Journal Issue: Volume: 36, No. 2 (2016)
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2016
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ISSN 1990-7974 eISSN 1990-7982
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Articles
A Study on Clinico-Epidemiological Profile of Poisoning in Children in a Rural Tertiary Care Hospital
(Nepal Paediatric Society (JNPS), 2016) Sil, Archan; Ghosh, Tarak Nath; Bhattacharya, Sudipta; Konar, Mithun Chandra; Soren, Baisakhi; Nayek, Kaustav
Abstract:
Introduction: Poisoning is an important cause of morbidity and mortality in paediatric age group. Objective of this study was to determine the pattern of poisoning in paediatric age group in respect to epidemiological characteristics, aetiology, clinical features and mortality in a major part of South Bengal.
Material and Methods: This was a retrospective, observational study conducted in the paediatric medicine ward and paediatric intensive care unit (PICU) of Burdwan Medical College from January, 2015 to December, 2015.All children in the age group of less than or equal to 12 years who visited the paediatric emergency with history of exposure to toxic substances were included in the study. Poisoning due to insect or animal bite was excluded from the study. Data was obtained from hospital records and the admission register of paediatric emergency, entered in the Microsoft excel sheet and analysed by using statistical software SPSS version 17.
Results: During the study period, 393 patients with poisoning were reported, which was 1.9% of all pediatric admissions. Majority were in the 1-3 year age group (59.6%). Volatile hydrocarbons accounted for the highest proportion of poisonings (153 cases, 38.9%).. GI system involvement (36.5 %) was most common. The total mortality of poisoning patients was 8.
Conclusion: Number of children, presenting with poisoning was higher in our study in comparison to other studies. Volatile hydrocarbons were common source of poisoning in our study. More epidemiological studies are required to identify socio-demographic risk factors of poisoning.
Behavioral Responses to Multisensory Stimulation in Preterm Infants
(Nepal Paediatric Society (JNPS), 2016) Kanagasabai, Parimala S.; Mohan, Divya; Lewis, Leslie E; Rao, Bhamini K.
Abstract:
Background: Behavioral responses of preterm infant to sensory stimulation in the Neonatal Intensive Care Unit (NICU) are important to understand. This would enable NICU professionals to be cautious of overloading stimulations and ensure stability in preterm infants. The aim of this study was to describe the range of behavioral responses associated with multisensory (auditory, visual, tactile and vestibular) stimulation in preterm infants.
Material and Methods: We recruited twenty-five preterm infants born at 28 to 36 weeks and birth weight of 1000 to 2000 grams for the study using convenience sampling. In the NICU, preterm infants from 32 weeks gestational age received multisensory stimulation session for duration of 12 minutes per day until discharge along with routine NICU care. During the stimulation, the behavioral responses of the preterm infants were observed and documented.
Results: Limb activity and yawning were the most frequently observed behaviors. Sixty-five percent of the behavioral responses were observed during tactile stimulation. The frequency of observed behavioral responses decreased with successive stimulation sessions, which could indicate habituation responses in preterm infants to multisensory stimulation.
Conclusions: Preterm infants showed behavioral responses indicating improved alertness and ability to integrate sensory stimulus. However, interpretation of preterm behaviors is a challenge because these behavioral responses could also indicate stress in preterm infants when coupled with other physiological and behavioral cues. Further studies are required to provide a detailed evidence for better clarity of infant’s responses to environmental stimuli.
Birth Order, Father's Occupation and Family Size are Strongly Associated with Thinness Among Bengalee Adolescent Girls of Darjeeling District, West Bengal (India)
(Nepal Paediatric Society (JNPS), 2016) Debnath, Mampi; Tigga, Pushpa Lata; Mondal, Nitish; Sen, Jaydip
Abstract:
Introduction: Undernutrition is a major issue in the developing countries such as India. The country has the largest adolescent population in the world and one of the primary focuses of nutritional assessment among them is undernutrition. The present cross-sectional study tries to determine the prevalence of thinness among adolescent girls of Darjeeling district using thinness (BMI-for-age) and to ascertain the effects of different socio-economic and demographic variables on the same.
Material and methods: The study was carried out among 387 school-going adolescent girls aged 9-14 years belonging to the Bengalee Hindu caste populations (BHCP). The prevalence of thinness was assessed using recently proposed international BMI-for-age cut-offs of Cole et al.
Results: The prevalence of overall thinness was 23.77%. The distribution of mild (Grade I), moderate (Grade II), and severe (Grade III) thinness were 17.31%, 4.39% and 2.07%, respectively. The results of the binary logistic regression analysis showed that birth order, family size and father’s occupation were significantly associated with overall prevalence of thinness (p<0.05).
Conclusion: The proper dissemination of awareness related to nutritional requirement, food habit, and appropriate dietary habit would be helpful to reduce the prevalence of thinness.
Clinical Utility of Serum Neutrophil Gelatinase Associated Lipocalin(NGAL) as an Early Marker of Acute Kidney Injury in Asphyxiated Neonates
(Nepal Paediatric Society (JNPS), 2016) Chandrashekar, Chenna; Venkatkrishnan, Akila
Abstract:
Introduction: Acute Kidney Injury (AKI) is a common devastating problem in the NICU. Since the kidney is the second most affected organ in asphyxiated neonates (after the brain), a marker to determine kidney injury becomes important. Serum Neutrophil Gelatinase Associated Lipocalin (NGAL) determines acute kidney injury even before Blood Urea Nitrogen (BUN) or serum creatinine values rise. The aim of this study was to determine the clinical utility of NGAL as an early marker of acute kidney injury in asphyxiated neonates.
Materials and Methods: This was a cohort study performed at a Level III NICU at JSS Hospital, Mysore, Karnataka, India over a period of two years. The study was conducted on30 term asphyxiated neonates and 30 term control neonates. Serum NGAL was measured within 6 hours after birth in an asphyxiated neonate using fluorescence immunoassay.
Results: A highly significant increase in serum NGAL in cases group with a median of 323ng/ml as compared to control group with median of 64ng/ml was observed. Of the 30 asphyxiated neonates, 23 were positive for NGAL, and of these 3 had AKI.A cutoff value of 155 ng/ml for Serum NGAL could detect AKI in asphyxiated neonates with a sensitivity of 75% and a specificity of 23%.
Conclusion: NGAL is raised in Asphyxiated neonates both with and without kidney injury. Therefore, it is not a specific marker for acute kidney injury in asphyxiated neonates.
Clinico-aetiological Profile of Congenital Hypothyroidism
(Nepal Paediatric Society (JNPS), 2016) Karki, Subhana Thapa; Rai, Ganesh Kumar; Karki, Buddha Bdr; Gurung, Roshma
Abstract:
Introduction: Thyroid hormone is critical for normal brain development in the early postnatal months. Biochemical diagnosis must be made soon after birth and effective treatment must be initiated promptly to prevent irreversible brain damage. Early diagnosis and adequate treatment from the first weeks of life result in normal linear growth and development. This study was conducted to find out the clinical features suggestive of congenital hypothyroidism and also its causation.
Materials and Methods: This was a hospital based retrospective study of 40 congenital hypothyroid children conducted at endocrine unit of Kanti Children’s hospital from 2067 to 2072. All congenital hypothyroid children were reviewed in detail and frequency of signs/symptoms was calculated and also the possible causes were established using ultrasonography and scintigraphy.
Results: Out of 40 congenital hypothyroid children 55% were male and 45% were female with M: F ratio of 1.23:1.Common age of presentation of congenital hypothyroidism was 6 to 12 months. The most frequent symptoms were decreased activity/ lethargy (78.9%) followed by stunted height (68.4%) and hypotonia (65.8%).Technetium thyroid scan was performed in 19 cases among which thyroid agenesis was the most common cause of congenital hypothyroidism (42.1%) followed by dyshormonogenesis (31.6%) and ectopic thyroid (26.3%).
Conclusion: Early diagnosis of congenital hypothyroidism is possible in some children based on clinical features followed by biomedical investigation soon after birth.