Journal Issue: Volume: 40, No. 1 (2020)
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2020
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ISSN 1990-7974 eISSN 1990-7982
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Articles
A Cross Sectional Study to Assess Peak Expiratory Flow Rate in Healthy School Children for Establishment of Normative Data
(Nepal Paediatric Society (JNPS), 2020) Sharma, Rajeev; Kaur, Avneet; Gupta, Manish; Kaur, Amarpreet; Arora, Hobinder; Singh, Sukhpal
Abstract:
Introduction: Peak Expiratory Flow Rate (PEFR) can be measured by cheap and portable instrument, peak flowmeter which is useful in detecting early asthmatic changes and monitoring the treatment response.
Methods: This study was conducted on 1000 normal healthy children of nine to 14 years of age of either sex from various schools of Faridkot district in South West Punjab, India. Anthropometry was done and PEFR was measured using Mini Bell Peak Flow Meter. Linear regression analysis was done and normograms were constructed.
Results: Linear regression equations were derived for PEFR with height, weight, BSA and BMI in boys and girls. The most significant correlation was seen with height (r = 0.527 in boys, r = 0.410 in girls) followed by body surface area (r = 0.506 in boys, r = 0.296 in girls). Body mass index had negative correlation (r = -0.200) with PEFR in girls. Nomograms were constructed on basis of linear regression equations of PEFR with height (-46.67 + 2.02 x height for boys, -12.64 + 1.50 x height for girls) and BSA (82.02 + 137.2 x BSA for boys, 96.61 + 88.11 x BSA for girls)
Conclusion: There is need for nomogram for each region so that personal value of PEFR can be compared to normal reference population and also with predicted value from regression equation as PEFR varies from region to region. The nomograms and regression equations derived from this study can be useful for predicting normal values of PEFR of children of South West Punjab.
Breastfeeding Pattern and its Associated Factors Among Mothers Working at Two Hospitals in Kathmandu
(Nepal Paediatric Society (JNPS), 2020) Basnet, Srijana; Shrestha, Merina; Adhikari, Tulashi; Shakya, Aarati
Abstract:
Introduction: Breastfeeding practices of women working at the hospital are likely to be modified by the facilities and support that they receive at the hospital. This study was done to evaluate the breast feeding practices and to analyse important factors that are associated with exclusive breast feeding till six months among women working at hospitals in Kathmandu, Nepal
Methods: A total of 110 women, with a young child between the ages of six months and two years were recruited from two hospitals in Kathmandu. A predesigned structured, interviewer-administered questionnaire was used for data collection.
Results: The mean age of the mothers was 29.85 ± 3.68 years. Ninety seven (88.2%) women were aware about initiation of breastfeeding within first hour of birth but only 64 (58.2%) women could practice it. Most women 100 (90.9%) were aware about exclusive breastfeeding but only 18 (16.3%) could practice exclusive breastfeeding till six months. Mean duration of exclusive breastfeeding was 2.86 ± 2.00 months and 20 (18.2%) mothers practiced mixed feeding since birth. The participants whose babies had prelacteal feeding had significantly shorter duration of mean exclusive breast feed {1.92 ± 2.18 (S.D)} compared to those who did not have prelacteal feed {3.33 ± 1.74 (S.D)} (p = 0.001). Those who delivered by normal vaginal delivery, initiated breastfeeding within first hour of delivery, expressed breast milk and got feeding breaks were associated with longer duration of mean exclusive breast feed.
Conclusion: The breast feeding practices among working women at hospital is quite low compared to national statistics on IYCF. Breast milk expression and feeding breaks for lactating working women could improve feeding practices.
Clinical and Immunological Spectrum of Systemic Lupus Erythematosus in Children
(Nepal Paediatric Society (JNPS), 2020) Kini, Sandesh; Y, Ramesh Bhat; Thunga, Chennakeshava; Shashidhara, Sowmya; Anand, Akshatha
Abstract:
Introduction: Systemic Lupus Erythematosus (SLE) is an auto immune disorder affecting mainly adolescent females and young women of reproductive age. The disease is characterised by widespread inflammation of blood vessels and connective tissues due to the presence of anti-nuclear antibodies (ANA). There are limited number of studies from South India on paediatric lupus. Our objectives were to study the clinical and immunological features of childhood SLE along with treatment modalities and its outcome at the end of one year follow up. The correlation between various auto-antibodies and systemic involvement was also assessed.
Methods: This was a retrospective observational study carried out in paediatric unit at a tertiary care centre in South India. Data was obtained through patient’s medical records. From April 2003 to April 2019, 32 children were diagnosed to have SLE as per the American college of Rheumatology 1997 criteria.
Results: The study population included 32 children fulfilling the criteria. Female to male ratio was 4.3:1. The mean age at diagnosis was 11.52 years. The most common clinical manifestations were renal (87.5%) followed by haematological (81.3%), musculoskeletal (59.4%), mucocutaneous (53.1%) and nervous system (31.3%) involvement. All patients were positive for anti-nuclear antibodies. Anti-double stranded DNA (78.1%) was the most common auto-antibody profile followed by anti-ribosomal p protein (37.5%) and anti-nucleosome antibody (37.5%). During the follow up, 13 (40.6%) children attained complete remission, 10 (31.2%) went into partial remission and nine (28.1%) had persisting active disease.
Conclusion: The clinical spectrum and outcome of paediatric SLE depends upon the age of presentation and number of organ systems involved at the time of diagnosis. Our study throws light on various aspects of SLE in children from developing countries like India.
Effectiveness of Glycerin Magnesium Sulphate Versus Heparin Benzyl Nicotinate Application Among Children with Phlebitis
(Nepal Paediatric Society (JNPS), 2020) Dahal, Akriti Shree; Tuitui, Roshani; Shrestha, Purna Devi; Sharma, Bharati; Acharya, Sharada; Dahal, Priyanka
Abstract:
Introduction: Phlebitis is the most common complication of intravenous infusion therapy. Incidence of phlebitis in children receiving intravenous therapy has been reported to be as high as 71.25%. The study was done to find out the effectiveness of glycerin magnesium sulphate versus heparin benzyl nicotinate application in children with phlebitis.
Methods: A pre-post control group design was used. A total of 43 subjects were randomly assigned into two groups [22 in experimental (glycerin magnesium sulphate application) and 21 in control (heparin benzyl nicotinate application) group] by lottery method. Data was collected using Modified Visual Infusion Phlebitis (VIP) Score.
Results: The comparison between VIP score was based on observations made before the interventions and at 12, 24, 36 and 48 hours after the intervention. Independent t tests showed significant difference in reduction of VIP score in experimental and control group after 12 hours and 24 hours of intervention. The study demonstrated that there is no statistically significant difference in reduction of VIP score among the subjects in experimental and control group at 12 hours (p = 0.219), 24 hours (p = 0.349), 36 hours (p = 0.695) and 48 hours (p = 0.424) after the intervention.
Conclusion: The study concludes that both glycerin magnesium sulphate and heparin benzyl nicotinate can be used effectively among children with phlebitis. However, after 24 hours of phlebitis, an alternative intervention needs to be used.
Morbidity and Mortality Pattern of Patients Admitted into Paediatric Intensive Care Unit of Tertiary Level Hospital of Nepal
(Nepal Paediatric Society (JNPS), 2020) Shrestha, Anil Kumar; Bhattarai, Susan; Paudel, Prajwal; Basel, Prem Lal
Abstract:
Introduction: The paediatric intensive care unit (PICU) takes care of critically ill paediatric patients. Regular evaluation of the outcomes of patients admitted to PICU is important to assess the effectiveness of various interventions. This study aimed to find the morbidity and mortality pattern of patients admitted to PICU of tertiary level Paediatric hospital of Nepal.
Methods: We conducted a retrospective, cross sectional observational study using the records of all the patients admitted to PICU of a tertiary level hospital from January 2017 to August 2017. We collected data on age, sex, geographical distribution, duration of PICU stay and the morbidity and mortality outcomes. Outcome is classified as transfer to ward, leave against medical advice (LAMA) and death. Data were analysed descriptively using SPSS version 23.
Results: Out of 358 patients admitted to PICU, the mean age was 1.83 years. Majority were infants (54.5%) with male:female ratio of 1.8:1. The major causes of PICU admission were respiratory disease (27.7%) followed by CNS disease (19.6%) and infections (17.3%). The average length of stay was 6.27 days. Overall mortality was 22.7%.
Conclusion: Respiratory infections were the primary cause of PICU admission and overall mortality rate was high at 22.7%. However, mortality rate was even worse for patients with multi-system involvement. We need prospective studies to examine the underlying reasons for mortality among patients with multi-system involvement.