Background: Thalassaemia is a chronic disorder requiring lifelong transfusions and medications causing emotional and financial burden to the family. This study was done to assess the knowledge and awareness of parents having a thalassemic child and to ameliorate their experiences in the upbringing of their child.Methods:A cross sectional, descriptive study was conducted in Pediatric Ward of a Tertiary care Hospital in Navi Mumbai from May-August 2016 in which parents of 40 beta Thalassemia major children between age group of 6 months to 15 years were enrolled. Parents were interviewed through a questionnaire to assess their knowledge, awareness, the practices they follow in regard to the transfusion, treatment, vaccination and prevention of thalassemia. The study also focuses on the emotional suffering of the parents.Results: 47.5% of parents were aware of thalassemia being a genetic disorder.62.5% were aware of regular blood transfusion. 23 parents were aware of the regular medications taken by their children. 42.5% parents had adequate knowledge of the optional vaccines to be taken. 90% parents followed a good practice of getting their child for regular blood transfusion and 92.5% gave them regular medicines.31 parents would periodically get their child investigated but 65% of parents lacked in giving optional vaccines to the child.60% agreed to undergo MTP while only 45% knew about the antenatal detection.Conclusions:Majority of parents followed good practice and had a positive attitude, though the knowledge and awareness about the disease was inadequate.
Objective: Breastfeeding (BF) has been accepted as the most vital intervention for reducing infant mortality and ensuring optimal growth and development of a child. A major barrier to successful BF is inconsistency in information and improper cultural practices. To assess the knowledge, attitude, and practices toward BF among nursing mothers following up in a tertiary care center in Navi Mumbai, Maharashtra. Methods: A community-based cross-sectional study was conducted among 512 mothers in Navi Mumbai in the state of Maharashtra, India, between January 2016 and June 2016 using a pre-set questionnaire. The mothers with children under the age of 2 years were interviewed following which descriptive statistics were obtained. Results: Our study highlights the growing awareness of the advantages of BF. Of the 512 mothers enrolled in our study, 78.9% believed in exclusive BF (EBF) till 6 months while 51% actually practiced EBF. Nearly 78% mothers felt shy to feed in public places. BF was initiated <1 h of delivery in 35.9% mothers while insufficient milk was the predominant reason (41.4%) in mothers to stop BF before 2 years. Conclusion: The majority of our participants had adequate knowledge and a positive attitude toward EBF, with right posture practiced while feeding.
Objectives To study the rational use of the blood components in pediatric and neonatal wards. Methods It was a retrospective study conducted by department of pediatrics of a tertiary care centre in western part of India. The patients were included from the pediatric ward, pediatric surgery ward, neonatal intensive care unit (NICU), pediatric intensive care unit (PICU) over a period of three months. All the patients below 12 y of age receiving blood components, admitted in general pediatric wards, pediatric intensive care unit, neonatal intensive care unit and pediatric surgery ward were included in the study. Each transfusion episode was assessed as per predetermined guidelines. Results Of the total 336 episodes of blood component transfusions, 244 episodes were appropriate and 92 episodes were inappropriate. Among these, platelets had highest inappropriate (36.84%) episodes followed by fresh frozen plasma (FFP) (28.95%) and packed red blood cell transfusions (PRBC) (21.21%). Majority inappropriate transfusions were seen in intensive care settings. Conclusions Almost one-third of blood component transfusions (FFP, platelets and PRBC) were given without any definitive indication. Judicious use of various blood products by following recommended guidelines may help in decreasing the inappropriate use of blood components.
Nephrotic syndrome (NS) is a kidney disorder in which, excess protein is being excreted through urine. While most cases of idiopathic nephrotic syndrome respond to steroid therapy and experience a limited number of relapses prior to complete remission, some cases suffer from frequent relapses and become steroid-dependent or are primarily steroid-resistant. Treatment options are limited to immunosuppressive drugs with significant side effect profiles. Infections in nephrotic syndrome are common and can be severe. Meningitis is one of the complications associated with nephrotic syndrome. Here, we report a child with steroid-resistant nephrotic syndrome (SRNS) with meningitis. Early detection and appropriate treatment of these complications can be lifesaving.
Introduction: The high incidence of low birth weight babies in India is due to the neglect of health and education of females, teenage marriages, frequent pregnancies, maternal malnutrition, ?nemi?, and infections. Objective: The objective of his study was to identify the role of various maternal factors such as maternal age, parity, regular antenatal care (ANC) visits, weight, anemia, socioeconomic status, and maternal pre-eclampsia affecting the nutrition of the fetus. Materials and Methods: In this observational study, 500 mother-infant pair recruited, consecutively. A detailed antenatal and postnatal history of the mother was recorded. Information obtained were age, the weight of mother, parity, number of antenatal visits, and maternal hemoglobin (Hb). Newborn taken for the study was weighed and assessed for their nutritional status using the clinical assessment of nutrition score. Results: Of 500 babies, 51.4% of babies were born to mothers aged ?20 years; and out of them, 76.5% of babies had fetal malnutrition. About 45.2% of babies born to primigravidae mother; of which, 85.9% had fetal malnutrition (FM). About 54.8% of babies born to multigravida mothers; of which, 45.3% had FM. Of 69.2% of mothers, who had irregular or no ANC, 75.1% of babies had FM. Mothers with weight ?50 kg were 45.6% and 78.9% of their babies had FM. In 44% of mothers, Hb was ?10 g% and 91.8% of babies born to these mothers had FM. Of 48.80% of babies born to pre-eclamptic babies, 77.5% of babies had FM. All these maternal factors were statistically significant in their impact on FM (p<0.05). Conclusion: Maternal nutrition and well-being are essential to bring down the percentage of FM in babies. Proper education not only of the mother but also of society as a whole, recognition of these factors and timely intervention will go a long way not only in improving the quality of life of babies born to such mothers but also in reducing the economic burden on a precariously balanced health-care system.
Introduction: Guillain Barre Syndrome (GBS), once considered a single clinical entity, is now recognized as a heterogeneous syndrome with several variants, with varied presentations and complaints. A case of GBS with Miller Fisher Syndrome (MFS), which has rarely been reported in India, is described in this case report. Case report: A 5 year old female presented to us complaining of double vision since 4 days and difficulty walking since past 2 days. The patient also had a history of fever 20 days prior to admission. There was paralysis of the sixth cranial nerve bilaterally (ophthalmoplegia), which resulted in convergent strabismus. Poor articulation of words was observed (dysarthria). Muscle strength was noted as 3/5 for all four limbs and mild gait unsteadiness was observed, with tendency to fall on either side. Nerve conduction study was suggestive of mild early generalised demyelinating neuropathy of the right ulnar nerve. The clinical examination of the patient pointed towards the diagnosis of Miller Fisher syndrome, a rare variant of Guillain Barre Syndrome. Patient showed slow regression of motor deficit with intravenous immunoglobulins (IVIG), administered at 2 gm/kg. Conclusion: Diagnosing MFS required high clinical suspicion as in many cases all symptoms may not appear at the same time. This case report demonstrates that clinicians should be aware of rare variants of GBS.
Introduction: Neonatal Sepsis (NS) is responsible for 30-50% of total neonatal deaths in developing countries. Blood culture is gold standard diagnostic test but has a low yield and is the time consuming. C-Reactive Protein (CRP) and Procalcitonin (PCT) are commonly used for diagnosis of sepsis. Aim: To study the role of CRP and PCT in the screening of NS and to compare PCT and CRP in relation to sensitivity, specificity and accuracy. Materials and Methods: A cross-sectional study was conducted inatertiarycareNeonatalIntensiveCareUnit(NICU)fromFebruary 2018 and November 2019. Neonates with signs and symptoms of sepsis or born to mothers with risk factors for sepsis were included. Those who received antibiotic before admission or had co-morbidities such as meconium aspiration, birth asphyxia, etc., were excluded. Investigations for sepsis including Complete Blood Count (CBC), CRP, PCT and Blood Culture were done. They were classified into three groups as group 1 clinical sepsis, group 2 suspected sepsis and group 3 confirmed sepsis. The statistical test used was Analysis of Variance (ANOVA) test and tests for sensitivity, specificity, positive predictive value, negative predictive value were also used. Results: The sensitivity, specificity, PPV, and NPV of CRP and PCT versus culture report were evaluated. The sensitivity was 61.90% and 90.47%, specificity was 72.45% and 82.75%, PPV was 61.90% and 79.16% and NPV was 72.45% and 92.30% for CRP and PCT, respectively. The accuracy of the test was 68.00% and 86.00% for CRP and PCT, respectively. Conclusion: PCT is a better septic marker than CRP in relation to sensitivity, specificity and accuracy and correlates positively with blood culture.
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