Journal Issue: Volume: 37, No. 2 (2017)
Loading...
Volume
Number
Issue Date
2017
Journal Title
Journal ISSN
ISSN 1990-7974 eISSN 1990-7982
Journal Volume
Articles
Asphyxia as a Risk Factor for Neonatal Hypoglycemia
(Nepal Paediatric Society (JNPS), 2017) Mufidati, Luthfina; Anggraini, Alifah; Wibowo, Tunjung
Abstract:
Introduction: Hypoglycemia leads to brain developmental disturbances and abnormality on its function. Perinatal stress including asphyxia is a significant cause of neonatal hypoglycemia, thus, it is important to prevent it by controlling its relevant confounding variables. The aims of this study were to identify the risk factors of neonatal hypoglycemia and its related variables, focusing on the role of asphyxia in neonatal hypoglycemia.
Material and Methods: We conducted a nested case control study using a cohort data from South East Asia Regional Neonatal-Perinatal Database year 2013 of the Maternal and Perinatal Unit, Dr. Sardjito General Hospital Yogyakarta. We randomly selected neonatal hypoglycemia as a case and neonatal without hypoglycemia as a control group. We identify the risk factors from the cohort data. Logistic regression analyses were performed to investigate the association between hypoglycemia and risk factors.
Results: A total of 1563 newborns were recruited in this study. Five hundred and twenty newborns were excluded due to incomplete data and major congenital anomalies. By simple randomization sampling, we selected 52 newborns in cases group and 104 newborns in control group. In multivariate models, being asphyxia, low birth weight (LBW), large for gestational age (LGA), and early onset of neonatal sepsis showed significant effects on risk of hypoglycemia, OR= 2.8 (95% CI: 1.01 – 7.80), OR 7.1 (95% CI 1.54-32.37), OR 37.2 (95% CI 6.28-219.85), and OR 40.6 (95% CI 10.84-152.01), respectively.
Conclusion: Asphyxia, LBW, LGA and early onset neonatal sepsis were significant risk factor for neonatal hypoglycemia.
Childhood Poisoning, A Rising Epidemic in Developing Nations: Large Single Centre Study
(Nepal Paediatric Society (JNPS), 2017) Mishra, Shubhankar; Ramkumar, T.V.; Biswas, Ashok Kumar; Panigrahi, Sambedana
Abstract:
Introduction: Poisoning is a major problem in children. The aims of this study were to determine the pattern of poisoning in children along with seasonal incidence, duration of treatment and outcome in referral centre of eastern India.
Materials and Methods: All the children admitted to paediatric ward of MKCG Medical college and hospital from 1st April 2015 to 31st March 2016 (1 year) with history or suspicion of poisoning and animal bites were included in the study. Brought dead patients and the children with side effects due to ingested drugs in prescribed amount were excluded from the study.
Results: Total 530 cases were documented with highest incidence in rainy season. 1-6 years children were mostly vulnerable (42.6%). Accidental mode was the major cause in small children and suicidal, in older. Animal bites and stings (n=241) were the commonest followed by chemical poisonings. Kraits were commonest culprit in snake envenomation group. Alprazolam was most common drug causing drug overdose. Total numbers of death were 27. Major cause of death was organo- phosphorus poisoning (OP) and snakebite. Mean days of hospitalization was 2.5 days and death after hospitalization was 1.8 days.
Conclusion: Most of the childhood poisonings were due to accidental cause. Animal bites were mostly due to snakes. Maximum numbers of deaths were due to OP poisoning. Watchful observation, clean and clear environment, understanding the problems of adolescence, friendly atmosphere in home can prevent most of the poisonings and animal bites in children.
Children with Cerebral Palsy and their Quality Of Life in Nepal
(Nepal Paediatric Society (JNPS), 2017) Shrestha, Niti; Paudel, Sabitra; Thapa, Ritesh
Abstract:
Introduction: Cerebral Palsy (CP) may affect individual’s everyday life and it may have significant impact on quality of life (QOL). The objective of this study was to assess the quality of life of children with Cerebral Palsy in Nepal.
Material and Methods: This is a descriptive cross sectional study that involved 42 children between 4 and 12 years of age. The Socio-demographic variables were obtained from interviews and CP related factors were obtained from medical reports. Validated CP-QOL child self-report and parent proxy version of questionnaire was used for data collection. Severity was assessed using Gross Motor Function Classification System (GMFCS), Manual Ability Classification System (MACS), Communication function Classification System (CFCS) and ICD-10 Classification System. Data were summarized using descriptive statistics. Kruskal Wallis and Man Whitney was used to find out association between Cerebral Palsy related factors and Quality of Life.
Results: 57.1% (n=24) were between 8 and12 years of age and 42.9% (n=18) were between 4 and 8 years of age. Overall QOL was reported to be fairly good. Both the child and Caregiver gave highest score on “Social wellbeing and acceptance” and “Emotional wellbeing and self-esteem domain” and Lowest Point in “Pain and Impact of disability”. This implies that Psychosocial Quality of Life is good in children with CP. Quality of Life as reported by child was better than Quality of Life reported by Caregiver.
Conclusion: Overall QOL is fairly good in children with CP. However, Pain and impact of disability impairs QOL.
Effectiveness of Antipyretic with Tepid Sponging Versus Antipyretic Alone in Febrile Children: A Randomized Controlled Trial
(Nepal Paediatric Society (JNPS), 2017) Basavaraj, Chetak Kadbasal; Pocha, Shyamala Gowri; Dhati, Ravi Mandyam
Abstract:
Introduction: Fever is the most common presenting complain for which children are brought to the paediatrician.Physical methods are widely used in treating febrile children, tepid sponging being commonly practiced in hospitals along with antipyretics. The objectives of this study were to compare the effectiveness of tepid sponging and antipyretic drug versus antipyretic drug alone in febrile children.
Material and Methods: This was a Randomized controlled trial done in JSS Medical College and Hospital. All children under the age of 6 months to 12 years, admitted with axillary temperature of >99oF were included in the study. A total of 500 children were included over two years study period. Children with recorded axillary temperature of >990F were randomized into control and study group by computer generated randomisation. Children in the control group received only paracetamol (15mg/kg) at 5 minutes and combined group received paracetamol and tepid sponging at five minutes. Axillary temperature was monitored every 15 minutes for a period of 2 hours in both the groups.
Results: There is no significant difference in reduction of temperature between the two groups by the end of two hours. Children in combined group had a higher level of discomfort than those in only antipyretic group.
Conclusion: Tepid sponging does not add to the efficacy of paracetamol in antipyresis and that addition of tepid sponging to antipyretic, results in additional discomfort for the child. This study, therefore, endorses the view that antipyretic alone without tepid sponging should be the modality of therapy in children with fever.
Endoscopic Profile of Children with Colorectal Polyps Attending a Tertiary Centre
(Nepal Paediatric Society (JNPS), 2017) Upadhyay, Satyam; Sharma, Anna; Sapkota, Prabita
Abstract:
Introduction: Polyps are the most common causes of colorectal bleeding in children. This report describes an endoscopic profile of children with colorectal polyps at Nepal Medical College and Teaching Hospital.
Materials and Methods: This prospective study was conducted in children who were evaluated for painless lower GI bleed who underwent colonoscopyin Nepal Medical College, Kathmandu, Nepal from November 2014 to May 2017. Patients with age of presentation less than or equal to 18 years and diagnosed endoscopically to have colorectal polyp were included in the study and were followed up till histopathological reports.
Results:A total of 35children with colorectal polyps were identified. Twenty-three (65.7%) patients were males and 12 (35.3%) were females, male/ female ratio being 2.1: 1. The mean age of the patients at the time of diagnosis was 5.2 years (±3.7 years), (range 1.3-13.5) years. The duration of bleeding varied from 1 week to 3 years (mean 13 months), and 23 (67.6%) children were symptomatic for more than 12 months. All patients (100%) had painless rectal bleed, eight (23.5%) presented with anaemia and two of them requiring blood transfusion before the procedure (< 7.0 gm/dl),seven (20.5%) patients had blood and mucus in stools, six (17.6%) of them had rectal mass (prolapsed polyp).
Conclusion:Juvenile colorectal polyps are the most common cause of painless rectal bleeding in young children. In the majority, these are solitary, occur in the rectosigmoid. Delay in treatment may cause anaemia.Colonoscopic snare polypectomy is a safe therapeutic modality.