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Background: India having 3rd highest incidence of low birth weight (LBW) infants (28%) in the world. Majority of deliveries in our country are conducted at home by untrained traditional birth attendants or relatives, so it is not possible for untrained birth attenders to operate weighing machine in rural areas, therefore to find an alternative method for the estimation of low birth weight we used simple anthropometric indicators like calf circumference which is easily used by rural communities.Methods: It was a Cross-sectional study done at tertiary care center, Udaipur, Rajasthan, India during 1 year period in 2018. 150 neonates without any congenital malformation delivered at hospital irrespective of gestational age were subjected to anthropometric measurements. The different anthropometric measurements like calf circumference, chest circumference were used and data was analyzed by using Receiver Operating Characteristic curve (ROC) to find out the cut-off values with the highest sensitivity and specificity for birth weight <2500gm and <1800gm. For comparison Pearson's Correlation coefficients was used.Results: From different anthropometric measurements, calf circumference of 9.38 cm and 7.90cm had higher sensitivity and specificity in detecting birth weight babies of <2500gm, and <1800gm respectively. The best correlation was observed in calf circumference (r=0.989) and (r=0.990) for identifying babies with birth weight group 1.21-1.80kg and group 1.81-2.50kg.Conclusions: In the absence of a weighing machine, simple measurements like calf circumference is the best indicator in identifying low birth weight babies.
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Background: Sepsis is one of the leading causes of mortality in children under 5 years by UNICEF statistics which is difficult to diagnose because of nonspecific initial clinical presentation and potential for rapid deterioration. In this regard use of Yale Observation Scale assists in early recognition of serious bacterial infection than other laboratory investigation as it is simple, quick, easy to apply and cost-effective bed side scale.Methods: All eligible young febrile infants and children were consecutively enrolled in the study. Axillary temperatures of the cases were documented. Yale observation scoring was done. Blood sample were sent for culture and sensitivity. Colonies were identified morphologically by Gram stain and biochemically. The collected data was analyzed using ROC curve for finding cut off scores of Yale Observation Scale for prediction of severe bacterial illness and final outcome. Statistical analysis was performed using the Statistical Packages for Social Sciences (SPSS) version 14 for MS Window.Results: Bacteremia was found in 23(15.3%) out of total 150 young febrile children enrolled in the present study. It shows that in lower YOS score blood culture was sterile and in higher YOS score blood culture was positive for bacteremia, which is statistically significant with p value (<0.05). As per ROC curve analyses the best cut off value of YOS for prediction of bacteremia was 17.5 with sensitivity 91.3%, specificity 81.9%, PPV 47.7% and NPV of 98.1%.Conclusions: YOS of '>17.5 has a good predictive ability for prediction of bacteraemia in young febrile children.
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Background: Attention deficit hyperactivity disorder (ADHD) is one of the most commonly diagnosed disorders of childhood (3-5%). The main characteristics of attention deficit hyperactivity disorder are inattention, hyperactivity, and impulsivity. 'The Objective of this study was to study prevalence of ADHD in school aged children.Methods: A cross sectional descriptive school-based study was conducted in a private school of Udaipur from January 2017 to September 2018.' All eligible students were included. Total 1200 students were enrolled. They were assessed for the presence of ADHD using INCLEN diagnostic tool and those found positive were further assessed for the presence of co-morbid conditions using child behavior checklist (CBCL).Results: In present study out of total 1200 students 730(60.83%) were male and 470(39.17%) were female. 76 (6.3%) students out of 1200 were ADHD Positive. ADHD was more common in male students (73.7%), urban locality (57.89%), in age group 6 to 9 years (44.7%) and higher economic class (46.1%). Hyperactivity-Impulsivity type was most common type (51.32%). Male students had predominance of hyperactivity (60.7%) whereas in female student's inattention type was predominant (45%). Aggressive Behavior (19.6%) and rule breaking behavior (80.4%) was more common in male. Somatic complaints were more common in females (60%). Oppositional defiant disorder was observed in male (21.4%) and female (10%) students. 15.8% of ADHD students had learning disorder.Conclusions: Present study shows 6.3% prevalence of ADHD. Hyperactivity type of ADHD was more common in boys, while Inattention type was more common in girls. Among associated co morbid conditions - aggressive behavior, rule breaking behavior and oppositional defiant disorder (ODD) was found to be more prevalent in boys while anxious behavior, somatic complaints and social problems were more commonly found in girls. Thought problems, learning disorders and conduct disorders are also observed in ADHD students.
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Background: Neonatal hyperbilirubinemia is a common condition that may occur in 60-70 % of term babies and the most common pathological cause leading to hyperbilirubinemia is ABO incompatibility. ABO incompatible newborns are reported to be at greater risk of significant hyperbilirubinemia and are associated with significant morbidity like development of kernicterus.' So early intervention, at proper time, is mandatory to prevent this sequel.Methods: A prospective study included 240 term new-borns with gestational age of >37 weeks and birth weight >2.5 kg born to 'O' blood group mothers. Soon after delivery, cord blood was sent for blood group, total bilirubin and direct coombs test. All enrolled new-borns were assessed clinically daily till day 5th for appearance of hyperbilirubinemia using Kramer method. The data was analysed using descriptive analysis, ROC curve in SPSS version 14.Results: Among two hundred forty ABO incompatible newborns, 40 (17%) had developed hyperbilirubinemia and among them most common blood group associated was B+ve (75%). Association between cord bilirubin content and maximum serum bilirubin content among newborn who developed hyperbilirubinemia was found to be significant (P value <0.01). As per ROC curve analysis, cord blood total bilirubin cut off value of 1.79mg/dl had sensitivity (82.5%), specificity (55.5 %), PPV (27.04%) and NPV (94.06).Conclusions: Cord blood total bilirubin levels ?1.79mg/dl has a good predictive ability for prediction of significant hyperbilirubinemia among ABO incompatible new-born. DCT is neither specific nor sensitive screening tool for development of Neonatal hyperbilirubinemia in ABO incompatibility.
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Neurofibromatosis type‑1 (NF‑1) is an autosomal dominant disorder, with increased risk of developing benign and malignant tumors of the gastrointestinal tract (GIT). However, the synchronous presence of multiple GIT stromal tumors and duodenal submucosal somatostatinoma, like in this 50‑year‑old female NF‑1 patient, is very rare. She presented with hematemesis, malena, along with multiple neurofibromas all over the body. Thorough radiological and peroperative work‑up revealed multiple ulcerated submucosal and serosal nodules in the proximal small intestine. Histological work‑up revealed diagnosis of a duodenal submucosal somatostatinoma with multifocal serosal gastrointestinal stromal tumors. This case is being reported to highlight the rare coincidence of multiple GIT tumors in an NF‑1 patient.