Journal Issue: Volume: 36, No. 3 (2016)
Loading...
Volume
Number
Issue Date
2016
Journal Title
Journal ISSN
ISSN 1990-7974 eISSN 1990-7982
Journal Volume
Articles
Substitute for the Breast Milk (Sale, Distribution and Control) Act 2049: Revisited
(Nepal Paediatric Society (JNPS), 2016) Shrestha, Merina; Basnet, S.; Shreshta, P.S.
NA
A Study of Variation in the Tube Feeding Rate by Nurses in a Tertiary NICU
(Nepal Paediatric Society (JNPS), 2016) Krishnegowda, Sushma; Vasudev, Prajwala Hassan; Doreswamy, Srinivasa Murthy; Veena, S.; Hemavathi, M.
Abstract:
Introduction: 50-60% of the low birth weight babies in a neonatal unit are on gravity feed via gavage tube as they often are not strong enough to sustain on oral feeds. Successful feeding depends on nursing skill and individual variation can be expected. As with many other nursing practices in NICU, considerable variation can be expected in gravity feeding rate as well. The objective was to determine the intra individual and inter individual variation in the rate of gravity feeding among the nurses.
Material and Methods: This was a Prospective study done in a Tertiary Neonatal care unit. Babies weighing < 2 kgon enteral feeds were included in study. The nurses carried out feeding in the standard prescribed manner. Time taken for feeds was noted.
Results: 21 nurses participated in the study. 15 babies were included and there were 342 feed events. During 75(22%) feeding events, the nurses had an assignment of less than four babies. During rest of the 267 (78%) feeding events, they had more than four babies assigned for care. The median volume of feed was 14 ml and median duration was 8 minutes. Feeding rate variation within same nurse varied from one to 37.5 times their base line rate and in between the nurses varied by minimum of 17 times.
Conclusion: A wide intra and interpersonal variation among the nurses, with respect to the rate of feeding of newborns was observed in our study.
Assessment of Intelligence of Duchenne Muscular Dystrophy (DMD) Children and Adolescents and Parental Stress in a Muscular Dystrophy Center in Nepal
(Nepal Paediatric Society (JNPS), 2016) Rana, Mita; Adhikari, Sirjana; Pradhan, Monalisa
Abstract:
Correction: On 21st May 2017 the word 'Adults' was changed to 'Adolescents' in the title of the article on NepJOL. The PDF was correct and has not been changed.
Introduction: Duchene Muscular Dystrophy (DMD) is an X-linked developmental disorder characterized by progressive muscle weakness, demanding many psychosocial adjustments for both parents and children; learning and behavioral problems, changing values, expectations, roles and responsibilities, separation and loss that lead to parental stress. This study is an attempt to explore the level of Intelligence Quotient of children and adolescents with DMD and further elucidate aspects of parental stress.
Material and Methods: The study involved 30 children and adolescents with DMD, chosen by convenient sampling method and one parent each, during their regular medical evaluation at the Duchene Muscular Dystrophy Foundation in Nepal. Measures used to collect data were the Draw a Man Test and Cohen’s Perceived Stress Scale.
Results: Age of the DMD children and adolescents ranged between 4 to 19 years with mean age 12.01 ± 6.26 years, 93.94% were male. 53.33% of the parents reported having average level of stress and 63.33% of DMD children and adolescents had average level of Intelligence Quotient (IQ > 70), 16.67% had mild (IQ between 50-69) and 10% each were found to have moderate and severe intellectual disability. Significant negative correlation (r = -0.393, p=0.05) was found between the level of intellectual functioning of DMD children and level of parent’s perceived stress.
Conclusion: Most of the parents experienced average to severe level of stress based on the duration of illness and the level of intellectual functioning of their DMD child. Parents experienced greater level of stress with children having low intelligence.
Behavioural Problems and Parental Over-protectiveness in Children with Asthma Authors
(Nepal Paediatric Society (JNPS), 2016) Sawant, Neena Sanjiv; Bhargava, Juhi; Deshmukh, Chandrahas T.
Abstract:
Introduction: Asthma in children often leads to behavioural problems due to the chronic nature of the disease. Parents also tend to be overprotective and many may not even consult a doctor for the same. The objectives were to study the various behavioural problems seen in children having asthma as compared to those with minor ailments, parental awareness about the same and their parenting styles.
Material and Methods: 75 parents of children of bronchial asthma and 75 parents of children having short term minor ailments formed the asthma and control groups respectively. The Behaviour Problem Index was used to assess the behavioural problems in children as documented by parents and parental overprotectivenesswas assessed using the Vulnerable Child/ Overprotecting Parent Scale.
Results:The demographic variables were comparable in both the groups. Behavioural problems on all domains and parental over protectiveness in the asthma group were found to be statistically significant as compared to control group. However there was no significant correlation between the parental over-protectivenessand the behavioural problems in both the groups.
Conclusions: Early referral to the psychiatrist with parental counselling will result in better outcomes for the child.
Breast Feeding as Analgesia in Neonates: A Randomized Controlled Trial
(Nepal Paediatric Society (JNPS), 2016) Singh, Rajesh Kumar; Simalti, Ashish Kumar; Singh, Daljit
Abstract:
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.