Pub Date : 2018-12-31DOI: 10.23937/2469-5769/1510029
V. Aravindhan, Charafeddine Lama, Sinno Durriyah, Mikati Mohamad A
Objective: Early Childhood Developmental Interventions (ECDIs) were developed with the aim of improving overall functional outcome of children over and above what the home environment provides. Cost-Benefit Analysis (CBA) of ECDIs using a flexible and easy to apply model that can complement the more granular and highly desirable CBA studies that often may be too difficult or too expensive to perform. Methods: Review and analysis of the relevant worldwide literature to determine, on a Percent Per Capita Gross National Product (PCGNP) comparative basis: i) Impact of interventions on cognitive outcomes, ii) Impact of improved cognitive outcome on expected later individualized PCGNP, and iii) Duration of ECDIs and their yearly costs. We subsequently performed a CBA based on an analysis model that uses IQ increases as a proxy for subsequent economic gains resulting from ECDIs. Results: The model used to calculate the impact of ECDIs during the preschool period (two years: ages 3 through 4), is based on the literature that shows the following: Interventions result in a mean increase of intelligence quotient of approximately 8 points, and a higher intelligence quotient is associated with a higher later PCGNP. Projections of revenue resulting from direct benefits of ECDIs versus initial costs revealed a breakeven point for recuperating costs of ECDI at the age of 24 years (range: 22-33 years) with a benefit-cost ratio of 4.19 (2.08-6.24). Conclusion: Our CBA provides a proposed model that can be applied across countries, and that allows for tailored modifications for specific communities (e.g. plugging in different costs for ECDIs). This model could potentially complement the more granular and more desirable cost-benefit studies whenever such studies are not possible to perform but a CBA is nevertheless needed.
{"title":"Impact of Early Childhood Developmental Intervention Programs: Cost-Benefit Analysis Using a Proposed Model","authors":"V. Aravindhan, Charafeddine Lama, Sinno Durriyah, Mikati Mohamad A","doi":"10.23937/2469-5769/1510029","DOIUrl":"https://doi.org/10.23937/2469-5769/1510029","url":null,"abstract":"Objective: Early Childhood Developmental Interventions (ECDIs) were developed with the aim of improving overall functional outcome of children over and above what the home environment provides. Cost-Benefit Analysis (CBA) of ECDIs using a flexible and easy to apply model that can complement the more granular and highly desirable CBA studies that often may be too difficult or too expensive to perform. Methods: Review and analysis of the relevant worldwide literature to determine, on a Percent Per Capita Gross National Product (PCGNP) comparative basis: i) Impact of interventions on cognitive outcomes, ii) Impact of improved cognitive outcome on expected later individualized PCGNP, and iii) Duration of ECDIs and their yearly costs. We subsequently performed a CBA based on an analysis model that uses IQ increases as a proxy for subsequent economic gains resulting from ECDIs. Results: The model used to calculate the impact of ECDIs during the preschool period (two years: ages 3 through 4), is based on the literature that shows the following: Interventions result in a mean increase of intelligence quotient of approximately 8 points, and a higher intelligence quotient is associated with a higher later PCGNP. Projections of revenue resulting from direct benefits of ECDIs versus initial costs revealed a breakeven point for recuperating costs of ECDI at the age of 24 years (range: 22-33 years) with a benefit-cost ratio of 4.19 (2.08-6.24). Conclusion: Our CBA provides a proposed model that can be applied across countries, and that allows for tailored modifications for specific communities (e.g. plugging in different costs for ECDIs). This model could potentially complement the more granular and more desirable cost-benefit studies whenever such studies are not possible to perform but a CBA is nevertheless needed.","PeriodicalId":73466,"journal":{"name":"International journal of pediatric research","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45839304","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 : 2018-12-31DOI: 10.23937/2469-5769/1510037
M HammoudNurah, V. H. de, Rossem Lenie van, W DalmeijerGeertje, H BiesmaDouwe, M WitJan, R. Maarten, Visser Gerard Ha
Purpose: Offspring from women with diabetes have an increased risk for childhood obesity, which may be related to the abnormal intrauterine environment, genetic imprinting or current diet and lifestyle. We analyzed whether diet and lifestyle differ between offspring from women with either type 1, type 2 or gestational diabetes. We collected completed questionnaires from parents of 51 offspring from women with type 1 diabetes (ODM1), 21 of women with type 2 diabetes (ODM2) and 87 of women with gestational diabetes (OGDM). Methods: All women with a pregnancy complicated by type 1, type 2 or gestational diabetes, who delivered between 1990 and 2006 in a tertiary center were contacted for this retrospective study. We compared offspring diet and lifestyle between offspring of maternal diabetes. Results: The prevalence of maternal overweight/obesity before pregnancy was significantly higher in women with DM2 compared to GDM and DM1; their offspring had a slightly higher incidence of overweight at follow-up as compared to the other groups. ODM2 skipped breakfast more often and were less frequently a member of a sports club but consumed less snacks. Intake of fruit, vegetables and sugar containing drinks were comparable between the groups. ODM2 parents judged their offspring as being more vulnerable and less healthy compared to peers, whilst ODM1 and OGDM parents report their children’s’ health comparable to peers. Conclusion: Lifestyle and dietary intake in childhood can be affected by different environmental and lifestyle factors. In this relatively small study offspring from women with type 2 diabetes seem to have a less healthy diet and lifestyle with might contribute to their increased risk of development of obesity later in life. Larger studies are needed to provide possible targeted interventions for prevention of childhood overweight/obesity in these children.
{"title":"Lifestyle, Diet and Body Mass Index in Offspring of Women with Pregestational and Gestational Diabetes","authors":"M HammoudNurah, V. H. de, Rossem Lenie van, W DalmeijerGeertje, H BiesmaDouwe, M WitJan, R. Maarten, Visser Gerard Ha","doi":"10.23937/2469-5769/1510037","DOIUrl":"https://doi.org/10.23937/2469-5769/1510037","url":null,"abstract":"Purpose: Offspring from women with diabetes have an increased risk for childhood obesity, which may be related to the abnormal intrauterine environment, genetic imprinting or current diet and lifestyle. We analyzed whether diet and lifestyle differ between offspring from women with either type 1, type 2 or gestational diabetes. We collected completed questionnaires from parents of 51 offspring from women with type 1 diabetes (ODM1), 21 of women with type 2 diabetes (ODM2) and 87 of women with gestational diabetes (OGDM). Methods: All women with a pregnancy complicated by type 1, type 2 or gestational diabetes, who delivered between 1990 and 2006 in a tertiary center were contacted for this retrospective study. We compared offspring diet and lifestyle between offspring of maternal diabetes. Results: The prevalence of maternal overweight/obesity before pregnancy was significantly higher in women with DM2 compared to GDM and DM1; their offspring had a slightly higher incidence of overweight at follow-up as compared to the other groups. ODM2 skipped breakfast more often and were less frequently a member of a sports club but consumed less snacks. Intake of fruit, vegetables and sugar containing drinks were comparable between the groups. ODM2 parents judged their offspring as being more vulnerable and less healthy compared to peers, whilst ODM1 and OGDM parents report their children’s’ health comparable to peers. Conclusion: Lifestyle and dietary intake in childhood can be affected by different environmental and lifestyle factors. In this relatively small study offspring from women with type 2 diabetes seem to have a less healthy diet and lifestyle with might contribute to their increased risk of development of obesity later in life. Larger studies are needed to provide possible targeted interventions for prevention of childhood overweight/obesity in these children.","PeriodicalId":73466,"journal":{"name":"International journal of pediatric research","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46464233","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 : 2018-12-31DOI: 10.23937/2469-5769/1510047
L. Lajos
D-penicillamine (D-PA) was first recognized as a potential benefit for neonatal hyperbilirubinemia (NHBI) caused by hemolytic diseases of the newborn infant or immaturity of UDP-glucuronyltransferase enzyme. During a long-term follow up study there was a remarkedly low incidence of retrolental fibroplasia (RLF) in the infants treated with D-PA in their neonatal period. Then, all infants < 1500 g birthweight were treated with D-PA to prevent retinopathy of prematurity (ROP). This preventive intervention was associated with elimination of all stages of ROP in this randomized, singlecentered comparison analysis (trial or RCT). The 14-day course of D-PA administration were replicated in other institutes in the USA and India. It is important to note that there was no intolerance or shortor long-term toxicity of the medication, in spite of the fact that D-PA was used 1020 times higher doses in the newborn period, than those in adult age. To our concept, the bilirubin-induced neurologic dysfunction (BIND), ROP and Autism Spectrum Disorders (ASD) are neurodegenerative and neurodevelopment diseases (NDs) of immature brain caused by accumulation of free metals and other neurotoxic formations, respectively, in the basal ganglia (BG) and other parts of the central nervous system (CNS) relevant to the above mentioned conditions. The main factor is the hemolysis of neonatal red blood cells. This process is going with the induction of a great amount of heavy metals (mainly iron and copper) and producing reactive oxygen an nitrogen species (ROS and (RNS). These elements are circulating in the bloodstream, and pass through the immature blood-brain-barrier (BBB), finding entrance into the central nervous system (CNS). The author hope that this review will be able to call the attention of neonatologists and the drug manufacturers’ onto this promising intravenous drug treatment.
d -青霉胺(D-PA)最初被认为对新生儿高胆红素血症(NHBI)有潜在的益处，这些高胆红素血症是由新生儿溶血性疾病或udp -葡萄糖醛基转移酶不成熟引起的。在一项长期随访研究中，在新生儿期接受D-PA治疗的婴儿中，网膜后纤维增生(RLF)的发生率明显较低。然后，所有出生体重< 1500 g的婴儿均接受D-PA治疗，以预防早产儿视网膜病变(ROP)。在这个随机、单中心比较分析(试验或随机对照试验)中，这种预防性干预与消除所有阶段的ROP有关。美国和印度的其他研究所也复制了为期14天的D-PA给药课程。值得注意的是，尽管新生儿使用的D-PA剂量比成人高1020倍，但该药物没有不耐受或短期长期毒性。在我们的概念中，胆红素诱导的神经功能障碍(BIND)、ROP和自闭症谱系障碍(ASD)是由于游离金属和其他神经毒性物质分别在基底节区(BG)和中枢神经系统(CNS)的其他部位积累而引起的未成熟大脑的神经退行性和神经发育疾病(NDs)。主要因素是新生儿红细胞溶血。这个过程伴随着大量重金属(主要是铁和铜)的诱导，并产生活性氧和活性氮(ROS和RNS)。这些元素在血液中循环，通过未成熟的血脑屏障(BBB)，进入中枢神经系统。作者希望这篇综述能够引起新生儿科医生和药品制造商对这种有前途的静脉注射药物治疗的重视。
{"title":"D-Penicillamine in the Neonatal Period: Past (!), Present (!?) and Future (?!)","authors":"L. Lajos","doi":"10.23937/2469-5769/1510047","DOIUrl":"https://doi.org/10.23937/2469-5769/1510047","url":null,"abstract":"D-penicillamine (D-PA) was first recognized as a potential benefit for neonatal hyperbilirubinemia (NHBI) caused by hemolytic diseases of the newborn infant or immaturity of UDP-glucuronyltransferase enzyme. During a long-term follow up study there was a remarkedly low incidence of retrolental fibroplasia (RLF) in the infants treated with D-PA in their neonatal period. Then, all infants < 1500 g birthweight were treated with D-PA to prevent retinopathy of prematurity (ROP). This preventive intervention was associated with elimination of all stages of ROP in this randomized, singlecentered comparison analysis (trial or RCT). The 14-day course of D-PA administration were replicated in other institutes in the USA and India. It is important to note that there was no intolerance or shortor long-term toxicity of the medication, in spite of the fact that D-PA was used 1020 times higher doses in the newborn period, than those in adult age. To our concept, the bilirubin-induced neurologic dysfunction (BIND), ROP and Autism Spectrum Disorders (ASD) are neurodegenerative and neurodevelopment diseases (NDs) of immature brain caused by accumulation of free metals and other neurotoxic formations, respectively, in the basal ganglia (BG) and other parts of the central nervous system (CNS) relevant to the above mentioned conditions. The main factor is the hemolysis of neonatal red blood cells. This process is going with the induction of a great amount of heavy metals (mainly iron and copper) and producing reactive oxygen an nitrogen species (ROS and (RNS). These elements are circulating in the bloodstream, and pass through the immature blood-brain-barrier (BBB), finding entrance into the central nervous system (CNS). The author hope that this review will be able to call the attention of neonatologists and the drug manufacturers’ onto this promising intravenous drug treatment.","PeriodicalId":73466,"journal":{"name":"International journal of pediatric research","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46469338","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 : 2018-12-31DOI: 10.23937/2469-5769/1510035
Singh Aaradhana, Sachan Ravi
{"title":"Congenital Cytomegalovirus Infection Presenting as Severe Conjugated Hyperbilirubinemia on First Day of Life","authors":"Singh Aaradhana, Sachan Ravi","doi":"10.23937/2469-5769/1510035","DOIUrl":"https://doi.org/10.23937/2469-5769/1510035","url":null,"abstract":"","PeriodicalId":73466,"journal":{"name":"International journal of pediatric research","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43870765","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 : 2018-12-31DOI: 10.23937/2469-5769/1510042
Salmi Issa Al, H. Suad
Non-communicable diseases (NCD) are rising throughout the globe over the last few decades. Developing countries bear the worse burden of these NCD. Similarly, low birthweight is increasing around the world where most of this prevalence commonly seen in the developing countries but as well in the well-developed countries where advancement of health care managed to increase the survival of the very low birthweight babies. In recent years, there has been great interest in the early development of the foetus and the impact of growth during the gestational period on the development of diseases in later life, and in particular that termed a ‘critical period’. The ‘critical period’ of growth of the kidney is the rapid growth period that starts from the ninth week of gestation onwards, which is determined by rapid cell division. Disproportionate growth of different organ systems in utero can occur because different tissues have different critical periods of growth at different times. LBW, which reflects adverse effects on development in the uterus, contributes to this phenomenon of disease programming in early life. It is not only the presence or absence of genes that control our destiny, but the way in which gene expression may be permanently changed by, for example, the nutritional environment in early life. Many epidemiological findings suggest that the risk of disease in adult life is programmed, and/or imprinted by the environment encountered before. The role of small size at birth with low number of cells may contribute to various NCD problem. Post-natal environmental factors further compound such a metabolic demand on body organs that lead to various organ function being overwhelmed with increase in metabolic rate. Hence this leads to increase demand upon various structures, such as nephron with hyperfiltration, organ dysfunction ensues. Hence, an early strategy health program is of great importance to be instituted to detect major risk factors which may arise early in life in those with LBW and or prematurity. Introduction Non-communicable Chronic diseases, such as diabetes, high blood pressure and kidney disease, are increasing rapidly in many populations globally. Poverty and socio-economic disadvantage, together with lifestyle and dietary changes are significant contributing factors [1,2]. Thrifty hypothesis proposes that type 2 diabetes mellitus (T2DM) and numerous components of metabolic syndrome consequence from derisory intrauterine environments for best fetal growth. Numerous studies have confirmed an increased risk of diabetes or impaired glucose tolerance in relation to low birthweight (LBW) [3]. In spite of number of critics, thrifty phenotype has modulated an important role for genetic factors in the aetiology of T2DM and concluded that “environmental, undoubtedly nutritional factors operating in early life play a chief causative part in T2DM and other components of metabolic syndrome. Barker, et al. stated that T2DM and high blood pr
{"title":"Birthweight and Gestational Age: Early Life Management Strategy to Population Health for Non-Communicable Diseases","authors":"Salmi Issa Al, H. Suad","doi":"10.23937/2469-5769/1510042","DOIUrl":"https://doi.org/10.23937/2469-5769/1510042","url":null,"abstract":"Non-communicable diseases (NCD) are rising throughout the globe over the last few decades. Developing countries bear the worse burden of these NCD. Similarly, low birthweight is increasing around the world where most of this prevalence commonly seen in the developing countries but as well in the well-developed countries where advancement of health care managed to increase the survival of the very low birthweight babies. In recent years, there has been great interest in the early development of the foetus and the impact of growth during the gestational period on the development of diseases in later life, and in particular that termed a ‘critical period’. The ‘critical period’ of growth of the kidney is the rapid growth period that starts from the ninth week of gestation onwards, which is determined by rapid cell division. Disproportionate growth of different organ systems in utero can occur because different tissues have different critical periods of growth at different times. LBW, which reflects adverse effects on development in the uterus, contributes to this phenomenon of disease programming in early life. It is not only the presence or absence of genes that control our destiny, but the way in which gene expression may be permanently changed by, for example, the nutritional environment in early life. Many epidemiological findings suggest that the risk of disease in adult life is programmed, and/or imprinted by the environment encountered before. The role of small size at birth with low number of cells may contribute to various NCD problem. Post-natal environmental factors further compound such a metabolic demand on body organs that lead to various organ function being overwhelmed with increase in metabolic rate. Hence this leads to increase demand upon various structures, such as nephron with hyperfiltration, organ dysfunction ensues. Hence, an early strategy health program is of great importance to be instituted to detect major risk factors which may arise early in life in those with LBW and or prematurity. Introduction Non-communicable Chronic diseases, such as diabetes, high blood pressure and kidney disease, are increasing rapidly in many populations globally. Poverty and socio-economic disadvantage, together with lifestyle and dietary changes are significant contributing factors [1,2]. Thrifty hypothesis proposes that type 2 diabetes mellitus (T2DM) and numerous components of metabolic syndrome consequence from derisory intrauterine environments for best fetal growth. Numerous studies have confirmed an increased risk of diabetes or impaired glucose tolerance in relation to low birthweight (LBW) [3]. In spite of number of critics, thrifty phenotype has modulated an important role for genetic factors in the aetiology of T2DM and concluded that “environmental, undoubtedly nutritional factors operating in early life play a chief causative part in T2DM and other components of metabolic syndrome. Barker, et al. stated that T2DM and high blood pr","PeriodicalId":73466,"journal":{"name":"International journal of pediatric research","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45951862","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 : 2018-12-31DOI: 10.23937/2469-5769/1510039
S. Sameer, K. Mithilesh, G. Raju
Introduction: Typhoid fever is a life-threatening systemic infection occurring in developing countries like India. The presenting signs and symptoms of typhoid fever in children differ from adults. Some studies indicate reemergence of sensitivity of Salmonella with chloramphenicol. Method: 164 children between 1-12 years of age with suspected enteric fever were enrolled in the study. Out of these, 73 patients were diagnosed as enteric fever and clinical features were compared among different age groups. Antibiotic sensitivity profile was also studied in blood culture positive patients. Results: Abdominal distension were significantly more commonly seen in children less than 5 years while nausea, constipation and blood in stool were completely absent in this age group. Abdominal pain and headache were significantly more in children more 5 years than compared to it younger group. The sensitivity for classical drugs Chloramphenicol, Ampicillin and Cotrimoxazole was found to be 70%, 80% and 47.5%, respectively. Conclusion: Clinical profile of enteric fever in children differ with age. There is re-emergence of sensitivity of Salmonella typhi for chloramphenicol, ampicillin and Cotrimoxazole in blood culture.
{"title":"Pediatric Nature of Enteric Fever with Emerging Antibiogram: A Cross Sectional Study","authors":"S. Sameer, K. Mithilesh, G. Raju","doi":"10.23937/2469-5769/1510039","DOIUrl":"https://doi.org/10.23937/2469-5769/1510039","url":null,"abstract":"Introduction: Typhoid fever is a life-threatening systemic infection occurring in developing countries like India. The presenting signs and symptoms of typhoid fever in children differ from adults. Some studies indicate reemergence of sensitivity of Salmonella with chloramphenicol. Method: 164 children between 1-12 years of age with suspected enteric fever were enrolled in the study. Out of these, 73 patients were diagnosed as enteric fever and clinical features were compared among different age groups. Antibiotic sensitivity profile was also studied in blood culture positive patients. Results: Abdominal distension were significantly more commonly seen in children less than 5 years while nausea, constipation and blood in stool were completely absent in this age group. Abdominal pain and headache were significantly more in children more 5 years than compared to it younger group. The sensitivity for classical drugs Chloramphenicol, Ampicillin and Cotrimoxazole was found to be 70%, 80% and 47.5%, respectively. Conclusion: Clinical profile of enteric fever in children differ with age. There is re-emergence of sensitivity of Salmonella typhi for chloramphenicol, ampicillin and Cotrimoxazole in blood culture.","PeriodicalId":73466,"journal":{"name":"International journal of pediatric research","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47105259","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 : 2018-12-31DOI: 10.23937/2469-5769/1510036
Precious Oloyede Iso, Sam Okpokowuruk Frances
Background: Sucking of the digits is the most common oral habit found in children. It is a form of non-nutritive sucking which appears to be influenced by various factors. When the habit becomes prolonged, it can lead to both dental and hand complications. Breastfeeding is one of the factors known to be protective against this habit in children. Therefore, the aim of this study was to find out the prevalence of digital sucking in our environment and the influence of breastfeeding/exclusive breast feeding including various sociodemographic variables on this habit in children in our environment. Methods: This study was a cross sectional, questionnaire-based study administered to one hundred and forty-five caregivers of children aged 0-18 years who attended the children’s outpatient clinic of the hospital, consecutively recruited over a period of three months. Data was analysed using the Statistical Package for Social Science(SPSS) version 20. Results: 145 respondents were analysed. The prevalence of digital sucking was 32.4% (95% CI = 0.25-0.41) while the prevalence of exclusive breastfeeding was 47.6% (67 out of 144). Exclusive breastfeeding and digit sucking demonstrated a significant negative association. Children who were exclusively breastfed were less likely to suck their fingers with a significant p-value of 0.025-univariate analysis (OR = 2.28; 95% CI = 1.11-4.70). This finding was sustained on multivariate analysis with children who were exclusively breastfed having approximately a three times reduction in the odds of sucking their finger (p = 0.09; 95% CI). There was no statistically significant difference (p = 0.252; OR = 0.96; 95% CI = 0.89-1.03) between the mean total duration of breastfeeding for children who sucked their fingers compared with their siblings who did not suck their fingers (9.73 ± 4.90 vs. 10.98 ± 5.14 months). A history of both parents sucking had a positive association with digital sucking with a significant p-value of 0.036 (OR = 4.63; 95% CI = 1.11-19.40)-univariate analysis. Conclusion: Prevalence of digital sucking in this study was 32.4% with children who were exclusively breastfed being less likely to suck their digits when compared to those who were not. Duration of breastfeeding beyond 6 months did not confer any additional advantage. A history of parental sucking was significantly associated with subsequent digital sucking in the children studied.
{"title":"Impact of Exclusive Breastfeeding on Digital Sucking in Children Attending the Children's Outpatient Department of University of Uyo Teaching Hospital, Uyo","authors":"Precious Oloyede Iso, Sam Okpokowuruk Frances","doi":"10.23937/2469-5769/1510036","DOIUrl":"https://doi.org/10.23937/2469-5769/1510036","url":null,"abstract":"Background: Sucking of the digits is the most common oral habit found in children. It is a form of non-nutritive sucking which appears to be influenced by various factors. When the habit becomes prolonged, it can lead to both dental and hand complications. Breastfeeding is one of the factors known to be protective against this habit in children. Therefore, the aim of this study was to find out the prevalence of digital sucking in our environment and the influence of breastfeeding/exclusive breast feeding including various sociodemographic variables on this habit in children in our environment. Methods: This study was a cross sectional, questionnaire-based study administered to one hundred and forty-five caregivers of children aged 0-18 years who attended the children’s outpatient clinic of the hospital, consecutively recruited over a period of three months. Data was analysed using the Statistical Package for Social Science(SPSS) version 20. Results: 145 respondents were analysed. The prevalence of digital sucking was 32.4% (95% CI = 0.25-0.41) while the prevalence of exclusive breastfeeding was 47.6% (67 out of 144). Exclusive breastfeeding and digit sucking demonstrated a significant negative association. Children who were exclusively breastfed were less likely to suck their fingers with a significant p-value of 0.025-univariate analysis (OR = 2.28; 95% CI = 1.11-4.70). This finding was sustained on multivariate analysis with children who were exclusively breastfed having approximately a three times reduction in the odds of sucking their finger (p = 0.09; 95% CI). There was no statistically significant difference (p = 0.252; OR = 0.96; 95% CI = 0.89-1.03) between the mean total duration of breastfeeding for children who sucked their fingers compared with their siblings who did not suck their fingers (9.73 ± 4.90 vs. 10.98 ± 5.14 months). A history of both parents sucking had a positive association with digital sucking with a significant p-value of 0.036 (OR = 4.63; 95% CI = 1.11-19.40)-univariate analysis. Conclusion: Prevalence of digital sucking in this study was 32.4% with children who were exclusively breastfed being less likely to suck their digits when compared to those who were not. Duration of breastfeeding beyond 6 months did not confer any additional advantage. A history of parental sucking was significantly associated with subsequent digital sucking in the children studied.","PeriodicalId":73466,"journal":{"name":"International journal of pediatric research","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68751088","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 : 2018-12-31DOI: 10.23937/2469-5769/1510030
Tognon Costanza, M. Luisa, L. Fascetti, Gamba Piergiorgio
Since many years, feasibility and safety of thoracoscopic surgery in infants with pulmonary malformations has been confirmed. Nevertheless, infants present some problems caused by the anatomical and physiological peculiarities typical of the age and of the size of the structures. Several ways to overcome these difficulties have been proposed to assure efficacy and safety of mono-pulmonary ventilation. The knowledge of the infant’s respiratory physiology is essential to prevent complications and eventually to treat them. In the same way the technical skill with all the available tools is mandatory for the airway management.
{"title":"The Different Approaches of Single Lung Ventilation in Infants with Pulmonary Malformation","authors":"Tognon Costanza, M. Luisa, L. Fascetti, Gamba Piergiorgio","doi":"10.23937/2469-5769/1510030","DOIUrl":"https://doi.org/10.23937/2469-5769/1510030","url":null,"abstract":"Since many years, feasibility and safety of thoracoscopic surgery in infants with pulmonary malformations has been confirmed. Nevertheless, infants present some problems caused by the anatomical and physiological peculiarities typical of the age and of the size of the structures. Several ways to overcome these difficulties have been proposed to assure efficacy and safety of mono-pulmonary ventilation. The knowledge of the infant’s respiratory physiology is essential to prevent complications and eventually to treat them. In the same way the technical skill with all the available tools is mandatory for the airway management.","PeriodicalId":73466,"journal":{"name":"International journal of pediatric research","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45578226","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 : 2018-12-31DOI: 10.23937/2469-5769/1510031
Мv Kushnareva, М. M. Kh, E. Keshishyan, A. Semenov
Background: The basis for the study is the high morbidity and mortality in premature infants with ventilator-associated pneumonia (VAP). There is a high incidence of complications (sepsis, bronchopulmonary dysplasia). Methods: A detailed analysis of the clinical course of VAP caused by Klebsiella pneumoniae in 14 premature infants was conducted. The sensitivity of Klebsiella pneumoniae strains to 18 antibiotics was studied by the method of standard discs. Results: Severe pneumonia had 10 infants, moderate stage was among 4 infants, an acute stage was observed in 12 patients, and prolonged stage was in 2 infants. Severe form of the disease was presented by pronounced symptoms of infectious toxicosis, respiratory and cardiovascular insufficiency, physical changes from the lungs. Bronchopulmonary dysplasia was developed in two infants. The mortality was rated 14%. Klebsiella pneumoniae was the causative agent of the primary infection in all infants (monoinfection was in 12 infants and association with other pathogens in 2 infants). All strains of Klebsiella pneumoniae were multidrug-resistant to antibiotics, but 57-86% of the strains retained sensitivity to Piperacillin, Piperacillin + Tazobactam, carbapenems, Amikacin and Ofloxacin. Conclusions: The complex treatment of VAP in premature infants should include antibacterial, detoxification, pathogenetic and syndromic therapies.
{"title":"Ventilator-Associated Pneumonia Caused by Klebsiella Pneumoniae in Preterm Newborn Infants","authors":"Мv Kushnareva, М. M. Kh, E. Keshishyan, A. Semenov","doi":"10.23937/2469-5769/1510031","DOIUrl":"https://doi.org/10.23937/2469-5769/1510031","url":null,"abstract":"Background: The basis for the study is the high morbidity and mortality in premature infants with ventilator-associated pneumonia (VAP). There is a high incidence of complications (sepsis, bronchopulmonary dysplasia). Methods: A detailed analysis of the clinical course of VAP caused by Klebsiella pneumoniae in 14 premature infants was conducted. The sensitivity of Klebsiella pneumoniae strains to 18 antibiotics was studied by the method of standard discs. Results: Severe pneumonia had 10 infants, moderate stage was among 4 infants, an acute stage was observed in 12 patients, and prolonged stage was in 2 infants. Severe form of the disease was presented by pronounced symptoms of infectious toxicosis, respiratory and cardiovascular insufficiency, physical changes from the lungs. Bronchopulmonary dysplasia was developed in two infants. The mortality was rated 14%. Klebsiella pneumoniae was the causative agent of the primary infection in all infants (monoinfection was in 12 infants and association with other pathogens in 2 infants). All strains of Klebsiella pneumoniae were multidrug-resistant to antibiotics, but 57-86% of the strains retained sensitivity to Piperacillin, Piperacillin + Tazobactam, carbapenems, Amikacin and Ofloxacin. Conclusions: The complex treatment of VAP in premature infants should include antibacterial, detoxification, pathogenetic and syndromic therapies.","PeriodicalId":73466,"journal":{"name":"International journal of pediatric research","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41738733","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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