Journal Issue: Volume: 33, No. 2 (2013)
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2013
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ISSN 1990-7974 eISSN 1990-7982
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Articles
A Study of Clinical Features, Management and Outcome of Organophosphate and Carbamate Poisoning in Children
(Nepal Paediatric Society (JNPS), 2013) Prasad Koirala, Deepak; Rao, Kalipatnam Seshagiri; Malla, Kalpana K; Malla, Tejesh Malla
Abstract:
Introduction: Organophosphates (OP) are commonly used pesticides in rural agricultural regions of Nepal and carbamates are popular household insecticides. Because of poor legislation these poisons are easily accessible and are the most popular suicidal poisons.
Materials and Methods: This was a retrospective study done in poisoning cases admitted in PICU of Manipal Teaching Hospital (MTH) over a seven year period.
Results: Out of 187 cases of poisoning, 30 (16.04%) were OPs and 4 (2.13%) were Carbamates. The male to female ratio was 56:44 and these poisonings were more common in rural areas (56%). Accidental poisoning (82.4%) was more common but suicidal attempts (17.6%) were also observed. Atropine and pralidoxime were used in 82.4% of the cases. The total atropinizing dose was 0.77±0.6 mg/kg and patients required 56.6±23.7 hours of atropinization. In our study 94.1% of the patients survived and none of them developed any sequel. Children developed muscarinic, nicotinic and CNS symptoms similar to adults. Complications were seen in 41.1% of the children and most common being seizure (85.7%). The most common OP observed in childhood poisoning was Metacid (methyl parathion) seen in 26.4% of the cases.
Conclusion: OP and Carbamate poisonings are common in children. Possibility of self-harm poisoning in adolescent females cannot be ignored. Atropine is the mainstay of therapy after initial resuscitation and complications are common in children. With prompt treatment the outcome is good even with complications. The case fatality rate is much less as compared to adults.
Clinical and Nutritional Assessment of Short Statured Indian Children with Celiac Disease
(Nepal Paediatric Society (JNPS), 2013) Mali, Lalit P; Meena, Shyam Sundar; Khatri, Poonam Chand; Kumar, T V Ram; Kumar, Praveen Kumar
Abstract:
Introduction: Celiac disease is an autoimmune disease, which is increasingly recognized as a cause of short stature in genetically susceptible population. The present study was undertaken to look for prevalence of celiac disease among the pediatric population with short stature (SS) and to study characteristics of these short statured children with celiac disease.
Materials and Methods: This is a prospective study conducted at a tertiary teaching hospital at Bikaner, Rajasthan to look for the occurrence of celiac disease amongst the pediatric population (<15 years) with short stature (n=100). Other common causes of short stature were also identified.
Results: Out of 100 short statured children, 38 (38%) had celiac disease and other major causes responsible were hypothyroidism, pituitary disorders, constitutional growth delay, and familial short stature. Chronic diarrhea, anorexia, anemia and behavioral changes were statistically more common in short statured children (<15 years) having celiac disease than non celiac patients.
Conclusion: We conclude that celiac disease is not an uncommon cause of short stature and stunted growth in this region. All short statured patients should be screened for celiac disease.
Compliance and Usability of Weber and Rinne’s Tests For Audio Acuity Among Primary School Children From a Health Resource Poor Community
(Nepal Paediatric Society (JNPS), 2013) Ahmadu, Baba Usman; Solomon, Joshua Danji; Zira, Fate Bala; Aisha, Abdallah Joda; Rimamchika, Musa; Ibrahim, Ahmad Ibrahim
Abstract:
Background: Normal auditory acuity is needed for transmission and reception of speech between teachers and students, and from student to student for effective communication and learning. Hearing impairment in school children will potentially cause difficulty perceiving speech clearly in the educational environment. Materials and
Methods: Auditory acuity measurements were conducted on 300 primary school children using the Weber and Rinne’s tests.
Results: Nearly all the children 292 (97.3%) had good hearing. Eight (2.7%) had ipsilateral conduction hearing impairment. Of these, 5 (62.5%) occurred on the right and 3 (37.5%) on the left ear; they were referred to the otorynolaryngologist for further evaluation and management.
Conclusion: Our subjects demonstrated high compliance to Weber and Rinne’s tests which were found to be usable in screening hearing impairment in school children. These tests can be incorporated into the school health programmes in resource poor countries where high tech hearing screening facilities are not readily affordable and available. In addition, the test can be conducted at primary health centers thereby decongesting both secondary and tertiary health facilities.
Correlation Between Malnutrition and Dental Caries in Children
(Nepal Paediatric Society (JNPS), 2013) Shakya, Ajay; Shenoy, Ramya; Rao, Ashwini Rao
Abstract:
Introduction: Dental caries and malnutrition is a public health problem, concentrated more among socioeconomically disadvantaged groups. This study aimed to evaluate the correlation between malnutrition and dental caries among 6, 10 and 12 years children in Mangalore.
Materials and Methods: Data about oral health status and body mass index of children of age groups 6, 10 and 12 were collected using a cross-sectional design. Anthropometric measurements and oral examinations were carried out. Statistical test was performed to look for categorical associations between BMI categories and dental caries prevalence and to see if any correlation exists between BMI Score and dental caries severity.
Results: The Pearson correlation test result suggested children with less BMI score tend to have more caries affected teeth than children with normal BMI.
Conclusions: Physicians and dentists treating young children should consider malnutrition as a risk marker for childhood caries. Inclusion of BMI calculation in the standard dental evaluation of any pediatric patient can provide a screen for prevention, timely diagnosis, and treatment of the children suffering from dental caries and malnutrition.
In Vitro Estimation of Lead Content in Nepalese Traditional Ayurvedic Medicines Commonly Used in Children
(Nepal Paediatric Society (JNPS), 2013) Ojha, Anil
Abstract:
Introduction: Ayurvedic remedies are popularly used in practice for long time in Nepal. It is regarded as safe and free from side effects. However there are published reports of the high content of heavy metals like lead in such preparations. No such study has been done in Nepal looking at the lead content in ayurvedic preparations. The aim of this study was to detect the level of lead in commonly used ayurvedic remedies used in paediatric population if any.
Materials and Methods: Seventeen samples were selected for lead estimation based on frequency of prescription and over the counter dispense. All of them were analyzed using Atomic Absorption Spectrophotometer (AAS) 6300 using flame mode.
Results: None of the samples had detectable level of lead in parts per billion.
Conclusion: Though this study did not detect lead in the seventeen samples of ayurvedic medicine, a larger study is needed involving large samples of these medicines with use of more sensitive equipment for testing.