Journal Issue: Volume: 42, No. 1 (2022)
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2022
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ISSN 1990-7974 eISSN 1990-7982
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Articles
Anaemia In Preschool Children:its Correlation With Pica
(Nepal Paediatric Society (JNPS), 2022) Kaur, Sukhdeep; Singh, Kunwar Pal
Abstract:
Introduction: According to the third National Family Health Survey, 79% of Indian children are anaemic. Pica is characterized by the persistent ingestion of non-nutritive substances such as plaster, charcoal, chalk, and earth for at least one month in a manner that is inappropriate for their developmental level. We investigated the correlation between pica behaviour and anaemia in preschool children.
Methods: In total, 103 children of ages six to 48 months attending the OPD were randomly included in this study for six months; they presented with clinical features of anaemia. Complete blood count and peripheral blood film examination were carried out. The children were assessed clinically for signs and symptoms of anaemia. History of ingestion of clay, sand, chalk, wall paints etc was asked from the parents.
Results: Most of the children (90.3%) had microcytic hypochromic anaemia with a mean haemoglobin value of 8.82 g / dl. The mean age was 18 months, and boys slightly outnumbered girls. In total, 57.3% of children had a positive history of pica, and all of them were found to be anaemic. However, no significant statistical correlation was observed between anaemia and history of pica.
Conclusions: All children with history of pica were anaemic and the most common type of anaemia was microcytic hypochromic. Although no significant statistical correlation was observed between and history of pica, it is very important for the clinicians to be cautious of this common condition and evaluate for anaemia
Anxiety and Depression and their Predictors among School Adolescents of Kathmandu, Nepal
(Nepal Paediatric Society (JNPS), 2022) Bajracharya, Shanti; Shakya, Sujata; Nagarkoti, Liza; Ban, Rita Kumari; Regmi, Kalpana
Abstract:
Introduction: Adolescence is a vulnerable period in which different physical, psychological and behavioral changes occur contributing to mental health issues. Depression and anxiety occur more commonly than would be expected by chance in children and adolescents. Undetected and untreated mental disorders can impair one’s ability to perform at school or work place, cope with daily life activities and can lead to severe mental disorders and related consequences. The aim of this study was to assess the levels of anxiety and depression and their predictors among the adolescents of Kathmandu, Nepal.
Methods: A cross-sectional study was conducted in different higher secondary schools of Kathmandu. Cluster random sampling method was used to select 482 students of Grade XI and XII. Beck Anxiety Inventory (BAI) and Beck Depression Inventory (BDI)-II were used to assess the levels of anxiety and depression.
Results: Among 482 students, 230 (47.7%) were females and 252 (52.3%) were males with mean age of 17.25 (± 1.01) years. Majority (38.6%) had minimal anxiety and 11.6% had severe anxiety. On the other side, 45.9% had no depression and 16.4% had severe depression. Grade, sex, health problem, use of gadget and academic performance are found to be the predictors of anxiety, while, the predictors of depression are age, sex, health problem and academic performance.
Conclusions: Anxiety and depression are found prevalent among the adolescents, which need to be explored and addressed immediately through appropriate measures. Psychological counseling and support services should be available to vulnerable students.
Clinico-epidemiological Profile of Children with Diphtheria in Tertiary Care Hospital of Nepal
(Nepal Paediatric Society (JNPS), 2022) Basnet, Srijana; Shrestha, Laxman; Bajracharya, Luna
Abstract:
Introduction: This study was conducted with the aim to describe the clinical presentation of diphtheria in children, relationship between clinical disease and immunization status, complications of the disease and adverse events due to anti diphtheria serum (ADS).
Methods: All patients admitted at Tribhuvan University Teaching Hospital, Kathmandu from July 2016 to November 2018 with clinical diagnosis of diphtheria were included in this study.
Results: There were total 12 children and age ranged from five to 15 years, out of which seven (58%) were males and five (42%) were females. All of them were immunized except one whose immunization status was unknown. All of them had tonsillopharyngeal diphtheria. Four patients (33%) also had nasal and five (42%) patients had additional laryngotracheal diphtheria. Seven patients had bull neck on presentation. Four patients had airway obstruction due to laryngotracheal diphtheria requiring tracheostomy. Throat swab for Corynebacterium Diphtheria by Albert stain and Gram stain were positive in 10 patients, and in nine, diagnosis was confirmed by culture. Six patients (50%) were given anti diphtheria serum (ADS) out of which four patients (66.66%) developed anaphylaxis. Myocarditis was the commonest complication seen in four patients (25%). All children with myocarditis developed complete heart block (CHB) and none of them survived.
Conclusions: Tonsillopharyngeal diphtheria was the most common clinical presentation and myocarditis was highly fatal complication. This study emphasizes on the need for careful surveillance, early laboratory confirmation and careful administration of ADS in patients with clinical diagnosis of diphtheria.
Clinico-radiological Profile and Outcome of Children with Viral Pneumonia admitted to Paediatric Intensive Care Unit in the pre COVID 19 period
(Nepal Paediatric Society (JNPS), 2022) Aroor, Shrikiran; Mundkur, Suneel; Kumar, Sandeep
Abstract:
Introduction: Viruses are common etiological agents of severe acute respiratory illness in under five children. Very few studies are available considering the profile of children with viral pneumonia admitted to paediatric intensive care unit (PICU) in our setting. Hence this study was done to describe the clinico- radiological profile and outcome of children diagnosed with viral pneumonia admitted to PICU.
Methods: This was a retrospective descriptive study done in the PICU of a tertiary care hospital in South India. The presenting clinical features, blood parameters, chest radiography findings, course during the hospital stay and outcome of children with viral pneumonia (RT- PCR Positive) admitted to PICU were studied.
Results: The aetiological profile of 28 children included - Influenza virus - 14 cases, Respiratory Syncytial Virus - 6 cases, Adeno virus - 4 cases, Human Boca virus - 2 cases, Human Rhino Virus - 1 case and Human metapneumo Virus - 1 case. Majority of children (50%) presented with severe respiratory distress. Predominant radiological picture included bilateral interstitial infiltrates followed by patchy alveolar consolidation. Eight children required mechanical ventilation. Complications included septic shock and MODS (n = 5), pneumothorax (n = 2), myocarditis (n = 2), pleural effusion (n = 1), ventilator associated pneumonia (n = 2) and pulmonary artery hypertension (n = 2). Mortality was observed in seven (25%) children. SpO2 / FiO2 ratio < 300, shock at admission, neutrophil leucocyte ratio > 2 and hypoalbuminemia were found to be significant predictors of mortality.
Conclusions: Malnutrition and iron deficiency analmia were the common risk factors. Patchy alveolar consolidation is also a common radiological finding along with interstitial infiltrates. Hypoalbuminemia was a common finding among non-survivors.
Determinants of Mortality in Preterm Newborns Admitted in a Neonatal Intensive Care Unit: Findings from a Tertiary Level Maternity Hospital in Nepal
(Nepal Paediatric Society (JNPS), 2022) Karmacharya, Shailendra Bir; Subedi, Kalpana Upadhyaya; Agrawal, Sumit; Pradhan, Noora; Barnwal, Ritesh; Paudel, Prajwal
Abstract:
Introduction: Prematurity is a major cause of admission in the NICU in most hospitals. Premature babies are likely to face complications. Understanding the factors contributing to preterm mortality is needed to identify interventions required to reduce neonatal mortality rate. This study aims to determine the causes of mortality in preterm babies.
Methods: A retrospective study was carried out in Paropakar Maternity and Women’s Hospital, Thapathali, Kathmandu, Nepal. All the preterm babies admitted in the sick newborn units were included. Descriptive statistics were performed using frequency and percentage. The bivariate and multivariate analyses were performed to determine the causes of mortality in preterm.
Results: Total 205 (71.4%) admitted preterm babies had complications at the time of admission. LBW babies were three times more likely to have mortality among preterm admission (p – value < 0.0001). Co-morbidities such as sepsis (p - value < 0.05) and perinatal asphyxia (p – value < 0.0001) were significantly associated with preterm mortality. The duration of stay among preterm babies was higher compared to term babies. The mortality rate was higher among preterm admission compared to term admission (60% vs 40%).
Conclusions: Preterm babies with LBW, neonatal sepsis and perinatal asphyxia are at greater risk of mortality. Improved antenatal and perinatal care, quality newborn care and appropriate infection prevention measures can help reduce preterm birth, prematurity related complications and mortality among these vulnerable group of newborns.