Browsing by Author "Gedam, DS"
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Publication Effect of Distraction Technique During Immunization to Reduce Behaviour Response Score (FLACC) to Pain in Toddlers(Nepal Paediatric Society (JNPS), 2013) Gedam, DS; Verma, M; Patel, U; Gedam, SAbstract: Introduction: Distraction techniques are important non pharmacological tools to reduce pain in infants and children. Few data are available regarding their effectiveness in toddlers. We have assessed effectiveness of audio-visual distraction techniques in toddlers during and after vaccination. Materials and Methods: The study used a quasi experimental three group pretest post test design. For all the three groups, the injections were administered by same staff nurse. Group- 1 (120 Patient) was encouraged to see and play with light and sound producing toy. Group- 2 (120 Patient) children were encouraged to see cartoon movie and children of control group- 3 (110 patient) were immunized without any distraction technique. A question form was used to determine the infant’s characteristics and the Face, Leg, Activity, Cry, Consolability (FLACC) Pain Scale was used to assess the level of pain. Data was collected between 1st April 2012 and 30th September 2012. Results: The mean pain score of test group during procedure (Group-1: 2.30 & Group-2: 3.65) were lower than the score of control group (Group-3: 5.30). Similarly after procedure Score (Group-1: 4.62 & Group-2: 2.79) were lower than the score of control group (Group-3: 6.20). Conclusion: The lower pain score in response to vaccination in test group indicates that distraction technique i.e. light & sound producing toys and cartoon movies are practical way to reduce pain during routine medical interventions in toddler.Publication Evaluation of physical growth and sexual maturation rating of Adolescent boys(Nepal Paediatric Society (JNPS), 2012) Gedam, DS; Waseem, M; Chansoria, MAbstract: Introduction: The present study is an attempt to evaluate the incidence of malnutrition as well as obesity. We have evaluated physical growth and sexual maturity rating of 10-18 years adolescent boys–overweight Vs Normal Vs Underweight. Material and Methods: A random sample of 530 adolescent boys (one private English Medium and one Govt. Hindi Medium School) between the ages of 10-18 years during the period of August 2008 to August 2009 constituted the material for this study. Weight, Height and BMI and Sexual maturation rating (SMR) were calculated. Results: Nearly 39% of the adolescent boys studied were either underweight (31%) or overweight (8%). All overweight adolescent boys have their mean weight more as compared to WHO 50th centile. Normal weight and underweight adolescent boys have lesser mean weight as compared to WHO 50th centile. All overweight and normal weight adolescent boys have their mean height lesser as compared to WHO 50th centile. All underweight adolescent boys except for age group of 12 yr have their mean height lesser as compared to WHO 50th centile. Underweight boys achieved different stages of genital growth prior to normal weight and overweight boys but lag behind as compared to Tanner. It was obvious that underweight boys achieved different stages of pubic hair growth prior to normal weight and overweight boys. Conclusion: Present study indicates that incidence of overweight children is also increasing significantly. Adolescent psychological need should be assessed and they should be given knowledge regarding their normal sexual growth pattern to decrease their anxiety.Publication Plummer-Vinson Syndrome: A Case Report(Nepal Paediatric Society (JNPS), 2011) Gedam, DS; Mandliya, J; Verma, MAbstract: Plummer-Vinson also known as sideropenic dysphagia is a disease that is characterized by classical triad of iron deficiency anemia, dysphagia and esophageal web. It is known to mostly affect white female mainly, but cases have been reported from other ethnic group in the literature. Treatment is very promising especially when it is not associated with carcinoma.