Journal Issue: Volume: 36, No. 1 (2016)
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Volume
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Issue Date
2016
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ISSN 1990-7974 eISSN 1990-7982
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Articles
Averting the Legacy of Kidney Disease; Focus on Childhood
(Nepal Paediatric Society (JNPS), 2016) Ingelfinger, Julie R; Kalantar-Zadeh, Kamyar; Schaefer, Franz
Abstract:
World Kidney Day 2016 focuses on kidney disease in childhood and the antecedents of adult kidney disease that can begin in earliest childhood. Chronic kidney disease (CKD) in childhood differs from that in adults, as the largest diagnostic group among children includes congenital anomalies and inherited disorders, with glomerulopathies and kidney disease in the setting of diabetes being relatively uncommon. In addition, many children with acute kidney injury will ultimately develop sequelae that may lead to hypertension and CKD in later childhood or in adult life. Children born early or who are small-for date newborns have relatively increased risk for the development of CKD later in life. Persons with a high-risk birth and early childhood history should be watched closely in order to help detect early signs of kidney disease in time to provide effective prevention or treatment. Successful therapy is feasible for advanced CKD in childhood; there is evidence that children fare better than adults, if they receive kidney replacement therapy including dialysis and transplantation, while only a minority of children may require this ultimate intervention Because there are disparities in access to care, effort is needed so that those children with kidney disease, wherever they live, may be treated effectively, irrespective of their geographic or economic circumstances. Our hope is that World Kidney Day will inform the general public, policy makers and caregivers about the needs and possibilities surrounding kidney disease in childhood.
Additional Use of Alarm Systems in Wakefulness in the Treatment of Mono-Symptomatic Nocturnal Enuresis
(Nepal Paediatric Society (JNPS), 2016) Kosilov, Kirill Vladimirovich; Loparev, Sergey Alexandrovich; Kuzina, Irina Gennadyevna; Shakirova, Olga Victorovna; Zhuravskaya, Natalia Serveevna; Lobodenko, Alexandra
Abstract:
Introduction: There are many factors associated with nocturnal enuresis in children and can be very challenging as regards its management. Consequently, misunderstanding could arise explaining the state when a child for years urinates in bed. The aim of this study was to investigate possibilities of increase of efficiency of alarm systems and decrease of time of result achievement in case of usage of such modernized therapy algorithm.
Materials and methods: 452 children (307 boys and 145 girls) took part in the study. All patients were randomly divided into two groups prior to alarm systems therapy. Group А patients (206) were offered to use alarm system (Wet Stop/ BYE-WET by PALCO LABS, Inc (USA) in normal mode. Group В patients (246) were using alarm system in wakefulness – urinated on device catching sensor. Alarm intervention was carried out within 12 weeks, total period of observation over the patients– 5 months.
Results: We found out that number of patients with urination in sleep after 3 months of therapy was reliably less in this group than in control (23.5 against 40.3 percent, p < 0.05).
Conclusion: Usage of alarm systems in patient’s wakefulness in addition to standard treatment regimen was improved the efficiency of Alarm-therapy up to 76.5 percent. Day training with the usage of alarm systems reliably increased the number of dry nights and self-wakening in case of desire to urinate. Usage of alarm systems in wakefulness was safe and did not result in additional refusal from treatment.
Association of Vitamin D Deficiency with Acute Lower Respiratory Infection in Toddlers Authors
(Nepal Paediatric Society (JNPS), 2016) Narang, Gursharan Singh; Arora, Sunita; Kukreja, Sahiba; Shifali, Dr
Abstract:
Introduction: Pneumonia remains a significant health problem in India with significant morbidity and mortality. Objectives of this study were to identifying an effective nutritional agent that reduces the need for antibiotics, duration of pneumonia and length of hospitalization would be highly cost-beneficial.
Material and Methods: This was a hospital-based case-control study: A total of 100 children including 50 cases and 50 controls, aged 2–60 months, were enrolled. Case definition of severe ALRI as given by the World Health Organization was used for cases. Controls were healthy children attending outpatients’ service for immunization or admitted for minor ailments other than ALRTI.
Results: Mean 25(OH)D concentrations in children of the study group were lower than those of the control group (20.431 ng/mL vs. 27.67 ng/mL; p = 0.035). Factors significantly associated with decreased risk of ALRTI in univariate analysis were: exclusive breastfeeding in the first 6 months (cases 13/50 (26%), controls 42/50 (84%); p=0.000); adequate exposure to sunlight (cases 14/50 (28%), controls 42/50 (84%); P=0.000); and serum 25OHD3 <20 ng/ml (cases 28/50 (56%), controls 0/50 (0%); p=.000). Multivariate logistic model indicated that severe vitamin D deficiency (OR=NA), exclusive breast feeding (OR=.174); 95% CI (.061- .521; p=.002) and adequate sunlight exposure (OR=.179) ;95%CI (.062-.519); p=.002) were significant independent predictive risk factors for ALRTI among the children between 2 months – 5 years of age (all p<0.05).
Conclusion: Severe vitamin D deficiency (<20ng/ml), nonexclusive breastfeeding in the first six months of life, inadequate sun exposure were significant risk factors for ALRTI in Indian children.
Changes in the Disease Spectrum of Hospitalized Children in a County Hospital of China
(Nepal Paediatric Society (JNPS), 2016) Liu, Yonglin; Liu, Juan; Shamsi, Bilal Haider; Hao, Xiao Xia
Abstract:
Introduction: Considering the present situation of disease spectrum changes, it is very important to understand the changes of disease in primary settings, to find out the feature of disease area, to direct the decision making so as to allocate the medical resources accordingly. The objectives of this study were to understand the changing trends in disease spectrum and mortality rate of children hospitalised in the department of paediatrics in Shenmu hospital, and to provide scientific basis for the future medical care and prevention of childhood diseases.
Material and Methods: A retrospective statistical analysis was done using the data regarding hospitalization of children in Shenmu County. The study lasted fifteen years, from January 1998 to December, 2012.
Results: A total of 23,448 children were hospitalized below the age of 14. Majority of the patients were younger than three years old constituting 78.8% (which included age 1 month~1 year 57.2%). The average number of days of hospitalization was 6~8 days, with a median time of six days. The leading cause of hospitalization was respiratory disease. Other major illnesses causing hospitalization included: infectious diseases, digestive tract diseases, neonatal diseases and nervous system diseases. A total of 144 children died during this period. The top three causes of death were: asphyxia, premature birth and neonatal respiratory distress syndrome.
Conclusion: The changing trends in paediatric disease hospitalisations and mortality rate over the 15 years are significant for clinicians so as to prevent and minimise such diseases by appropriate preventive and therapeutic options to contain them.
Correlation between Insulin Like Growth Factor -1 and Anthropometric Measurements of Premature Infants
(Nepal Paediatric Society (JNPS), 2016) Abdelwahab, Amina; Khashana, Abdelmoneim; Ahmed, Nesma; Younis, Soha
Abstract:
Introduction: It is agreed that insulin like growth factor 1 (IGF- 1) influence growth. IGF-1) is a significant endocrine mediator of growth and encourages cellular propagation, survival, and differentiation. The aim of this study was to correlate insulin like growth factor 1 and anthropometric measurements in the neonatal age of the premature infants.
Material and Methods: This study was performed at a level III intensive care unit at Suez Canal university hospital, Ismailia, Egypt. It is a cross sectional analytical study in the period from the March 2014 to September 2014. All cases are premature and were imperiled to history taking, clinical examination includes weight, length, head circumference and measurement of serum (IGF-1).
Results: There were a total of 40 neonates. Gestational age extended from 31 to 36 weeks with a mean of 34.32±1.68 weeks; weight ranged from 1.15 to 3.20 kg with a mean of 2.14±0.59 kg and length ranged from 37 to 49 cm with a mean of 43.85±3.25 cm. Regarding neonatal gender, 21 neonates out of 40 neonates (52.5%) were males and 19 neonates (47.5%) were females. Mother’s age ranged from 19 to 35 years with a mean of 27.47±4.46 years. IGF- 1α concentration, it ranged from 13.55 ng/ml to 163.34 ng/ml with a mean of 99.64±32.43 ng/ml and there was statistically significant decrease in neonates with restricted growth when compared to non-restricted growth group (77.67±30.92 ng/ml vs 121.62±13.64 ng/ml respectively).
Conclusion: There was significant correlation between IGF-1α and weight and head circumference of preterm neonates.