Asian Journal of Clinical Pediatrics and Neonatology https://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> Society for Health Care & Research Development en-US Asian Journal of Clinical Pediatrics and Neonatology 2347-3355 A Comparative Study of Pulse Oximetry Screening and Clinical Examination in Diagnosis of Congenital Heart Disease https://aijournals.com/index.php/ajcpn/article/view/637 <p><strong>Background: </strong>Pulse oximetry is a reliable and non-invasive method for measuring oxygen saturation and has a rapid response. During the past several years pulse oximetry has gained wide spread use in the neonatal oxygen monitoring. The present study was done to determine if a pulse oximetry screening combined with clinical examination is superior in the diagnosis of congenital heart disease to clinical examination alone. <strong>Subjects and Methods: </strong>The term new-born babies born in NARAYANA medical college and Hospital during the study period of 12months (February 2018 to January 2019) had a thorough clinical examination on day 2 of life with emphasis on peripheral pulses, cyanosis, tachypnea, cardiac pulsations and murmurs. Pulse oximetry screening was done within 4hrs of birth and at 48-72hrs of life. Chest X-ray, ECG and Echocardiogram were done for those babies with either abnormal clinical examination or pulse oximetry reading.Clinical examination was done again 2 weeks after discharge. <strong>Results: </strong>Though routine clinical examination is effective in detection of congenital heart disease in new-borns, combining pulse oximetry and clinical examination after birth had a higher sensitivity for detection of congenital heart diseases in new-borns. <strong>Conclusion: </strong>Combining clinical examination and pulse oximetry can enhance the clinician’s ability to detect life-threatening congenital heart disease in a timely manner. This issue requires the formulation of national policy that will make screening for CCHD a priority.</p> Shaik Nazeer Ahmed ##submission.copyrightStatement## 2019-05-16 2019-05-16 7 2 1 5 A Study on Outcome of Early Caffeine Administration in Very Preterm Neonates https://aijournals.com/index.php/ajcpn/article/view/638 <p><strong>Background: </strong>Apnea intervals frequently occur in very preterm infants. Methylxanthenes stimulate breathing efforts and hence have been used for treating apnea of prematurity. Aim: to study the outcome of early caffeine administration in very preterm neonates. <strong>Subjects and Methods:</strong> The first (1st) group babies received early caffeine within 48 hours of life before developing apnea. The second group (2nd) group babies received caffeine late after 48 hours, after onset of apneic episode. <strong>Results:</strong> There was no significant difference in the number of episodes of apnea, bradycardia and hypoxemia. Also no significant difference in the incidence of Patent ductus arteriosus (PDA), Intra ventricular hemorrhage (IVH), Necrotizing enterocolitis (NEC), Retinopathy of prematurity (ROP) or Bronchopulmonary dysplsia (BPD). <strong>Conclusion:</strong> There was no significant difference noted in the number of episodes of apnea, bradycardia and hypoxemia in the group with early caffeine administratration compared to late caffeine administration.</p> Dr Basavaraj Hareesh Sanikam Pavan Pujar Anjali R Pushpalatha K ##submission.copyrightStatement## 2019-05-16 2019-05-16 7 2 6 8 Clinicoetiological Study of Epilepsy in Children Presenting To Speciality Epilepsy Clinic at Tertiary Medical Hospital https://aijournals.com/index.php/ajcpn/article/view/639 <p><strong>Background: </strong>Objectives: To identify the clinical &amp; etiological profile of children and the characteristics of seizures in them along with therapeutic response. <strong>Subjects and Methods: </strong>All patients who attended the Epilepsy Clinic &amp; fulfilled the selection criteria were enrolled in study. This is a descriptive study of 18 months &amp; involved analysis of records of the patients who came to specialty OPD. Three groups were formed accordingly - focal, generalized &amp; unknown onset with further etiological sub-divisions -Genetic, Structural/Metabolic, Immune, Infectious &amp; Unknown. <strong>Results: </strong>In all, 417 patients were studied. The distribution as per clinical presentation was- group I (generalized) 215(58.5%) - group II (focal) 154(36.9%), group III (unknown) 48(4.6%). The main etiologies were perinatal asphyxia (28.3%) NHBI (11.4%) in (structural-metabolic) sub group. In Genetic &amp; Infectious, Channelopathies (10.5%) &amp; Post Meningitis Sequelae (4.7%)were main etiology. 56.3% of the patient in group II were on more than 3 AEDs. 14.3% in group I were weaned of AEDs. 61.4% patients in group II were having neurodevelopmental Sequelae. EEG revealed abnormal activity in 30(6.2%) in group I &amp; 31(19.3%) in group II. Maximum patient with refractory epilepsy were seen in group III. <strong>Conclusion: </strong>To have a good management of epilepsy we need to have multi-dimensional classification of epilepsy based on both clinical &amp; etiological spectrum. Perinatal Asphyxia &amp; NHBI are one of the most common yet avertible etiologies.</p> Zankhana R. Parekh Umesh Joshi Nitish Vora Aasheeta Shah ##submission.copyrightStatement## 2019-05-16 2019-05-16 7 2 9 12 An Observational Study of Neonates Admitted in NICU of a Tertiary Care Hospital in Rohtas, Bihar https://aijournals.com/index.php/ajcpn/article/view/657 <p><strong>Background: </strong>Globally, 2.6 (2.5–2.8) million newborns died in 2016. A High neonatal mortality rate reflects the presence of unfavourable social, economic, and environmental conditions not conducive to neonates. The present study was done to find various factors related to infants morbidity and mortality in a tertiary care centre of Rohtas, Bihar. <strong>Subjects and Methods: </strong>The present prospective observational study was conducted in the neonatal intensive care unit of a tertiary care centre in Bihar. Data were collected by interview method using a predesigned, semi-structured questionnaire. <strong>Results: </strong>There were a total of 1030 admissions with pre-term admissions constituted 44.95%. Majority of admissions was due to LBW (64.17), admitted before 3 days. Majority of neonates (69.02%) were discharged after medical treatment. Pre-term and related complications were ranked highest (44.95%). Mortality rates among inborns (10.29%) and outborns (11.67%) were nearly similar in the study; there was no significant difference in death rates of inborn and outborn neonates (Chi-square value = 1.22). LBW (8.97%) neonates were having 2.79 times high mortality than normal. <strong>Conclusion: </strong>Prematurity, sepsis, and birth asphyxia were accounting for morbidities and mortalities among neonates. The preterm and LBW babies had significantly higher mortality even with standard intensive care; therefore a strong and effective antenatal program with extensive coverage of all pregnant females specifically in outreach areas should be developed which will help in decreasing preterm deliveries and lowering the incidence of LBW babies.</p> Rambilas Ranjan ##submission.copyrightStatement## 2019-05-25 2019-05-25 7 2 13 16 Clinical Profile and HIV Status of the HIV Exposed Infants from Birth to 6 Months of Life https://aijournals.com/index.php/ajcpn/article/view/664 <p><strong>Background: </strong>Approximately 15-25% of HIV-infected newborns in developed countries present with a rapid disease course, with onset of AIDS and symptoms during the 1st few months of life and a median survival time of 6-9 months if untreated. In resource-poor countries, the majority of HIV-infected newborns will have this rapidly progressing disease. <strong>Subjects and Methods: </strong>All babies who were exposed to HIV positive mother irrespective of mode of delivery and received NVP birth dose within 6 to 12 hours&nbsp; of delivery and prophylaxis continued till 6 weeks according to PPTCT guidelines 2012 by National AIDS Control organization(NACO). <strong>Results: </strong>Among 21 babies, 19 (90.5%) babies had both parents HIV positive and in 2 (9.5%) only mother was HIV positive. Out of the 21 mothers in this study, Almost 9(42.8%) mothers had CD4 count of &lt;350 and remaining 12(57.2%) mothers had CD4 count &gt;350. <strong>Conclusion: </strong>Out of 21 babies, 15 (71.4%) were delivered by spontaneous vaginal delivery, 5 (23.8%) through LSCS and 1 (4.8%) by Instrumental (forceps) delivery.</p> Hamsa M Sampath Kumar C Rajendra V Naidu Prakash K Wari ##submission.copyrightStatement## 2019-05-28 2019-05-28 7 2 17 21 The Benefits of New ARV Prophylaxis in Infants Who are on Exclusive Breast Feeding in Reducing the Risk of Mother to Child Transmission https://aijournals.com/index.php/ajcpn/article/view/665 <p><strong>Background: </strong>Antiretroviral prophylaxis given soon after birth to all HIV exposed infants is effective in reducing MTCT which forms the basis of post exposure prophylaxis strategy. Infant ARV prophylaxis is also highly effective in reducing transmission through breast milk. <strong>Subjects and Methods: </strong>All mothers were counseled regarding advantages and disadvantages of both exclusive breast feeding and mixed feeding and was started on EBF on their choice. Babies were followed up at birth, 4weeks, 6weeks, 10weeks, 14weeks and monthly thereafter until 6 months of age and during every visit detailed history and clinical examination was performed and entered in preformed proforma. HIV status was evaluated at 6weeks and 6 months of life by direct blood spot for&nbsp; HIV -1 DNA PCR by ICTC and if it was positive it was confirmed by whole blood sample for HIV -1 DNA PCR at ART Centre. <strong>Results: </strong>At the end of 6 months, most common clinical morbidity noticed in HIV exposed exclusively breast fed infants was clinical pallor in 4(19.0%), followed by URTI, splenomegaly in 2(9.5%), and hepatomegaly, loose stools, oral thrush, severe acute malnutrition, and microcephaly was observed in 1(4.8%) babies. <strong>Conclusion: </strong>The breast milk of HIV-infected women may confer protection against common infant pathogens.</p> Hamsa M Sampath Kumar C Rajendra V Naidu Prakash K Wari ##submission.copyrightStatement## 2019-05-28 2019-05-28 7 2 22 26