Journal Issue: Volume: 43, No. 2 (2023)
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2023
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ISSN 1990-7974 eISSN 1990-7982
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Articles
Levosalbutamol via Metered-Dose Inhaler with Spacer Versus Nebulizer for Acute Exacerbation of Bronchial Asthma in Children – A Randomized Controlled Trial
(Nepal Paediatric Society (JNPS), 2023) Perumal, Arunprasath; Balagurunathan, Muruganantham; Arumugam, Jayavardhana
Abstract:
Introduction: Acute paediatric asthma can pose an emergency challenge requiring medical preparedness. Hence, it is prudent to identify the best drug delivery option for managing acute asthma exacerbations. The objective of the study was to compare the effectiveness of metered dose inhaler with spacer (MDI-S) versus nebulizer (NEB) in delivering levosalbutamol for acute exacerbation of asthma in children.
Methods: This randomized clinical trial enrolled 58 children aged five to 15 years with mild-moderate asthma and randomly divided them into two treatment groups – Group MDI-S (N = 29) and Group NEB (N = 29). Pulmonary Index Score (PIS) along with signs and symptoms of asthma were compared between the groups before and one hour after levosalbutamol treatment. Chi square test was used to compare continuous variables and the level of significancewas set at P < 0.05.
Results: The two groups showed no significant differences in median age, age of wheezing onset, prior hospitalizations, and PIS before treatment (p > 0.05). Even one hour after treatment, they did not differ significantly in PIS and hospital admissions (P > 0.05). All children showed improvement in their asthmatic status after the therapy and none showed any worsening of their condition.
Conclusions: Metered dose inhaler with spacer is an effective and efficient alternate to the routinely used nebulizer for managing acute asthmatic episodes in children.
Efficacy of Nasal Continuous Positive Airway Pressure Delivered by Nasal mask Versus Nasal Prongs in Neonates
(Nepal Paediatric Society (JNPS), 2023) Kulkarni, Suhas P.; Jaiswal, Jai Prakash
Abstract:
Introduction: Nasal continuous positive airway pressure (CPAP) is the standard therapy for neonatal respiratory distress. It is delivered using nasal mask (NM) or nasal prong (NP), both of which can result in nasal trauma. The type of nasal interface used is an important determinant of nasal injury. The superiority of one over the other is debatable necessitating further research to identify the more efficacious, safe and convenient nasal continuous positive airway pressure (CPAP) interface. This study was conducted to compare the efficacy of NM Nasal continuous positive airway pressure (CPAP) versus NP CPAP.
Methods: Sixty neonates < 37 weeks and having respiratory problems were alternately divided into two groups based on the respiratory support provided: Group A (NM CPAP) and Group B (NP CPAP). They were followed up on a daily basis during their NICU stay and placed on regular recall until three months of age. Between-group comparisons were done using Wilcoxon-Sign Rank Test and Proportion test. P-value ≤ 0.05 indicated statistical significance.
Results: Patients in Group A (NM CPAP) showed significantly less number of days of CPAP therapy (P = 0.0033) and lesser failure rate (P = 0.0198) compared to those in Group B (NP CPAP). Incidence of complications was also lower in Group A than in Group B.
Conclusion: NM CPAP is more efficacious and safer than NP CPAP for the treatment of respiratory problems in neonates.
An Assessment of the School Health Services Among Primary Schools in Ido/Osi LGA of Ekiti State, Nigeria
(Nepal Paediatric Society (JNPS), 2023) Adeyemi, Ebenezer Olatunji; Olatunya, Oladele Simeon; Ojulowo, Oluwakemi Blessing; Atoyebi, Olatunji Emmanuel; Bolaji, Olufunke Bosede; Adebami, Olusegun Joseph
Abstract:
Introduction: School Health Service (SHS) connotes the preventive and curative health services to pupils and other members of the school community. Its purpose is to help children achieve the maximum health possible for them to obtain full benefits from their education through early detection and treatment of diseases that could impinge their health and learning. This study aimed at ascertaining the state of the school health services in Ido / Osi Local Government Area (LGA), of Ekiti Sate, Nigeria.
Methods: Sixty-seven schools comprising 19 private and 48 public primary schools were surveyed. They were inspected for the availability of the components of the SHS and evaluated using the SHS evaluation scale. Data were analyzed using SPSS version 25.0.
Results: None of the schools had a doctor or a trained first aider. Only 4.5% of the schools had a nurse. First aid boxes were present in most of the schools with 65.7% (84.2% of private vs 58.3% of public) having essential materials and drugs in their first aid boxes. Children with communicable diseases were sent home by most of the schools (98.5%). 95.8% public schools benefitted from the Federal Government home grown school feeding programme which was lacking in the private schools. Only two private (10.5%) and one public (2.0%) schools attained the minimum acceptable score on SHS respectively.
Conclusions: The state of SHS in Ido / Osi is poor. Stakeholders must provide the needed money, materials and manpower to achieve an effective SHS in the area.
A Study of Blood Thiamine Levels in Infants with Pulmonary Hypertension
(Nepal Paediatric Society (JNPS), 2023) SN, Prashanth; Keshabhoina, Madhuri
Abstract:
Introduction: Pulmonary hypertension (PH) has been linked to significant morbidity and mortality for a long time in children. The causes of pulmonary hypertension have different mechanisms. Over the past few years there has been a rise in the incidence of acute pulmonary hypertension, more in the infant age group. Some studies have shown that this clinical presentation overlaps with that of infantile thiamine deficiency and that intravenous administration helps with rapid recovery. Through this study we wanted to correlate blood thiamine levels with pulmonary hypertension in infants.
Methods: This study was conducted among 30 infants admitted in JSS hospital, Mysuru over a period of 18 months. Among these, 15 were taken as cases with pulmonary hypertension, 15 as controls without pulmonary hypertension and thiamine status of all of them were estimated. Two milliliter of blood was sent in EDTA vacutainer for testing for thiamine pyrophosphate by LCMS method.
Results: The mean age of study population was 4.93 (+- 2.70) months, with male predominance of 80%. A significant correlation between thiamine levels and PH was found in this study, with a strong to moderate negative correlation by using Pearson correlation coefficient.
Conclusions: This study concludes that there is significant correlation between thiamine and pulmonary hypertension, and thiamine may be used as a variable in identification of acute pulmonary hypertension in infants.
Clinico-Etiological Profile of Children Suffering with Recurrent Abdominal Pain in a Tertiary Care Centre of Western Uttar Pradesh, India
(Nepal Paediatric Society (JNPS), 2023) Malik, Sunil; Prajapati, Ramneesh; Punj, Ajay
Abstract:
Introduction: Abdominal pain is one of the most encountered problems in paediatrics, which baffles the experienced paediatrician, disturbs the parents, and adversely affects the quality of life of a child. This study was planned to find the prevalence, clinical spectrum, and etiological profile of recurrent abdominal pain in western Uttar Pradesh, India.
Methods: An observational descriptive study was conducted from 0ctober 2019 to October 2020 at a tertiary care hospital. All children attending the Paediatric OPD between the age group of four to 16 years, suffering from recurrent abdominal pain were included in the study. Detailed history and examination of each patient were recorded on predesigned pretested performa.
Results: The prevalence of recurrent abdominal pain (RAP) was found 0.34%, and approximately 2/3rd of RAP cases were from the adolescent age group (11 - 16 years). A strong association between a non-vegetarian diet and junk food was found with RAP (P < 0.05). A significant correlation was found between school absenteeism and RAP (P = 0.0027). It was observed that approximately 61% of the cases experienced pain for an average of one to two episodes per week and one to three hours per episode. We observed that localization of pain in the majority of cases was diffuse 30 / 75 (40%), and 67% of the children were found to have an organic cause of RAP (P = 0.0041). IBS and functional dyspepsia were contributing major causes of non-organic RAP.
Conclusions: RAP has significant prevalence among children. Junk food and non-vegetarian diet was significantly associated with RAP. Major causes of non-organic RAP were IBS and functional dyspepsia. Dietary modification and personal hygiene may play a significant role as a preventive measure for RAP.