NepMed is a Nepal MEDLINE(Medical Literature Analysis and Retrieval System Online) by Nepal Health Research Council(NHRC). It includes bibliographic information for articles from academic biomedical journals covering medicine, dentistry, nursing, pharmacy, dentistry veterinary medicine, and allied health sciences.
Recent Submissions
Blood Glucose Levels and Characteristics of Hypoglycemia in Low Birth Weight Neonates
(Nepal Paediatric Society (JNPS), 2021) Y, Ramesh Bhat; George, Juanitha; Lewis, Leslie; Purkayastha, Jayashree
Abstract:
Introduction: Low birth weight (LBW) neonates comprising of preterm and small for gestational age (SGA) are at risk of hypoglycemia. Hypoglycemia as such in LBW neonates is not well characterized. We aimed to study the blood glucose levels of these neonates and characterise the hypoglycemia.
Methods: Blood glucose levels in singleton neonates with birth weight between 1500 gm and 2499 gm were studied prospectively. Glucose levels were assessed at six hour intervals in the first 48 hours of life and extended if indicated. Glucose level ≤ 45 mg/dL in the first 24 hours and < 50 mg/dL thereafter was considered hypoglycaemia.
Results: A total of 320 among 3822 neonates satisfied inclusion criteria; 104 had at least one low glucose reading with an incidence of hypoglycaemia of 32.5%. Preterm neonates constituted 158 (49.4%) and SGA 76 (23.8%). Mean blood glucose values were lowest in the first hour of life (60.1 ± 17.2 mg/dL). Incidence of hypoglycemia was highest within one hour of life followed by day two of life (16.3% and 11.6% respectively). About 86 (82.6%) neonates were asymptomatic. Overall, 75% of neonates had a single episode of hypoglycemia and 25% had a recurrence. Hypoglycaemia was noted in 31.8% of neonates born to diabetic mothers, mostly in the first hour (57.1%). Other risk factors for hypoglycemia included intrapartum fluids, birth weight < 2000 g and polycythemia.
Conclusions: About a third of LBW neonates had hypoglycemia; mostly on the first hour and day one of life. Asymptomatic nature of hypoglycaemia in the large majority and recurrent hypoglycemia in 25% cases warrants glucose monitoring in this subgroup.
Birth Interval and its Association with adverse Childhood Nutritional outcomes among under-Five Children in Bangladesh: A Longitudinal Study
(Nepal Paediatric Society (JNPS), 2021) Kamal, SM Mostafa; Moniruzzaman, Md
Abstract:
Introduction: Short birth spacing is reported to have health consequences for both mother and child. This study aims is to examine the effect of short birth interval on nutritional outcomes of under-five children in Bangladesh.
Methods:We used data from the latest five rounds of Bangladesh Demographic and Health Surveys conducted from 2004 to 2017-18. The short birth interval is defined as birth spacing of <24 months and 24-35 months between two subsequent births. The outcomes of interest are stunting and underweight. Both bivariate and multivariate statistical analyses were employed. Results of the multivariate analysis are shown by odds ratios (ORs) with 95% confidence intervals (CIs). Data were analyzed by Stata 15/IC.
Results: A total of 16,100 under-five children of second and higher-order births were included for analysis. Of the children, 12% were born at a space of <24 months, and 19% were born with a space of 24-35 months. The proportion of children with short birth interval was found decreasing. Results of the logistic regression analysis show thatcompared to the birth interval of 36-59 months children born to women with birth interval <24 months were significantly (P<0.001) at higher risk of being stunted (OR = 1.44, 95% CI: 1.27, 1.57) and underweight (OR = 1.42, 95% CI: 1.27, 1.58). A similar result was obtained for the birth interval of 24-35 months.
Conclusion: Short birth interval remains a problem of childhood nutrition in Bangladesh. Research to explore causal pathways and programs to lengthen space between inter-pregnancy should be intensified.
Assessment of Foetal Malnutrition Using CAN Score and its Comparison With Various Anthropometric Parameters and Proportionality Indices
(Nepal Paediatric Society (JNPS), 2021) Kapoor, Anju; Awasthi, Sukarn; Yadav, Ankit; Tiwari, Shraddha
Abstract:
Introduction: Nutritional status at birth is assessed by using various anthropometric parameters and proportionality indices. Present study aims to assess the utility of CAN score in identifying fetal malnutrition (FM) which would have been missed by using anthropometry alone. We also aim at re-evaluating the cut-off value of CAN score for our population.
Methods: Nutritional status of 411 neonates was assessed using anthropometric parameters, proportionality indices and CAN score. Effectiveness of each parameter in detecting FM was assessed and compared with CAN score cutoff < 25 as well as new found cut-off < 27 using appropriate statistical tools.
Result: Mean (SD) of all anthropometric parameters were significantly less in FM group (p < 0.001). CAN score identified FM in 18.5% (76 / 411) babies whereas weight for GA identified 8.8% (36 / 411) babies as SGA and 91.2% as AGA (375 / 411); 12.3% (46 / 375) babies identified as AGA, were found to be malnourished by CAN score. Similar trend is seen with other parameters too. ROC curves show that AUC for birth weight, mid arm circumference, body mass index, Ponderal index, length and MAC / HC for determining FM was 0.891, 0.855, 0.837, 0.761, 0.749 and 0.714 in decreasing order. Birth weight with cut-off 2300 grams in a term newborn has maximum AUC making it the best marker for predicting FM. Present study identifies more FM by using modified CAN score cut off < 27 instead of < 25, 32.11% (132 / 411) and 18.5% (76 / 411) respectively.