Journal Issue: Volume: 34 No. 2 (2014)
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Issue Date
2014
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ISSN 1990-7974 eISSN 1990-7982
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Articles
Blood Pressure Profile and Hypertension in Urban Adolescents: Need for Cognisance
(Nepal Paediatric Society (JNPS), 2014) Faujdar, Dharmajeet Singh; Kunte, Renuka; Bhalwar, Rajvir
Abstract:
Objective: To find the profile of blood pressure and the prevalence of hypertension in adolescents in an urban area.
Methods: A cross sectional study was carried out in Adolescent students in the age group of 11-17 years, in a school in an urban area of Pune, belonging to upper socioeconomic group to measure their blood pressure and anthropometric parameters.
Results: The mean SBP and DBP in both boys and girls were found to increase with increasing age and anthropometric measurements. The prevalence of hypertension was 12.23% in boys and 10.1% in girls and the prevalence of overweight as per BMI was 19.14% in boys and 18.62% in girls. The prevalence of hypertension observed in overweight children (36.1% in boys 30.8% in girls) was significantly (p<0.000) higher than normal weight children (6.5% in boys and 5.36% in girls). Among the anthropometric variables only weight & BMI had moderately strong correlation with SBP(r-0.559 &0.506).
Conclusion: Hypertension is prevalent among adolescent population and overweight/obesity has been found to play a crucial role in predicting rise in BP in them. It is recommended bp monitoring be made mandatory part of school health services programme for early detection & instituting preventive measures.
Breastfeeding Practices as Observed in Those Attending a Teaching Hospital for Perinatal Care
(Nepal Paediatric Society (JNPS), 2014) Anyanwu, Onyinye Uchenna; Ezeonu, Thecla Chinonyelum; Ezeanosike, Obumneme Beniah; Okike, Clifford Onuora
Abstract:
Introduction: The promotion and support of breastfeeding is a global priority with benefits for maternal and infant health, especially in low-income and middle-income countries where the relevance for child survival is undisputed. Timely initiation of breastfeeding within one hour of birth, exclusive breastfeeding for six months with continued breastfeeding till 2years and beyond are important aspects of breast feeding for child survival. The objective of the study was to describe the practice and perception of breast feeding amongst mothers at the post natal wards of the Federal Teaching Hospital, Abakaliki.
Materials and Methods: This study was a questionnaire based cross sectional view of breastfeeding practices of mothers who received perinatal care at the Federal Teaching Hospital Abakaliki, Ebonyi, South Eastern Nigeria.
Results: 16.1% initiated breastfeeding within one hour, while others initiated later for reasons like poor lactation (19.6%); too tired (15.4%); felt dirty after delivery (5.3%) and caesarean section. Exclusive breastfeeding was not the intention of 30.8% for reasons like, too demanding(15.4%); cannot satisfy baby (38.6%); spouse and relations would not accept (26.5%); Work/School schedule would not permit (13.6%). Mode of delivery and socioeconomic class were significantly associated with time of initiation. Neither maternal age nor parity significantly influenced the overall practice of breastfeeding.
Conclusion: Few mothers practice correct breastfeeding in this tertiary health institution suggesting that more work to improve the knowledge and attitudes of mothers is required starting from the antenatal period.
Breastfeeding Practices in Kathmandu
(Nepal Paediatric Society (JNPS), 2014) Mathema, Smriti
Abstract:
Introduction: In spite of significant evidence on a number of important health benefits of breastfeeding, it has been seen that a vast number of infants in Nepal are not being breastfed appropriately based on standard recommendations. This study was conducted to evaluate the breastfeeding practices prevalent in Kathmandu.
Materials and Methods: This was across-sectional survey carried out over a period of 24 months from January 2011 to December 2012 on a convenient sample of children aged 6 months to 23 months when they were brought for treatment to Kathmandu Medical College and Teaching Hospital. Breastfeeding was defined according to the recent WHO guidelines and mothers were interviewed as per a structured questionnaire.
Results: There were 1250 children enrolled in the study, out of which almost all infants (99.7%, n=1246) received colostrum. Only 62.64% (n=783) babies received breast milk as their first food. Initiation of breastfeeding within one hour of delivery was done by 719 (57.5%) mothers. The median duration of exclusive breastfeeding was 3.8 months.
Conclusion: This study reflects that majority of infants in Kathmandu are still not fed in accordance with breastfeeding recommendations and guidelines. More attention should be given to a proper community-based program including subsequent monitoring of its implementation as exclusive breastfeeding has been proved to be one of the most effective ways to improve infant survival.
Clinical Profile of Acute Poisoning in Children at a Teaching Hospital in Lalitpur
(Nepal Paediatric Society (JNPS), 2014) Dhakal, Ajaya Kumar; Shrestha, D; Shakya, A; Shah, SC; Shakya, H
Abstract:
Introduction: Acute poisonings are one of the common cause of emergency visits and hospital admissions and is potentially preventable cause of childhood mortality and morbidity. The objectives of this study were to identify the common type of poisoning in children, to determine types of poisoning according to age and to find out the common age group in which the incidence of poisoning was high.
Materials and Methods: It was a descriptive observational study done in a teaching hospital in Lalitpur, Nepal in patients aged 1 month to 18 years who visited the emergency department and were admitted to hospital with history of alleged poisoning from 2009 July to 2014 January.
Results: Fifty patients were included. Drugs, kerosene and organophosphorus were most common cause of poisoning. Drugs and kerosene below 10 years of age and organophosphorus and drugs above 10 years of age were common types of poisoning. Maximum numbers (50%) of children with poisoning cases were below five year of age. Mean duration of hospital stay was 2.1days and mean age of poisoning was 7.8 years with a male(54%) predominance. Majority of poisoning occurred at home (84%) and 68% of patients were symptomatic at presentation to hospital with 84% of patients presenting to hospital within six hours.
Conclusion: This study showed that drugs, kerosene and organophosphorus were most common forms of poisoning. Young children were most vulnerable for acute poisoning.
Clinico-Epidemiological Study of Acute Flaccid Paralysis at a Tertiary Centre
(Nepal Paediatric Society (JNPS), 2014) Chaudhary, Shipra; Bhatta, Nisha Keshary; Khanal, Basudha; Bhandari, Rabin; Singh, Rupa Rajbhandari
Abstract:
Objectives: To study the clinico-epidemiological profile of different causes of Acute Flaccid Paralysis (AFP) including Acute Encephalitis Syndrome (AES) and their associated co-morbidities.
Methodology: A prospective hospital-based study was carried out including all cases fulfilling AFP case definition. History, clinical examination, necessary investigations were performed and required treatment given. Regular follow-ups were done and final classification made alongwith AFP surveillance team.
Results: Out of 43 children included in the study, 18 expired and 25 completed follow-up. Final classification showed 53.5% AES, 9.3% Guillain Barre Syndrome (GBS), 9.3% dyselectrolytemia, 9.3%, peripheral neuritis, 7% Non-Polio Entero Virus (NPEV) and 11.6% others. Fever, altered sensorium and convulsions were present in 79.1%, 65.1% and 58.1% respectively. Eighty-four percent had asymmetrical paralysis with quadriparesis in 72%. Cerebrospinal fluid was abnormal in 34.9%. Japanese encephalitis serology was positive in 4.7%. The mean GCS was 9.53±4.27 with a significant difference between survivors and non-survivors (p=0.02). Almost half (52.2%) required ICU care, of which 14 expired (p=0.005). Seventeen children needed mechanical ventilation, of which 13 died (p<0.001). Requirement of inotropes and complications like respiratory failure and autonomic failure were significantly related to death.
Conclusion: AES, being one of the commonest causes of AFP, should be included in AFP surveillance. Poor GCS, requirement of inotropes, complications like respiratory failure and autonomic failure are related with poor prognosis. This study also helped in national surveillance of AFP cases in the eastern region and the target to achieve polio eradication in our country.