Journal Issue: Volume: 39, No. 1 (2019)
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2019
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ISSN 1990-7974 eISSN 1990-7982
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Articles
Bacteriological Profile and Antibiotic Sensitivity Pattern of Neonatal Sepsis in Central Paediatric Referral Hospital in Nepal
(Nepal Paediatric Society (JNPS), 2019) Bhattarai, Susan; Chapagain, Ram Hari; Mishra, Deepak; Shrestha, Anil Kumar; Shrestha, Sushan Man
Abstract:
Introduction: Neonatal sepsis is the most common cause of neonatal morbidity and mortality. The causative organisms of neonatal sepsis are changing and so do their antibiotic sensitivity pattern. So it is important to regularly monitor the change in bacteriological profile and their antimicrobial sensitivity pattern to help update the treatment guidelines of neonates. This study aimed to study the microbiological patterns of neonatal sepsis and their antibiotic susceptibility pattern in a tertiary care centre in Kathmandu.
Methods: A prospective study was carried out among cases of neonatal sepsis admitted in Neonatal Intermediate Care Unit (NIMCU) of a tertiary care referral hospital from August 2015 to August 2016. Prospective data were collected with pretested and standardised proforma and analysed using SPSS version 20.
Results: Out of 311 neonates admitted over a period of one year with diagnosis of neonatal sepsis, male:female ratio was 2.1:1. Among them 234 (75.2%) cases were of LONS and 77 (24.8%) were of EONS. Blood culture was positive in 47 neonates (15.1%). The organisms isolated included staphylococcus aureus (34.0%), klebsiella (32%), CONS (24%), escherechia coli (6%) and enterobacter (4%). In LOS, gram positive organisms staphylococcus and CONS were the commonest ones (61.4%). In EOS, gram negative organism klebsiella (65%) was more common. Most of staph aureus were susceptible to penicillins, amikacin and cefotaxime. Klebsiella was found to be resistant to penicillins, amikacin and cefotaxime.
Conclusion: There is possible increasing incidence of gram positive septicemia in LONS and increasing emergence of resistance of kleibsella to the common antibiotics ampicillin, amikacin and cefotaxime.
Blood Heavy Metal Levels in Children with Autism Spectrum Disorder: A Cross- Sectional Study From Northern India
(Nepal Paediatric Society (JNPS), 2019) Sehgal, Rachna; Gulati, Sheffali; Gupta, Yogendra Kumar; Sapra, Savita; Mehta, Manju; Pandey, Ravindra Mohan; Kumar, Gajendra; Srivastava, Amita; Kabra, Madhulika
Abstract:
Introduction: The role of heavy metals in the etio-pathogenesis of ASD is controversial. Paucity of studies from Indian subcontinent with different sociocultural and environmental background prompted the present study.
Methods: Sixty children aged three to 12 years with Autism Spectrum Disorder (ASD) and 60 age matched controls were enrolled. Detailed history including possible exposure history to various heavy metals was taken. Severity of ASD was assessed using Childhood Autism Rating Scale 2. Blood level of metals was estimated by Inductively coupled plasma - atomic emission spectroscopy (ICP-AES).
Results: Mean blood mercury levels in the two groups of ASD and controls was comparable (p = 0.28). Median blood cadmium and arsenic levels were higher in controls possibly due to higher ground water use and insecticide exposure. (7/60 versus 17/60, p = 0.04) and (2/60 versus 7/60, p = 0.08) while mean blood zinc level was lower in controls. Lead was significantly higher in greater proportion of children with ASD. (11/60 vs 1/60, p = 0.002). Children with ASD had significantly higher pica (26/60 versus 10/60, p = 0.001) and higher median number of days of antibiotics during infancy (24.5 (0-120) versus 15 (0-60), p = 0.004). None of the heavy metal tested had significant correlation with the severity of ASD.
Conclusions: Mean blood mercury, lead, zinc, arsenic and cadmium did not show significant association with diagnosis of ASD. High levels of toxic metals in both children with ASD and controls points towards an urgent need to contain environmental pollution by heavy metals.
Clinico-Radiological Profile of Neurocysticercosis in Children
(Nepal Paediatric Society (JNPS), 2019) Prasad, Prem Lochan; Dawra, Reetika; Chandra, Surabhi
Abstract:
Introduction: Neurocysticercosis (NCC) is the most common parasitic disease of the nervous system caused by the larval stage of Taenia solium (also known as pork tapeworm). Clinical manifestations are pleomorphic and determined mainly by the location, number and viability of cysts as well as by the host response. Neuroimaging is the most useful diagnostic study for parenchymal disease.
Methods: The study was conducted in the Paediatric Ward of a tertiary care teaching institute, Bareilly, India. The study was conducted on 50 subjects. The study was a hospital based, prospective, observational study. All admitted children between one year to 18 years and diagnosed to have neurocysticercosis were included the study. Statistical analysis was done by single and double sample proportion test. P value of less than 0.05 was considered significant.
Results: Maximum numbers of patients were in age group of five-14 years. Males (62%) were more commonly affected than females. Seizure was found to be the commonest presentation of NCC. In our study majority of cases were diagnosed by CT scan. 70% of the patients enrolled in this study demonstrated ring enhancing lesions on neuroimaging. Maximum number of patients had lesions in the parietal lobe followed by frontal lobe.
Conclusions: NCC is common in the age group of five to 14 years. Focal seizures were the most common presentation. Other symptoms were headache and vomiting. Vegetarians were more commonly affected than non vegetarians. Single ring enhancing lesion in parietal area was the commonest neuroimaging findings.
Complementary Feeding Practices And Its Economic And Social Impact: A Cross Sectional Hospital Based Study
(Nepal Paediatric Society (JNPS), 2019) Bisoi, Swarup Kumar; Mohanty, Mamata Devi; Dash, Dillip Kumar; Giri, Satabdi
Abstract:
Introduction: According to NHFS-4 data, around 38% of under-five Indian children are malnourished and stunted. In addition to poor socio-economic status, faulty complementary feeding practice is a major contributor to this. The objective of this study is to know the prevailing complementary feeding practices in our area, the most common food type preferred for introduction during initiation of complementary feeds, knowledge of the mother and their family members regarding complementary feeding, the factors influencing in decision making and its financial burden on the family.
Methods: This hospital based cross-sectional study was conducted in a private Medical College in Bhubaneswar, Odisha, India. 256 mothers of infants between six months to two years attending Paediatric OPD from December 2018 to June 2019 were selected by random sampling technique. Data were collected using a structured questionnaire.
Results: Out of the total 256 subjects interviewed, 134 (76.13%) out of 176 families belonging to lower income group preferred commercially available processed food over home food as the initial weaning food as compared to 32 (40%) out of 80 of the high income group preferring the same. The lower income group spent 22.3% of the total family income on commercial preparations to feed their infants in the age group six to 12 months. Whereas high income group families spend an average of 14.3% of family income on baby food products in the same age group. Despite being in regular contact with the local physician, in 85% of the total visits to the doctor, the opportunity wasn’t utilised to counsel the family member about complementary feeding practices.
Conclusions: Commercial preparations are the primary preferred weaning food. The dietary diversity of complementary food is very poor, thus affecting growth and development. The false perception that commercial preparations are critical to child growth and development is overburdening the family finances.
Extravasation Injuries, Pressure Ulcers and Ocular Surface Disorders in a Tertiary Paediatric Intensive Care Unit in South India
(Nepal Paediatric Society (JNPS), 2019) Amatya, Puja; Sadasivam, Kalaimaran
Abstract:
Introduction: Extravasation injuries, pressure ulcers (PU), and ocular surface disorders (OSD) like exposure keratitis are common problems that we encounter in critically ill children admitted in Paediatric Intensive Care unit (PICU). There is sparse data regarding these injuries due to under reporting by staffs in intensive care unit. The primary aim of this study was to know the prevalence of extravasation injuries, ocular surface disorders and pressure ulcers in tertiary intensive care unit of south India. The secondary objective of this study was to re-evaluate the prevalence of these injuries after interventions.
Methods: During pre-intervention period, number of children with extravasation injuries, pressure ulcers and ocular surface disorders were identified. The qualitative improvement practices was implemented to decrease the prevalence of these injuries. This was followed by re-evaluation of these injuries during post-intervention period.
Results: During pre-intervention period the overall prevalence of these injuries was 36/273 (13.2%). The prevalence of extravasation injuries, pressure ulcers and ocular surface disorders was 16/273 (5.9%), 12/273 (4.4%) and 8/273 (2.9%) respectively. The qualitative improvement practices were implemented in intensive care unit. During post-intervention period, the prevalence of these injuries was reduced to 10/157 (6.4%). The extravasation injuries reduced to 4/157 (2.5%), PUs to 4/157 (2.5%) and OSD to 2/157 (1.3%).
Conclusions: The extravasation injuries, PUs and OSD are common problems in critically ill children. The qualitative improvement practices should be implemented and reinforced in intensive care units to prevent these injuries.