Browsing by Author "Singh, Daljit"
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Publication Breast Feeding as Analgesia in Neonates: A Randomized Controlled Trial(Nepal Paediatric Society (JNPS), 2016) Singh, Rajesh Kumar; Simalti, Ashish Kumar; Singh, DaljitAbstract: Introduction: Major myth regarding neonatal pain suggests that neonates because of their neurological immaturity do not experience pain. Although exact mechanism is not known, it is proposed that breast feeding through combination of various senses and the closeness of the infant’s mother, saturates the senses thus reducing perception of noxious stimuli. The objective of this study was to investigate the analgesic effect of breastfeeding during blood sampling through heel lance in healthy term neonates. Material and Methods: This was a Randomized controlled trial done in a Tertiary level Neonatal Intensive Care Unit. Sixty healthy term newborns, undergoing heel prick were included in study. Neonates were randomly assigned to two groups: Group I (breastfed) with; Group II (not breast fed). Babies were given heel prick and crying time, Heart rate, SpO2 and BP monitored. Changes in various physiological parameters following a heel prick were studied in two groups. Results: Neonates in both groups expressed pain by crying, increase in heart rate, fall in transcutaneous oxygen saturation and rise in blood pressure. Compared to control group, the babies who were breast fed were found to have lesser crying time (40.04 sec and 69.09 sec respectively, p<0.05) and lesser rise in heart rate (rise of 21.78 and 34.46 bpm respectively, p<0.03). In the breast fed group there was a trend to a lesser decrease in oxygen saturation and lesser rise in blood pressure though this was not statistically significant. Conclusion: Breast feeding offers a quick and effective means of reducing pain in neonates during routine neonatal procedures.Publication Chronic Recurrent Multifocal Osteomyelitis: An Unusual Cause of “Aches and Pains”(Nepal Paediatric Society (JNPS), 2018) Jamal, Ahmad; John, Biju; Awariwar, Mahesh; Dalal, Shamsher; Singh, DaljitAbstract: Children are often brought to the paediatric out-patient department with non specific aches and pains. Though the majority of them have only a benign diagnosis, some may harbour rare conditions like chronic recurrent multifocal osteomyelitis (CRMO). Case: We describe a 11 year old girl who presented with migratory pain across various parts of hip and lower limbs without any significant signs. After six months of OPD visits, she was diagnosed to have CRMO following an incidental X-ray which led to a musculoskeletal MRI. Conclusion: CRMO is a rare auto-inflammatory disorder which must be kept in mind when encountering a relatively healthy child with poorly defined limb pains along with paucity of signs.Publication Comparison of Oral Trichlophos and Intranasal Midazolam for Sedation in Minimally Invasive Paediatric Procedures (RAMT Study)(Nepal Paediatric Society (JNPS), 2018) Sharma, Manoj; Yenamandra, Kamal K.; Kalita, Jitu; Dash, Shaswat; Singh, DaljitAbstract: Introduction: Uncooperative child does not allow completion of procedures, denying valuable data required for clinicians. Material and Methods: An open labelled parallel group prospective randomized control study was conducted at zonal hospital Jorhat. We evaluated 200 children randomized into two groups using computer based randomization. Participants aged 3 months to 5 years (n=200) were randomized to receive 50 mg/kg Triclofos sodium orally or intranasal spray of midazolam 0.2 mg/kg. Results: Adequate sedation (Ramsay reactivity score of 3 and 4) was obtained in 86% children in midazolam group as compared to 80% in triclofos group with p value of 0.138. Mean duration for onset of sedation was 20 min ± 5.4 min in Trichlophos group and 12 min ± 4.5 min with Intranasal Midazolam which was statistically significant with p-value of <0.001. The mean duration of post procedural sedation was found to be 24.00 ± 9.21 min in midazolam group and 49.00 ± 16.99 min in triclofos group (p=<0.001) which was statistically significant. No significant difference was seen for side effects frequency between the two drugs (15% in Triclofos, 10% in Midazolam group; p=0.285). Conclusion: We conclude that intranasal midazolam is more effective than oral trichlophos with a comparable safety profile.