Pub Date : 2023-06-02DOI: 10.32677/ijch.v10i6.3868
Shreyas A Surpure, B. Rathod
Children presenting neurological problems and a history of “not cried immediately at birth” are labeled to have cerebral palsy due to birth asphyxia. Although this may be true in many situations, the presence of some additional features may help determine an alternate diagnosis. We present such a case with an alternate diagnosis. A child with a history of birth asphyxia was labeled as a case of global developmental delay or a case of cerebral palsy by the treating doctors. However, the child had certain dysmorphic features such as bulbous nose, depressed nasal bridge, low-set ears, high-arched palate, squint, and flat feet. The child was initially treated in the Neonatal Intensive Care Unit after birth. Later, she developed various neurological features, with frequent episodes of aspiration pneumonia and seizures which were managed with anticonvulsant drugs and antimicrobial agents. She also had some additional non-specific features. On detailed evaluation, the child was diagnosed to have 1q43q44 microdeletion. Search for an alternate or additional diagnosis should be carried out if a child presenting with global developmental delay has some additional syndromic features. This will help in the prognostication of child and help parents in future pregnancy.
{"title":"Global developmental delay in a child with asphyxia neonatorum: Why search for an additional explanation?","authors":"Shreyas A Surpure, B. Rathod","doi":"10.32677/ijch.v10i6.3868","DOIUrl":"https://doi.org/10.32677/ijch.v10i6.3868","url":null,"abstract":"Children presenting neurological problems and a history of “not cried immediately at birth” are labeled to have cerebral palsy due to birth asphyxia. Although this may be true in many situations, the presence of some additional features may help determine an alternate diagnosis. We present such a case with an alternate diagnosis. A child with a history of birth asphyxia was labeled as a case of global developmental delay or a case of cerebral palsy by the treating doctors. However, the child had certain dysmorphic features such as bulbous nose, depressed nasal bridge, low-set ears, high-arched palate, squint, and flat feet. The child was initially treated in the Neonatal Intensive Care Unit after birth. Later, she developed various neurological features, with frequent episodes of aspiration pneumonia and seizures which were managed with anticonvulsant drugs and antimicrobial agents. She also had some additional non-specific features. On detailed evaluation, the child was diagnosed to have 1q43q44 microdeletion. Search for an alternate or additional diagnosis should be carried out if a child presenting with global developmental delay has some additional syndromic features. This will help in the prognostication of child and help parents in future pregnancy.","PeriodicalId":22476,"journal":{"name":"The Indian journal of child health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74478837","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-06-02DOI: 10.32677/ijch.v10i6.3998
K S Anupriya, N Pradeep
Background: Neonatal jaundice is a very common condition worldwide, occurring in up to 60% of term and 80% of pre-term newborns in the 1st week of life and the most common cause for readmission. The present study was conducted to evaluate the predictive value of umbilical cord blood albumin level for subsequent development of neonatal jaundice in healthy term neonates. The present study is conducted to find usefulness of cord blood albumin in predicting the subsequent development of significant neonatal jaundice. Methods and Methods: This is a hospital-based prospective study conducted in 100 healthy term neonates. Cord blood albumin level estimation was done at birth. Total serum bilirubin estimation was done for all babies with clinically suspected jaundice at 72–96 h of age. The neonates were divided into three Groups A, B, and C based on the cord albumin levels of <2.8 g/dL, 2.8–3.3 g/dL, and >3.3 g/dL, respectively. The main outcome of the study was inferred in terms of serum bilirubin ≥17 mg/dL, newborn required phototherapy, and exchange transfusion. Results: Groups A, B, and C had 21, 35, and 44 newborns, respectively. In Group A, 18 (85.7%) neonates had total bilirubin of >17 mg/dL, of which 16 (76.19%) required phototherapy and 2 (9.52%) needed exchange transfusion. 23 (65.7%) neonates in Group B developed jaundice, of which 12 (34.2%) needed phototherapy and none of them required exchange transfusion. In Group C, 15 (34.09%) developed jaundice of which 1 (2.2%) required phototherapy and none of them required exchange transfusion (p<0.001). Conclusion: Cord blood albumin level ≤2.8 g/dL is a significant risk factor for developing neonatal hyperbilirubinemia that requires early intervention, while cord blood albumin >3.3 g/dL is probably safe for early discharge. Hence, this can help to identify the at-risk neonates. Hence, routine determination of cord blood albumin level can be advocated to keep a track on at-risk neonates.
{"title":"Cord blood albumin level as a predictor of neonatal physiological jaundice in healthy term neonate","authors":"K S Anupriya, N Pradeep","doi":"10.32677/ijch.v10i6.3998","DOIUrl":"https://doi.org/10.32677/ijch.v10i6.3998","url":null,"abstract":"Background: Neonatal jaundice is a very common condition worldwide, occurring in up to 60% of term and 80% of pre-term newborns in the 1st week of life and the most common cause for readmission. The present study was conducted to evaluate the predictive value of umbilical cord blood albumin level for subsequent development of neonatal jaundice in healthy term neonates. The present study is conducted to find usefulness of cord blood albumin in predicting the subsequent development of significant neonatal jaundice. Methods and Methods: This is a hospital-based prospective study conducted in 100 healthy term neonates. Cord blood albumin level estimation was done at birth. Total serum bilirubin estimation was done for all babies with clinically suspected jaundice at 72–96 h of age. The neonates were divided into three Groups A, B, and C based on the cord albumin levels of <2.8 g/dL, 2.8–3.3 g/dL, and >3.3 g/dL, respectively. The main outcome of the study was inferred in terms of serum bilirubin ≥17 mg/dL, newborn required phototherapy, and exchange transfusion. Results: Groups A, B, and C had 21, 35, and 44 newborns, respectively. In Group A, 18 (85.7%) neonates had total bilirubin of >17 mg/dL, of which 16 (76.19%) required phototherapy and 2 (9.52%) needed exchange transfusion. 23 (65.7%) neonates in Group B developed jaundice, of which 12 (34.2%) needed phototherapy and none of them required exchange transfusion. In Group C, 15 (34.09%) developed jaundice of which 1 (2.2%) required phototherapy and none of them required exchange transfusion (p<0.001). Conclusion: Cord blood albumin level ≤2.8 g/dL is a significant risk factor for developing neonatal hyperbilirubinemia that requires early intervention, while cord blood albumin >3.3 g/dL is probably safe for early discharge. Hence, this can help to identify the at-risk neonates. Hence, routine determination of cord blood albumin level can be advocated to keep a track on at-risk neonates.","PeriodicalId":22476,"journal":{"name":"The Indian journal of child health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85825272","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-05-01DOI: 10.32677/ijch.v10i5.3910
S. Ganapathy, S. Buddhavarapu
Background: Infant formula usage in hospitals is inevitable in certain circumstances. We explored the high-risk groups who required formula during hospital stays during the post-intervention phase of a quality improvement initiative for improving exclusive breastfeeding (EBF) rates in hospitals. Methods: A retrospective and case–control study was conducted involving 50 cases of neonates who received infant formula and 200 control who were exclusively breastfed. Data regarding maternal and neonatal details were from breastfeeding assessment forms and case record which was collected prospectively during the program. We compared common risk factors between the two groups. Results: There was a strong association between infant formula usage and cesarean sections, assisted reproductive technology (ART) conceptions, multiple gestations, neonatal intensive care unit admissions, being small for gestational age, and being an infant of a diabetic mother. First-h breastfeeding was associated with a higher likelihood of EBF in the hospital. In the final model, ART conception, multiple gestations, and delayed initiation of breastfeeding were strong predictors of the use of infant formula in the hospital. Conclusion: Initiating breastfeeding within the 1st h promotes EBF. ART conception and multiple gestations remain strong risk factors for formula usage, the social, physiological, and genetic reasons for which will need to be studied in detail.
{"title":"Risk factors for infant formula usage during the initial hospital stay in term and late pre-term neonates after implementation of a breastfeeding support program: A retrospective case–control study from a tertiary care hospital","authors":"S. Ganapathy, S. Buddhavarapu","doi":"10.32677/ijch.v10i5.3910","DOIUrl":"https://doi.org/10.32677/ijch.v10i5.3910","url":null,"abstract":"Background: Infant formula usage in hospitals is inevitable in certain circumstances. We explored the high-risk groups who required formula during hospital stays during the post-intervention phase of a quality improvement initiative for improving exclusive breastfeeding (EBF) rates in hospitals. Methods: A retrospective and case–control study was conducted involving 50 cases of neonates who received infant formula and 200 control who were exclusively breastfed. Data regarding maternal and neonatal details were from breastfeeding assessment forms and case record which was collected prospectively during the program. We compared common risk factors between the two groups. Results: There was a strong association between infant formula usage and cesarean sections, assisted reproductive technology (ART) conceptions, multiple gestations, neonatal intensive care unit admissions, being small for gestational age, and being an infant of a diabetic mother. First-h breastfeeding was associated with a higher likelihood of EBF in the hospital. In the final model, ART conception, multiple gestations, and delayed initiation of breastfeeding were strong predictors of the use of infant formula in the hospital. Conclusion: Initiating breastfeeding within the 1st h promotes EBF. ART conception and multiple gestations remain strong risk factors for formula usage, the social, physiological, and genetic reasons for which will need to be studied in detail.","PeriodicalId":22476,"journal":{"name":"The Indian journal of child health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91452535","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-05-01DOI: 10.32677/ijch.v10i5.3939
Mahesh Gowda, No K O, Doddabele Layout
Background: Annual type 1 diabetes cases in children under the age of 15 are estimated to be around 96,000 worldwide. The pathophysiological explanation for diabetes-related hearing loss is speculative. Usually, hearing loss is bilateral, gradual onset, affecting higher frequencies. It is a well-known entity in type 2 diabetic mellitus. This study aims at knowing the prevalence of hearing loss in children with type 1 diabetic mellitus with respect to duration of diabetic mellitus. Materials and Methods: A hospital-based comparative study was conducted involving 60 diabetic children and 60 healthy (control) children. Brainstem evoked response audiometry test was done in both groups. Reports were compared and prevalence of sensorineural hearing loss in diabetic children and the corelation with the duration of disease were analyzed. Results: The mean age among cases was 11.93±2.9 years and the mean age among controls was 9.08±1.92 years. Among diabetic group, 25 (41.7%) were male, 35 (58.3%) were female. Among non-diabetic group, 33 (55%) were male, 27 (45%) were female. Although none of the diabetic children had hearing loss, the differences in absolute latency waves I, II, III, IV, and V between diabetic group and non-diabetic group in the right ear and waves I and II and III and V between diabetic group and non-diabetic group in the left ear was found to be statistically significant (p<0.05). The difference in interpeak latency values of wave I and wave V between diabetic and non-diabetic group in right ear and between wave I–V and wave III–V in the left ear was found to be statistically strongly significant (p<0.001). This indicates prolonged absolute latency and interpeak latency among diabetics than non-diabetics. Since none of the diabetic children had hearing loss, the corelation of hearing loss with the duration of the disease was unable to obtain. Conclusion: This study stresses on the need for frequent follow-up and hearing evaluation of the type 1 diabetic children for the early detection of hearing loss.
{"title":"Study of sensorineural hearing loss in children with type 1 diabetic mellitus and the corelation with the duration of the disease in a tertiary care center","authors":"Mahesh Gowda, No K O, Doddabele Layout","doi":"10.32677/ijch.v10i5.3939","DOIUrl":"https://doi.org/10.32677/ijch.v10i5.3939","url":null,"abstract":"Background: Annual type 1 diabetes cases in children under the age of 15 are estimated to be around 96,000 worldwide. The pathophysiological explanation for diabetes-related hearing loss is speculative. Usually, hearing loss is bilateral, gradual onset, affecting higher frequencies. It is a well-known entity in type 2 diabetic mellitus. This study aims at knowing the prevalence of hearing loss in children with type 1 diabetic mellitus with respect to duration of diabetic mellitus. Materials and Methods: A hospital-based comparative study was conducted involving 60 diabetic children and 60 healthy (control) children. Brainstem evoked response audiometry test was done in both groups. Reports were compared and prevalence of sensorineural hearing loss in diabetic children and the corelation with the duration of disease were analyzed. Results: The mean age among cases was 11.93±2.9 years and the mean age among controls was 9.08±1.92 years. Among diabetic group, 25 (41.7%) were male, 35 (58.3%) were female. Among non-diabetic group, 33 (55%) were male, 27 (45%) were female. Although none of the diabetic children had hearing loss, the differences in absolute latency waves I, II, III, IV, and V between diabetic group and non-diabetic group in the right ear and waves I and II and III and V between diabetic group and non-diabetic group in the left ear was found to be statistically significant (p<0.05). The difference in interpeak latency values of wave I and wave V between diabetic and non-diabetic group in right ear and between wave I–V and wave III–V in the left ear was found to be statistically strongly significant (p<0.001). This indicates prolonged absolute latency and interpeak latency among diabetics than non-diabetics. Since none of the diabetic children had hearing loss, the corelation of hearing loss with the duration of the disease was unable to obtain. Conclusion: This study stresses on the need for frequent follow-up and hearing evaluation of the type 1 diabetic children for the early detection of hearing loss.","PeriodicalId":22476,"journal":{"name":"The Indian journal of child health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80425476","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-05-01DOI: 10.32677/ijch.v10i5.3914
Nishant Tawari, Rajesh Agrawal, Keshav Kala
Aeromonas salmonicida is a ubiquitous Gram-negative bacterium. It mainly found in aquatic ecosystem. It is most common pathogen in salmonids. Reported infections due to A. salmonicida in humans are very rare. A 5-year-old child admitted with fever since more than a week and loose motions. The blood culture showed growth of A. salmonicida. The child responded well to intravenous antibiotics and discharged after 5 days of admission. A. salmonicida is a rare but potential pathogen for human infections. Modern diagnostic methods are being effective in diagnosing it and empirical antibiotics (Cephalosporin) are helpful in treating it.
{"title":"Aeromonas salmonicida: A very rare but potential threat to human","authors":"Nishant Tawari, Rajesh Agrawal, Keshav Kala","doi":"10.32677/ijch.v10i5.3914","DOIUrl":"https://doi.org/10.32677/ijch.v10i5.3914","url":null,"abstract":"Aeromonas salmonicida is a ubiquitous Gram-negative bacterium. It mainly found in aquatic ecosystem. It is most common pathogen in salmonids. Reported infections due to A. salmonicida in humans are very rare. A 5-year-old child admitted with fever since more than a week and loose motions. The blood culture showed growth of A. salmonicida. The child responded well to intravenous antibiotics and discharged after 5 days of admission. A. salmonicida is a rare but potential pathogen for human infections. Modern diagnostic methods are being effective in diagnosing it and empirical antibiotics (Cephalosporin) are helpful in treating it.","PeriodicalId":22476,"journal":{"name":"The Indian journal of child health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74425155","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-05-01DOI: 10.32677/ijch.v10i5.3942
Swathi R, Maulik Shah, Agnes Puthussery
Background: Indomethacin and ibuprofen (IBU) have been approved for the pharmacological closure of hemodynamically significant patent ductus arteriosus (hsPDA) in preterm infants. Recent works have demonstrated that paracetamol (PCM) can also be used but more research is required regarding efficacy and safety. Objectives: The objective is to compare the efficacy and safety of PCM and IBU for the treatment of hsPDA in preterm infants. Methodology: An observational study was designed with ethical clearance and parental consent. Patients were evaluated for hsPDA by clinical and 2 D echo findings. After inclusion and exclusion criteria, consecutive 100 patients were assigned between PCM and IBU and were given a 3-day course. After echocardiographic and clinical evaluation, if required, a second course with same drug was given. The outcome measures were the rate of ductal closure, the safety of drugs, and adverse events. Results: The PCM group had a closure rate of 76.25% and the IBU group had 75%. IBU had a significantly higher rate of closure in the first course (45% vs. 16.25%). The mean closure time observed was 4.54 days and 4 days for PCM and IBU, respectively. PCM gave a higher closure rate in the low-birth-weight group and where platelet counts were below normal. Regarding the safety aspect also no significant difference between groups was observed. Conclusion: PCM can be advised as a first-line treatment for hsPDA cases in preterm infants and is a better choice in cases of comorbidities and patients with low platelet count.
背景:吲哚美辛和布洛芬(IBU)已被批准用于早产儿血流动力学显著性动脉导管未闭(hsPDA)的药理学封闭。最近的研究表明，扑热息痛(PCM)也可以使用，但还需要更多的研究来确定其有效性和安全性。目的:目的是比较PCM和IBU治疗早产儿hsPDA的疗效和安全性。方法:一项观察性研究是在伦理许可和家长同意的情况下设计的。通过临床和二维超声检查评估患者是否患有hsPDA。按照纳入和排除标准，连续100例患者被分配到PCM和IBU之间，并给予3天疗程。在超声心动图和临床评估后，如果需要，给予相同药物的第二个疗程。结局指标为导管闭合率、药物安全性和不良事件。结果:PCM组闭合率为76.25%，IBU组闭合率为75%。IBU在第一个疗程的愈合率明显更高(45% vs. 16.25%)。PCM和IBU的平均封闭时间分别为4.54天和4天。在低出生体重组和血小板计数低于正常的组中，PCM的闭合率更高。在安全性方面，两组之间也没有观察到显著差异。结论:PCM可作为早产儿hsPDA的一线治疗方案，对于合并症和血小板计数低的患者是较好的选择。
{"title":"Comparison of efficacy of paracetamol and ibuprofen for treatment of hemodynamically significant patent ductus arteriosus in preterm infants","authors":"Swathi R, Maulik Shah, Agnes Puthussery","doi":"10.32677/ijch.v10i5.3942","DOIUrl":"https://doi.org/10.32677/ijch.v10i5.3942","url":null,"abstract":"Background: Indomethacin and ibuprofen (IBU) have been approved for the pharmacological closure of hemodynamically significant patent ductus arteriosus (hsPDA) in preterm infants. Recent works have demonstrated that paracetamol (PCM) can also be used but more research is required regarding efficacy and safety. Objectives: The objective is to compare the efficacy and safety of PCM and IBU for the treatment of hsPDA in preterm infants. Methodology: An observational study was designed with ethical clearance and parental consent. Patients were evaluated for hsPDA by clinical and 2 D echo findings. After inclusion and exclusion criteria, consecutive 100 patients were assigned between PCM and IBU and were given a 3-day course. After echocardiographic and clinical evaluation, if required, a second course with same drug was given. The outcome measures were the rate of ductal closure, the safety of drugs, and adverse events. Results: The PCM group had a closure rate of 76.25% and the IBU group had 75%. IBU had a significantly higher rate of closure in the first course (45% vs. 16.25%). The mean closure time observed was 4.54 days and 4 days for PCM and IBU, respectively. PCM gave a higher closure rate in the low-birth-weight group and where platelet counts were below normal. Regarding the safety aspect also no significant difference between groups was observed. Conclusion: PCM can be advised as a first-line treatment for hsPDA cases in preterm infants and is a better choice in cases of comorbidities and patients with low platelet count.","PeriodicalId":22476,"journal":{"name":"The Indian journal of child health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89427915","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-04-04DOI: 10.32677/ijch.v10i4.3892
Manu Rajeev, V. Bhaskar
Introduction: Prescription errors are common and every step in the process of writing a prescription has the potential for error. These errors can be broadly attributed to the lack of knowledge or lack of skill. Poor legibility, inaccuracy in writing, incomplete prescriptions, omissions, and use of abbreviations are the most common type of errors. Objectives: The primary objective of our study was to assess the completeness and legibility of the prescriptions. This is to estimate the rates of skill-based errors. Secondary objective of this study was to assess the appropriateness of the prescriptions using the pediatrics: Omission of Prescriptions and Inappropriate prescriptions (POPI) tool. Methods: This was a cross-sectional study, conducted in the pediatric outpatient department of a tertiary teaching hospital in New Delhi, India. Prescriptions received by outpatients attending both the general and special pediatric clinics were collected and evaluated using the World Health Organization Guide to Good Prescribing and the Medical Council of India guidelines. Results: A total of 343 prescriptions were assessed, in which 753 drugs were prescribed. A total of 1709 errors were uncovered pertaining to the completeness of the prescription. A majority of the prescriptions were written by postgraduates trainees (206), followed by senior residents (61), consultants (42), and junior residents (20). Abbreviations were used while mentioning the drug names in 53.64% prescriptions. The mean legibility score of all prescriptions was 3.35. Forty (11.66%) prescriptions were found inappropriate as per the International POPI tool. Conclusion: The legibility and completeness are largely overlooked yet crucial to the “Art of Prescription Writing.” They deserve as much awareness and education as the appropriateness of the drugs prescribed. The international POPI tool is a promising tool to analyze the appropriateness of pediatric prescriptions.
{"title":"How well are we prescribing medications to our children?","authors":"Manu Rajeev, V. Bhaskar","doi":"10.32677/ijch.v10i4.3892","DOIUrl":"https://doi.org/10.32677/ijch.v10i4.3892","url":null,"abstract":"Introduction: Prescription errors are common and every step in the process of writing a prescription has the potential for error. These errors can be broadly attributed to the lack of knowledge or lack of skill. Poor legibility, inaccuracy in writing, incomplete prescriptions, omissions, and use of abbreviations are the most common type of errors.\u0000Objectives: The primary objective of our study was to assess the completeness and legibility of the prescriptions. This is to estimate the rates of skill-based errors. Secondary objective of this study was to assess the appropriateness of the prescriptions using the pediatrics: Omission of Prescriptions and Inappropriate prescriptions (POPI) tool.\u0000Methods: This was a cross-sectional study, conducted in the pediatric outpatient department of a tertiary teaching hospital in New Delhi, India. Prescriptions received by outpatients attending both the general and special pediatric clinics were collected and evaluated using the World Health Organization Guide to Good Prescribing and the Medical Council of India guidelines.\u0000Results: A total of 343 prescriptions were assessed, in which 753 drugs were prescribed. A total of 1709 errors were uncovered pertaining to the completeness of the prescription. A majority of the prescriptions were written by postgraduates trainees (206), followed by senior residents (61), consultants (42), and junior residents (20). Abbreviations were used while mentioning the drug names in 53.64% prescriptions. The mean legibility score of all prescriptions was 3.35. Forty (11.66%) prescriptions were found inappropriate as per the International POPI tool.\u0000Conclusion: The legibility and completeness are largely overlooked yet crucial to the “Art of Prescription Writing.” They deserve as much awareness and education as the appropriateness of the drugs prescribed. The international POPI tool is a promising tool to analyze the appropriateness of pediatric prescriptions.","PeriodicalId":22476,"journal":{"name":"The Indian journal of child health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89606719","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-04-04DOI: 10.32677/ijch.v10i4.3953
Dr Chirag L U, Lohit Kumbar, C. Selvan, Manjunath Pr
An ambiguous genitalia is a commonly referred clinical scenario to endocrinology outpatient department. Accurate diagnosis is paramount to prevent associated salt-wasting crisis, direct the gender of rearing in the short-term, and monitoring for the development of malignancy in the gonads in the long-term. 17 beta-hydroxysteroid dehydrogenase 3 deficiency (17 β HSD 3) is one of the causes of defective testosterone biosynthesis. 17β-HSD3 deficiency should be suspected in children with female external genitalia with inguinal hernias or mild clitoromegaly; as well as males with ambiguous genitalia who develop virilization and gynecomastia at puberty. A hormonal evaluation may not always be diagnostic which makes genetic confirmation essential.
{"title":"A rare case report of ambiguous genitalia","authors":"Dr Chirag L U, Lohit Kumbar, C. Selvan, Manjunath Pr","doi":"10.32677/ijch.v10i4.3953","DOIUrl":"https://doi.org/10.32677/ijch.v10i4.3953","url":null,"abstract":"An ambiguous genitalia is a commonly referred clinical scenario to endocrinology outpatient department. Accurate diagnosis is paramount to prevent associated salt-wasting crisis, direct the gender of rearing in the short-term, and monitoring for the development of malignancy in the gonads in the long-term. 17 beta-hydroxysteroid dehydrogenase 3 deficiency (17 β HSD 3) is one of the causes of defective testosterone biosynthesis. 17β-HSD3 deficiency should be suspected in children with female external genitalia with inguinal hernias or mild clitoromegaly; as well as males with ambiguous genitalia who develop virilization and gynecomastia at puberty. A hormonal evaluation may not always be diagnostic which makes genetic confirmation essential.","PeriodicalId":22476,"journal":{"name":"The Indian journal of child health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79244841","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-04-01DOI: 10.32677/ijch.v10i4.3900
Meghana N, Pradeep N
Background: Dengue is a cause of public health concern with case fatality rate of 1%. Ferritin is an acute-phase reactant which is produced in response to infection and inflammation. The aim of this study is to evaluate serum ferritin levels in various phases of dengue in pediatric dengue patients. Methods: A hospital-based, prospective, and observational study was done involving 30 dengue cases diagnosed by positive NS1 antigen or dengue specific serology (capture enzyme-linked immunosorbent assay). Serum ferritin was estimated by electrochemiluminescence in all three phases of dengue. Clinical and platelet count monitoring was done daily; respectively. All children classified as dengue with or without warning signs and severe dengue according to the World Health Organization guidelines on diagnosis treatment, prevention, and control of dengue, 2009. Results: Out of total of 30 children with mean age of the children were 7 years, and 61% were male who were majority. High serum ferritin levels were noted during critical phase. Eight children with dengue shock syndrome and one with acute respiratory distress syndrome were managed in intensive care unit as compared to non-severe dengue with statistically significant difference as p<0.05. Increase in serum ferritin is associated with severe thrombocytopenia. The mean hospital stay duration was found to be 5±3 days (mean±standard deviation). Conclusion: Serum ferritin levels taken on admission can serve as a reliable and cost-effective biomarker in the assessment and in predicting the severity of dengue fever. Serum ferritin levels may help in identifying an uncomplicated dengue illness, from that of patients who may require inpatient admission/intensive critical care.
{"title":"Study of serum ferritin levels in various phases of dengue in pediatric dengue patients admitted in a tertiary hospital","authors":"Meghana N, Pradeep N","doi":"10.32677/ijch.v10i4.3900","DOIUrl":"https://doi.org/10.32677/ijch.v10i4.3900","url":null,"abstract":"Background: Dengue is a cause of public health concern with case fatality rate of 1%. Ferritin is an acute-phase reactant which is produced in response to infection and inflammation. The aim of this study is to evaluate serum ferritin levels in various phases of dengue in pediatric dengue patients.\u0000Methods: A hospital-based, prospective, and observational study was done involving 30 dengue cases diagnosed by positive NS1 antigen or dengue specific serology (capture enzyme-linked immunosorbent assay). Serum ferritin was estimated by electrochemiluminescence in all three phases of dengue. Clinical and platelet count monitoring was done daily; respectively. All children classified as dengue with or without warning signs and severe dengue according to the World Health Organization guidelines on diagnosis treatment, prevention, and control of dengue, 2009.\u0000Results: Out of total of 30 children with mean age of the children were 7 years, and 61% were male who were majority. High serum ferritin levels were noted during critical phase. Eight children with dengue shock syndrome and one with acute respiratory distress syndrome were managed in intensive care unit as compared to non-severe dengue with statistically significant difference as p<0.05. Increase in serum ferritin is associated with severe thrombocytopenia. The mean hospital stay duration was found to be 5±3 days (mean±standard deviation).\u0000Conclusion: Serum ferritin levels taken on admission can serve as a reliable and cost-effective biomarker in the assessment and in predicting the severity of dengue fever. Serum ferritin levels may help in identifying an uncomplicated dengue illness, from that of patients who may require inpatient admission/intensive critical care.","PeriodicalId":22476,"journal":{"name":"The Indian journal of child health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76034975","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-04-01DOI: 10.32677/ijch.v10i4.3828
Mithu Barman, Jolly Rabha, S. Rohman
Purpose: The given study was done to find out the changes in biochemical profiles before and after nutritional rehabilitation of the children admitted at the Department of Paediatrics, Assam Medical College with severe acute malnutrition (SAM). Materials and Methods: A hospital based observational study was conducted from May 2020 to April 2021 with 55 consecutive cases of SAM. Vitros System 5600 was used for analysis of 13 biochemical parameters. Results: The mean values of serum sodium, potassium, and chloride at admission were 134.59±19.37 mEq/L, 4.22±0.80 mEq/L, and 101.12±16.36 mEq/L and that after rehabilitation were 136.66±19.95 mEq/L, 4.42±0.68 mEq/L, and 103.97±4.83 mEq/L. While that for magnesium, calcium, and phosphorous on admission were 2.11±0.38 mg/dL, 8.70±1.00 mg/dL, and 4.33±1.23 mg/dL and that after rehabilitation were 2.10±0.29 mg/dL, 9.45±0.65 mg/dL, and 4.76±0.84 mg/dL, respectively. The mean values of serum total protein, albumin, globulin, and A: G on admission were 6.53±1.44 g/dL, 3.30±0.88 g/dL, 3.23±0.87 g/dL, and 1.06±0.33, respectively, and that after rehabilitation were 6.84±0.98 g/dL, 3.86±0.57 g/dL, 2.98±0.69 g/dL, and 1.34±0.28, respectively. The mean of urea and creatinine on admission were found to be 26.25±19.30 mg/dL and 0.34±0.24 mg/dL, respectively, and that after rehabilitation were 23.91±11.76 mg/dL and 0.31±0.15 mg/dL respectively. Random blood sugar (RBS) on admission was 85.20±17.88 mg/dL and that after rehabilitation was 94.18±14.82 mg/dL. After rehabilitation, the mean value of calcium, phosphorous, albumin, A: G, and RBS were significantly raised. The minimum duration required for rehabilitation was 12 days with prevalence being maximum among the Tea-tribes (80.00%). Conclusion: The biochemical derangements in a patient with SAM are associated with significant morbidity and get improved after nutritional rehabilitation.
目的:本研究旨在了解阿萨姆邦医学院儿科收治的患有严重急性营养不良(SAM)的儿童在营养康复前后的生化特征变化。材料与方法:2020年5月至2021年4月，在医院进行了一项观察性研究，连续55例SAM。采用Vitros System 5600对13项生化指标进行分析。结果:入院时血清钠、钾、氯均值分别为134.59±19.37 mEq/L、4.22±0.80 mEq/L、101.12±16.36 mEq/L，康复后分别为136.66±19.95 mEq/L、4.42±0.68 mEq/L、103.97±4.83 mEq/L。入院时镁、钙、磷含量分别为2.11±0.38 mg/dL、8.70±1.00 mg/dL、4.33±1.23 mg/dL，康复后分别为2.10±0.29 mg/dL、9.45±0.65 mg/dL、4.76±0.84 mg/dL。入院时血清总蛋白、白蛋白、球蛋白、A: G均值分别为6.53±1.44 G /dL、3.30±0.88 G /dL、3.23±0.87 G /dL、1.06±0.33;康复后血清总蛋白、白蛋白、球蛋白、A: G均值分别为6.84±0.98 G /dL、3.86±0.57 G /dL、2.98±0.69 G /dL、1.34±0.28。入院时尿素和肌酐平均值分别为26.25±19.30 mg/dL和0.34±0.24 mg/dL，康复后尿素和肌酐平均值分别为23.91±11.76 mg/dL和0.31±0.15 mg/dL。入院时随机血糖(RBS)为85.20±17.88 mg/dL，康复后为94.18±14.82 mg/dL。康复后，钙、磷、白蛋白、A: G、RBS均值均显著升高。康复所需的最短时间为12天，茶部落的患病率最高(80.00%)。结论:急性脑脊髓炎患者的生化紊乱与发病率显著相关，经营养康复后得到改善。
{"title":"Changes in biochemical profiles of children with severe acute malnutrition on admission and after nutritional rehabilitation","authors":"Mithu Barman, Jolly Rabha, S. Rohman","doi":"10.32677/ijch.v10i4.3828","DOIUrl":"https://doi.org/10.32677/ijch.v10i4.3828","url":null,"abstract":"Purpose: The given study was done to find out the changes in biochemical profiles before and after nutritional rehabilitation of the children admitted at the Department of Paediatrics, Assam Medical College with severe acute malnutrition (SAM).\u0000Materials and Methods: A hospital based observational study was conducted from May 2020 to April 2021 with 55 consecutive cases of SAM. Vitros System 5600 was used for analysis of 13 biochemical parameters.\u0000Results: The mean values of serum sodium, potassium, and chloride at admission were 134.59±19.37 mEq/L, 4.22±0.80 mEq/L, and 101.12±16.36 mEq/L and that after rehabilitation were 136.66±19.95 mEq/L, 4.42±0.68 mEq/L, and 103.97±4.83 mEq/L. While that for magnesium, calcium, and phosphorous on admission were 2.11±0.38 mg/dL, 8.70±1.00 mg/dL, and 4.33±1.23 mg/dL and that after rehabilitation were 2.10±0.29 mg/dL, 9.45±0.65 mg/dL, and 4.76±0.84 mg/dL, respectively. The mean values of serum total protein, albumin, globulin, and A: G on admission were 6.53±1.44 g/dL, 3.30±0.88 g/dL, 3.23±0.87 g/dL, and 1.06±0.33, respectively, and that after rehabilitation were 6.84±0.98 g/dL, 3.86±0.57 g/dL, 2.98±0.69 g/dL, and 1.34±0.28, respectively. The mean of urea and creatinine on admission were found to be 26.25±19.30 mg/dL and 0.34±0.24 mg/dL, respectively, and that after rehabilitation were 23.91±11.76 mg/dL and 0.31±0.15 mg/dL respectively. Random blood sugar (RBS) on admission was 85.20±17.88 mg/dL and that after rehabilitation was 94.18±14.82 mg/dL. After rehabilitation, the mean value of calcium, phosphorous, albumin, A: G, and RBS were significantly raised. The minimum duration required for rehabilitation was 12 days with prevalence being maximum among the Tea-tribes (80.00%).\u0000Conclusion: The biochemical derangements in a patient with SAM are associated with significant morbidity and get improved after nutritional rehabilitation.","PeriodicalId":22476,"journal":{"name":"The Indian journal of child health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89008923","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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