Asian Journal of Clinical Pediatrics and Neonatology <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 (Dr. Rohit Varshney) (Mr Shadan Pasha) Tue, 28 Jul 2020 04:50:01 +0000 OJS 60 Sleep Disorder in Children Suffering from Autism Spectrum Disorder in the Hilly Area of Uttarakhand <p><strong>Background</strong>: Autism Spectrum Disorder (ASD) includes neurodevelopmental problems throughout life that affect all areas of child development such as abnormal and impaired social interaction, problems in communication, restricted interest, repetitive and stereotypical behaviors. Sleep problems are most commonly complained by parents of children suffering from ASD. About 20-30% of children less than 5 years with normal development give complaints of sleep problems mainly of bedtime resistance, sleep onset delay and night awakening. Less commonly reported sleep disturbance by parents is nightmares or night terrors repetitive and stereotypical behavior. Less frequently reported complain is of breathing sleep disorder. It has already been proved by many studies that ASD children have more complaints about sleep problems than in normal children. But the data of children with ASD having sleep problems in the Indian population is less, so with our study we want to know the prevalence of ASD children with sleep problems in children of the hilly area of Uttarakhand. Objective: The study aims to know the different problems related to sleep faced by children suffering from ASD ( Age range from 4 to 10 years ) with autistic spectrum disorders using the Children’s Sleep Habit Questionnaire (Preschool and school-age, abbreviated version). <strong>Subjects and Method s: </strong>All patients of ASD presenting to the Psychiatry and Pediatric Outpatient department of Government Medical College and Susheela Tiwari trust Hospital, Haldwani, Uttarakhand from in February 2019 to January 2020. It’s a cross-sectional study of children with different problems related to sleep faced by children suffering from ASD ( Age range from 4 to 10 years ) with autistic spectrum disorders using the Children’s Sleep Habit Questionnaire (CSHQ) (Preschool and school-age, abbreviated version). <strong>Results: </strong>Demographic and clinical characteristics: The sample consisted of 30 children of ASD with sleep problems ( Mean Age 8.06 years, SD 3.25, Male 21 and Female 9 Children) age range from 4 Years to 10 Years and is compare from 30 normal children (mean age 9.06 Years, SD 3.15, Male 21 and Female 9) for the control group. Both groups were analysed using CSHQ tools. There were no statistically significant differences in age and gender (P value more than 0.05). About 60% (n=18) of the children suffering from ASD had an intellectual disability and 40% (n=12) children with ASD had normal Intellectual. Comparison of Total CSHQ score, bedtime resistance and sleep anxiety showed a statistically significant difference in children suffering from ASD with sleep disorder when compared from normal children. Using CSHQ tools sleep onset delay, night waking, day time sleepiness, parasomnias and sleep –disorder breathing does not show any statistical difference between children with ASD and normal children used as Control. <strong>Conclusion: </strong>This study compared sleep problems between children with ASD and typically developing children (4-10 Years of age) and examined associated factors of sleep problems in ASD from a different point of view.</p> Ashok Kumar, Shweta Joshi, Sushil Ojha Copyright (c) 2020 Author Thu, 09 Jul 2020 00:00:00 +0000 Urine Uric Acid Creatinine Ratio as a Diagnostic and Prognostic Marker of Neonatal Birth Asphyxia <p><strong>Background</strong>: Cerebral hypoxia can result in anaerobic glycolysis which leads to decreased phosphorylase production and increased uric acid which gets excreted in the urine where it can be easily detected. The aim of the study is to assess the utility of urine uric acid creatinine ratio (UA/Cr) as an additional marker of neonatal depression and birth asphyxia and its utility as a potential prognostic indicator for the immediate outcome. <strong>Subjects and Methods: </strong>It was a case-control study that included 30 newborns born with an APGAR score of less than 7 at 1-min and requiring positive pressure ventilation. Cases were sub-grouped into neonatal depression and birth asphyxia. Newborns with moderate and severe encephalopathy were considered to have an unfavourable outcome. The urine UA/Cr was estimated in both groups. One-way Anova test, Spearman’s rho and Receiver Operating Characteristic curve were used for statistical analysis. <strong>Results: </strong>The mean differences of urine UA/Cr were statistically significant (p=0.011) in birth asphyxia (3.02 1.34), neonatal depression (2.31 0.81) and controls (2.01 0.69). A significant negative correlation was seen with APGAR at 1-min (r=-0.43; p=0.001) and 5-min (r=-0.52; p=0.001) and umbilical cord blood pH (r= -0.29; p=0.021). The mean difference of UA/Cr between those with unfavorable (3.23 1.49) and favourable (2.14 0.73) outcomes was significant (p=0.006). A ratio 2.85 suggested the unfavourable outcome. <strong>Conclusion: </strong>The urine UA/Cr is a useful diagnostic and prognostic biomarker in newborns with birth asphyxia.</p> Ashwi R Krishnan, Praveen Nayak, Sumanth Shetty Bellipady, Rathika D. Shenoy Copyright (c) 2020 Author Thu, 09 Jul 2020 00:00:00 +0000 Predictors of Overweight and Obesity among Children in Haldwani, Uttarakhand <p><strong>Background</strong>: Obesity has become a concerning pediatric health problem in the modern era with lifestyle changes in globalization, economic development and easy access to technology. The aim of the study is to study the anthropometric profile of overweight and obesity and its associated risk factors. <strong>Subjects and Methods: </strong>A school-based cross-sectional study was implemented among randomly chosen 100 obese&nbsp; and overweight children aged between 10-18 years over 15 months. Data was collected using a structured self-administered questionnaire and anthropometry was done and categorized as overweight and obese as per WHO BMI- age cutoff. <strong>Results: </strong>41 % (n=41) were obese and 59% (n=59) were overweight. 65 % (n=65) were males. In all the age groups the mean weight of males was more except in the age group 10-12 years. Mean weight (64.39&nbsp; 12.88 kg) and mean BMI (26.04&nbsp;&nbsp; 1.95 kg/m2) of obese children is significantly higher than mean weight (56.73&nbsp; &nbsp;9.76 kg) and mean BMI (23.25&nbsp; 1.98 kg/m2) of overweight children respectively. Risk factors like skipping breakfast (p= 0.034), calorie excess&nbsp;&nbsp; (p= 0.032), junk food intake more than once (p=0.008) and junk food daily (p=0.036) were found to be significantly associated with childhood obesity. <strong>Conclusion: </strong>Sensitization of parents and teachers with school-based programs like active participation in sports, regular anthropometric examinations of students are important measures that can be taken to curb this rising problem.</p> Bhawna Choudhary, Nutan Singh, Ankush Bathla, Ramesh Chand Copyright (c) 2020 Author Sun, 05 Jul 2020 00:00:00 +0000 Association of Self-Reported Quality of Life in Children with Level of Bronchial Asthma Control <p><strong>Background</strong>: To assess the association of self-reported quality of life (QOL) by using mini- pediatric asthma quality of life questionnaire (mini-PAQLQ) in children aged between 7-15 years with a level of asthma control. <strong>Subjects and Methods: </strong>Prospective observational study conducted in the asthma clinic in the outpatient department from September 2016 to August 2017. All the cases of asthma, as defined by GINA guidelines, aged between 7-15 years with parental consent were recruited. The level of control was also assessed according to GINA guidelines. Excluded were clinically suspected cases of chronic lung diseases except for bronchial asthma and any other chronic medical condition. QOL was assessed by using mini-PAQLQ which had three domains i.e. Symptoms, emotions and limitation of activity. Each domain had questions and their responses coded on a visual scale with 7 options. <strong>Results: </strong>From September 2016 to August 2017, total enrolled were 85 of which 51 (60%) were partly controlled and 34(40%) were well controlled. Mean mini-PAQOL score in patients with partly control was low (3.59 0.93) as compared to those with well-controlled asthma (5.83 1.21) (p=0.0001). <strong>Conclusion: </strong>Self-reported QOL of children with partly controlled asthma was found to be impaired in all the domains as compared to those with well-controlled asthma.</p> Shalini Verma, Shally Awasthi, Sarika Gupta Copyright (c) 2020 Author Thu, 09 Jul 2020 00:00:00 +0000 The Consequences of Prior Initiation of Breast Feeding on Blood Glucose Levels in Neonates Born In a Tertiary Care Hospital <p><strong>Background</strong>: Hypoglycemia is the most common event of failure of metabolic adjustments in the newborn. Changes in maternal and fetal monitoring techniques, administration of glucose-containing solutions during labor, delivery and early feeding in neonates significantly alter blood glucose concentrations during the first week of postnatal life. <strong>Subjects and Methods: </strong>A total of 90 healthy (60 born by FTND, 30 born by LSCS) term, AGA infants were longitudinally evaluated at birth, at one hour after feeds (post feed), and after 6 hours of life. Plasma glucose was estimated from Heel Prick capillary samples by glucometer method. The influence of mode of delivery, the interval between feeds, sex, birth weight, on blood glucose was analyzed. <strong>Results: </strong>The way of delivery did not affect the plasma glucose concentration in neonates. There was a substantial increase in blood glucose concentration after the first feed irrespective of their birth weight. It was found that female babies had a higher blood glucose concentration than male babies during our study period. All babies maintained normal blood glucose with the continuation of breastfeeding. <strong>Conclusion: </strong>Plasma glucose levels are satisfactorily maintained in healthy term infants without resort to pre-lacteal feeds and mode of delivery did not influence plasma glucose. There is no need to check blood glucose levels routinely in an asymptomatic, healthy, term, breastfed infants.</p> Rizwan-U- Zama, Ayesha Siddiqa, A.N. Thobbi, Tehseen Sajid Mudhol, R Shruthi Copyright (c) 2020 Author Thu, 09 Jul 2020 00:00:00 +0000 A Study on Correlation of Umbilical Cord Arterial Blood pH with Perinatal Asphyxia & Early Neonatal Outcome <p><strong>Background: </strong>Perinatal asphyxia is one of the major causes of neonatal morbidity &amp; mortality. Asphyxia can damage almost every organ of neonate. Our purpose was to determine the correlation of cord blood pH with birth asphyxia &amp; early neonatal outcome. <strong>Subjects and Methods: </strong>A prospective study was conducted over a period of one year at STH Haldwani. We enrolled 108 term neonates with signs of fetal distress, thick MSL, non-reassuring NST &amp; there were subjected for estimation of umbilical cord blood pH, APGAR score, outcome looked were resuscitation needed, NICU admission, delay in feed &amp; encephalopathy (sarnat &amp; sarnat stage). <strong>Results: </strong>In our study, cord blood pH had significant correlation with perinatal asphyxia(R=-0.926). Area under ROC curved showed that mean pH &lt;7.1 (ROC=0.998) is very significant in predicting the adverse outcome. <strong>Conclusion: </strong>Cord blood pH is very sensitive and specific &amp; has good correlation in predicting the birth asphyxia &amp; adverse neonatal outcome. Measurement of cord blood pH is recommended in all the neonates with signs of fetal distress.</p> Nutan Singh, Asheesh Kumar Gupta, Ajay Kumar Arya Copyright (c) 2020 Author Thu, 09 Jul 2020 00:00:00 +0000 Clinical Profile of Neonatal Early Onset Sepsis: A Study on the Current Scenario <p><strong>Background</strong>: Neonatal early onset sepsis remains to be a challenge in India, owing to its variable presentation, diagnostic difficulty and high fatality. An attempt needs to be made to study its clinical profile for easy identification of such babies, with new antibiotic guidelines formulated based on current microorganisms isolated. The aim of the study is to study the clinical profile of early onset sepsis in neonates in terms of&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; the risk factors, clinical factors and etiology, and ascertain factors associated with definite sepsis. <strong>Subjects and Methods: </strong>This hospital based cross-sectional study enrolled neonates with suspected early onset sepsis. Those with congenital anomalies, surgical conditions, gestation &lt;28 weeks and birth weight &lt;1kg excluded. Subjects were subjected to sepsis screen and blood culture, and their perinatal history recorded. Blood culture positive babies were considered to have definite sepsis. Data was analysed using Chi square with SPSS 18. <strong>Results</strong>: Among 300 babies enrolled, 70 babies had definite sepsis. The most common organism isolated was Klebsiella (27.1%) and Staphylococcus hemolyticus (21.4%), most showing sensitivity to Ampicillin and Gentamicin. Respiratory distress was the commonest presentation (71.3%). A significant association with definite sepsis was seen with prematurity (p =0.0026) and low birth weight (p =0.0052), perinatal risk factors namely premature rupture&nbsp; of membranes (p =0.004), foul smelling liquor (p=0.016) and birth asphyxia (p-value=0.02). 28.3% had positive sepsis screen, which was significant (p = 0.001). <strong>Conclusion</strong>: Early onset sepsis needs prompt identification and treatment initiation, possible with aid of sepsis screen and high index of suspicion with certain perinatal risk factors and gestational age and birth weight.</p> Kiran C Pankaj, Sristi Ganguly, Manas R Upadhyay Copyright (c) 2020 Author Thu, 09 Jul 2020 00:00:00 +0000 Association between Thyroid Profile and Serum Bilirubin Levels in Term Neonates on Day 3 of Life <p><strong>Background</strong>: Neonatal indirect hyperbilirubinemia is a common clinical scenario that manifests as jaundice in the first week of life. Studies have shown that the physiological peak of serum bilirubin (SBR) levels is highest at 72 hours of life as a result of which SBR is measured at&nbsp; 72 hours of life routinely. The American Academy of Pediatricians (AAP) recommends routine screening for congenital hypothyroidism within the first week of life for all neonates. In common practice, both parameters are assessed simultaneously at 72 hours of life. This study aims&nbsp;&nbsp;&nbsp;&nbsp; to correlate thyroid Profile and serum bilirubin levels assessed in term neonates at 72 hours of life. <strong>Subjects and Methods: </strong>Our retrospective study included 105 term neonates born through cesarean-section at MMCHRI, Kanchipuram; between August 2018 and August 2019. Pre-term, neonates born to eclamptic, pre-eclamptic, diabetic, hypothyroid, Rh-incompatible mothers were excluded from the study. The data collected included Birth Weight, Gestational Age, Thyroid Profile (T3, T4, TSH), SBR (Total and Direct). Data were analyzed using SPSS v16. <strong>Results: </strong>The mean gestational age of the study population was 268.05&nbsp; 6.25 days, and mean birth weight was 2.997&nbsp; 0.36 kgs. The mean serum levels&nbsp; of total bilirubin were 11.36 3.52 mg/dl. The mean serum fT3, fT4, TSH levels were 8.17 23.2 pg/ml, 2.16 1.68 ng/dl and 4.07 3.4 mIU/ml respectively. A positive association was noted between serum TSH and total serum bilirubin (r= 0.176, p = 0.067) but not statistically significant. <strong>Conclusion: </strong>Our study has not shown a significant association between serum TSH and SBRT in term neonates. However, the simultaneous assessment remains practical in practice.</p> Prahlad Kadambi, MA Ramprakash, Gandi Soujanya, L Sushanth Prabhath Reddy Copyright (c) 2020 Author Thu, 09 Jul 2020 00:00:00 +0000