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Incidence and risk factors of hypoglycemia among neonates: A prospective study 新生儿低血糖的发生率和危险因素:一项前瞻性研究
Pub Date : 2021-07-01 DOI: 10.33545/26643685.2021.v4.i2a.149
Dr. Ashwin R Dangi, Dr. Jayant R Salvi
Background and Aim: it has been observed that low levels of the blood glucose do not cause health issues in the neonates. This is due to the fact that the neonates are adjusting to the life outside the uterus. Present study was carried out to study incidence and risk factors of hypoglycemia among neonates in semi urban areas. Material and Methods: This was a hospital based prospective study performed at the Department of Pediatrics, Nootan general hospital NMCRC Visnagar, India January 2021 to June 2021. 150 neonates were included. Ballards score was used to divide them into four groups of gestational age. Standard glucometer was used to measure blood glucose in mothers and neonates. For mothers, it was measured at time of delivery. For neonates, it was measured at zero, three, six, twelve and twenty four hours of birth. Standard treatment protocol was followed for neonatal hypoglycemia Results: As the mother blood glucose increased the babies blood glucose decreased with r=-0.18 but this correlation was not found to be statistically significant ( p> 0.05). The differences in the blood glucose levels at different time points at different gestational ages were not found to be statistically significant. As maternal blood glucose increased, neonatal glucose decreased. Important risk factors found for hypoglycemia in neonates were being born by lower segment cesarean section (LSCS), low for gestational age (LGA) babies and small for gestational age (SGA) babies, pre-term and post term babies. But these risk factors were not found to be statistically significant ( p> 0.05). Conclusion: Hypoglycemia is surprisingly common among neonates in developing countries There was a wide variation of blood glucose levels in newborns. Preterm and post-term babies, babies delivered by LSCS, LGA and SGA babies were more prone for hypoglycemia requiring blood glucose monitoring.
背景和目的:已经观察到低血糖不会引起新生儿的健康问题。这是由于新生儿正在适应子宫外的生活。本研究旨在探讨半城市地区新生儿低血糖的发生率及危险因素。材料和方法:这是一项基于医院的前瞻性研究,于2021年1月至2021年6月在印度Visnagar的Nootan综合医院儿科进行。纳入了150名新生儿。用巴拉德评分法将她们分为四组胎龄。使用标准血糖仪测量母亲和新生儿的血糖。对母亲来说,是在分娩时测量的。对于新生儿,在出生后0、3、6、12和24小时进行测量。结果:随着母亲血糖升高,婴儿血糖降低,r=-0.18,但相关性无统计学意义(p> 0.05)。不同胎龄、不同时间点的血糖水平差异无统计学意义。随着母亲血糖升高,新生儿血糖降低。新生儿低血糖的重要危险因素是低段剖宫产(LSCS)、低胎龄(LGA)婴儿和小胎龄(SGA)婴儿、早产儿和足月后婴儿。但这些危险因素差异无统计学意义(p> 0.05)。结论:低血糖症在发展中国家的新生儿中非常普遍,新生儿的血糖水平差异很大。早产儿和足月儿、LSCS、LGA和SGA生儿更容易发生低血糖,需要进行血糖监测。
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引用次数: 0
Assessment of serum ferritn level in detection of iron deficiency anaemia in paediatric patients: Prospective analysis 评估血清铁蛋白水平检测缺铁性贫血的儿科患者:前瞻性分析
Pub Date : 2021-07-01 DOI: 10.33545/26643685.2021.v4.i2a.148
Dr. Patel Riya Biponbhai, Dr. Pragya Khanna
Introduction: Major form in which iron is stored in the body is serum ferritin. It can detect early changes in body iron store. It causes little patient discomfort as compared to bone marrow iron studies. In this study, we used serum ferritin level to assess the level of iron storage in the children less than five years of age. Iron stores are depleted below this value. Materials & Methods: Sample size includes 100 children under the age of 5 years from the opd of the department. The blood was divided into two halves, one was sent for cbc evaluation and from other half the serum was separated through centrifugation for the estimation of serum ferritin level. Results: The range of the serum iron level in the study was 0.2 – 340 ng/ml. The mean serum iron level in the study was 51.8 ng/ml. Out of 100 patients, there were 76 patients with serum level less than 12 ng/ml; they were iron deficient. There were 20 children with iron deficiency in the infants group, there were 34 patients in toddlers group and there were 24 children in preschool group. Discussion & Conclusion: For the early detection of the status of the iron stores in the body is done by serum ferritin concentration. Iron deficiency anemia continues to be a significant public health problem in the world. Serum ferritin level is a good screening test for early detection of iron deficiency anemia in children less than 5 years of age. When it is used in assess with other test for iron status in body, it is considered as more specific indicator for the detection of the iron stores.
铁在体内储存的主要形式是血清铁蛋白。它可以检测体内铁含量的早期变化。与骨髓铁研究相比,它几乎不会引起患者不适。在这项研究中,我们使用血清铁蛋白水平来评估5岁以下儿童的铁储存水平。铁储量低于这个值就会耗尽。材料与方法:样本量为本科门诊5岁以下儿童100例。血液被分成两半,一部分送去做cbc评估,另一部分通过离心分离血清用于估计血清铁蛋白水平。结果:本研究血清铁水平范围为0.2 ~ 340 ng/ml。研究中平均血清铁水平为51.8 ng/ml。100例患者中,76例患者血清水平低于12 ng/ml;他们缺铁。婴儿组缺铁20例,幼儿组缺铁34例,学龄前缺铁24例。讨论与结论:通过测定血清铁蛋白浓度可早期检测机体铁储备状态。缺铁性贫血仍然是世界上一个重大的公共卫生问题。血清铁蛋白水平是早期发现5岁以下儿童缺铁性贫血的良好筛查试验。当它与其他铁在体内状态的检测一起评估时,被认为是检测铁储量的更具体的指标。
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引用次数: 0
Clinico-epidemiological profile of children with of asymptomatic phase of renal disease 儿童肾脏疾病无症状期临床流行病学分析
Pub Date : 2021-01-01 DOI: 10.33545/26643685.2021.v4.i1c.141
Khizerulla Sharief, Venkatesh Ks, M. VeeralokanadhaReddy, B. Kiran
Pyuria is defined as more than 5WBCs/mm 3 of urine and if this definition is taken into consideration it correlates in 90% cases of UTI. However, pyuria may be masked in significant infections due to Proteus, Klebsiella and Pseudomonas due to disintegration of White Blood Cells caused by alkaline condition produced by these urease positive organisms. Children were subjected to physical examination, blood pressure recording and urine was collected and further analyzed. All children were advised to collect mid stream clean catch urine sample under strict aseptic precautions. The collected urine samples were tested for protein, blood and bacteria by dipstick method and microscopy rapid screening test like griess nitrate test was done. 95% of the children had no RBCs in urine. 2.8% showed 1-5 RBCs/ HPF. Significant hematuria (> 5 RBCs/ HPF) was seen in 2.2% of children.
脓尿被定义为超过5wbc / mm3的尿液,如果考虑到这一定义,它与90%的尿路感染病例相关。然而,脓尿可能在由变形杆菌、克雷伯氏菌和假单胞菌引起的严重感染中被掩盖,因为这些脲酶阳性生物产生的碱性条件导致白细胞解体。对患儿进行体格检查,记录血压,收集尿液并进一步分析。建议所有儿童在严格的无菌预防措施下收集中游干净的捕获尿液样本。采集的尿样采用试纸法检测蛋白质、血液和细菌,并进行镜下快速筛选试验如硝态氮试验。95%的儿童尿液中没有红细胞。2.8%为1-5个红细胞/ HPF。2.2%的儿童出现明显血尿(> 5红细胞/ HPF)。
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引用次数: 0
Prevalence of asymptomatic phase of renal disease in slum school children 贫民窟学龄儿童肾脏疾病无症状期的患病率
Pub Date : 2021-01-01 DOI: 10.33545/26643685.2021.v4.i1c.140
Khizerulla Sharief, Venkatesh Ks, M. VeeralokanadhaReddy, B. Kiran
Routine use of diagnostic ultrasound in pregnancy has led to the detection of urologic abnormality in many fetuses. The most common abnormality detected is hydronephrosis caused by the P.U.J. obstruction followed by multicystic dysplastic kidney . Bilateral renal dysplasia or agenesis may be associate with oligohydramnios. However antenatal diagnosis of posterior urethral valves may be missed unless a scan is undertaken late in pregnancy. A cross sectional study was conducted on 500 school going children of both sexes. An informed consent was obtained followed by a visit to the institution. Children were subjected to physical examination, blood pressure recording and urine was collected and further analyzed. Culture repeated on cases with significant have shown the growth of same organism in 7 cases. Thus asymptomatic bacteriuria was taken as 1.4%.E. coli (42.8%) was the most common isolated organism followed by Klebsiella (28.5%).
常规使用超声诊断妊娠导致发现许多胎儿泌尿系统异常。最常见的异常是由P.U.J.梗阻引起的肾积水,然后是多囊性肾发育不良。双侧肾发育不良或发育不全可能与羊水过少有关。然而,除非在妊娠后期进行扫描,否则可能会错过后尿道瓣的产前诊断。对500名在校男女儿童进行了一项横断面研究。在获得知情同意后,访问了该机构。对患儿进行体格检查,记录血压,收集尿液并进一步分析。对有显著意义的病例进行重复培养,发现7例有相同的微生物生长。无症状菌血症占1.4%。大肠杆菌(42.8%)是最常见的分离菌,其次是克雷伯菌(28.5%)。
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引用次数: 0
Assessment of nutritional status of under five children attending outpatient department at a tertiary care hospital in North India 印度北部一家三级保健医院门诊部五岁以下儿童营养状况评估
Pub Date : 2021-01-01 DOI: 10.33545/26643685.2021.V4.I1A.115
M. Gupta, Ankur Puri, R. Jindal
The nutrition status is always neglected issue of public health. The study was done to assess the nutritional status of children attending pediatric OPD at tertiary level hospital by anthropometric measurements and to know the health status of these children and their relation with nutritional status. The nutritional profile of children of age group 0-5 years attending Paediatric OPD was studied. Total 1000 under five children were equally divided into the age groups 0-12 months, 1-2 years, 2-3years, 3-4 years and 4-5 years. A total of 40.1%, 45.2%, 16.3% of children had underweight, stunted and wasting, respectively. Total malnutrition prevalence was 63.1%. As per MUAC, 48.9% children were having mild to moderate malnutrition whereas 1.8% children had severe malnutrition. Malnutrition was more prevalent in girls and in 1-5 years age group children and was found statistically significant. Reduction of malnutrition can be ensured by availability of supplementary feeds and immunization.
营养状况一直是一个被忽视的公共卫生问题。本研究采用人体测量法评估三级医院儿科门诊儿童的营养状况,了解儿童健康状况及其与营养状况的关系。研究了儿科门诊0-5岁儿童的营养状况。1000名5岁以下儿童平均分为0-12个月、1-2岁、2-3岁、3-4岁和4-5岁年龄组。体重不足占40.1%,发育不良占45.2%,消瘦占16.3%。营养不良总患病率为63.1%。根据MUAC的数据,48.9%的儿童患有轻度至中度营养不良,1.8%的儿童患有严重营养不良。营养不良在女孩和1-5岁年龄组的儿童中更为普遍,这在统计上是显著的。通过提供补充饲料和免疫接种,可以确保减少营养不良。
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引用次数: 0
Congenital malaria due to Plasmodium vivax infection in a neonate 新生儿间日疟原虫感染所致先天性疟疾
Pub Date : 2021-01-01 DOI: 10.33545/26643685.2021.V4.I1A.114
Sirish Bhupathi, Manil Shah, Rinam Doshi
Introduction: Congenital malaria occurs through vertical transmission of parasites from mother during pregnancy/perinatally during labour. Presence of maternal antibody may delay symptoms upto 3-6 weeks after birth. Case Representation: A 21days neonate presented with not accepting feed, excessive crying, fever since 2days. On examination baby was pale, lethargic, febrile, hepatosplenomegaly+. Peripheral smear-rings & trophozoits of P. vivax , diagnosed as congenital malaria with neonatal sepsis. IV. Ceftriaxone, IV. Amikacin started. Chloroquine was given. Discussion: This case shows importance of considering congenital malaria as differential diagnosis of neonatal sepsis in neonates with history of malaria during pregnancy. Mechanisms for congenital transmission of malaria include maternal transfusion into fetal circulation at delivery/during pregnancy. Sometimes mother might had mild episode malarial during the 9 th month of pregnancy, resolved spontaneously, and remained undiagnosed. The time of onset of symptoms in congenital malaria can vary from immediately after birth to few weeks. The drug of choice for congenital malaria remains chloroquine.
导言:先天性疟疾是通过母亲在怀孕期间/分娩期间的围产期寄生虫垂直传播而发生的。母体抗体的存在可使症状延迟至出生后3-6周。病例描述:1例21天新生儿,出现不进食,哭闹过度,发热2天。经检查,婴儿面色苍白,嗜睡,发热,肝脾肿大+。间日疟原虫外周涂片环和滋养体,诊断为先天性疟疾伴新生儿败血症。开始静脉注射头孢曲松、阿米卡星。给了氯喹。讨论:本病例显示考虑先天性疟疾作为鉴别诊断新生儿败血症的重要性,在怀孕期间有疟疾史的新生儿。先天性疟疾传播的机制包括分娩时/怀孕期间母亲输血进入胎儿循环。有时母亲可能在怀孕的第9个月有轻微的疟疾发作,自然消退,但仍未确诊。先天性疟疾出现症状的时间从出生后立即到几周不等。治疗先天性疟疾的首选药物仍然是氯喹。
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引用次数: 1
Factors affecting the severity of hemolytic disease of the new-born due to ABO incompatibility ABO血型不合影响新生儿溶血性疾病严重程度的因素
Pub Date : 2021-01-01 DOI: 10.33545/26643685.2021.v4.i1b.132
K. Mendapara, A. Makwana
Background and Aim: ABO incompatibility is one of the most common cause of hemolytic disease of fetus and new born. Better understanding of the factors affecting its severity helps to optimise care. The objective of this study was to investigate the factors affecting the severity of HDN due ABO incompatibility in new-borns. Methods: This study was a prospective observational study conducted in the NICU, department of Pediatrics, P.D.U Government Medical College and Hospital, Rajkot. The study was conducted from January 2019 to June 2019; 50 new-borns with ABO incompatibility i.e., having blood group A or B born to mothers with blood group O, presenting with jaundice and or anemia were enrolled in the study. Various maternal and neonatal factors and their possible association in affecting the severity of HDN were studied . Results: In our study, 27 neonates (54%) were male and 23 neonates (46%) were female. Percentage of O-A and O-B incompatible neonates were 26 (52%) and 24 (48%) respectively. The various maternal and neonatal factors had no significant association in affecting the severity of the disease. The mean age of presentation was 3.74 ± 2.34 days. Jaundice was detected in the first 24 hours of life in 6% neonates. The mean initial indirect bilirubin was 19.77 ± 2.50, and initial hemoglobin was 14.41 ± 2.07. Ten neonates (20%) had anemia. Total of 15 neonates (30%) had evidence of hemolysis in the form of spherocytosis. Direct Coombs Test was positive in one case. The mean duration of phototherapy was 54.62 ± 5.79 hours. Three neonates (6%) required exchange transfusion and 4 neonates (8%) received IVIG. The mean duration of stay was 4.18 ± 1.04 days. Conclusion: Although none of the factors had a significant association in affecting the severity of HDN due to ABO incompatibility, we should remember that ABO incompatibility is not always a benign condition and should be considered even in those with a negative DCT. Early identification of high-risk neonates with ABO incompatibility and prompt diagnosis and treatment can reduce morbidity and mortality.
背景与目的:ABO血型不合是导致胎儿和新生儿溶血病最常见的原因之一。更好地了解影响其严重程度的因素有助于优化护理。本研究旨在探讨新生儿ABO血型不合导致HDN严重程度的影响因素。方法:本研究是一项前瞻性观察性研究,在拉杰科特市P.D.U政府医学院和医院儿科NICU进行。该研究于2019年1月至2019年6月进行;研究人员招募了50名ABO血型不合的新生儿,即O型血母亲所生的A或B型血的新生儿,这些新生儿表现为黄疸和/或贫血。研究了影响HDN严重程度的各种母体和新生儿因素及其可能的关联。结果:本组新生儿中,男婴27例(54%),女婴23例(46%)。O-A和O-B不相容的新生儿比例分别为26(52%)和24(48%)。各种母体和新生儿因素在影响疾病严重程度方面没有显著关联。平均发病年龄为3.74±2.34天。6%的新生儿在出生后24小时内发现黄疸。平均初始间接胆红素为19.77±2.50,初始血红蛋白为14.41±2.07。10名新生儿(20%)有贫血。15例新生儿(30%)有球型红细胞增多的溶血症状。1例直接库姆斯试验呈阳性。平均光疗时间为54.62±5.79小时。3名新生儿(6%)需要换血,4名新生儿(8%)接受了IVIG。平均住院时间为4.18±1.04天。结论:尽管这些因素与ABO不相容导致的HDN严重程度没有显著相关性,但我们应该记住,ABO不相容并不总是良性的,即使在DCT阴性的患者中也应该考虑ABO不相容。早期发现ABO血型不合高危新生儿并及时诊断和治疗可降低发病率和死亡率。
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引用次数: 0
Efficacy of Rifapentine plus isoniazid in the treatment of tuberculosis infection in children in India 利福喷丁联合异烟肼治疗印度儿童结核感染的疗效观察
Pub Date : 2021-01-01 DOI: 10.33545/26643685.2021.v4.i1c.143
R. Singh, Umesh Kumar
Background: Treatment of tuberculosis (TB) infection effectively prevents its progression and cures it. Persons aged 12 and older can safely and effectively take rifapentine and isoniazid for three months to treat latent tuberculosis infection. Published data for children is limited. Data on the 3-month weekly rifapentine plus isoniazid (3 HP) in children in India are currently unavailable.Objective: To compare the treatment completion rates and incidence rates of adverse drug reactions among childrens with TB undergoing the 9H and 3HP regimens. Methods: This was a prospective, open-label, multicentre randomised trial involving children with newly diagnosed TB. 263 participants were randomised into two groups to have 131 patients in the 3HP group and 132 to the 9H group. Primary endpoint was completion of the 270-day treatment within 12 months. Adverse drug reaction were analysed in both the groups. Results: Comparing the 9H group with the 3HP group, those who dropped out of the 9H group stopped participating more often. Reason for dropping out was consent withdrawal. Incidence of hepatotoxicity was lower in the 3HP group than in the 9H group. However, grade 2 and 3 ADR were more in the 3HP group. Conclusion: An increased completion rate was seen with the 3HP regimen compared with the 9H regimen, as well as better tolerance to adverse effects.
背景:结核病(TB)感染的治疗可以有效地预防其发展并治愈它。12岁及以上的人可以安全有效地服用利福喷丁和异烟肼三个月来治疗潜伏性结核感染。已发表的儿童数据有限。印度儿童每周使用利福喷丁加异烟肼(3 HP) 3个月的数据目前尚无。目的:比较9H和3HP方案治疗结核儿童的治疗完成率和药物不良反应发生率。方法:这是一项前瞻性、开放标签、多中心随机试验,涉及新诊断结核病的儿童。263名参与者随机分为两组,3HP组131名患者,9H组132名患者。主要终点是在12个月内完成270天的治疗。分析两组患者的药物不良反应。结果:9H组与3HP组比较,退出9H组的人停止参与的频率更高。退出的原因是同意撤回。3HP组肝毒性发生率低于9H组。3HP组2级和3级不良反应较多。结论:与9H方案相比,3HP方案完成率更高,并且对不良反应的耐受性更好。
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引用次数: 0
Prevalence of Temporomandibular Joint Disorders in Paediatric Age Group 儿童年龄组颞下颌关节疾病的患病率
Pub Date : 2021-01-01 DOI: 10.22271/27069567.2021.V3.I1C.116
Dr. Adrama
TMJ malfunction is quiet common in swimmers. This study is done to understand the prevalence of the disorders associated with swimming in paediatric age group. According to previous studies there is a high demand on neck rotation and upper limb activities for the propulsion of the body inside the water and which negative synchronized activities of jaw and mastication structure. There is no studies have been attempted to find out the prevalence of TMD among competitive swimmers through there is a greater demand on TMJ structure due to their swimming mechanics.
颞下颌关节功能障碍在游泳者中很常见。本研究旨在了解儿童年龄组游泳相关疾病的患病率。根据以往的研究,人体在水中的推进对颈部旋转和上肢活动有很高的要求,而下颚和咀嚼结构的同步活动是消极的。由于竞技游泳运动员的游泳力学对其颞下颌关节结构有较大的要求,因此尚无研究试图找出竞技游泳运动员中颞下颌关节的患病率。
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引用次数: 0
Evaluation of skin prick test reactivity in children with allergic diseases: A cross sectional study 过敏性疾病儿童皮肤点刺试验反应性评价:一项横断面研究
Pub Date : 2021-01-01 DOI: 10.33545/26643685.2021.v4.i1b.136
K. Kumar, Rsv Srikrishna, I. Pavan, M. Surendranath, M. Nagaraju
Allergic diseases are developed through complex interaction between exposure to environmental substances and genetic susceptibility. The prevalence of allergic diseases has increased during last decade globally. The present cross sectional study was designed to evaluate the skin prick test reactivity in children with allergic diseases. A total of 400 children between age group 1-12 years were recruited. The Skin prick tests (SPT) using 14 standardized allergen extracts were conducted in the volar surface of forearm. Majority children had asthma (52.5%), followed by atopic dermatitis (22.75%) and allergic rhinitis (15.75%). Food habits triggering allergic conditions in 76% children, environmental factors in 4.75% children, pets in 8.25% and indoor conditions in 11% children. Skin prick test was positive to egg (13.5%), milk (22%), wheat (9.75%), apple (4.5%), cereals (6.5%), cat (18%), dog (6%), blatella (9.5%), aspergillus fumigatus (9.5%), fungi (12.75%), Dermatophytes farina (24.75%), Dermatophytes pteromyssinus (23.75%), Blomia tropicalis (9.5%) and Bermuda grass (13.75%). Determination of allergen sensitization patterns in children with atopic disease is crucial for selecting proper preventive and therapeutic strategies which helps to improve quality of life of in children.
过敏性疾病是通过暴露于环境物质和遗传易感性之间的复杂相互作用而发展起来的。在过去十年中,全球过敏性疾病的患病率有所增加。本横断面研究旨在评价皮肤点刺试验在儿童变应性疾病中的反应性。总共招募了400名年龄在1-12岁之间的儿童。采用14种标准化过敏原提取物在前臂掌面进行皮肤点刺试验(SPT)。以哮喘(52.5%)居多,其次为特应性皮炎(22.75%)和变应性鼻炎(15.75%)。饮食习惯引发过敏的儿童占76%,环境因素占4.75%,宠物占8.25%,室内条件占11%。皮肤点刺试验对鸡蛋(13.5%)、牛奶(22%)、小麦(9.75%)、苹果(4.5%)、谷物(6.5%)、猫(18%)、狗(6%)、小蠊(9.5%)、烟曲霉(9.5%)、真菌(12.75%)、farina皮癣菌(24.75%)、pteromyssinus皮癣菌(23.75%)、Blomia tropicalis(9.5%)和Bermuda grass(13.75%)呈阳性。确定儿童特应性疾病过敏原致敏模式对选择正确的预防和治疗策略至关重要,有助于提高儿童的生活质量。
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引用次数: 0
期刊
International Journal of Paediatrics and Geriatrics
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