Journal Issue: Volume: 30, No. 2 (2010)
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2010
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ISSN 1990-7974 eISSN 1990-7982
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Articles
Conflict of Interest in Peer-Reviewed Medical Journals: The World Association of Medical Editors (WAME) Position on a Challenging Problem
(Nepal Paediatric Society (JNPS), 2010) Ferris, Lorraine E; Fletcher, Robert H
Abstract
("This Editorial may appear in other medical and biomedical journals whose editors are members of WAME." Note to
WAME Members: This editorial is being offered for publication in WAME member journals at the discretion of
their editors. WAME retains copyright.)
Psychiatric Morbidity Profiles of Child and Adolescent Psychiatry Out-Patients in a Tertiary-Care Hospital
(Nepal Paediatric Society (JNPS), 2010) Shakya, Dhana Ratna
Abstract
Background: Psychiatric morbidity is ubiquitous, affecting children, adolescents and adults. Age factors play a great role in pattern of morbidity profile. Psychiatric morbidity profile of children and adolescents may indicate different needs and priorities.
Objective: This study aims to sort out referral pattern, attitude about psychiatric referral and morbidity profile among child and adolescent psychiatric out-patients in a tertiary-care general hospital.
Methodology: A total of 100 consecutive child and adolescent patients in psychiatry OPD coming into contact with investigator psychiatrist were enrolled during the study period. Diagnoses were made according to the ICD-10.
Results: Fifty three of the subjects were female, majority of the cases (79) were of age between 13-18 years. Main ethnicity-caste groups seeking care were Mongol, Brahmin, Chhetri and indigenous Terai tribes. People from semi-urban and urban settings predominated in this study. Great majority (more than 80%) had reached this service in the 4th or in more than the 4th step of their help seeking. Most of the subjects were comfortable and happy about psychiatric referral. More than half had presented mainly with physical and somatic complaints. Major psychiatric diagnoses encountered were mood (affective), anxiety, seizure, dissociative conversion disorders and mental retardation. Four percent of subjects had suicidal behaviours and 17% migraine headache.
Conclusion: Common psychiatric diagnoses among these child and adolescent out-patients are mood, anxiety, seizure, dissociative conversion disorders and mental retardation.
Wilm’s Tumor: Ten Year Experience at Kanti Children’s Hospital
(Nepal Paediatric Society (JNPS), 2010) Sah, Kailash Prasad; Rai, Ganesh Kumar; Shrestha, PN; Shrestha, Amit
Abstract:
Introduction: Wilm's tumor is the second most common abdominal tumor in children. It arises from the kidney. The survival of children with Wilm's tumor has improved over the past 25 years.
Objectives: To study the clinical presentation of Wilm’s tumor and evaluate the ten year survival.
Materials and Methods: A retrospective hospital based study was conducted at Kanti Children's Hospital from March 1998 to February 2008. A total of 60 histopathologically diagnosed children below 14 yr of age were included in the study.
Results: About 2/3rd (66.5%) presented with abdominal swelling followed by abdominal pain (16.5%) and fever (13.5%). A few children manifested with red colored urine (3.5%). The age of children ranged from one month to 13 years with the mean age of 36 months. Males were affected more than the females (M:F=3:1). Most affected age group was 2 to 5 yrs (41.5%) followed by 1 to 2 yrs (25.0%). Most of the cases were in stage III (36.5%) followed by stage II (33.5%). SIOP protocol was used to treat these children and overall 10 year survival rate was 50.0%. One fifth (20%) of the cases died, 16.5% relapsed and 13.5% lost to follow up.
Conclusion: Despite severe resource limitations, paediatric oncology unit at Kanti Children’s Hospital has been successfully treating Wilm's tumor with the success rate of 50.0%.
Role of CSF Analysis for the First Episode of Febrile Seizure among Children between Six Months to Five Years of Age
(Nepal Paediatric Society (JNPS), 2010) Shrestha, Shree Krishna
Abstract:
Introduction: A febrile convulsion is defined as a seizure that occurs in association with fever in children from six months to five years of age, with no evidence of a central nervous system infection or other identifiable causes of seizure and no history of an afebrile seizure. Simple febrile seizures are brief (<15 minutes), generalized, and occur in association with fever and only once during a 24-hour period without postictal pathology. Febrile Seizures have longer duration (>15 min), or have focal features or if
they recur within 24 hours are defined as complex. In May 1996, the American Academy of Paediatrics (AAP) issued practice parameters regarding the neurodiagnostic evaluation of children with a first simple febrile seizure, who present within 12 hours after the seizure. It may be due to meningitis. This study was done to find out role of cerebro spinal fluid (CSF) analysis to rule out the meningitis in different age group of children presenting with first episode of fever with seizure.
Design: A prospective study was carried out from June 2008 to July 2009 at the Western Regional hospital, Department of Paediatrics, Pokhara, Nepal. A total of 110 hospitalized children between the age group five months to 5 years were included in the study. (21.4%) had meningitis while in 12-18 months, 6 out of 31 (19.3%) had
meningitis and in more than 18 months age group only 4 out of 51 (7.84%) were detected with meningitis.
Conclusion: In cases of apparent febrile seizure, meningitis should always be considered as a differential diagnosis. Lumbar puncture is must to rule out meningitis in all children between the ages of six months to eighteen months presenting with first episode of fever with seizure to rule out meningitis, even in the absence of meningeal signs.