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> en-US dir.aijournals@gmail.com (Dr. Rohit Varshney) Thu, 16 May 2019 14:24:37 +0000 OJS 3.1.1.2 http://blogs.law.harvard.edu/tech/rss 60 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## https://aijournals.com/index.php/ajcpn/article/view/637 Thu, 16 May 2019 00:00:00 +0000 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## https://aijournals.com/index.php/ajcpn/article/view/638 Thu, 16 May 2019 00:00:00 +0000 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## https://aijournals.com/index.php/ajcpn/article/view/639 Thu, 16 May 2019 00:00:00 +0000 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## https://aijournals.com/index.php/ajcpn/article/view/657 Sat, 25 May 2019 00:00:00 +0000 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## https://aijournals.com/index.php/ajcpn/article/view/664 Tue, 28 May 2019 00:00:00 +0000 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## https://aijournals.com/index.php/ajcpn/article/view/665 Tue, 28 May 2019 00:00:00 +0000 A Retrospective Study of Early Discharge and Outcomes of Pre-Term Infants from a Tertiary Care Centre in Rohtas, Bihar https://aijournals.com/index.php/ajcpn/article/view/719 <p><strong>Background: </strong>In developing countries parents want early discharge of infants. Preterm infants are at risk of several morbidities if stayed long in hospital. There are different policies for discharge and most rely on achieving a weight of 2000 grams. Recent studies have emphasized the role of physiological parameters to discharge preterm infants. The objective of this study was to find out the outcomes of early discharge of pre-term infants from a tertiary care centre in Rohtas, Bihar. <strong>Subjects and Methods: </strong>This study was a retrospective study. The data was collected from all ex pre-term infants (gestation&lt;34 weeks at birth) admitted in this NICU between 1st January, 2017 to 31st December, 2018. They were stratified in two groups based on gestation at birth: Group I (n= 70: 26-29 weeks, Group II (n=234): 30-34 weeks. The outcome measure was re-admission and/or mortality within 4 weeks after discharge of all the eligible infants. The reasons for re- admission or mortality were also recorded. <strong>Results: </strong>The mean± (SD) duration of stay was 42.5±18 vs 15±12 days in group I vs II infants. Two and six infants were re-admitted within four weeks after discharge in group I and group II respectively. <strong>Conclusion: </strong>Early easy home discharge for preterm infants born &lt;34 weeks can be done and it is safe and feasible. Large prospective clinical trials are required to confirm these advantages of early home discharge of preterm infants.</p> Rambilas Ranjan ##submission.copyrightStatement## https://aijournals.com/index.php/ajcpn/article/view/719 Wed, 19 Jun 2019 00:00:00 +0000 To Study Serum Total Protein and Serum Albumin in Children with Grade III and Grade IV Protein Energy Malnutrition (Cases) and in Children with Grade I and Grade II Protein Energy Malnutrition (Controls) https://aijournals.com/index.php/ajcpn/article/view/765 <p><strong>Background: </strong>This was a hospital based case control study, conducted in the Nutrition Rehabilitation centre in Index Medical College Hospital &amp; Research Centre, Indore, Department of Pediatrics. <strong>Subjects and Methods: </strong>Children with PEM grade I and II without any other pathological problem.The children admitted in the department. <strong>Results: </strong>In study group, majority of children had PEM grade III malnutrition while in control group, equal number of children had PEM grade I and grade II malnutrition. This table shows that majority of children in study group had lower level of serum protein levels as compared with control group, and there is progressive fall in its level as the severity of malnutrition increases. This table shows that majority of children in study group had lower level of serum albumin levels as compared with control group, and there is progressive fall in its level as the severity of malnutrition increases. <strong>Conclusion: </strong>The study concludes that estimation of serum T3, T4 and TSH levels in severely malnourished children admitted and co-relation with serum protein and serum albumin levels. To conclude, altered thyroid profile in PEM is perhaps a defense mechanism against excessive metabolic stimulation and energy consumption. The resultant hypometabolism protect the malnourished child with low calories reserve from an early death.</p> RashmiEkka Dehariya, Gunvant Singh Eske ##submission.copyrightStatement## https://aijournals.com/index.php/ajcpn/article/view/765 Sat, 29 Jun 2019 00:00:00 +0000 Assessment of Anaemic Children Visited in OPD of Department of Paediatrics in a Tertiary Care Hospital of Western UP https://aijournals.com/index.php/ajcpn/article/view/767 <p><strong>Background: </strong>Anemia is accompanied by a reduction in quantity of red blood cells, often along with decreased hemoglobin levels or altered red blood cell morphology. Hence; present study was planned to assess the paediatric patients diagnosed with anaemia. <strong>Subjects and Methods: </strong>A total of 50 paediatric subjects were included in the present study. Only those subjects were included in the present study in which confirmed diagnosis of anemia was obtained after haematological examination. Detailed clinical details and demographic data of all the subjects were obtained. A self-framed questionnaire was used for obtaining the details of past medical history and family history of all the subjects. All the results were compiled and analysed by SPSS software. <strong>Results: </strong>Majority of them (64 percent) were females while the remaining 36 percent were males. Significant results were obtained while assessing the gender-wise distribution of anaemic patients. Positive family history of anaemic was found to be present in 36 percent of the patients. 70 percent of the patients of the present study had rural residence, while the remaining 30 percent had urban residence. Gastroenteritis was the most common associated diagnosis found to be present in 30 percent of the patient population. <strong>Conclusion: </strong>Anemia is a common worldwide hazard affecting significant portion of paediatric population. Higher prevalence of anaemia is seen among females with associated gastric manifestations.</p> Monica Agarwal ##submission.copyrightStatement## https://aijournals.com/index.php/ajcpn/article/view/767 Sat, 29 Jun 2019 00:00:00 +0000