Journal Issue: Volume: 33, No. 3 (2013)
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2013
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ISSN 1990-7974 eISSN 1990-7982
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Articles
Prevalence and Causes of Anemia in Six to Sixty Months Old Children: A Cross-Sectional Study at Kathmandu Medical College and Teaching Hospital
(Nepal Paediatric Society (JNPS), 2013) Mathema, Smriti; Shrestha, Anup
Abstract:
Introduction: Anemia is one of the most common problems in children, especially in the developing countries. Nutritional anemia is associated with impaired performance of a range of mental and physical functions in children. This study was conducted to evaluate the prevalence and possible causes of anemia in children attending tertiary care center in Nepal.
Material and Methods: This was a prospective hospital based cross-sectional study done at Kathmandu Medical College and Teaching Hospital, Kathmandu, Nepal over a period of 10 months from March to December 2012. Children between the age group of 6 months to 60 months attending the Paediatric Out-Patient Department were randomly selected. The haemoglobin concentration was measured with an Automated Haematology Counter (Sysmex, Japan) following the manufacturer’s instructions. Anemia in children is defined as a hemoglobin level less than 11 gm/ dl.
Results: There were 500 children enrolled in the study, out of which 191 (38.2%) were found to be anemic. Mild anemia was observed in 31.2%, moderate in 6.6% and severe in 0.4%. The commonest age group affected was between 24 months to 35 months old children. Anemia was more common in female children (41.9%) compared to males (35.8%). 118 anemic children were further investigated for the cause of anemia and 103 (87.3%) had iron deficiency anemia.
Conclusion: This study reflects that prevalence of anemia still remains high and iron deficiency is the leading cause of nutritional anemia in children. Timely intervention can both prevent and treat childhood anemia.
Admission Hypothermia Among Neonates Presented to Neonatal Intensive Care Unit
(Nepal Paediatric Society (JNPS), 2013) Akter, Shaheen; Parvin, Rubiya; Yasmeen, B.H. Nazma
Abstract:
Introduction: In developing countries, thermal protection of the newborn is not properly addressed. Neonates presented to Neonatal intensive care unit (NICU) for admission with various problems are frequently found to be hypothermic. The objective of this study was to determine the incidence and associated risk factors for neonatal hypothermia on admission to NICU.
Materials and Methods: This was a prospective observational study carried over a period of three years at Enam Medical College and Hospital (EMCH) among the newborns admitted to NICU. Hypothermia has been defined as axillary temperature <36.5°C (<97.7° F). Temperature was measured at admission. Data were collected regarding perinatal and socio economic factors. Bivariate and multivariate analysis has been done to see the association of risk factors.
Result: A total of 2310 babies between 0 and 680 h of age (mean 43± 12 hours) were studied. Thirty four percent (785) of the neonates had hypothermia. Mean gestation was 34±3 weeks and 42.5% were inborn. Significant determinants of neonatal hypothermia at admission included factors like preterm (p=0.03), low birth weight (p=0.005), normal delivery (p=0.012), birth asphyxia (p=0.001) below average socioeconomic status (p=0.001) and long distance (>10 km) travelled by the neonate (p=0.03). Independent variables are resuscitation at birth [p=.001, Odds Ratio (OR), 2.43; Confidence Interval (CI), 1.47 to 4.00], (p=0.001), age less than 24 hours (p=.02; OR 2.25; CI, 1.13 to 4.47), low birth weight (p=0.03; OR,2.0; CI, 1.06 to 3.82), caesarean section(C/S) delivery (p=.006; OR 1.35; CI, 1.18-2.12) and below average economic status (p=0.001; OR, 2.76; CI, 1.56 to 5.90).
Conclusion: Incidence of admission hypothermia among neonates in our NICU was 34%. Independent risk factors are resuscitation at birth, very low birth weight, C/S delivery, age less than 24 hours and poor socio-economic condition. Proper thermal care should be provided for neonates both at home and hospitals.
Assessment of Mental Health Problems of School Children Aged 11-17 Years Using Self Report Strength and Difficulty Questionnaire (SDQ)
(Nepal Paediatric Society (JNPS), 2013) Rimal, Hem Sagar; Pokharel, Archana
Abstract:
Introduction: It is now recognized that psychological disorders, among children and adolescents have high prevalence rate. Currently, there is limited data on the prevalence of mental health problems among adolescents especially in the developing country like Nepal. The objective of this study was to investigate the prevalence of mental health issues among school children aged 11-17 years.
Materials and Methods: The self rated version of Strength and Difficulty Questionnaire (SDQ-YR1) were given to the students and answers were collected and the data was analyzed using SPSS version 16.1. The questions were in the Likert scale 0(not true), 1(somewhat true) and 2(certainly true). The data collected also included parent’s educational and occupational status.
Results: A total of 159 students participated in the study after receiving well informed consent from the parents. There were 96(60%) boys and 63 (40%) girls’ participants in the study. Among all the participants in this study 18.6% had a total-Strength and Difficulty Questionnaire (SDQ) score that can be classified as abnormal by published cutoffs. The emotional problems (24.5%) and peer relationship problem (22%) were the two common problems screened as an abnormal SDQ score. Girls were significantly more likely to have emotional problems than boys (p value <0.05) where as boys were significantly more likely to have Hyperactivity/inattention score in SDQ than girls (p value<0.05).Gender difference was also significant statistically as girls had higher abnormal total SDQ score than boys (p value < 0.05).
Conclusion: There is high prevalence of mental health issues in children but a study in large sample is recommended.
Clinical Profile and Outcome of Neonates Admitted to Neonatal Intensive Care Unit (NICU) at a Tertiary Care Centre in Eastern Nepal
(Nepal Paediatric Society (JNPS), 2013) Shah, Gauri Shankar; Yadav, Satish; Thapa, Anil; Shah, Lokraj
Abstract:
Introduction: Neonatal period is the most susceptible period of life due to different causes, which in most cases are preventable. Every year millions of neonates are born and a large proportion of them are admitted to the neonatal intensive care unit (NICU) for various indications. One of the Millennium Development Goals is to reduce under five mortality by two thirds by 2015. Therefore, this study was conducted to identify the clinical profile, pattern of diseases and common causes of mortality and morbidity in neonates admitted to NICU.
Materials and Methods: A retrospective study was conducted at level III Neonatal NICU of a tertiary -care teaching hospital from January, 2012 to December, 2012.
Results: Total of 361 neonates were admitted in NICU. Eighty six neonates (23.8%) were admitted due to prematurity and 73 (20.2%) with birth asphyxia. Among birth asphyxia, 40(54.8%)were in HIE III, 27.4% and 17.8% in HIE II and HIE I, respectively. One hundred eighteen (32.6%) cases were diagnosed as sepsis. The overall mortality was 20.2% during hospital stay.
Conclusions: Sepsis, prematurity and birth asphyxia were major causes for admission in NICU. All these etiologies are preventable up to some extent and, if detected earlier, can be effectively treated in order to reduce morbidity and mortality.