals.com/index.php/ajcpn/article/view/1372 Sun, 12 Apr 2020 00:00:00 +0000 Impact of Psychotherapy on School Performance in School Going Adolescent http://aijournals.com/index.php/ajcpn/article/view/1376 <p><strong>Background: </strong>Psychotherapy is the use of psychological methods particularly when based on interpersonal interaction to help a person to change behavior and overcome emotional problems like aggression, low self-esteem, anxiety .As a part of Psychotherapy,counseling is a learning oriented process which usually occurs in an interactive relationship with the aim of helping students to learn more about him or herself..<strong>Subjects and Methods:</strong>The study was conducted in department of Paediatrics Dr SushilaTiwari Hospital HaldwaniUttarakhand.It was a school based study and students of 9th and 10th class (13-17 years) with normal IQ were included.The result was analysed on the basis of a preformed questionnaire filled by children, teacher, parents before and after counseling and taking record of previous school performance.<strong>Result:</strong>150 students 39 female and 111 male&nbsp; participated in the study.84.7% agreed that counseling sessions were helpful to them.72% students&nbsp; have shown&nbsp; good improvement in academic performance and 64% have shown increment of 6 to 10% marks.<strong>Conclusion:</strong>Counseling programmes create a positive impact on the academic performances, career choices, course selection, college and career planning. This study shows that use of excessive social media and poor concentration in studies are among the major causes of poor performances.</p> Prerna Panwar, Nutan Singh, Ramesh Chand Copyright (c) 2020 Asian Journal of Clinical Pediatrics and Neonatology http://aijournals.com/index.php/ajcpn/article/view/1376 Sat, 25 Apr 2020 00:00:00 +0000 Assessment of Nutritional Status in Children with Cerebral Palsy http://aijournals.com/index.php/ajcpn/article/view/1377 <p><strong>Background: </strong>Cerebral palsy refers to a group of disorders that affect movement or posture. The present study was conducted to nutrition status in children with cerebral palsy.<strong>Subjects and Methods:</strong>The present study was conducted on 120 children age ranged 7-16 years diagnosed with cerebral palsy. Nutritional status assessment was based on the TSF and AFA estimates derived from TSF and mid-upper arm circumference (MUAC) measurements. Children were classified into underweight, &lt;5th normal weight, 5-84.89th and overweight, &gt;85<sup>th</sup>.<strong>Result:</strong>There were 70 boys and 50 girls in present study. Common type was spastic in 90, dyskinetic in 20 and ataxic in 10 patients. GMFCS levels was level I in 30, level II in 15, level III&nbsp; in 18, level IV in 9 and level V in 48 patients. The mean TSF and AFA Z-scores were significantly lower in low functioning children than in moderate functioning children (P&lt; 0.05).Underweight and overweight prevalence were 13.1 % and 4.9 % respectively. The underweight prevalence was significantly higher in girls than in boys (P&lt; 0.05), whereas overweight prevalence was significantly higher in boys than in girls (P&lt; 0.05). Both underweight (P- 0.148) and overweight (P- 0.421) prevalence was not significantly different across age groups. Underweight prevalence was significantly higher in the low functioning group (P&lt; 0.05).<strong>Conclusion:</strong>Authors found that cerebral palsy children face nutritional challenges. It is more common in underweight as compared to overweight children.</p> Mohana Copyright (c) 2020 Asian Journal of Clinical Pediatrics and Neonatology http://aijournals.com/index.php/ajcpn/article/view/1377 Sat, 25 Apr 2020 00:00:00 +0000 Evaluation of Clinical & Etiological Profile of Children with Seizures http://aijournals.com/index.php/ajcpn/article/view/1378 <p><strong>Background: </strong>Seizures are a transient occurrence of signs and/or symptoms resulting from abnormal excessive or synchronous neuronal activity in the brain. Better understanding of seizures in terms of clinical presentation and etiology is required not only for abortion of acute attack but also for long term control of epilepsy.<strong>Subjects and Methods: </strong>This retrospective observational study included those children who were admitted with seizures within last 1 year time period of our study. Variables including age, sex, type of seizure, laboratory test results, neuroimaging, EEG findings, duration of hospital stay, diagnosis and final outcome were studied.<strong>Results: </strong>Incidence of seizures decreased with increasing age with less than 5 years age group most commonly involved. Generalized tonic clonic seizure were the most common type of seizure with febrile seizures being most common. etiology followed by CNS infections. Febrile seizures had best outcome while CNS infections had highest morbidity and mortality.<strong>Conclusion: </strong>We found CNS infections to be the most common etiology and a poor outcome. Acute episode of seizures is one of the commonest causes of hospitalization with high morbidity and mortality. Being a developing nation, strict measures to prevent infection can reduce the occurrence of seizures in children thus preventing long term neurological sequelae in children.</p> Jagannath H.N Copyright (c) 2020 Asian Journal of Clinical Pediatrics and Neonatology http://aijournals.com/index.php/ajcpn/article/view/1378 Sat, 25 Apr 2020 00:00:00 +0000