Introduction: Language is a fundamental skill and a foundation stone for multiple cognitive and socio-emotional aspects of development. Considering that well-developed language abilities enable children to negotiate the social-relational demands of school life and provide the foundational knowledge upon which academic skills are built, there is a higher chance of scholastic difficulties, social and, behavioural and emotional maladjustments resulting in poor mental health in those who have language delay.
Methods: An ambispective study conducted at a tertiary centre after taking ethical approval from the institutional review board. Children with isolated early language delay were reassessed at school age for intelligence quotient, language development, adaptive behaviours and behavioural issues.
Results: out of 57 children, persistence of poor language skills was seen in 65%, mean IQ score was 90 ( ± 17. 067) and mean VABS score was 94 ( ± 15). 61.4% children had significant behavioural issues. On interview, most worrisome issue reported by children was ‘being teased by friends’ due to poor language skills. Additionally, lower social competence level was noted in children who had poor language skills.
Conclusions: persistence of language, cognitive and behavioural dysfunctions in children with seemingly benign ‘speech and language delay’ at an early age, emphasizes the importance of comprehensive reassessment of these children at school age for early recognition and management.
{"title":"Behavioural Profile, Linguistic skills, Adaptive Behaviours and Intellectual Functioning of School aged Children with History of Early Language Delay","authors":"Arpita Gupta, MKC Nair, Babu George, Leena ML","doi":"10.60086/jnps482","DOIUrl":"https://doi.org/10.60086/jnps482","url":null,"abstract":"Introduction: Language is a fundamental skill and a foundation stone for multiple cognitive and socio-emotional aspects of development. Considering that well-developed language abilities enable children to negotiate the social-relational demands of school life and provide the foundational knowledge upon which academic skills are built, there is a higher chance of scholastic difficulties, social and, behavioural and emotional maladjustments resulting in poor mental health in those who have language delay.
 Methods: An ambispective study conducted at a tertiary centre after taking ethical approval from the institutional review board. Children with isolated early language delay were reassessed at school age for intelligence quotient, language development, adaptive behaviours and behavioural issues.
 Results: out of 57 children, persistence of poor language skills was seen in 65%, mean IQ score was 90 ( ± 17. 067) and mean VABS score was 94 ( ± 15). 61.4% children had significant behavioural issues. On interview, most worrisome issue reported by children was ‘being teased by friends’ due to poor language skills. Additionally, lower social competence level was noted in children who had poor language skills.
 Conclusions: persistence of language, cognitive and behavioural dysfunctions in children with seemingly benign ‘speech and language delay’ at an early age, emphasizes the importance of comprehensive reassessment of these children at school age for early recognition and management.","PeriodicalId":39140,"journal":{"name":"Journal of Nepal Paediatric Society","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136071681","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}
Introduction: Bloodstream infection is a major cause of morbidity and mortality which requires antibiotic treatment. Antimicrobial resistance is an emerging serious public health threat in both developed and developing countries. Children are more susceptible to infections requiring an appropriate choice of antibiotic based on blood culture. This study aims to investigate the bacteriological profile and antibiotic sensitivity pattern of blood culture isolates and compare the yield of bacterial growth between Brain Heart Infusion Broth (BHIB) or BD BACTEC culture media.
Methods: A total of 12,795 blood samples were sent for bacteriological culture either for BHIB or BACTEC techniques, 10994 and 1801 samples respectively. Chi-square test was used for showing association between BACTEC and BHIB among isolates.
Results: The findings showed that the BACTEC method detected more positive isolates than the BHIB method. The rate of isolation was found highest among children under five years. The most common pathogens isolated were Staphylococcus species (28.1%), Staphylococcus aureus (25.6%), Acinetobacter species (12%), Pseudomonas species (8.2%), Klebsiella species (6.6%), CONS (4.4%), Escherichia coli (4.4%), Salmonella Typhi (3.5%), Enterobacter species (3.2%) and Streptococcus species (0.3%).
Conclusions: Staphylococcus aureus was the commonest isolate identified in the current study. BACTEC culture method detected the higher percentage of isolates than BHIB method.
{"title":"Assessment of Bacterial Profile and Antimicrobial Susceptibility Pattern of Bacterial Isolates from Blood Culture in Tertiary Level Paediatric Hospital of Nepal","authors":"Anil Kumar Shrestha, Nisha Sharma, Pratiksha Bhattrai, Nayanum Pokhrel, Sohani Bajracharya, Umesh Prasad Sah, Prajwal Paudel","doi":"10.60086/jnps481","DOIUrl":"https://doi.org/10.60086/jnps481","url":null,"abstract":"Introduction: Bloodstream infection is a major cause of morbidity and mortality which requires antibiotic treatment. Antimicrobial resistance is an emerging serious public health threat in both developed and developing countries. Children are more susceptible to infections requiring an appropriate choice of antibiotic based on blood culture. This study aims to investigate the bacteriological profile and antibiotic sensitivity pattern of blood culture isolates and compare the yield of bacterial growth between Brain Heart Infusion Broth (BHIB) or BD BACTEC culture media.
 Methods: A total of 12,795 blood samples were sent for bacteriological culture either for BHIB or BACTEC techniques, 10994 and 1801 samples respectively. Chi-square test was used for showing association between BACTEC and BHIB among isolates.
 Results: The findings showed that the BACTEC method detected more positive isolates than the BHIB method. The rate of isolation was found highest among children under five years. The most common pathogens isolated were Staphylococcus species (28.1%), Staphylococcus aureus (25.6%), Acinetobacter species (12%), Pseudomonas species (8.2%), Klebsiella species (6.6%), CONS (4.4%), Escherichia coli (4.4%), Salmonella Typhi (3.5%), Enterobacter species (3.2%) and Streptococcus species (0.3%).
 Conclusions: Staphylococcus aureus was the commonest isolate identified in the current study. BACTEC culture method detected the higher percentage of isolates than BHIB method.","PeriodicalId":39140,"journal":{"name":"Journal of Nepal Paediatric Society","volume":"35 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136071795","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}
Introduction: Breast milk is a natural and perfect food that protects against illness and death by acting as the baby’s first immunization. The employment of the mother is considered to be one of the most important barriers to exclusive breastfeeding (EBF).
Methods: A hospital-based descriptive cross-sectional study was done to find out the associated factors with EBF among working mothers. A total of 150 working mothers having children six to 24 months were selected. Self-developed semi-structured interview schedule was used. Pre-testing was done on 15 (10%) of the total sample and necessary modifications were done. Data were analyzed by using descriptive (Frequency, percentage) and inferential statistics (Chi-square and odds ratio).
Results: A total of 52 (34.66%) working mothers reported to have practice of EBF for six months. Majority (80%) of the working mothers fed colostrum. Majority (92.85%) of the working mothers gave powdered milk due to inadequate milk secretion. Regarding Expressed Breast Milk (EBM) storage, more than 50% had no idea about EBM and 47 (31.33%) of the mothers had a breastfeeding room at their workplace. 80 (53.33%) mothers had allowed children in their workplace while 47 (88.0%) had family support. EBF was associated with mode of delivery (OR = 0.440, 95% CI: 0.214 - 0.903), child hospitalization in the past (OR = 0.139, 95% CI: 0.031 - 0.618), facility of express breastmilk (OR = 4.087, 95% CI: 0.978 - 17.079) and flexible working environment (OR = 4.2, 95% CI: 1.789 - 9.863).
Conclusions: About only one-third of working mothers had given EBF to their child. Vaginal delivery, child hospitalization in the past, a facility of EBM at home, and a flexible working environment were associated factors with EBF among working mothers.
{"title":"Factors Associated with Exclusive Breastfeeding among Working Mothers Attending Maternal and Child Health Clinic","authors":"Narayani Devi Sigdel, Sochana Sapkota, Sharada Acharya","doi":"10.60086/jnps485","DOIUrl":"https://doi.org/10.60086/jnps485","url":null,"abstract":"Introduction: Breast milk is a natural and perfect food that protects against illness and death by acting as the baby’s first immunization. The employment of the mother is considered to be one of the most important barriers to exclusive breastfeeding (EBF).
 Methods: A hospital-based descriptive cross-sectional study was done to find out the associated factors with EBF among working mothers. A total of 150 working mothers having children six to 24 months were selected. Self-developed semi-structured interview schedule was used. Pre-testing was done on 15 (10%) of the total sample and necessary modifications were done. Data were analyzed by using descriptive (Frequency, percentage) and inferential statistics (Chi-square and odds ratio).
 Results: A total of 52 (34.66%) working mothers reported to have practice of EBF for six months. Majority (80%) of the working mothers fed colostrum. Majority (92.85%) of the working mothers gave powdered milk due to inadequate milk secretion. Regarding Expressed Breast Milk (EBM) storage, more than 50% had no idea about EBM and 47 (31.33%) of the mothers had a breastfeeding room at their workplace. 80 (53.33%) mothers had allowed children in their workplace while 47 (88.0%) had family support. EBF was associated with mode of delivery (OR = 0.440, 95% CI: 0.214 - 0.903), child hospitalization in the past (OR = 0.139, 95% CI: 0.031 - 0.618), facility of express breastmilk (OR = 4.087, 95% CI: 0.978 - 17.079) and flexible working environment (OR = 4.2, 95% CI: 1.789 - 9.863).
 Conclusions: About only one-third of working mothers had given EBF to their child. Vaginal delivery, child hospitalization in the past, a facility of EBM at home, and a flexible working environment were associated factors with EBF among working mothers.","PeriodicalId":39140,"journal":{"name":"Journal of Nepal Paediatric Society","volume":"25 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136071909","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}
Introduction: Neonatal disease severity scoring systems are widely used to predict severity of illness. Existing scoring systems contain variables like pH, PO2 / FiO2 ratio, and base excess, which are difficult to obtain in resource-limited settings. Modified sick neonatal score (MSNS) is based on eight clinical variables which are easy to calculate and are also accurate enough at the same time. This study was done to evaluate MSNS for predicting the outcome of neonates in our settings.
Methods: This was prospective observational study done at neonatal intensive care unit (NICU) of tertiary care hospital in Nepal from February 2021 to January 2022. The parameters required for the score were recorded at admission. Total score was calculated and outcome was noted. Data collected was analyzed using SPSS Statistics for Windows, v21.0. Chi square test, Mann-Whitney U test and ROC analysis were used for statistical analysis.
Results: Total of 195 neonates were discharged and 37 expired. The mean MSNS score among expired was 8.16 ± 1.625 and discharged was 10.99 ± 1.753. For a cutoff score of ≤ 10, sensitivity and specificity; Positive and negative predictive value were 89.2% and 60.5%; 30.7% and 98.3% respectively. The area under the curve (AUC) of MSNS was 0.875 (CI 95%; 0.817 - 0.934). Lower MSNS score was also associated with requirement of iontrope and ventilator support.
Conclusions: MSNS can be used as an important clinical tool for predicting the severity of disease in neonates in resource limited settings.
{"title":"Modified Sick Neonatal Score (MSNS) in Predicting the Outcome of Neonates in Tertiary Care Hospital","authors":"Sajal Twanbasu, Puja Amatya, Ganesh Shah","doi":"10.60086/jnps490","DOIUrl":"https://doi.org/10.60086/jnps490","url":null,"abstract":"Introduction: Neonatal disease severity scoring systems are widely used to predict severity of illness. Existing scoring systems contain variables like pH, PO2 / FiO2 ratio, and base excess, which are difficult to obtain in resource-limited settings. Modified sick neonatal score (MSNS) is based on eight clinical variables which are easy to calculate and are also accurate enough at the same time. This study was done to evaluate MSNS for predicting the outcome of neonates in our settings.
 Methods: This was prospective observational study done at neonatal intensive care unit (NICU) of tertiary care hospital in Nepal from February 2021 to January 2022. The parameters required for the score were recorded at admission. Total score was calculated and outcome was noted. Data collected was analyzed using SPSS Statistics for Windows, v21.0. Chi square test, Mann-Whitney U test and ROC analysis were used for statistical analysis.
 Results: Total of 195 neonates were discharged and 37 expired. The mean MSNS score among expired was 8.16 ± 1.625 and discharged was 10.99 ± 1.753. For a cutoff score of ≤ 10, sensitivity and specificity; Positive and negative predictive value were 89.2% and 60.5%; 30.7% and 98.3% respectively. The area under the curve (AUC) of MSNS was 0.875 (CI 95%; 0.817 - 0.934). Lower MSNS score was also associated with requirement of iontrope and ventilator support.
 Conclusions: MSNS can be used as an important clinical tool for predicting the severity of disease in neonates in resource limited settings.","PeriodicalId":39140,"journal":{"name":"Journal of Nepal Paediatric Society","volume":"27 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136071803","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}
There have been few reports of mild encephalopathy with reversible splenic lesions (MERS) associated with COVID-19 in infants. Here, we present a case of MERS in a 23-month-old infant with COVID-19 in Japan during the Omicron variant epidemic. The increase in COVID-19 acute encephalopathy in infants, including those with MERS, should be considered in the future due to the prevalence of the Omicron variant strain. Meanwhile, whether the cause is COVID-19, acute encephalopathy with a lesion localized in the splenium of the corpus callosum can be treated with temporary anticonvulsant therapy, as is generally the case with MERS.
{"title":"Mild Encephalopathy with Reversible Splenic Lesions in an Infant with COVID-19","authors":"Natsuki Yagi, Ryo Sugitate, Mariko Shimizu, Tomomi Ogata","doi":"10.60086/jnps498","DOIUrl":"https://doi.org/10.60086/jnps498","url":null,"abstract":"There have been few reports of mild encephalopathy with reversible splenic lesions (MERS) associated with COVID-19 in infants. Here, we present a case of MERS in a 23-month-old infant with COVID-19 in Japan during the Omicron variant epidemic. The increase in COVID-19 acute encephalopathy in infants, including those with MERS, should be considered in the future due to the prevalence of the Omicron variant strain. Meanwhile, whether the cause is COVID-19, acute encephalopathy with a lesion localized in the splenium of the corpus callosum can be treated with temporary anticonvulsant therapy, as is generally the case with MERS.","PeriodicalId":39140,"journal":{"name":"Journal of Nepal Paediatric Society","volume":"3 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136071199","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}
Introduction: The global “under-five mortality” has dropped 60% from 93 deaths per 1,000 live births in 1990 to 37 in 2020 in the last three decades. It is vital to adopt proven quality improvement initiatives to provide quality care to improve neonatal mortality and morbidity. Aim of the study was to assess the impact of the quality improvement interventions and strategies in reducing the neonatal mortality statistics.
Methods: The study was conducted in a 500 bedded Government Hospital in India. The management implemented various tactics, such as enhancing the existing infrastructure, upgrading equipment, augmenting the workforce, and implementing established clinical protocols, to enhance the quality of intensive care services provided in the NICU. The QI points were identified based on the shortcomings that were identified and shortlisted based on the working of NICU pre QI implementation. The outcome was measured as neonatal mortality indicators and the data was compared between pre and post implementation period.
Results: After implementing quality improvement measures, there were notable enhancements in the total floor area, availability of skilled personnel, and equipment. The number of total admissions to the NICU increased by 79%, and mortality reduced from 20.93% to 7.82%. There was a statistically significant decrease in disease-specific neonatal mortality rates, with a p-value of less than 0.001.
Conclusions: This study concludes that implementation of proper and comprehensive QI interventions and strategies in NICUs can help in decreasing the neonatal mortality.
{"title":"Impact of Quality Improvement (QI) Initiatives on Neonatal Mortality in NICU: A Retrospective Analysis in Tertiary Care Centre in Western India","authors":"Prabhudev Basavaraj Hasbi, Jitendra Kumar Jain, Mohit Ajmera, Gopikishan Sharma, Chetan Meena, Amrita Mayanger","doi":"10.60086/jnps488","DOIUrl":"https://doi.org/10.60086/jnps488","url":null,"abstract":"Introduction: The global “under-five mortality” has dropped 60% from 93 deaths per 1,000 live births in 1990 to 37 in 2020 in the last three decades. It is vital to adopt proven quality improvement initiatives to provide quality care to improve neonatal mortality and morbidity. Aim of the study was to assess the impact of the quality improvement interventions and strategies in reducing the neonatal mortality statistics.
 Methods: The study was conducted in a 500 bedded Government Hospital in India. The management implemented various tactics, such as enhancing the existing infrastructure, upgrading equipment, augmenting the workforce, and implementing established clinical protocols, to enhance the quality of intensive care services provided in the NICU. The QI points were identified based on the shortcomings that were identified and shortlisted based on the working of NICU pre QI implementation. The outcome was measured as neonatal mortality indicators and the data was compared between pre and post implementation period.
 Results: After implementing quality improvement measures, there were notable enhancements in the total floor area, availability of skilled personnel, and equipment. The number of total admissions to the NICU increased by 79%, and mortality reduced from 20.93% to 7.82%. There was a statistically significant decrease in disease-specific neonatal mortality rates, with a p-value of less than 0.001.
 Conclusions: This study concludes that implementation of proper and comprehensive QI interventions and strategies in NICUs can help in decreasing the neonatal mortality.","PeriodicalId":39140,"journal":{"name":"Journal of Nepal Paediatric Society","volume":"43 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136071800","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}
Manju Shrestha, Basant Rai, Jyoti Agrawal, Shipra Chaudhary, Kala Shrestha, Rupa Raj Bhandari Singh
Introduction: Malnutrition among children remains one of the most important causes of morbidity and mortality in the developing countries like Nepal. Multiple interrelated determinants are involved in causing malnutrition that needs to be catered. This study aims to assess the prevalence and associated factors of malnutrition among under-five children in eastern Nepal.
Methods: This is a hospital-based correctional study. The enrolment occurred between Jan 2018 and Dec 2019 among children who visited nutrition clinic in our hospital. The data analyses were performed using Logistic regression and 95% confidence interval along with p-value. A p-value < 0.05 was considered statistically significant.
Results: A total of 310 children were analyzed for malnutrition. Among them, the prevalence of underweight, stunting and wasting was 34.10, 32.45, 17.54 % respectively. Among them, majority of the mother belonged to young age group between 18- 25 years, 216 (69.68%) were females and 120 (38.71%) and Majority of malnutrition fell in the age group of 12 – 23 months. Mother’s age, mother’s education, family size, economic status, child’s age and sex, exclusive breast, ethnicity, mother’s occupation and total family size were found to be significantly associated with malnutrition.
Conclusions: This study highlights serious concern of malnutrition among under five years old children in eastern part of Nepal. Multiple hierarchically interrelated determinants associated with child, mother and the social environmental factors were found significant in malnutrition among the children.
{"title":"Prevalence and Associated Factors of Malnutrition in Under Five Children in Eastern Nepal: A Hospital Based Study","authors":"Manju Shrestha, Basant Rai, Jyoti Agrawal, Shipra Chaudhary, Kala Shrestha, Rupa Raj Bhandari Singh","doi":"10.60086/jnps492","DOIUrl":"https://doi.org/10.60086/jnps492","url":null,"abstract":"Introduction: Malnutrition among children remains one of the most important causes of morbidity and mortality in the developing countries like Nepal. Multiple interrelated determinants are involved in causing malnutrition that needs to be catered. This study aims to assess the prevalence and associated factors of malnutrition among under-five children in eastern Nepal.
 Methods: This is a hospital-based correctional study. The enrolment occurred between Jan 2018 and Dec 2019 among children who visited nutrition clinic in our hospital. The data analyses were performed using Logistic regression and 95% confidence interval along with p-value. A p-value < 0.05 was considered statistically significant.
 Results: A total of 310 children were analyzed for malnutrition. Among them, the prevalence of underweight, stunting and wasting was 34.10, 32.45, 17.54 % respectively. Among them, majority of the mother belonged to young age group between 18- 25 years, 216 (69.68%) were females and 120 (38.71%) and Majority of malnutrition fell in the age group of 12 – 23 months. Mother’s age, mother’s education, family size, economic status, child’s age and sex, exclusive breast, ethnicity, mother’s occupation and total family size were found to be significantly associated with malnutrition.
 Conclusions: This study highlights serious concern of malnutrition among under five years old children in eastern part of Nepal. Multiple hierarchically interrelated determinants associated with child, mother and the social environmental factors were found significant in malnutrition among the children.","PeriodicalId":39140,"journal":{"name":"Journal of Nepal Paediatric Society","volume":"12 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136072023","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}
Introduction: Assessing the severity of acute asthma objectively is important to guide treatment. Peak Expiratory Flow Rate (PEFR) is used for this. Paediatric Asthma Score (PAS) is a user-friendly asthma score in children. Our aim was to validate the efficacy of PAS in comparison with PEFR for assessing severity of acute asthma.
Methods: The study included 32 children in the age group of five to 14 years, with mild to moderate asthma exacerbation. The PEFR and the PAS were measured before treatment, 15 min, 30 min, and one hour after treatment, and at discharge. Paired t-test was used to establish construct validity by comparing pre-and post-treatment PEFR and PAS. The criterion validity was calculated by correlating pre-and post-treatment PASs with PEFRs.
Results: The mean predicted PEFR improved with treatment by 22.35% (p < 0.001) by one hour. Pre- and post-treatment PASs significantly correlated with PEFRs. The correlation of pre-treatment PEFR and PAS was r = -0.491 (p = 0.004), that for post-treatment at 1hour was r = -0.505 (p = 0.003).
Conclusions: The study validities the PAS as a measure of severity of asthma. The PAS is thus a simple alternative to the PEFR to estimate airway obstruction in children within the age group to five to 14 years with acute asthma exacerbations.
{"title":"Validation of the Paediatric Asthma Score (PAS) in Evaluation of Acute Exacerbation of Asthma in Children","authors":"Joswin K Jose, Aparna Namboodiripad","doi":"10.60086/jnps495","DOIUrl":"https://doi.org/10.60086/jnps495","url":null,"abstract":"Introduction: Assessing the severity of acute asthma objectively is important to guide treatment. Peak Expiratory Flow Rate (PEFR) is used for this. Paediatric Asthma Score (PAS) is a user-friendly asthma score in children. Our aim was to validate the efficacy of PAS in comparison with PEFR for assessing severity of acute asthma.
 Methods: The study included 32 children in the age group of five to 14 years, with mild to moderate asthma exacerbation. The PEFR and the PAS were measured before treatment, 15 min, 30 min, and one hour after treatment, and at discharge. Paired t-test was used to establish construct validity by comparing pre-and post-treatment PEFR and PAS. The criterion validity was calculated by correlating pre-and post-treatment PASs with PEFRs.
 Results: The mean predicted PEFR improved with treatment by 22.35% (p < 0.001) by one hour. Pre- and post-treatment PASs significantly correlated with PEFRs. The correlation of pre-treatment PEFR and PAS was r = -0.491 (p = 0.004), that for post-treatment at 1hour was r = -0.505 (p = 0.003).
 Conclusions: The study validities the PAS as a measure of severity of asthma. The PAS is thus a simple alternative to the PEFR to estimate airway obstruction in children within the age group to five to 14 years with acute asthma exacerbations.","PeriodicalId":39140,"journal":{"name":"Journal of Nepal Paediatric Society","volume":"143 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136071686","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}
Introduction: Stretched penile length is the most relevant measurement to define the size of the penis, which varies in various ages, geographical regions and ethnicities. Thus, a population specific normative data on stretched penile length helps in early diagnosis of penile abnormalities and endocrine disorders in children.
Methods: A cross sectional study was done in 501 healthy boys from neonatal period till 12 years of age. Boys with abnormalities of external genitalia, suspected endocrine disorders, suspected syndromes, chronic diseases were excluded from the study. Stretched penile length was measured with a transparent ruler from the pubic ramus till the tip of the glans penis excluding the foreskin. Height and weight of the boys were also recorded. Spearman’s rank correlation coefficient test was used to find the correlation of stretched penile length vs height and weight of the boys. P < 0.05 was considered significant.
Results: The median, 5th, 95th percentiles of stretched penile length were calculated. The median stretched penile length of the boys ranged from 3.01 (2.32, 3.06) cm in infancy to 6.33 (6.04, 6.62) cm by 12 years. The correlation of stretched penile length vs height and weight showed a statistically significant positive correlation. (rs = 0.979, p < 0.001; rs = 0.971, P < 0.001 respectively).
Conclusions: Our study provides normative data on stretched penile length from neonatal period till 12 years of age. There was a significant positive correlation between stretched penile length and height and weight of the boys.
简介:拉伸后的阴茎长度是定义阴茎大小最相关的测量，在不同的年龄、地理区域和种族中有所不同。因此，对儿童阴茎拉伸长度的人群特异性规范数据有助于早期诊断阴茎异常和内分泌紊乱。
方法:对501例新生儿至12岁健康男孩进行横断面研究。排除外生殖器异常、疑似内分泌紊乱、疑似综合征、慢性疾病的男孩。用透明尺测量拉伸后的阴茎长度，从耻骨支到龟头(不包括包皮)尖端。这些男孩的身高和体重也被记录了下来。采用Spearman秩相关系数检验，分析拉伸阴茎长度与男孩身高、体重的相关性。P & lt;0.05被认为是显著的.
结果:计算拉伸后阴茎长度的中位数、第5、第95百分位。男孩的阴茎伸展长度中位数从婴儿期的3.01 (2.32,3.06)cm到12岁时的6.33 (6.04,6.62)cm不等。拉伸后阴茎长度与身高、体重呈显著正相关。(rs = 0.979, p <0.001;rs = 0.971, P <0.001) # x0D公司;结论:本研究提供了新生儿期至12岁阴茎拉伸长度的规范数据。伸直后阴茎长度与男孩身高、体重呈显著正相关。
{"title":"Stretched Penile Length in Boys - A Cross-sectional Single Centre Study","authors":"Saranya Lakshmanapillai Ramuppillai, Rangasamy Krishnamoorthi, Saranya Ravichandran, Jithesh Kumar Somasundaram, Naveen Rengarajan Dhanalakshmi","doi":"10.60086/jnps494","DOIUrl":"https://doi.org/10.60086/jnps494","url":null,"abstract":"Introduction: Stretched penile length is the most relevant measurement to define the size of the penis, which varies in various ages, geographical regions and ethnicities. Thus, a population specific normative data on stretched penile length helps in early diagnosis of penile abnormalities and endocrine disorders in children.
 Methods: A cross sectional study was done in 501 healthy boys from neonatal period till 12 years of age. Boys with abnormalities of external genitalia, suspected endocrine disorders, suspected syndromes, chronic diseases were excluded from the study. Stretched penile length was measured with a transparent ruler from the pubic ramus till the tip of the glans penis excluding the foreskin. Height and weight of the boys were also recorded. Spearman’s rank correlation coefficient test was used to find the correlation of stretched penile length vs height and weight of the boys. P < 0.05 was considered significant.
 Results: The median, 5th, 95th percentiles of stretched penile length were calculated. The median stretched penile length of the boys ranged from 3.01 (2.32, 3.06) cm in infancy to 6.33 (6.04, 6.62) cm by 12 years. The correlation of stretched penile length vs height and weight showed a statistically significant positive correlation. (rs = 0.979, p < 0.001; rs = 0.971, P < 0.001 respectively).
 Conclusions: Our study provides normative data on stretched penile length from neonatal period till 12 years of age. There was a significant positive correlation between stretched penile length and height and weight of the boys.","PeriodicalId":39140,"journal":{"name":"Journal of Nepal Paediatric Society","volume":"72 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136071789","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}
Introduction: The quality care is an essential aspect of hospital service in improving health outcomes. Quality of children’s care can be assessed by measuring the parental satisfaction.
Methods: A descriptive cross-sectional design was used. Non-probability purposive sampling was used to select 167 parents of children who were admitted in Kanti Children Hospital. Data were collected by interviewing either the father or mother as roomed-in by using the Pediatric family satisfaction questionnaire (PFSQ) containing three domains as modified to suit to local context. Data were entered, cleaned and analyzed in statistical package for the social sciences SPSS version 22. Chi-square test and Spearman rank correlation coefficient were used to analyze the data.
Results: Findings revealed that the overall satisfaction among majority (59.9%) of the respondents was low. However, domain wise, almost all (94.6%) respondents were satisfied in medical care followed by 89.2% in nursing care and lowest proportion (42.5%) was satisfied with hospital services and accommodation. Parental overall satisfaction was significantly higher among those admitted in surgical unit (p = 0.00) and among those with days of hospitalization as more than 6 days (p = 0.01). Findings also showed a moderate correlation between the satisfaction with nursing care and medical care (r = 0.64).
Conclusions: Parents tend to have low satisfaction with the care provided to the admitted children whereas domain wise satisfaction is high in medical and nursing care and low in hospital services. Therefore, in order to increases the parental satisfaction, more focus should be given to improve the quality of hospital services and accommodation.
{"title":"Parental Satisfaction with the Care of Admitted Children in a Tertiary Level Hospital","authors":"Kabita Pandey, Sanjana Shrestha, Sarala Shrestha","doi":"10.60086/jnps491","DOIUrl":"https://doi.org/10.60086/jnps491","url":null,"abstract":"Introduction: The quality care is an essential aspect of hospital service in improving health outcomes. Quality of children’s care can be assessed by measuring the parental satisfaction.
 Methods: A descriptive cross-sectional design was used. Non-probability purposive sampling was used to select 167 parents of children who were admitted in Kanti Children Hospital. Data were collected by interviewing either the father or mother as roomed-in by using the Pediatric family satisfaction questionnaire (PFSQ) containing three domains as modified to suit to local context. Data were entered, cleaned and analyzed in statistical package for the social sciences SPSS version 22. Chi-square test and Spearman rank correlation coefficient were used to analyze the data.
 Results: Findings revealed that the overall satisfaction among majority (59.9%) of the respondents was low. However, domain wise, almost all (94.6%) respondents were satisfied in medical care followed by 89.2% in nursing care and lowest proportion (42.5%) was satisfied with hospital services and accommodation. Parental overall satisfaction was significantly higher among those admitted in surgical unit (p = 0.00) and among those with days of hospitalization as more than 6 days (p = 0.01). Findings also showed a moderate correlation between the satisfaction with nursing care and medical care (r = 0.64).
 Conclusions: Parents tend to have low satisfaction with the care provided to the admitted children whereas domain wise satisfaction is high in medical and nursing care and low in hospital services. Therefore, in order to increases the parental satisfaction, more focus should be given to improve the quality of hospital services and accommodation.","PeriodicalId":39140,"journal":{"name":"Journal of Nepal Paediatric Society","volume":"143 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136071794","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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