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> Society for Health Care & Research Development en-US Asian Journal of Clinical Pediatrics and Neonatology 2347-3355 Socio Demographic Characteristics and Laboratory Evaluation of Children Admitted to Tertiary Care Hospital with Ascites <p><strong>Background: </strong>The most important consideration in a patient with a new onset of ascites is to perform a peritoneal tap and to ascertain the cause. A peritoneal tap is also indicated in a patient with known liver disease who presents with sudden clinical deterioration, worsening encephalopathy, or unexplained fever. A missed or delayed diagnosis of spontaneous bacterial peritonitis could potentially lead to sepsis and significant morbidity &amp; mortality. Prophylactic antibiotic therapy with a quinolone is often recommended.<strong>Subjects and Methods: </strong>All children with ascites were included in study irrespective of their primary diagnosis. Detailed history, complete physical examination &amp; routine investigations were done in all patients. Ascitic tap was done after taking written consent from the guardian with full aseptic precaution.<strong>Results: </strong>Diagnostic ascitic tap was done in 48 patients, off which it was clear in 70.83%. In 8 patients the fluid was hazy in appearance suggestive of possibly infective origin either due to elevated protein or cells. One patient had milky appearance of ascetic fluid that suggests chylous nature of it.<strong>Conclusion: </strong>Proteinuria (33.3%), Hypoalbuminemia (42.16%), reversed AG ratio (34.3%) &amp; hypercholesterolemia (37.2%) were present all together in 33.3% (34) patients suggestive of Nephrotic syndrome.</p> Keludeppa Talawar Copyright (c) 2019 Asian Journal of Clinical Pediatrics and Neonatology 2019-09-17 2019-09-17 7 3 01 05 Efficacy of Indigenous Bubble CPAP in Neonates withRespiratory Distress <p><strong>Background: </strong>Respiratory distress in newborn due to varied aetiology is one of the common causes for new born admission to NICU, new born morbidity and mortality. Bubble CPAP is a simple, cost effective and gentle mode of respiratory support in newborns with respiratory distress. It reduces the need for mechanical ventilation in appropriately selected cases. In this paper we review our institute experience of using very low cost indigenous CPAP as primary way of respiratory support and its outcome. Objectives: Effectiveness of indigenous CPAP as a low cost measure in treatment of respiratory distress in newborn period and its outcome. Design: Prospective observational study.<strong>Subjects and Methods: </strong>This study included 100 consecutive both term and preterm&nbsp; newborns admitted for respiratory distress due to varied aetiologies like respiratory distress syndrome, transient tachypnea of newborn, apnea of prematurity, birth asphyxia, meconium aspiration syndrome, etc in our NICU over a period of 1 year. Exclusion criteria being babies put on CPAP for post-extubation respiratory distress and babies with severe life threatening surgical conditions. Downe’s scoring for term and Silvermann’s scoring for preterm babies were used to assess the severity of respiratory distress and also to assess the response to indigenous CPAP.<strong>Results: </strong>Out of 100 newborns with respiratory distress treated with indigenous CPAP, 73% improved, 21% were further put on mechanical ventilation and 6% were discharged against medical advise. Failure of CPAP was associated with co morbidities like sepsis, congenital heart diseases, PPHN and IVH.<strong>Conclusion: </strong>Indigenous bubble CPAP is low cost equipment (Total cost Rs.301) effective in treatment of respiratory distress in newborn at resource limited neonatal intensive care units where newborn admissions are in excess.</p> Keludeppa Talawar Ramesh Pattar Bhuvaneshwari Yelamali Raghavendra Vanaki Copyright (c) 2019 Asian Journal of Clinical Pediatrics and Neonatology 2019-09-17 2019-09-17 7 3 06 08 To Compare the Morbidity and Mortality Pattern of late Preterm and Term Neonates at GRMC, Gwalior <p><strong>Background: </strong>This is a hospital based prospective observational study, carried out at Gajara Raja Medical College, Gwalior. All the inborn late preterm babies have been included in the study. Selection of late preterm neonates is done by determination of gestational age.<strong>Subjects and </strong><strong>Methods:</strong>All the inborn late preterm babies have been included in the study. Selection of late preterm neonates is done by determination of gestational age. We compared the mortality and morbidity pattern of preterm neonates with the term counterpart, the data of term neonates retrieved from hospital record.<strong>Results:</strong>Maximum no. of cases in late preterm in Jaundice i.e. 9%, followed by Septicaemia 7.8% &amp;Respiratory Distress 7.6%. In Term Jaundice i.e. 3.34%, followed by Septicaemia 3.38% &amp;Respiratory Distress 3.41%. In our study Neonatal convulsions were more common among the late preterm neonates as compare to term group.<strong>Conclusion:</strong>In our study jaundice, septicemia, respiratory distress and hypoglycemia were found as major morbidities, among late preterm the rate was found to be 9%,7.8%,7.6% and 6% respectively while in term group the rate was 3.34%, 3.38%, 3.41% and 2.56% respectively.The mortality and morbidity among late preterm neonates were higher as compared to their term counterparts, implying the need for special attention to these babies because they may be overlooked among other preterm and sick babies.</p> Neetu Sharma Manish Rathore Copyright (c) 2019 Asian Journal of Clinical Pediatrics and Neonatology 2019-09-30 2019-09-30 7 3 9 11 Effect of Mobile Gaming / Computer Gaming On the Physical, Academic & Psychological Performance of School Going Adoloscents <p><strong>Background: </strong>The present research study was design to investigate the factors affecting academic performance as well as physical performance of school going children of schools of Indore district. The variable under consideration were academic performance and physical performance as a dependent variable and gender,age, residential area(rural/urban),accommodation, study hours, sleep hours ,time spend on mobile and electronic gaming were independent variables. <strong>Subjects and Methods: </strong>The data was collected from 670 students of age group 11-15years of different school of Indore using simple random sampling technique.378 student were found to have access to mobile gaming/electronic gaming with more than 2 hour of routing access. <strong>Results:</strong>For analysis Chi-square was used.The finding revealed that school performance regarding physical activity, academic performance, &amp; psychomotor effect in the class had declined with repetitive use of mobile phone and electronic gaming. <strong>Conclusion: </strong>A linear model was also proposed that will be helpful to improve the performance of school going Teenagers.</p> Tanmay Verma Sunil Malani Unique Sagar Swati Prashant Copyright (c) 2019 Asian Journal of Clinical Pediatrics and Neonatology 2019-09-30 2019-09-30 7 3 12 15 Paediatric Pelvic Tumours; Presentation, Diagnosis and Challenges of Treatment in a Low Resource Setting <p><strong>Background: </strong>Paediatric pelvic solid tumours present peculiar challenge in clinical diagnosis due to their inherently obscure anatomic location, and the varied, often vague symptoms. Difficult surgical access and presence of important surrounding pelvic structures make their surgical treatment particularly challenging.Aim: To report our experience with paediatric pelvic solid tumours and to highlight the presentation pattern and challenges of diagnosis and treatment in our setting. <strong>Subjects and Methods: </strong>This is a five year retrospective study of pelvic solid tumours in children seen in our centre between December 2013 and November 2018. Data retrieved were demographics, presenting symptoms and duration, previous treatments, findings on examination, laboratory investigations, treatment given in our centre, histology of tumours and duration of follow up, outcome. Analysis was done on Microsoft Excel spread sheet Windows 2007. <strong>Results: </strong>Twenty three cases comprising 7 males and 16 females were included in this study. The age range was 1 to 14 years with a median at 6.5 years. Ten(43.5%) of these cases were benign, and 13(56.5%) were malignant. The teratomas comprised 9 benign cystic mature teratomas and 6 malignant teratomas. There were 4 mortalities and one recurrence. <strong>Conclusion: </strong>The anatomic location and vague early symptoms of pelvic tumours make early diagnosis difficult in our setting. High morbidity and mortality is the direct consequence. In a resource poor setting as ours, scrupulous physical examination including digital rectal examination is key to early diagnosis.</p> Okoro Philemon E Eke Gracia Copyright (c) 2019 Asian Journal of Clinical Pediatrics and Neonatology 2019-10-10 2019-10-10 7 3 16 19 Acute diarrhea, feeding and diet: Is caregivers approach out of rationale? <p><strong>Background: </strong>The&nbsp;feeding and or diet in&nbsp;infants&nbsp;and&nbsp;young&nbsp;children with acute&nbsp;diarrhea&nbsp;is&nbsp;an&nbsp;unresolved&nbsp;health&nbsp;problem&nbsp;at the community level. Despite&nbsp;recommendations&nbsp;from several&nbsp;bodies, including the World Health Organization that&nbsp;feeding&nbsp;should be&nbsp;continued&nbsp;during&nbsp;diarrhea.&nbsp;The&nbsp;practice&nbsp;of withholding balance diet or breast feeding during the acute&nbsp;diarrhea&nbsp;is still prevalent and it&nbsp;is&nbsp;one&nbsp;of the&nbsp;major&nbsp;public&nbsp;health&nbsp;issue, and&nbsp;this&nbsp;may&nbsp;lead&nbsp;to&nbsp;development&nbsp;of&nbsp;malnutrition, which&nbsp;may&nbsp;further prevent&nbsp;recovery&nbsp;from diarrhea. <strong>Aims &amp;&nbsp;objectives:</strong> We aimedtoassess caregivers approach towards&nbsp;feeding and or diet in&nbsp;children&nbsp;with acute&nbsp;diarrhea. <strong>Subjects and Methods: </strong>This&nbsp;was&nbsp;aqualitative, cross-sectional,&nbsp;hospital&nbsp;based survey carried among caregivers of infants&nbsp;and&nbsp;young&nbsp;children&nbsp;aged&nbsp;6&nbsp;months&nbsp;- 24&nbsp;months&nbsp;of either&nbsp;sex with acute diarrhea&nbsp;from April 2017 to December 2018. <strong>Results: </strong>the attitude of caregivers towards feeding and or diet in children with acute diarrhea was not appropriate, which may lead to bad clinical outcomes in terms of recovery from diarrhea and further may increase the burden of malnutrition. <strong>Conclusion: </strong>There was gross irrational approach of caregivers found towards feeding and or diet in younger children with acute diarrhea and to prevent myths towards feeding and or diet, the health awareness towards basic nutrition is need of era and to be maintained at the highest level in the community</p> Jaigam Abbas Dinesh Chandra Pandey Ashish Verma Copyright (c) 2019 Asian Journal of Clinical Pediatrics and Neonatology 2019-10-10 2019-10-10 7 3 20 23 Study on Renal Function in Acute Diarrheal Disease with Dehydration <p><strong>Background: </strong>Decreasing trend of exclusive breast feeding and faulty practices of bottle-feeding play an important role in the causes of acute diarrhoea. The main cause of death in acute diarrhoea is dehydration, which results from the loss of fluid and electrolytes in diarrheal stools. The present work was planned to assess renal function (Blood Urea and Serum Creatinine) in acute diarrheal disease with dehydration.<strong>Subjects and Methods: </strong>The present hospital based prospective study was conducted at department of paediatrics GSL Medical College &amp; General Hospital, Rajahmundry, which includes consecutive patients attending OPD and inpatients in view of acute diarrhea between 1 month and 5years of age. A detailed history from the patients with acute gastroenteritis was taken .The procedure of the study was explained &amp;required consent for the study was taken. Examination of the patient was done &amp; all relevant data was obtained.<strong>Results: </strong>B. Urea levels were elevated (&gt;35mg/dl) in 35.1% cases and normal in 64.9% cases with mean being 44.93 mg/dl. S.Creatinine levels were elevated(&gt;0.7mg/dl) in 32% cases and rest having normal levels with mean being 0.68mg/dl. Maximum age incidence was found in age group of less than 1 yr (50.5%).<strong>Conclusion: </strong>The present study aimed at noting the biochemical changes in patients having acute diarrhoea. Like any other electrolyte abnormalities which occur in conditions other than diarhoea, are basically asymptomatic &amp; does not require aggressive correction of electrolytes.</p> S Surya Veera Kumar G Kalyan Chakravarthi Copyright (c) 2019 Asian Journal of Clinical Pediatrics and Neonatology 2019-10-10 2019-10-10 7 3 24 27 Knowledge, Attitude and Practice Study about Complementary Feeding in Mothers with Children Upto 02 Years Age Group in Urban Slums across Bhopal City <p><strong>Background: </strong>Objective of our study was to assess the knowledge, attitude and practice of complementary feeding among mothers in various Urban Slums across Bhopal City. <strong>Subjects and Methods: </strong>A cross sectional study was done about knowledge of mothers with children below 2 years of age with help of pretested self designed questionnaire based interview who are attending Anganwadi Centre &amp; Slum Areas. <strong>Results: </strong>In our study most of mothers did not know correct time of starting complementary feeding, they also did not know what food can be given, frequency and amount of complementary feed. <strong>Conclusion: </strong>Knowledge of Mother’s concerning timing of complementary feeding is inadequate and practice and attitude are inappropriate. Majority of them are not aware of the current recommendations. Health education about correct feeding should be given to mothers and family members including appropriate time for complementary feeding initiation, complementary foods, it’s preparation and practices to give on proper time and amount and hygiene. It will help to prevent malnutrition, infant and under 5 mortality and morbidity and improve the health status of children. Correct information and guidelines about complementary feeding is not reaching the target population. False beliefs, customs and attitude of the mother tend to wean the child late. Poor breastfeeding and inappropriate complementary feeding practices are the principal proximate causes of malnutrition during the first two years of life.Study Design: Cross Sectional Study</p> Deepti Singh Sunita Lakhwani D.P.S. Gaharwar Copyright (c) 2019 Asian Journal of Clinical Pediatrics and Neonatology 2019-10-12 2019-10-12 7 3 28 30 Knowledge, Attitude and Practice Study About Use of ORS in Diarrhea in Mothers with Children 02-05 Year Age Group Residing in Various Urban Slums of Bhopal City <p><strong>Background: </strong>KAP study for use of ORS in Diarrhea in mothers with children 02-05 year age group. The objective of the study was to assess the Knowledge, Attitude and Practice use of ORS in Diarrhea among mothers at various Urban Slums of Bhopal City.<strong>Subjects and Methods: </strong>A cross sectional descriptive study was conducted among mothers having children 02-05 year age group.&nbsp; All mothers were interviewed through a self designed pretested structured questionnaire regarding use of ORS in Diarrhea of their infants and socio demographic profile.<strong>Results: </strong>Majority of the mothers were illiterate, and not aware about benefits of use of ORS. Although mother’s knowledge was lacking but most of mother use of ORS in Diarrhea in their children.<strong>Conclusion: </strong>Most of mothers do not follow practice of use of ORS in Diarrhea and had lack of knowledge. The knowledge regarding method of use of ORS for management of diarrhoea was found to be inadequate in this study. Though many mothers are aware that it is useful most are not aware of its method of use. More measures need to be adopted to improve this knowledge and make mothers aware about the method of use and availability of ORS.</p> Deepti Singh Sunita Lakhwani D.P.S. Gaharwar Copyright (c) 2019 Asian Journal of Clinical Pediatrics and Neonatology 2019-10-12 2019-10-12 7 3 31 33 Incidence of Neuroimaging Abnormality in Children Presenting with New Onset Afebrile Seizures <p><strong>Background: </strong>Seizures &amp; epilepsy affects infants &amp; children more than any other group.&nbsp; There is lack of data that has looked at Neuroimaging in all children after a first afebrile, hence the present study was planned to determine incidence of Neuroimaging abnormality in children presenting with new onset afebrile seizures.<strong>Subjects and Methods: </strong>Children in the age group of six months to sixteen years who presented to the department of Paediatrics, GSL Hospital with the symptoms of first episode of afebrile seizures were evaluated prospectively. Cases with first episode of afebrile seizures that came to pediatrics department during the period of September 2012 to July 2014 were taken. Detailed history was taken and seizures categorized according to the Classification proposed by International League Against Epilepsy (ILAE) 2006.<strong>Results: </strong>Abnormal neuroimaging is seen 60 cases (75%)in which highest number of abnormal Neuroimaging is seen in 5-9 years(41.7%) followed by 30% in 9-13 years. Complex partial seizures are more common (41.3%) followed by generalized seizures (31.3%) in our study group. Brief seizures (&lt;5mins) are more common which are 85% than prolonged seizures(&gt;15mins) that are of 15%. Maximum affected age group in our study was age group between 5 -9 yrs 38.8% followed by 9-13 yrs 26.6%.<strong>Conclusion: </strong>Although cysticercosis incidence is greater in pork eaters, feco-oral route is also a major route of disease transmission and may also occur in population not eating pork. Cysticercosis is also more common in low socioeconomic status, poor hygiene and sanitation conditions which are evident in this study.</p> R Rama Krishna Paramahamsa Gangina Sriram Copyright (c) 2019 Asian Journal of Clinical Pediatrics and Neonatology 2019-10-12 2019-10-12 7 3 34 40