Journal Issue: Volume: 39, No. 2 (2019)
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2019
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ISSN 1990-7974 eISSN 1990-7982
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Articles
Childhood Neurocysticersosis: A Rural Teaching Hospital Experience
(Nepal Paediatric Society (JNPS), 2019) Bhalla, Arjun Sakha; Maini, Baljeet; Gaur, Bablu Kumar
Abstract:
Introduction: Neurocysticercosis (NCC) is caused by the larval stage of Taenia Solium. Neurocysticercosis is the most common cause of acquired epilepsy in developing countries. In India NCC has been identified as a significant cause of seizures.
Methods: This prospective observational study was conducted on 150 children of NCC up to 18 years of age in a tertiary care hospital. The diagnosis was based on clinical and laboratory/ radiological evaluation of the patients. Socio-clinical, radiological and serological data of the patients were analysed.
Results: A total of 150 children were enrolled in this study. The commonest age group of the cases in this study was six to 10 years. Male to female ratio was 1.8:1. The largest percentage of cases belonged to upper lower class (56%) and lowest was 4% in upper class. Sixty percent subjects were non vegetarian. Seizures were the most common presentation (96%). Headache was present in 44% cases. Single lesion was commonest type of lesion on radiological examination with frontal cortex as most commonly involved area of brain. Stage II NCC was commonest type of lesion on MRI. EEG was abnormal in 38% cases. Serum ELISA for cysticercosis was positive in 10% cases. Number of lesions was not associated with age group, type of seizure or any particular area of brain.
Conclusion: Stage II NCC the commonest type of NCC. Single lesion NCC was more common than multiple lesions. All cases with atypical presentation and positive ELISA had multiple lesions. Frontal portion of cortex was most commonly involved.
Clinico-Demographic Profile of Febrile Seizure and Its Association With Iron Deficiency
(Nepal Paediatric Society (JNPS), 2019) Birua, Shyama; Sarkar, Suman; Bera, Aparajita; Khan, Kalimuddin
Abstract:
Introduction: Febrile seizure (FS) is recognised as the most frequent type of seizure in children (age six months to five years). This observational study was conducted in our hospital to assess any possible association of febrile convulsion with iron deficiency anaemia (IDA) and to see the incidence of iron deficiency in six months to five years old children.
Methods: Eighty eight Simple febrile seizure patients of age six months to five years fulfilled the inclusion criteria and were enrolled between April 2018–March 2019. A pre-designed proforma including detailed history, physical examinations, systemic examinations and relevant investigations were filled-up.
Results: Eighty eight subjects with FS were studied. Occurrence of IDA was 67.04% among them. Age was significantly associated with haemoglobin (Hb%) (p-value = 0.000), severity of anaemia (p-value = 0.000), mean corpuscular volume (MCV) (p-value = 0.000), mean corpuscular haemoglobin (MCH) (p-value = 0.000), mean corpuscular haemoglobin concentration (MCHC) (p-value = 0.000) and serum ferritin (p-value = 0.000). However, no significant association between Hb% and gender was found (p-value = 0.890).
Conclusions: Considering the clinico-demographic context of the present study and extent of anxiety and worries of parents of FS children, it is imperative to initiate FS prevention and control programme. Nearly two-third of study subjects had significant low serum ferritin indicating association of simple febrile seizure with IDA. However, prevalence of IDA as a risk factor for FS needs to be studied on adequate and representative sample so that iron supplementation could be started as an inbuilt strategy of simple febrile seizure management.
External Environment, Enabling Factors and Predisposing Characteristics of Fully Immunised Children in Nepal
(Nepal Paediatric Society (JNPS), 2019) Thapa, Kanchan; Suwal, Bhim Raj; Adhikary, Pratik
Abstract:
Introduction: Immunisation is a cost-effective public health intervention worldwide responsible for the reduction of infant and child morbidity and mortality. Full immunisation is a state of obtaining all vaccination according to the Immunisation schedule of Nepal.
Methods: The secondary data of Nepal was downloaded from the DHS Program. A total of 1709 children aged 16-23 months were analysed for descriptive statistics. All the analyses were weighted by its sampling weight. The full immunisation status indicates those who completed 1 dose of BCG, 3 doses of Polio, 3 doses of DPT and 1 dose of Measles. The independent variables are further subdivided into enabling, predisposing and external environmental factors.
Results: Over half of children (52.6%) were from Terai, nearly a quarter (23.0%) from province 2. More males (53.5%) and the majority of (86.1%) children with birth order one to three were immunised. Mother aged < 20 years (62%), working father (96.1%), working mother (59.7%), educated father (87.3%) and educated mother (70.7%) had children with complete immunisation. Non-smoker mother (94.6%) had fully immunised children. Nearly three quarters (73.5%) from a middle and rich family, those with PNC within 3 days (35.9%), delivered at a health facility (64.2%), and had PNC check from the skilled provider (12.1%) had completely immunised their children.
Conclusions: Significant differences based on external environment, enabling factors and predisposing factors for full immunisation status was observed. Specific interventions based on these factors are recommended.
Hypertension and its Determinants Among School Going Adolescents: A Cross Sectional Study in Nepal
(Nepal Paediatric Society (JNPS), 2019) Shakya, Sujata; Bajracharya, Shanti
Abstract:
Introduction: Hypertension is a chronic life threatening non- communicable disease. It increases the risk for cardiovascular diseases even leading to premature death. Almost half of the adults with hypertension had elevated blood pressure during childhood. With globalisation and lifestyle changes, adolescents are exposed to various risk factors. However, diagnosis in this population is difficult due to absence of symptoms. Thus, regular blood pressure screening is essential in these groups. This study aimed to find out the prevalence of hypertension and its determinants among the school going adolescents of Kathmandu, Nepal.
Methods: This was a descriptive cross sectional study which included five private secondary schools of Kathmandu, Nepal. The adolescent students studying in classes VIII, IX and X were the study subjects. Two stage cluster random sampling technique was used to select 356 participants. Data collection was done by doing anthropometric measurements, blood pressure measurement and through self administered questionnaire.
Results: The study depicted that the prevalence of elevated blood pressure was 12.4%, stage 1 hypertension 32.3% and stage 2 hypertension 9.8%. Similarly, 13.8% were overweight and 1.4% were obese. Bivariate analysis depicted significant association of prevalence of hypertension with gender, religion and obesity (p < 0.05). The multivariate analysis shows that the significant predictors of elevated blood pressure and/or hypertension were gender and obesity. Males were six times more likely to have elevated blood pressure (AOR = 6.058, CI = 2.571 - 14.274) and 2.8 times more likely to be hypertensive (AOR = 2.838, CI = 1.688 - 4.773) compared to females. Similarly, compared to obese/ overweight students, thin and normally built ones have less likelihood of having elevated blood pressure and hypertension.
Conclusions: Hypertension has been prevalent among adolescents, due to various behavioural risk factors. This is really challenging and of public health significance. Regular screening of adolescents is essential for early detection and management of hypertension.
Impact of Kangaroo Mother Care on Outcome of Very Low Birthweight Preterm Newborns in a Tertiary Hospital in Abakaliki, Nigeria Authors
(Nepal Paediatric Society (JNPS), 2019) Ezeanosike, Obumneme; Daniyan, Olapeju; Anyanwu, Onyinye Uchenna; Asiegbu, Uzoma; Ezeonu, Chinonyelum; Onwe-Ogah, Emeka; Onyire, Onyire
Abstract:
Introduction: KMC was developed for care of preterm and low birth weight babies due to shortage of staff and inadequate incubator care enabling early discharge from the hospital for close follow-up at home. It is essential in resource-limited countries where there is epileptic power supply. Therefore, strengthening the evidence for KMC becomes imperative in these resource-limited and adverse cultural regions.
Methods: The KMC register of the Newborn Special Care Baby Unit of a tertiary hospital was used to analyse records from January 2016 to February 2018. A total of 55 preterm babies enrolled into KMC were studied. The age and parity of the mother, sex, birth weight, admission and discharge temperatures and weights, duration of KMC per day was retrieved from the KMC register.
Results: The mothers’ ages ranged from 18 to 40 years (mean 28.6 ± 6.2 years) with 34% being inexperienced first-time mothers and 10% grand multipara. The birth weights of the babies ranged from 0.9 kg to 2.5 kg. Primiparous women were more likely to do KMC for longer durations. A linear regression model showed that the duration of KMC was related to parity. (R2 = 0.12, p = 0.02). On average there was significant weight gain on discharge with a paired t-test (t = 5.881, df = 44) comparing the discharge and commencement weights showing a mean difference of 0.123 kg (CI 0.081 kg, 0.165 kg, p < 0.001).
Conclusions: KMC impacts positively on all parameters of the extremely LBW and premature babies and the duration of KMC is positively associated with better outcome.