ABSTRACT
Background: Neonatal hypoglycaemia, a common metabolic problem, often goes unnoticed owing to lack of specific symptoms. It can lead to considerable mortality and morbidity with long term neurological sequelae. Adequate breast feeding play an important role in maintaining normal glucose levels. So, this study is done to assess the incidence of hypoglycaemia in exclusively breast fed low birth weight babies, both term and preterm neonates and evaluate the impact of early breast feeding on glycaemic status upto 72 hours of life.Methods: This study was conducted over 12 month period involving 236 AGA (Appropriate for gestational age), SGA (Small for gestational age) babies with birth weight between 1.6-2.49 kg. Blood glucose values were measured at birth, 3h, 6h, 12h, 24h, 48h and 72h of life after delivery which was independent of feeding time. Hypoglycaemia was assessed against age of onset, gestational age, sex of baby, mode of delivery and time of initiation of breast feeding.Results: Total 56 episodes of hypoglycaemia were recorded in 52 babies of which 46 (27%) were term SGA babies and 6(8%) were preterm AGA babies (p=0.00148). The incidence of hypoglycaemia was found to be 22%, highest during the first 24 hours of life (93%) and delayed breast feeding is the most commonly noted risk factor (p=0.00024).Conclusions: Low birth babies are more prone to develop hypoglycaemia especially in first 24 hours of life with delayed introduction of breast feeding being one of the common risk factors and asymptomatic hypoglycaemia can be managed with frequent breast feeding without any formula feeds.
ABSTRACT
Background: Childhood pneumonia is the single leading cause of mortality in children aged less than 5 years. Most cases occur in India (43 million); pneumonia is responsible for about 19% of all deaths in children aged less than 5 years. According to Child Health and Epidemiology Reference Group (CHERG) latest estimates, Pneumonia was responsible for 0.397 million of a total estimated 1.682 million under-five deaths in India.Methods: A hospital based prospective longitudinal study. In the present study 200 cases belong to age group 2 months to 5 years' fulfilling WHO criteria for pneumonia who were' attended to the department of paediatrics, Siddhartha medical college' from January 2017 to January 2018 were evaluated the risk factors in relation to their outcomes after obtaining consentResults: Out of 200 children with severe pneumonia' 11 risk factors are studied for significance against outcomes like Death of the patient, mechanical ventilation oxygen supplementation, hospital stay of patient and total duration of illness, Risk factors found to be significant are maternal literacy (p =0.0002617), malnutrition (p <0.00001), exclusive' breastfeeding (p <0.05), low birth weight (p <0.05), immunisation (p=0.01).Conclusions: Severe malnutrition, maternal illiteracy, exclusive breast feeding, improper immunization and low birth weight are having a significant association with poor outcomes in children with severe pneumonia. Proper preventive strategies to decrease the incidence of these risk factors can help in increasing the survival rate of children with severe pneumonia.