Background and objective: In developing countries low maternal vitamin A stores combined with increased demands of pregnancy and lactation may lead to its deficiency in breastfed infants. This study evaluates the effects of maternal supplementation with a high dose of vitamin A on the serum retinol levels of exclusively breastfed infants, and their morbidity in the first six months of life. Setting: Hospital based. Study design: Randomised controlled trial. Subjects and methods: Mothers of the test group (n=150) were orally supplemented with a single dose of retinol (209 µmol) soon after delivery and were advised exclusive breastfeeding for six months. Before supplementation retinol levels were estimated in the mothers' and newborns' blood, and in colostrum. On follow up, breastmilk and infants' serum retinol contents were assessed monthly for six months. Retinol level <0.7 µmol/l indicated vitamin A deficiency. Morbidity patterns like vitamin A deficiency, diarrhoea, febrile illnesses, acute respiratory infection, measles, and ear infection were also studied and compared between the two groups. Results: Presupplement mean maternal serum retinol levels were 0.98 and 0.92 µmol/l and mean breastmilk levels were 3.85 and 3.92 µmol/l in the test and control groups respectively (p>0.05). Mean cord blood retinol levels were also comparable (0.68 v 0.64 µmol/l). After supplementation, the test group showed a rise in mean breastmilk retinol content (12.08 v 2.96 µmol/l) which remained significantly higher for four months. The infants' mean serum retinol level, initially 322.06% of the baseline value, was significantly higher for five months. In the control group, significant numbers of mothers and infants showed deficient breastmilk and serum retinol throughout the follow up (p<0.01). Decreased incidence and duration of various diseases were also found in the test group suggesting lesser morbidity. Conclusion: Maternal supplementation with single megadose vitamin A is an effective strategy for vitamin A prophylaxis of exclusively breastfed infants of 0-6 months.
Urinary tract infections (UTIs) are a common, potentially serious, and often occult bacterial infections of childhood. UTI is more frequent in females than males at all ages with the exception of the neonatal period. Urinary tract infections imply invasion of urinary tract by pathogens which may involve the upper or lower urinary tract depending on the infection in kidney, bladder and urethra. OBJECTIVES: To determine the incidence of UTI in febrile children below 5years of age and to know the aetiological profile of UTI among the same group of children with fever. METHODS: This cross sectional observational study included all febrile children from one month to 5years of age, admitted in Pediatric ward in MGM Medical College, Kishanganj, Bihar. RESULTS: Overall incidence rate of UTI in the present study was 6% with maximum incidence in children <2years of age. Among culture positive cases majority (50%) grew E. coli. DMSA revealed renal cortical scarring in 42. 85% cases following UTI. CONCLUSION: From the present study it can be concluded that UTI is a common bacterial infection in infant and children. Rapid evaluation and treatment of UTI is important to prevent renal parenchymal damage and renal scarring or renal failure.
ABSTRACT:A cross sectional and observational study was done to find out existing level of knowledge, attitude and practice of different types of unhealthy habits among the school children. Total 300 students (Classed I to V) were included in this study. Chi square test, Z test and t test were applied to find out magnitude of knowledge, attitude and practices of unhealthy habits. A declining trend of knowledge, attitude and practice scores were seen in the study group and inclining trend was noted in the control group. Thus, the study carried out showed that sustained action is necessary to affect behavior change.
ABSTRACT:A prospective and descriptive clinical study was done to study etiological factors of birth asphyxia and its outcome. Total 150 newborn babies were included in this study and 1190 normal babies were taken as control to study etiological factors for birth asphyxia. Data analysis was done by Z test, chi square test, univariate and ultivariate logistic regression analysis of risk factors. In this study statistically significant association between severity of perinatal asphyxia and severity of HIE was seen. In this study, significant proportion of neonates develop HIE following asphyxia insult. The identification of HIE following perinatal hypoxic insult is important because of the predictive significance for future motor and cognitive deficits. KEYWORDS: Birth asphyxia, HIE, predictive significance. INTRODUCTION:Perinatal asphyxia, neonatal asphyxia or birth asphyxia is a medical condition resulting from deprivation of oxygen to a newborn infant that lasts long enough during the process to cause physical harm, usually to the brain. Hypoxic damage can occur to most of the infants organs (Heart, lungs, liver, gut, kidney), but brain damage is of most concern and perhaps the least likely to completely heal. (1) Birth asphyxia is one of the major causes of early neonatal mortality in India. Among the institutional births, incidence is 5% and accounts for 24.3% of neonatal deaths. (2) The greatest risk of adverse outcome is seen in newborn infants with fetal acidosis (pH <5), a five minute apgar score of 0-3, hypoxic ischemic encephalopathy (HIE) or multi organ malfunctions. (3) Sarnat and Sarnat described their HIE grading in 21 infants in 1976 (4) in a study relating electroen-cephalographic findings to the clinical conditions of infants. Later on this classification was modified by Levene based on clinical observation. HIE was classified as mild HIE (Stage I) in which the infant was hyper alert with normal muscle tone, reflexes were normal and seizures were absent. Moderate HIE (Grade II) presented with an infant being lethargic, decreased muscle tone, weak or absent reflexes and seizures were present. In severe HIE (Grade III) the level of consciousness was very much depressed (Stuporose) with flaccid muscle tone, absent reflexes and seizures were either too frequent or difficult to control.The common worry of health professional and parents is the permanent brain damage that birth asphyxia can cause and the common aim is to reduce the number of newborns affected. Improving women's' health and health care will reduce the risk factors and decrease the number of newborns needing resuscitation.Nevertheless, there is one single intervention for dealing ith asphyxia when it occursResuscitation. Therefore, every birth attendant must be both skilled and equipped to resuscitate newborns that don't start breathing spontaneously.So, appropriate and effective resuscitation at birth is a cornerstone of optimal neonatal care. The new guidelines provide for a uniform, systematic and action oriented approach to the neo...
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