Browsing by Author "John, BM"
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Publication An Assessment of Drawing Age in Pre-School Children Using 'Draw-A-Man' Test(Nepal Paediatric Society (JNPS), 2014) Raja, S; John, BMAbstract: Introduction: Goodenough-Harris ‘Draw-a-Man’ Test has been traditionally used as a simple tool to measure mental development in a child. There have very few studies looking at utility of ‘Draw a man’ test in the Indian subcontinent in the recent past. We carried out an assessment of correlation of drawing age with chronological age in pre-school children by the ‘Draw- a- man test’ and looked for any associations with respect to a deviation (delay or advancement) in the calculated drawing age. Materials and Methods: A cross-sectional descriptive study was conducted on 100 neurologically normal pre-school children between 36 to 72 months. The data was then analyzed with Pearson correlation and Chi square test on SPSS version 14.0 Result: There was a low positive correlation between drawing age and chronological age (Pearson correlation: r=+0.31, p=0.002).There were more boys (p=0.004) and more children with prematurity (p=0.012) in the group with low or equal drawing age compared to chronological age. Conclusion: In view of the low positive correlation found in our study, further studies with a larger sample need to be conducted to establish the ‘Draw-a-man’ test as a screening tool for mental age assessment in our subcontinent. We did find a significant association of deviation of drawing age from chronological age with respect to gender and prematurity.Publication Incidence of Acute Kidney Injury in 1 - 14 years old Critically ill Children in a Tertiary care Center Authors(Nepal Paediatric Society (JNPS), 2023) Pooja, Vijaykumar; John, BM; Kalra, Suprita; Devgan, AmitAbstract: Introduction:Acute Kidney injury (AKI) is associated with poor outcomes in critically ill hospitalized children. There are very few studies on incidence of AKI based on urine output criteria of KDIGO (Kidney Disease: Improving Global Outcome) and time lag between the fall in urine output and rise in serum creatinine. This study was therefore aimed at determining the same. Methods: A prospective study was conducted in the Department of Paediatrics of a tertiary care hospital. 171 critically ill children between one to 14 years who were admitted in PICU were enrolled. Hourly urine output and eight hourly serum creatinine levels were measured and incidence of AKI was calculated along with lag time between fall in urine output and rise in serum creatinine. Outcome of children with AKI was also studied. Data analysis was done using SPSS software version 25.0 and Microsoft excel 2007. Results: The mean age + SD of children in the study was 5.5 years ± 3.76 with a range of one to 14 years, with 62.6 % of them being boys. The incidence of AKI in the study population was 14.62%. The mean lag time between fall in urine output and rise in serum creatinine was found to be 13.21 hours. AKI had a significant association with mortality, use of nephrotoxic drugs, inotropes and mechanical ventilation. Conclusions: A significant number of critically ill children develop AKI and its occurrence portends a poor outcome. Utilization of the KDIGO reduced urine output criteria as a marker of AKI allows for early detection and interventionPublication Predictors of Outcome in Neonates with Respiratory Distress(Nepal Paediatric Society (JNPS), 2015) John, BM; Venkateshwar, V; Dagar, VAbstract: Introduction: Many of the parameters utilised in scoring systems used to predict disease severity in respiratory distress in neonates are not readily available in the primary care facility of developing countries. This study was carried out to assess the utility of birth weight, gestational age, APGAR score at 5 min, baseline oxygen saturation and Downe’s score in prediction of requirement of respiratory support and mortality in neonates with respiratory distress. Material and Methods: A prospective study was carried out in the neonatal intensive care unit of a tertiary teaching hospital. 165 consecutively admitted neonates presenting with respiratory symptoms were included in the study. The relevant parameters and investigations were documented in a structured performa. The neonates were followed up for outcomes which included requirement of respiratory support and mortality. Results: A higher mortality was associated with birth weight of < 1620 grams, gestational age of < 31 weeks, APGAR score of < 6, Downe’s score of > 3 and baseline oxygen saturation of < 86 % (p values < 0.001). The requirement of mechanical ventilation was more with birth weight of < 2000 grams, gestational age of < 32 weeks, APGAR score of < 7, Downe’s score of > 4 and baseline oxygen saturation of < 87 % (p value < 0.001). The requirement of any respiratory support at 72 hours was associated with birth weight of < 1894 grams, gestational age of < 37 weeks, APGAR score of < 7, Downe’s score of > 3 and baseline oxygen saturation of < 89 % ( p-value <0.001). Conclusions: Readily available parameters like birth weight, gestational age, APGAR score, oxygen saturation and Downe’s score could together be used to predict mortality and requirement of respiratory support in the resource limited setting.