Pub Date : 2022-12-31DOI: 10.3126/jnps.v42i2.39821
Adeel Moideen, Apurv Barche, Sneha J. Andrade, Aditya Verma, L. Lewis, Jayashree Purkayastha, Ayesha Erum Hadi
Introduction: Neutrophil surface CD64 (Cluster of differentiation 64), the highaffinity Fc receptor, is quantitatively up-regulated during infection and sepsis. The diagnostic utility of NCD64 as a reliable marker of neonatal sepsis has not been explored so far. Hence this study has been conducted to compare NCD64 with other currently used infection markers including total leucocyte count, platelet count, absolute neutrophil count (ANC), band:neutrophil ratio and highly sensitive C reactive protein (hs-CRP). Methods: Consecutively born neonates between March 2014 to November 2014 were enrolled with documented sepsis (n = 81), clinical sepsis (n = 35), and no sepsis (n = 87). NCD64 was analyzed by flow cytometry. Results: Sepsis episodes had a higher median CD64 index of 10.35 (Range: 15.88, 6.87) as against 2.97 (Range: 5.53, 1.64) in the control group (p < 0.001). The percentage of NCD64 positive cells was also significantly higher in the sepsis group compared to the control group (63.90 ± 2.67 vs 15.07 ± 1.95; p = 0.001). In the ROC curve analysis NCD64, percentage of NCD64 positive cells had the highest AUC (AUC-0.914) using a cutoff of 28.01%, followed by CD64 mean fluorescence intensity (MFI) with an AUC of 0.850 using a cutoff of 5.54. NCD64 was significantly elevated in the groups with documented and clinical sepsis (p < 0.001). Conclusions: NCD64 is a highly sensitive marker for neonatal sepsis. Prospective studies incorporating NCD64 into a sepsis scoring system are warranted.
中性粒细胞表面CD64 (Cluster of differentiation 64)是一种高亲和力Fc受体，在感染和脓毒症期间被定量上调。到目前为止，NCD64作为新生儿败血症的可靠标志物的诊断效用尚未得到探讨。因此，本研究将NCD64与目前使用的其他感染标志物进行比较，包括白细胞总数、血小板计数、绝对中性粒细胞计数(ANC)、带中性粒细胞比率和高敏C反应蛋白(hs-CRP)。方法:2014年3月至2014年11月连续出生的新生儿中，有记录的脓毒症(n = 81)、临床脓毒症(n = 35)和无脓毒症(n = 87)。流式细胞术检测NCD64。结果:脓毒症发作的CD64指数中位数为10.35(范围:15.88,6.87)，高于对照组的2.97(范围:5.53,1.64)(p < 0.001)。脓毒症组NCD64阳性细胞比例明显高于对照组(63.90±2.67 vs 15.07±1.95;P = 0.001)。在NCD64的ROC曲线分析中，NCD64阳性细胞的AUC最高(AUC-0.914)，截止值为28.01%;其次是CD64的平均荧光强度(MFI)， AUC为0.850，截止值为5.54。NCD64在记录在案的败血症和临床败血症组中显著升高(p < 0.001)。结论:NCD64是一种高度敏感的新生儿败血症标志物。将NCD64纳入败血症评分系统的前瞻性研究是有必要的。
{"title":"Role of Neutrophil CD64 in the Diagnosis of Neonatal Sepsis","authors":"Adeel Moideen, Apurv Barche, Sneha J. Andrade, Aditya Verma, L. Lewis, Jayashree Purkayastha, Ayesha Erum Hadi","doi":"10.3126/jnps.v42i2.39821","DOIUrl":"https://doi.org/10.3126/jnps.v42i2.39821","url":null,"abstract":"Introduction: Neutrophil surface CD64 (Cluster of differentiation 64), the highaffinity Fc receptor, is quantitatively up-regulated during infection and sepsis. The diagnostic utility of NCD64 as a reliable marker of neonatal sepsis has not been explored so far. Hence this study has been conducted to compare NCD64 with other currently used infection markers including total leucocyte count, platelet count, absolute neutrophil count (ANC), band:neutrophil ratio and highly sensitive C reactive protein (hs-CRP).\u0000Methods: Consecutively born neonates between March 2014 to November 2014 were enrolled with documented sepsis (n = 81), clinical sepsis (n = 35), and no sepsis (n = 87). NCD64 was analyzed by flow cytometry.\u0000 Results: Sepsis episodes had a higher median CD64 index of 10.35 (Range: 15.88, 6.87) as against 2.97 (Range: 5.53, 1.64) in the control group (p < 0.001). The percentage of NCD64 positive cells was also significantly higher in the sepsis group compared to the control group (63.90 ± 2.67 vs 15.07 ± 1.95; p = 0.001). In the ROC curve analysis NCD64, percentage of NCD64 positive cells had the highest AUC (AUC-0.914) using a cutoff of 28.01%, followed by CD64 mean fluorescence intensity (MFI) with an AUC of 0.850 using a cutoff of 5.54. NCD64 was significantly elevated in the groups with documented and clinical sepsis (p < 0.001).\u0000Conclusions: NCD64 is a highly sensitive marker for neonatal sepsis. Prospective studies incorporating NCD64 into a sepsis scoring system are warranted.","PeriodicalId":39140,"journal":{"name":"Journal of Nepal Paediatric Society","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43266222","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 : 2022-12-31DOI: 10.3126/jnps.v42i2.42865
Aparajita Gupta, Shuvendu Roy, Prateep Paul
The neurotoxicity of the vinca alkaloids in the form of peripheral neuropathy is well known, however, cranial neuropathy is not widely recognized especially in children. We describe here in three children with malignancies who developed vinca alkaloid induced cranial nerve palsies during treatment which resolved on institution of pyridoxine and pyridostigmine. Vinca-alkaloid-induced cranial nerve palsies represent a potentially dangerous but reversible condition.
{"title":"Effectiveness of Pyridostigmine and Pyridoxine in Vinca AlkaloidInduced Cranial Neuropathy – A Case Series","authors":"Aparajita Gupta, Shuvendu Roy, Prateep Paul","doi":"10.3126/jnps.v42i2.42865","DOIUrl":"https://doi.org/10.3126/jnps.v42i2.42865","url":null,"abstract":"The neurotoxicity of the vinca alkaloids in the form of peripheral neuropathy is well known, however, cranial neuropathy is not widely recognized especially in children. We describe here in three children with malignancies who developed vinca alkaloid induced cranial nerve palsies during treatment which resolved on institution of pyridoxine and pyridostigmine. Vinca-alkaloid-induced cranial nerve palsies represent a potentially dangerous but reversible condition.","PeriodicalId":39140,"journal":{"name":"Journal of Nepal Paediatric Society","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42950920","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 : 2022-12-31DOI: 10.3126/jnps.v42i1.38053
Arditya Dyah Ayu Pitaloka, E. Nurhayati, H. Hadi, Katherine Lee, B. A. Paramashanti
Introduction: Exclusive breastfeeding is beneficial for mother and child health. However, exclusive breastfeeding rate is low among young mothers. Thus, our study aimed to examine the relationship between maternal breastfeeding motivation and exclusive breastfeeding and determine whether the early marriage age influences both variables in Gunung Kidul District, Yogyakarta Special Region, Indonesia. Methods: A cross-sectional design was conducted among young adolescent mothers. A total of 144 married women who had young children aged six to 12 months were selected using simple random sampling. Exclusive breastfeeding was the dependent variable, while maternal breastfeeding motivation was the independent variable. Descriptive statistics, chi-square test, multiple logistic regression, and mantel haenzel tests were performed to analyse the relationship between variables using STATA 14.2. Results: Maternal age at marriage > 20 years (OR = 2.98; 95%CI: 1.15-7.74) and good maternal breastfeeding motivation (OR = 22.02; 95%CI: 7.55-64.2) were associated with exclusive breastfeeding practice. In the stratification analysis, a larger association was found between maternal breastfeeding motivation and exclusive breastfeeding among younger mothers (OR=3.96; 95%CI: 2.25-6.97) compared to older mothers (OR = 1.79; 95%CI: 1.29-2.48). Conclusions: Maternal breastfeeding motivation positively influences exclusive breastfeeding practice. Notably, young mothers are more likely to be motivated to breastfeed their children exclusively than older mothers. The results suggest a need to improve maternal breastfeeding motivation through quality prenatal and postnatal care services that involve other family members.
{"title":"Is Maternal Breastfeeding Motivation and Exclusive Breastfeeding Influenced by early Marriage age?","authors":"Arditya Dyah Ayu Pitaloka, E. Nurhayati, H. Hadi, Katherine Lee, B. A. Paramashanti","doi":"10.3126/jnps.v42i1.38053","DOIUrl":"https://doi.org/10.3126/jnps.v42i1.38053","url":null,"abstract":"Introduction: Exclusive breastfeeding is beneficial for mother and child health. However, exclusive breastfeeding rate is low among young mothers. Thus, our study aimed to examine the relationship between maternal breastfeeding motivation and exclusive breastfeeding and determine whether the early marriage age influences both variables in Gunung Kidul District, Yogyakarta Special Region, Indonesia.\u0000Methods: A cross-sectional design was conducted among young adolescent mothers. A total of 144 married women who had young children aged six to 12 months were selected using simple random sampling. Exclusive breastfeeding was the dependent variable, while maternal breastfeeding motivation was the independent variable. Descriptive statistics, chi-square test, multiple logistic regression, and mantel haenzel tests were performed to analyse the relationship between variables using STATA 14.2.\u0000 Results: Maternal age at marriage > 20 years (OR = 2.98; 95%CI: 1.15-7.74) and good maternal breastfeeding motivation (OR = 22.02; 95%CI: 7.55-64.2) were associated with exclusive breastfeeding practice. In the stratification analysis, a larger association was found between maternal breastfeeding motivation and exclusive breastfeeding among younger mothers (OR=3.96; 95%CI: 2.25-6.97) compared to older mothers (OR = 1.79; 95%CI: 1.29-2.48).\u0000Conclusions: Maternal breastfeeding motivation positively influences exclusive breastfeeding practice. Notably, young mothers are more likely to be motivated to breastfeed their children exclusively than older mothers. The results suggest a need to improve maternal breastfeeding motivation through quality prenatal and postnatal care services that involve other family members.","PeriodicalId":39140,"journal":{"name":"Journal of Nepal Paediatric Society","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45676911","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}
Formerly called congenital cystic adenomatoid malformation (CCAM), congenital pulmonary airway malformation (CPAM) is a rare but most common congenital lung malformation that may manifest as an asymptomatic lesion at birth or in later life. The diagnosis may be difficult and is easily confused for pneumothorax often resulting incorrect ICD insertion on an emergency basis, which causes complications and delays accurate diagnosis. We report a case of a neonate, who presented with increasing respiratory distress at birth and hyperlucency in a chest radiograph initially misdiagnosed as pneumothorax and ICD inserted, later correctly diagnosed as CPAM type I with help of a CT chest. This case report is presented to highlight that CPAM is a rare cause of respiratory distress in newborns at birth.
{"title":"Was It Pneumothorax? A Case Report of a Neonate with Congenital Pulmonary Airway Malformation from Rural Nepal","authors":"Pradip Kumar Paudel, Pragya Devkota, Bibek Devkota","doi":"10.3126/jnps.v42i2.39397","DOIUrl":"https://doi.org/10.3126/jnps.v42i2.39397","url":null,"abstract":"Formerly called congenital cystic adenomatoid malformation (CCAM), congenital pulmonary airway malformation (CPAM) is a rare but most common congenital lung malformation that may manifest as an asymptomatic lesion at birth or in later life. The diagnosis may be difficult and is easily confused for pneumothorax often resulting incorrect ICD insertion on an emergency basis, which causes complications and delays accurate diagnosis. We report a case of a neonate, who presented with increasing respiratory distress at birth and hyperlucency in a chest radiograph initially misdiagnosed as pneumothorax and ICD inserted, later correctly diagnosed as CPAM type I with help of a CT chest. This case report is presented to highlight that CPAM is a rare cause of respiratory distress in newborns at birth.","PeriodicalId":39140,"journal":{"name":"Journal of Nepal Paediatric Society","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44703311","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 : 2022-12-31DOI: 10.3126/jnps.v42i3.47355
Pankaj Kumar, Raj Kumar, P. Singh
Introduction: There are few studies that suggest low Vitamin D levels are associated with asthma. Present study was conducted to evaluate the association between vitamin D levels with asthma and its severity in children. Methods: This cross-sectional study included 70 children (35 asthmatic and 35 controls) aged between three to 12 yrs. CBC, AEC, IgE, spirometry, chest X-ray, and serum vitamin D levels were measured. Vitamin D levels were categorized according to guidelines of the American Academy of Paediatrics (2008) and compared between the two groups. The association between vitamin-D levels with asthma and its severity was studied. Results: The mean age of study group cases was 9.23 ± 2.62 yr. The male:female ratio in the study group was 2.5: 1. Cough and wheezing was the commonest manifestation (100%). Most of the patients had mild asthma (45.71%). Asthma was more common in the urban population (68.57%) and children belonging to lower socioeconomic status (51.43%). The markers of allergic disorders {Eosinophils, AEC and IgE} were elevated (all p-values ≤ 0.0001) in study group. Mean serum vitamin D levels in the study group and control group patients were 45.21 ± 28.52 nmol/L and 57.03 ± 40.01 nmol / L respectively. The mean levels of vitamin D in the study group were insufficient as per AAP criteria. Vitamin D levels were more deficient in severe asthma (26.19 ± 14.46 nmol/L). Conclusions: In the present study Vitamin D insufficiency was seen in patients with asthma.
{"title":"Study of Vitamin D Level in Paediatric Asthma at a Tertiary care Center","authors":"Pankaj Kumar, Raj Kumar, P. Singh","doi":"10.3126/jnps.v42i3.47355","DOIUrl":"https://doi.org/10.3126/jnps.v42i3.47355","url":null,"abstract":"Introduction: There are few studies that suggest low Vitamin D levels are associated with asthma. Present study was conducted to evaluate the association between vitamin D levels with asthma and its severity in children.\u0000Methods: This cross-sectional study included 70 children (35 asthmatic and 35 controls) aged between three to 12 yrs. CBC, AEC, IgE, spirometry, chest X-ray, and serum vitamin D levels were measured. Vitamin D levels were categorized according to guidelines of the American Academy of Paediatrics (2008) and compared between the two groups. The association between vitamin-D levels with asthma and its severity was studied.\u0000Results: The mean age of study group cases was 9.23 ± 2.62 yr. The male:female ratio in the study group was 2.5: 1. Cough and wheezing was the commonest manifestation (100%). Most of the patients had mild asthma (45.71%). Asthma was more common in the urban population (68.57%) and children belonging to lower socioeconomic status (51.43%). The markers of allergic disorders {Eosinophils, AEC and IgE} were elevated (all p-values ≤ 0.0001) in study group. Mean serum vitamin D levels in the study group and control group patients were 45.21 ± 28.52 nmol/L and 57.03 ± 40.01 nmol / L respectively. The mean levels of vitamin D in the study group were insufficient as per AAP criteria. Vitamin D levels were more deficient in severe asthma (26.19 ± 14.46 nmol/L).\u0000Conclusions: In the present study Vitamin D insufficiency was seen in patients with asthma.","PeriodicalId":39140,"journal":{"name":"Journal of Nepal Paediatric Society","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41744716","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 : 2022-12-31DOI: 10.3126/jnps.v42i2.41967
T. Kundu, Arpan Dutta, Abhilash Chatterjee, A. Chowdhury
Introduction: Bronchial asthma is an inflammatory reversible obstructive airway disease. This study aims to determine the association between serum magnesium to calcium ratio with level of asthma control in children by comparing serum magnesium to calcium ratio between - children with well controlled, partly controlled and uncontrolled asthma. Methods: An analytical cross sectional study was done on 90 children diagnosed with bronchial asthma between five to 12 years age from January 2019 to June 2020. Children were selected from the outpatient and inpatient departments of paediatric medicine of a tertiary care medical college hospital. They were classified into well controlled, partly controlled and uncontrolled groups as per Global Initiative for Asthma (GINA) assessment of asthma control in children. The serum magnesium to serum calcium ratio of these children were compared between the groups classified. Results: Mean level of serum magnesium to calcium ratio in well controlled group was 0.29857 (SD 0.07633), partly controlled 0.2439 (SD 0.0532), uncontrolled 0.2545 (SD 0.04467), respectively. Serum magnesium to calcium ratio more than or equal to 0.3 was positively correlated with well controlled asthma. Comparisons of serum magnesium to calcium ratio of well controlled group with partly controlled, uncontrolled and both partly and uncontrolled were statistically significant. Conclusions: Higher serum magnesium to calcium ratio is associated with well controlled asthma. In our study, serum magnesium to calcium ratio more than 0.3 is significantly associated with well controlled asthma.
{"title":"Association between Serum Magnesium to Calcium Ratio with Level of Asthma Control in Children","authors":"T. Kundu, Arpan Dutta, Abhilash Chatterjee, A. Chowdhury","doi":"10.3126/jnps.v42i2.41967","DOIUrl":"https://doi.org/10.3126/jnps.v42i2.41967","url":null,"abstract":"Introduction: Bronchial asthma is an inflammatory reversible obstructive airway disease. This study aims to determine the association between serum magnesium to calcium ratio with level of asthma control in children by comparing serum magnesium to calcium ratio between - children with well controlled, partly controlled and uncontrolled asthma.\u0000Methods: An analytical cross sectional study was done on 90 children diagnosed with bronchial asthma between five to 12 years age from January 2019 to June 2020. Children were selected from the outpatient and inpatient departments of paediatric medicine of a tertiary care medical college hospital. They were classified into well controlled, partly controlled and uncontrolled groups as per Global Initiative for Asthma (GINA) assessment of asthma control in children. The serum magnesium to serum calcium ratio of these children were compared between the groups classified.\u0000Results: Mean level of serum magnesium to calcium ratio in well controlled group was 0.29857 (SD 0.07633), partly controlled 0.2439 (SD 0.0532), uncontrolled 0.2545 (SD 0.04467), respectively. Serum magnesium to calcium ratio more than or equal to 0.3 was positively correlated with well controlled asthma. Comparisons of serum magnesium to calcium ratio of well controlled group with partly controlled, uncontrolled and both partly and uncontrolled were statistically significant.\u0000Conclusions: Higher serum magnesium to calcium ratio is associated with well controlled asthma. In our study, serum magnesium to calcium ratio more than 0.3 is significantly associated with well controlled asthma.","PeriodicalId":39140,"journal":{"name":"Journal of Nepal Paediatric Society","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46147237","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 : 2022-12-31DOI: 10.3126/jnps.v42i2.44302
Ashish Jain, S. R. Chitgupikar, Madhavi Bhardwaraj, P. Subramanian
Introduction: The binasal prongs are used in neonatal intensive care unit (NICU) to provide nasal Continuous Positive Airway Pressure (n-CPAP) in preterm neonates. A variable degree of nasal trauma is the most common complication of n-CPAP therapy. This can be reduced by use of appropriately sized binasal prongs that are customized to the anatomical measurements of noses. The aim was to estimate the nasal two-dimensional anthropometrical parameters among Indian neonates across different gestations; to compare between both sexes and between neonates with different intra uterine growth status and gestational ages. Methods: Hundred and one neonates across different gestational ages (24 – 42 weeks) and intrauterine growth status who were admitted to the NICU of a tertiary teaching hospital were enrolled and grouped into five categories based on their gestational ages viz. 37 – 42 weeks, 34 – 36 weeks, 31 – 33 weeks, 28 – 30 weeks, and 24 – 27 weeks. Seven nasal and para-nasal measurements were taken (nostril width, nostril length, columella width, columella length, nose width, nose length and philtrum length) for each neonate using a vernier caliper. Results: All anthropometrical measurements differed significantly across gestations especially between 37 - 42 and 24 - 27 wks (p = 0.00). Males differed from females only with respect to nostril width (p = 0.032). The measurements varied significantly when compared among small for gestational age, appropriate for gestational age and large for gestational age neonates. Conclusions: The nasal parameters differed significantly among various GA and intra-uterine growth statuses, which should help design appropriate sizes of bi-nasal prongs.
{"title":"Nasal Anthropometry among Term and Preterm Indian Neonates- Does Size Matter?","authors":"Ashish Jain, S. R. Chitgupikar, Madhavi Bhardwaraj, P. Subramanian","doi":"10.3126/jnps.v42i2.44302","DOIUrl":"https://doi.org/10.3126/jnps.v42i2.44302","url":null,"abstract":"Introduction: The binasal prongs are used in neonatal intensive care unit (NICU) to provide nasal Continuous Positive Airway Pressure (n-CPAP) in preterm neonates. A variable degree of nasal trauma is the most common complication of n-CPAP therapy. This can be reduced by use of appropriately sized binasal prongs that are customized to the anatomical measurements of noses. The aim was to estimate the nasal two-dimensional anthropometrical parameters among Indian neonates across different gestations; to compare between both sexes and between neonates with different intra uterine growth status and gestational ages.\u0000Methods: Hundred and one neonates across different gestational ages (24 – 42 weeks) and intrauterine growth status who were admitted to the NICU of a tertiary teaching hospital were enrolled and grouped into five categories based on their gestational ages viz. 37 – 42 weeks, 34 – 36 weeks, 31 – 33 weeks, 28 – 30 weeks, and 24 – 27 weeks. Seven nasal and para-nasal measurements were taken (nostril width, nostril length, columella width, columella length, nose width, nose length and philtrum length) for each neonate using a vernier caliper.\u0000Results: All anthropometrical measurements differed significantly across gestations especially between 37 - 42 and 24 - 27 wks (p = 0.00). Males differed from females only with respect to nostril width (p = 0.032). The measurements varied significantly when compared among small for gestational age, appropriate for gestational age and large for gestational age neonates.\u0000 Conclusions: The nasal parameters differed significantly among various GA and intra-uterine growth statuses, which should help design appropriate sizes of bi-nasal prongs.","PeriodicalId":39140,"journal":{"name":"Journal of Nepal Paediatric Society","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49394708","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 : 2022-12-31DOI: 10.3126/jnps.v42i3.46552
A. Jain, B. Maini, Shahzad Alam Ansari, R. Rastogi
A three months old female baby presented to the emergency with complaints of excessive crying, rapid breathing and high - grade fever for one day. On arrival, the patient had respiratory distress with endotracheal tube in situ and bilateral crepitations on auscultation. Oral cavity examination revealed a well-circumscribed, white colored mass with a smooth surface extending from the uvula. The baby was managed successfully by surgery and the baby has been asymptomatic on follow up.
{"title":"Epidermoid Cyst of Uvula: A Rare Cause of Upper Airway Obstruction","authors":"A. Jain, B. Maini, Shahzad Alam Ansari, R. Rastogi","doi":"10.3126/jnps.v42i3.46552","DOIUrl":"https://doi.org/10.3126/jnps.v42i3.46552","url":null,"abstract":"A three months old female baby presented to the emergency with complaints of excessive crying, rapid breathing and high - grade fever for one day. On arrival, the patient had respiratory distress with endotracheal tube in situ and bilateral crepitations on auscultation. Oral cavity examination revealed a well-circumscribed, white colored mass with a smooth surface extending from the uvula. The baby was managed successfully by surgery and the baby has been asymptomatic on follow up.","PeriodicalId":39140,"journal":{"name":"Journal of Nepal Paediatric Society","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47185538","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 : 2022-12-31DOI: 10.3126/jnps.v42i2.42135
Apoorva, Sadiqua Anjum, Swapna L, Alimelu M, Himabindu Singh, Kalyan
Introduction: COVID-19 pandemic has affected the KMC practices in our SNCU. Lack of clear guidelines and training about continuing KMC in COVID-19 times has further lead to decrease in KMC practices. Methods: This is a prospective single centered quality improvement study conducted in the inborn unit of a tertiary care hospital. Intervention phase was done in August and September 2020. Preterm mother-infant dyads who were admitted in the inborn Level 2 Neonatal care unit with birth weight less than 2000 grams were enrolled in this study. A QI team comprising of resident doctors, nurses and supporting staff and a lactation counsellor was formed. The potential barriers for prolonged KMC were evaluated using fish bone analysis. A variety of measures were introduced and subsequently tested by seven plan-dostudy-act (PDSA) cycles. Data on percentage of initiation of KMC was measured by bedside nurses on daily basis and the data was plotted on run chart every week during implementation phase. Results: 116 eligible mother-infant dyads were studied during implementation period (50 days). We achieved our goal by step-wise implementation of changes through multiple PDSA cycles. The percentage of initiation of KMC among eligible preterm infants has increased from baseline of 43.4% to 83.3% and duration of KMC from 1.5 mean hours to 4.5 hours over a period of eight weeks. Conclusions: Ongoing quality improvement measures increased the percentage of initiation and duration of KMC among eligible preterm infants without addition of extra man power.
{"title":"A Quality Improvement Initiative on sustaining Kangaroo Mother Care Practices During COVID Pandemic","authors":"Apoorva, Sadiqua Anjum, Swapna L, Alimelu M, Himabindu Singh, Kalyan","doi":"10.3126/jnps.v42i2.42135","DOIUrl":"https://doi.org/10.3126/jnps.v42i2.42135","url":null,"abstract":"Introduction: COVID-19 pandemic has affected the KMC practices in our SNCU. Lack of clear guidelines and training about continuing KMC in COVID-19 times has further lead to decrease in KMC practices.\u0000Methods: This is a prospective single centered quality improvement study conducted in the inborn unit of a tertiary care hospital. Intervention phase was done in August and September 2020. Preterm mother-infant dyads who were admitted in the inborn Level 2 Neonatal care unit with birth weight less than 2000 grams were enrolled in this study. A QI team comprising of resident doctors, nurses and supporting staff and a lactation counsellor was formed. The potential barriers for prolonged KMC were evaluated using fish bone analysis. A variety of measures were introduced and subsequently tested by seven plan-dostudy-act (PDSA) cycles. Data on percentage of initiation of KMC was measured by bedside nurses on daily basis and the data was plotted on run chart every week during implementation phase.\u0000Results: 116 eligible mother-infant dyads were studied during implementation period (50 days). We achieved our goal by step-wise implementation of changes through multiple PDSA cycles. The percentage of initiation of KMC among eligible preterm infants has increased from baseline of 43.4% to 83.3% and duration of KMC from 1.5 mean hours to 4.5 hours over a period of eight weeks.\u0000Conclusions: Ongoing quality improvement measures increased the percentage of initiation and duration of KMC among eligible preterm infants without addition of extra man power.","PeriodicalId":39140,"journal":{"name":"Journal of Nepal Paediatric Society","volume":"79 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41263304","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 : 2022-12-31DOI: 10.3126/jnps.v42i3.46231
Onyinye Uchenna Anyanwu, H. Uro-Chukwu, J. Obuna
Sexual violence a common form of GBV may often be hidden by survivors for reasons such as, shame, and anticipatory stigma. Myths, can make certain acts of sexual violence appear acceptable than peno-vaginal penetration. The effect of non or restricted disclosure is that clients may not receive complete care from the existing health systems. We report a case of restricted disclosure resulting from anticipatory stigma by a girl child who was sexually assaulted by a male neighbor.
{"title":"A Case of Restricted Disclosure Due to Anticipatory Stigma and Shame In An 11year Old Survivor of Sexual Assault","authors":"Onyinye Uchenna Anyanwu, H. Uro-Chukwu, J. Obuna","doi":"10.3126/jnps.v42i3.46231","DOIUrl":"https://doi.org/10.3126/jnps.v42i3.46231","url":null,"abstract":"Sexual violence a common form of GBV may often be hidden by survivors for reasons such as, shame, and anticipatory stigma. Myths, can make certain acts of sexual violence appear acceptable than peno-vaginal penetration. The effect of non or restricted disclosure is that clients may not receive complete care from the existing health systems. We report a case of restricted disclosure resulting from anticipatory stigma by a girl child who was sexually assaulted by a male neighbor.","PeriodicalId":39140,"journal":{"name":"Journal of Nepal Paediatric Society","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42942559","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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