Journal Issue: Volume: 37, No. 1 (2017)
Volume
Number
Issue Date
2017
Journal Title
Journal ISSN
ISSN 1990-7974 eISSN 1990-7982
Journal Volume
Articles
Analysis of Predictors of Relapse in Children with Steroid Sensitive Nephrotic Syndrome
(Nepal Paediatric Society (JNPS), 2017) Bhatta, Mukesh; Shah, Gauri Shankar; Mishra, Om Prakash
Abstract:
Introduction: Children with idiopathic nephrotic syndrome (INS) are steroid responsive but have relapses in subsequent non-treatment period. The objective of the present study was to analyze the factors which could predict relapses in these children.
Material and Methods: Forty patients of INS aged 1-14 years of both gender were enrolled over one year period and followed for six months after treatment of initial episode of Nephrotic Syndrome.
Results: The median age of children was 4.5 years and male to female ratio 1.9:1. There were 24(60%) relapses and 16(40%) non-relapses. The relapses had significantly higher mean total leukocyte count, serum urea, potassium and cholesterol than non-relapses. It was also observed that the median age of onset in relapses was significantly lower than non-relapses (p<0.001). Also, the median time to response to steroid therapy was longer in relapses than non-relapses (p<0.001). Children who relapsed had infections at the time of relapse.
Conclusion: Thus, onset of disease in younger age group, late response to steroid therapy and presence of infections were found to be associated with relapses in these children.
Bacteriological Profile of Neonatal Sepsis and Antibiogram of the Isolates Authors
(Nepal Paediatric Society (JNPS), 2017) Parajuli, Roshan; Pant, Narayan Dutt; Bhandari, Raju; Giri, Anil; Rai, Suman; Acharya, Ganesh Prasad; Shah, Pradeep Kumar
Abstract:
Introduction: Neonatal sepsis is a serious problem in developing countries like Nepal. The main objectives of this study were to determine the bacteriological profile of neonatal sepsis, to determine the antimicrobial susceptibility patterns of the causative agents and to evaluate the association between the neonatal sepsis and the different characteristics of the neonates.
Methods: A hospital based cross-sectional study was conducted among a total of 450 neonates suspected of suffering from sepsis. Blood culture was performed using statdard microbiological techniques. The colonies grown were identified on the basis of colony morphology, Gram’s stain and biochemical tests. The antimicrobial susceptiblility testing was performed by Kirby Bauer disc diffusion method.
Results: Out of total 450 blood samples, 92 (20.4%) were culture positive. Of which, 16 (17.4%) samples contained gram negative bacteria and 76 (82.6%) samples contained gram positive cocci. The most common bacterial pathogens isolated were Staphylococcus epidermidis (67.4%) followed by Escherichia coli (13%). All gram positive cocci were susceptible to vancomycin, while all gram negative bacilli were sensitive to amikacin. There was statistically significant relationship between neonatal sepsis and gestation age of neonates.
Conclusions: Neonatal sepsis is still present as a serious problem in Nepal. Staphylococcus epidermidis was the most common cause of the neonatal sepsis. Prematurely delivered neonates should be given more care, as they are more prone to suffering from neonatal sepsis. Vancomycin and amikacin can be used as the drugs of choice for preliminary treatment of neonatal sepsis in our settings.
Can the Weight Reduction Program Improve Obese Thai Adolescents’ Body Mass Index and Autonomous Motivation?
(Nepal Paediatric Society (JNPS), 2017) Kanlayanee, No-In; Tuicomepee, Arunya; Jiamjarasrangsi, Wiroj; Sithisarankul, Pornchai
Abstract:
Introduction: Overweight and obesity has impacted both the physiological and psychological health of children and adolescents. Evidence of cross-cultural studies has showed mixed results regarding weight reduction program (WRPs) based on self-determination theory (SDT) and social cognitive theory (SCT) affecting students with overweight and obesity. This study examined the effectiveness of a WRP on body mass index (BMI) and autonomous motivation in overweight and obese Thai adolescents.
Material and Methods: An experimental study with intervention and control groups was employed. Participants were 304 Thai obese 7th- to 12th-grade students, ranging in age from 12 to 19 years. The intervention group was assigned to a program based on SDT and SCT, consisting of (1) a 12-week weight control phase and (2) a 12-week follow-up phase. The control group was assigned to a general health education program. The data were collected via psychometric questionnaires and anthropometric data.
Results: There were no statistical differences in adjusted means of BMI and autonomous motivation of physical activity and dietary intake occurred among participants in the two groups. Compared to those in the control group, participants in the intervention group showed a 0.4 smaller increase in BMI and a 0.4 greater decrease in autonomous motivation of dietary intake.
Conclusion: The WRP based on SDT and SCT showed no apparent effectiveness in improving BMI or autonomous motivation among these participants. Future studies should incorporate program that effectively harmonize with core school teaching activities and schedules.
Clinical Features, Laboratory Findings and Complications of Scrub Typhus in South Indian Children
(Nepal Paediatric Society (JNPS), 2017) Gopalakrisna, Manjunath Vaddambal; Suryaprakash, Hedda; Kumar, G. Shankarappa Vijay; Kumar, Kalenahalli Jagadish; Murthy, Doreswamy Srinivasa
Abstract:
Introduction: Scrub typhus clinical features are non-specific and resemble other tropical infections like malaria, dengue and typhoid fever. Therefore appropriate gold standard laboratory tests are necessary to confirm the diagnosis of scrub typhus. Aim of this study was to determine the incidence, clinical features, laboratory data and complications of scrub typhus in South Indian Children.
Materials and Methods: Children with fever of more than seven days who were tested negative for common tropical infections were subjected to IgM-IFA for scrub typhus.
Results: Out of 857 children, 74 were eligible for IFA test. Out of these, 27(3.1%) tested positive for scrub typhus. Clinical features included hepatomegaly (96.3%), generalized lymphadenopathy (81.5%), splenomegaly (81.5%), hypotension (59.3%), rash (14.8%), eschar (7.4%), thrombocytopenia (66.7%), elevation of SGOT (85.2%) and SGPT (81.5%). Complications include hepatitis (14.8%), pneumonia (14.8%), myocarditis (14.8%) meningoencephalitis (3.7%) and MODS (3.7%).
Conclusion: Scrub typhus should be considered in the differential diagnosis of a febrile child having hepatosplenomegaly, lymphadenopathy, liver dysfunction and thrombocytopenia.
Effect of Helminth Infestationin Children Infected with Human Immunodeficiency Virus (HIV)
(Nepal Paediatric Society (JNPS), 2017) Orji, Maria-Lauretta Chito; Onyire, Nnamdi Benson; Ibe, Bede C.; Ibekwe, Roland
Abstract:
Introduction: Infection by human immunodeficiency virus results in immune destruction, while studies among the Ethiopian immigrants in Israel showed that chronic helminthiasis induces immune dysregulation. With destruction of CD4+ cell and consequently progression to AIDS, the host may be more susceptible to invading organisms such as helminths. This study was aimed at determining the effect of immune state on the prevalence and intensity of helminth infection in HIV infected children in two hospitals in Abakaliki.
Material and Methods: It was a cross sectional study that involved consecutive recruitment of 84 confirmed HIV infected children attending the ART clinic. Stool analysis for subjects was done, using the Kato-Katz technique. Blood sample for estimation of CD4 cell count was carried outusing flow cytometer from the HIV positive subjects.
Results: A total of 84 subjects were recruited during the study period, majority were males (58.3%). Male to female ratio was 1.4:1. The age range of participants was 2-17 years, while mean age of subjects infected with helminthiasis was 6.10± 3.34 year. A significant number of subjects in advanced and severe immunological stages had helminthiasis (χ2 =12.49, p=0.001). There was however no significant relationship between intensity of helminthiasis and immunologic stages of subjects.
Conclusion: The study suggests that immunodeficiency state may increase the susceptibility of helminth infection in HIV infected children. Hence children with HIV/AIDS may benefit from routine testing and/or de-worming of helminth infection.