Journal Issue: Volume: 28, No. 1 (2008)
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Volume
Number
Issue Date
2008
Journal Title
Journal ISSN
ISSN 1990-7974 eISSN 1990-7982
Journal Volume
Articles
Childhood Immunizations in Nepal: Present Situation and Future Directions Authors
(Nepal Paediatric Society (JNPS), 2008) Adhikari, N
NA
Breastfeeding: Within One Hour of Birth Can Save One Million Babies
(Nepal Paediatric Society (JNPS), 2008) Shrestha, PS
NA
Meconium Stained Amniotic Fluid – A Potential Predictor Of Meconium Aspiration Syndrome
(Nepal Paediatric Society (JNPS), 2008) Swain, P; Thapalial, A
Abstract:
Objective: To identify potential predictors of Meconium Aspiration Syndrome (MAS) in pregnancies complicated by meconium-stained amniotic fluid (MSAF) & to review the incidence, morbidity and mortality of Meconium Aspiration Syndrome (MAS).
Methods: In the period of 2003 to 2006,175 pregnancies with thick meconium-stained AF were delivered; of these, 15 neonates developed MAS and 160 did not. The two groups were compared retrospectively according to maternal findings, pregnancy outcome, and neonatal complications, using univariate analysis (P < 0.05 considered significant) and stepwise multiple logistic regression analysis to identify independent significant factors for prediction of MAS.
Results: Incidence of MSAF was 13.97% and that of MAS was 8.57%. All deliveries associated with thick MSAF had developed MAS. 40% mothers were associated with PROM & prolonged labour. Most common & significant risk factors associated with MAS were increased gestational age, increased cesarean section (LSCS) & low Apgar scores at 1 minute and 5 minute. Mortality rate was 6.66% & mechanical ventilation was used in only 1(6.66%) case.
Conclusion: MAS are associated with higher incidence of LSCS, lower 1 minute & 5 minute Apgar score & higher gestational weeks. 40% mothers were associated with PROM & prolonged labour. The neonatal morbidity & mortality is significantly more frequent in relation to thick meconium stained amniotic fluid. Specific delivery room resuscitation procedure, early diagnosis & proper management can prevent development of MAS as well as morbidity & mortality.
Clinico- Biochemical Profile of Neonatal Seizure
(Nepal Paediatric Society (JNPS), 2008) Shah, GS; Singh, MK; Budhathoki, S; Kalakheti, BK; Baral, DD
Abstract:
Objectives: The present study was undertaken to study the incidence, etiological factor, and days of onset, clinical types and biochemical abnormalities in babies having neonatal seizures.
Materials and Methods: This is a retrospective, observational hospital based study. Ninety neonates, who developed seizures before 28 days of life and admitted to neonatal intensive care unit and nursery with neonatal seizure, were evaluated for incidence, etiological factor, clinical types and biochemical abnormalities found in neonatal seizure. The variables were analysed using Chi- Square and student t- test.
Results: The incidence of neonatal seizure was 10.3/ 1000 live births. The seizures were common in male babies. 65 (72.2%) neonates were born to multiparous women while 35 (38%) were born to primigravidas. In birth asphyxia (n= 40), the most common type of seizure observed was subtle seizure 20 (50%), followed by focal clonic 10 (25%) and multifocal clonic 5 (12.5%). Tonic type of seizure was observed in 3 (7.5%) and myoclonic in 2 (5%). Meningitis and septicaemia was the second most common cause of neonatal seizure observed in our study. Among metabolic abnormalities hypoglycaemia was found in 20 (22%) and hypocalcaemia in 10 (11%).
Conclusion: The commonest cause of seizure was birth asphyxia presenting within 72 hours of life. Among infection septicaemia and meningitis was the most common cause leading to neonatal seizure. Among biochemical abnormalities the most common cause of seizure observed in our study was hypoglycaemia and hypocalcaemia. Subtle seizures were the commonest type of seizure observed in this study.
Clinico-Radiological Spectrum of Neuronal Migrational Disorders: A Study of Paediatric Patients in the Western Region of Nepal
(Nepal Paediatric Society (JNPS), 2008) Swain, PK; Dhaliwal, MS; Thapalial, A; Tiwari,PK
Abstract:
Objective: This study was conducted in a tertiary care paediatric hospital to ascertain the spectrum of clinical and radiological features of Neuronal Migrational Disorders in children. The role of inheritance in Neuronal Migrational Disorders is under intense investigation. Studies on Neuronal Migrational Disorders (NMDs) in children from developing countries are lacking.
Method: Retrospective analysis of records of diagnosed cases by neuroimaging as Neuronal Migrational Disorders in the Department of Paediatrics.
Results: Eighteen Children (2days to 8years age) with different types of neuronal migrational disorder based on neuro-imaging were included. Observed anomalies included Lissencephaly (33.3%), Pachygyria (16.6%), Polymicrogyria (5.5%), Heterotopia (11.1%), Schizencephaly (22.2%) and Hemimegalencephaly (5.5%). Focal Seizure in 5 (27.7%) cases, Generalised Tonic Clonic Seizures in 3 (16.6%) and Myoclonic Seizure in 2 (11.1%) cases were the types of seizure present in 10 (55.5%) patients. Five patients presented with Quadriparesis, two with Hemiplegia and one with Congenital Talipes Equinovarus. All the eighteen patients had some degree of Cognitive Developmental Delay.
Conclusion: Lissencephaly is the most common type of Neuronal Migrational Disorder followed by Schizencepahly. Focal Seizure and Quadriparesis were the common manifestations. Family history of similar cases with parental consanguinity in Schizencephaly cases gives a clue to the autosomal recessive mode of inheritance. Family history of similar cases of Schizencephaly without any history of consanguinity indicates an autosomal pattern of inheritance.