Journal Issue: Volume: 44 No. 1 (2024)
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Volume
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Issue Date
2024
Journal Title
Journal ISSN
ISSN 1990-7974 eISSN 1990-7982
Journal Volume
Articles
Breastfeeding Indicators Among Mothers in Kerala, India: A Descriptive Cross-sectional study
(Perinatal Society of Nepal (PESON), 2024) P, Namitha; P J, Mercy; K, Rajamohanan; K G, Swapna
Abstract:
Introduction: The World Health Organization (WHO) and the United Nations Children’s Fund (UNICEF) advocate for comprehensive breastfeeding indicators to enhance current breastfeeding rates in the community. These include the early initiation of breastfeeding, six-month exclusive breastfeeding, and continuation of breastfeeding, along with complementary feeds for at least a biennial span or beyond. This study aimed to ascertain the prevalence of breastfeeding among mothers in the community.
Methods: A descriptive cross-sectional study was undertaken among 945 mothers having children aged from two to three years in the community. A multistage cluster sampling was done to select the mother-baby dyads. The data were collected using a validated semi-structured interview schedule and analyzed by descriptive statistics (Frequency and percentage) using SPSS version 27.
Results: The early-initiation rate of breastfeeding in the study group was 76%. Among this 65% (breastfed within half an hour) for normal delivery, and 48% (within 0 - 1 hour) for Caesarean section. The exclusive breastfeeding rate was 71% and the continuation of lactation till two years and beyond was 77.78%.
Conclusion: The present study shows the breast milk feeding within the first hour after birth and exclusive breastfeeding were 76% and 71% respectively. Although there has been improvement, Kerala needs to improve the early commencement of breastfeeding and exclusive breast feeding.
Impact of COVID-19 Lockdown on Sedentary Behavior and Changes in Weight in Children: A Systematic Review
(Perinatal Society of Nepal (PESON), 2024) Aravindakshan, Sreeja S; David, Anita; M R, Athirarani; S, Geetha; Agarwal, Prakash
Abstract:
The restrictions and lockdown during Covid 19 may result in dangerous consequences and long-term ill health in future. This systematic review explores the impact of Covid 19 lockdown on changes in weight and sedentary behavior in children and adolescents. A comprehensive literature search was done through electronic databases searched from May 2021 to December 2022 including MEDLINE, Google scholar, Ovid Medline. In total 4162 studies were retrieved, of which twenty studies were found to be eligible. Out of them there were one case report, five prospective cohort, twelve cross sectional studies, one trend study, one longitudinal study and one interrupted time series study with a total participant of 183720. These participants were children and adolescents aged less than or equal to 19 years. The findings from these studies collectively indicate that the COVID-19 pandemic has had a significant impact on weight gain, overweight, and obesity across different age groups. Factors such as changes in dietary habits, reduced physical activity, and disrupted routines likely contributed to these outcomes. These findings underscore the importance of promoting healthy lifestyles, including balanced nutrition and regular physical activity, to mitigate the negative effects of prolonged periods of restricted movement and altered routines. The changing lifestyles among children and adolescents will certainly affect the health which in turn will result in metabolic syndrome risks. Hence importance must be given to physical activity.
Clinical and Laboratory Predictors of Acute Kidney Injury in Childhood Severe Malaria
(Perinatal Society of Nepal (PESON), 2024) Ibrahim, Olayinka Rasheed; Alao, Michael Abel; Adeboye, Muhammed Nurudeen
Abstract:
Introduction: Despite being responsible for the highest burden of global malaria infection, there are limited data on malaria-associated acute kidney injury (MAKI) among Nigerian children for informed decisions. This study described the incidence and predictors of malaria-associated AKI among a cohort of 541 children in northwestern Nigeria.
Method: This was a retrospective review of malaria cases from 1st January 2019 to December 31, 2020. We extracted socio-demographics, clinical features, and laboratory parameters from the records of the children with confirmed cases of severe malaria. AKI was defined and staged according to the 2012 Kidney Disease: Improving Global Outcomes (KDIGO) criteria. We carried out bivariate analysis and entered variables that were significant into binary logistic regression in order to determine predictors of AKI.
Result: Out of the 541 children, 208 (38.4%) had MAKI. Of the 208, 165 (79.3%) were in stage 1, 26 (12.5%) were in stage 2, and 17 (8.2%) were in stage 3. Clinical features associated with AKI included hypoxemia, respiratory distress, loss of consciousness, prostration, passage of dark-colored urine, and shock (p<0.05). Laboratory parameters associated with AKI included acidosis, leukocytosis, hyponatremia, and hyperkalemia (p<0.05). Factors that independently predicted AKI included the passage of dark-colored urine with an adjusted odds ratio (AOR)-3.853 (95% CI 2.417, 6.143), hyponatremia-AOR 2.346, (95% CI 1.287, 4.277), and hyperkalemia-AOR 3.122, (95% CI 1.031, 9.393).
Conclusion: The incidence of malaria-associated AKI is high among children in northwestern Nigeria. The presence of dark-colored urine, hyponatremia, and hyperkalemia strongly predict the risk for AKI.
Clinical Characteristics and Outcome of Multisystem inflammatory syndrome in Children in a Tertiary Care Center, Nepal
(Perinatal Society of Nepal (PESON), 2024) Amatya, Puja; Rajbhandari, Rateena; Tuladhar, Sucharita; Basnet, Sangita; Ojha, Anil Raj; Shrestha, Shrijana
Abstract:
Introduction: Multisystem inflammatory syndrome in children (MIS-C) manifests a few weeks after infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). It is characterized by fever and multi-organ dysfunction. This disease has been increasingly reported from various countries since the outbreak of coronavirus in 2019. This study was done to determine the clinical characteristics and outcome of children with multisystem inflammatory syndrome in our settings.
Methods: This was a retrospective study in children aged 1 month to 14 years fulfilling the World Health Organization case definition of MIS-C conducted between January 2020 and March 2022 in a tertiary care center, Nepal. The clinical characteristics, treatment and outcome parameters of these patients were reviewed and analyzed.
Results: A total of 36 patients with MIS-C was reviewed, 20 (55.5%) were male with median age of 6 years (IQR 1.6-10). All children with MIS-C had fever while gastrointestinal symptoms were present in 24 (66.6%), cough in 15 (41.7%) and rash in 13 (36%). Twelve patients (33.3%) had cardiac symptoms of which 3 (8%) patients had dilated coronary arteries. Other presentations were Kawasaki disease like features (8), toxic shock syndrome (5), meningoencephalitis (3), subconjunctival hemorrhage (1), and pulmonary edema (1). Intravenous immunoglobulin was given in 18 (50%) patients, steroid in 23 (64%) and aspirin in 30 (83.3%) patients. All patients survived.
Conclusion: The most common symptoms of multisystem inflammatory syndrome in children were fever, gastrointestinal symptoms, cough and rash. The overall outcome of patients even with severe disease was good.
Comparison of KRS and WBSS Clinical Scores to Assess the Severity of Bronchiolitis: Single centre Prospective Observational study
(Perinatal Society of Nepal (PESON), 2024) Sankannavar, Ashwini; Puttalinga, Divyashree; Kembavi, Sushank; Shivalingaiah, Kavyashree D
Abstract:
Introduction: Various scoring system has been proposed to assess the severity of bronchiolitis, most common scores being Wang Bronchiolitis Severity Score (WBSS) and Kristjansson Respiratory Score (KRS). None of these scoring systems are standardised in assessing severity. The present study was aimed to compare WBSS and KRS scores in assessing severity of bronchiolitis.
Methods: Present study is a prospective observational study. Children aged less than two years, diagnosed as bronchiolitis, were included. WBSS and KRS were calculated at admission. These scores were co related with severity of bronchiolitis and duration of hospital stay.
Results: A total of 69 participants were included in the study. The two scores significantly corelates with the severity of bronchiolitis (P - 0.0001), with accuracy 89.86% and 85.51% respectively for KRS and WBSS respectively. Both scores have good sensitivity {KRS (CI= 96.6 – 100%) and WANG score (96.6- 100%)}. The two scores were significantly correlated with the duration of hospital stay, with a correlation coefficient of r2 of 0.6818 (P < 0.001) for WBSS and r2 of 0.6622 (p < 0.001) for KRS.
Conclusion: Both WBSS and KRS scores were accurate in predicting the severity of bronchiolitis at admission and also duration of hospital stay.