RESUMO
Justification: Suicide is an important cause of adolescent mortality and morbidity in India. As pediatricians are often the first point of contact for adolescents and their families in the healthcare system, they need guidelines to screen, assess, manage and prevent adolescent suicidal behavior to ensure survival, health and mental well-being of this vulnerable population. Objectives: To formulate guidelines to aid pediatricians for prevention and management of adolescent suicidal behavior. Process: Indian Academy of Pediatrics, in association with Adolescent Health Academy, formed a multidisciplinary committee of subject experts in June, 2019 to formulate guidelines for adolescent suicide prevention and management. After a review of current scientific literature and preparation of draft guidelines, a national consultative meeting was organized on 16 August, 2019 for detailed discussions and deliberations. This was followed by refining of draft guidelines, and discussions over e-mail where suggestions were incorporated and the final document was approved. Guidelines: Pediatricians should screen for mental distress, mental disorders and suicidal and para-suicidal (non-suicidal self-injury) behavior during adolescent health visits. Those with suicidal behavior should be referred to a psychiatrist after providing emergency healthcare, risk assessment, immediate counselling and formulation of a safety plan. Pediatricians should partner with the community and policymakers for primary and secondary prevention of adolescent suicide.
RESUMO
Background: Febrile seizure is an event in infancy or childhood, usually occurring between 3 months and 5 years of age associated with fever but without evidence of intracranial infection. The aim of the study was to estimate the usefulness of neutrophil-to-lymphocyte ratio (NLR) in patients with simple and complex febrile seizures.Methods: Retrospective case control'' study was done in a paediatric in patients admitted to tertiary care hospital.' Study period'' was from January 2017 to December 2019. 200 children were analysed in the study. 100 out of 200 were under control group (febrile children without seizure). Remaining 100 were under case group (children with febrile seizure), 54 out of 100 children had'' complex febrile seizure, 46 out of 100 had simple febrile seizure. NLR ratio was done in all children.Results: Total 200 children were analysed in this study.'' High NLR ratio'' was noted among the cases (87 out of 100) compared to control (30 out of 100) p value = <0.001. Among the cases CFS had high NLR ratio compared to SFS, however p value was not significant (0.072).Conclusions: Children with febrile seizure had high NLR ratio compared to those without seizures. However no significant difference was noted between those with simple febrile seizure and complex febrile seizure'' However, larger trials are required'' to assess whether higher NLR can be taken as an independent risk factor for febrile seizure.
RESUMO
Background: Type 2 Diabetes is becoming more common at younger age group. It is important to screen children and adolescents for prediabetes to prevent long-term complications of diabetes. This study was conducted to study the prevalence of prediabetes in children and its association with risk factorsMethods: It is a Prospective hospital-based study. Children aged 6 to 18 years admitted in the Pediatric ward of tertiary care hospital were included. Study was done over a period of 2 years November 2015-October 2017. Participants were screened to find out the prevalence of prediabetes. Prediabetes was defined as fasting glucose concentration (FBS)of 100-125 mg/dl or a HbA1c value of between 5.7% and 6.4%, or a two-hour post-glucose tolerance concentration (OGTT) of 140-199mg/dl.Results: 607 children participated in the study.56.3% were males. Prevalence of Prediabetes was 20.4% with a combination of OGTT, FBS and HbA1c tests. Prevalence by OGTT was 5.9%, HbA1c 4.1% and by FBS was 17.1%. Higher prevalence of prediabetes was associated with male gender, frequent consumption of junk foods, decreased physical activities, overweight, obesity and high waist to hip ratio. Combination of FBS with GTT and FBS with' HbA1c had better sensitivity and specificity when compared to combination of OGTT with HbA1c .Conclusion: Screening of children for prediabetes at younger age especially those with risk factors and intervention with lifestyle modification may help in delaying the progression of the disease.
RESUMO
Background: Venipuncture is one of the most common cause of iatrogenic pain in neonates which is equally stressful to the parents as well as to the personnel performing the procedure. Despite an abundance of data that demonstrate the efficacy of local anesthetics for reducing venipuncture pain in neonates their use in day to day practice is not used widely used. Our objective was to evaluate the efficacy of EMLA cream and 5% Lignocaine cream versus placebo for pain relief in newborns undergoing venipuncture.Methods: Present study was a hospital based, double blind randomised, case control study. A 240 eligible new-borns were randomised into EMLA, 5%lignocaine and placebo groups after randomization. The respective creams were applied 1 hour before the procedure and pain scores were assessed using NIPS scoring during venepunture. Data was analysed using SPSS ver. 20.0 statistical package. Student's unpaired t-test and paired t tests was used to compare continuous data, and to compare pain scores one-way ANOVA was used to compare categorical data. A p-value <0.05 was considered statistically significant.Results: Paired t-tests revealed significant lower NIPS scores in EMLA and 5% lignocaine group than the placebo group (p value=0.001).Conclusions: From present study it can be concluded that both EMLA and 5% lignocaine are equally efficacious and cost effective in reducing the pain of venepuncture in neonates.