Introduction: Pneumonia remains a significant health problem in India with significant morbidity and mortality. Objectives of this study were to identifying an effective nutritional agent that reduces the need for antibiotics, duration of pneumonia and length of hospitalization would be highly cost-beneficial.Material and Methods: This was a hospital-based case-control study: A total of 100 children including 50 cases and 50 controls, aged 2–60 months, were enrolled. Case definition of severe ALRI as given by the World Health Organization was used for cases. Controls were healthy children attending outpatients’ service for immunization or admitted for minor ailments other than ALRTI.Results: Mean 25(OH)D concentrations in children of the study group were lower than those of the control group (20.431 ng/mL vs. 27.67 ng/mL; p = 0.035). Factors significantly associated with decreased risk of ALRTI in univariate analysis were: exclusive breastfeeding in the first 6 months (cases 13/50 (26%), controls 42/50 (84%); p=0.000); adequate exposure to sunlight (cases 14/50 (28%), controls 42/50 (84%); P=0.000); and serum 25OHD3 <20 ng/ml (cases 28/50 (56%), controls 0/50 (0%); p=.000). Multivariate logistic model indicated that severe vitamin D deficiency (OR=NA), exclusive breast feeding (OR=.174); 95% CI (.061- .521; p=.002) and adequate sunlight exposure (OR=.179) ;95%CI (.062-.519); p=.002) were significant independent predictive risk factors for ALRTI among the children between 2 months – 5 years of age (all p<0.05).Conclusion: Severe vitamin D deficiency (<20ng/ml), nonexclusive breastfeeding in the first six months of life, inadequate sun exposure were significant risk factors for ALRTI in Indian children.J Nepal Paediatr Soc 2016;36(1):14-18
Introduction: Neonatal hyperbilirubinaemia is common problem which is benign in majority of neonates. Rh iso immune hemolytic disease as a cause of hyperbilirubinemia is becoming nearly nonexistent due to the use of prophylactic anti D. Hence Isoimmune hemolytic disease due to ABO incompatibility assumes significance as a cause of significant hyperbilirubinaemia. This study was conducted to determine the incidence of ABO incompatibility, ABO iso immune disease in new born, to determine critical cord serum bilirubin level to predict subsequent significant hyperbilirubinemia. Material and Methods: The study was done in neonatal ICU of a tertiary care hospital where 100 full term healthy newborns with B.W≥2500gm and gestational age ≥37 wk with blood group A, B, AB, born to mothers with O blood group without simultaneous Rh incompatibility at SGRDIMSR were included. Serum bilirubin was measured approximately at 12-24hrs, 36-48hrs, 60-72hrs. Results: Out 100 ABO incompatible newborns 33(33%) developed ABO isoimmune disease manifesting as significant hyperbilirubinaemia with any of the four total serum bilirubin levels exceeding threshold levels defined for phototherapy. TSB of ≥ 2.16mg/d1 from cord blood has a sensitivity of 100% specificity of 89.55%, NPV 100% and PPV of 82.50% to predict significant hyperbilirubinaemia. Conclusion: A critical cord S.bilirubin between 2.16 mg/d1 and 4.09mg/d1 will predict all newborns who will have significant hyperbilirubinaemia and can be used as a safe demarcator to decide time of discharge. Any therapeutic intervention if necessary can be started as early as possible.
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