A study to identify knowledge, attitude and practices prevalent amongst the caregivers of children below five years presenting with acute diarrhoea in a tertiary care centre

Background: Diarrhoeal infections are the second leading cause of death worldwide in under-five children covering 9% of the total deaths. The objective of the study was to assess and compare mothers' knowledge, attitude and practice regarding prevention and management of diarrhoea in children.Methods: A cross-sectional hospital-based observational study was conducted in a tertiary centre amongst all 356 children between age group 2 months to 60 months admitted with acute watery diarrhea. A pre-tested questionnaire and face-to-face interviews with the mothers was used as a data collection tool.Results: Most of the mothers 282 (79.2%) were 20-30-year-old, 51.4% were illiterate, 57.3% were unemployed and 27.2% were daily wage labourers. 44.6% people came from rural background and 78.9% belonged to lower socio-economic strata. 30.3% were exclusively breastfed and 69.7% were on top feeds. Animal milk was taken by 62.1%, 46.6% had dilution and 50.6% used bottles for feeding. 70.5% of mothers washed their hands at the time of feeding of their child, 93.8% mother covered food in their houses while only 26.7% of mothers gave freshly cooked food. Mother's outlook on various aspects of diarrhea was sought. Very few mothers considered poor sanitation (2.5%) andcontaminated water (12.6%) as a source of diarrhea. Only 8.7% mothers knew about the role of ORS in diarrhea and maximum (53.4%) considered that diarrhea could not be avoided by any measure.Conclusions: Mother's knowledge regarding causes, management and prevention of diarrhea needs to be upgraded to allow better utilisation of health resources by the families.

Prognostic significance of initial management of childhood diarrhoea in rural areas: an observational study

Background: To identify current evidence in order to guide scaling up of initial management of diarrhoea among children of age group 2-60 months in rural areas of the country.Methods: This hospital based cross sectional study included all children 2 months to 60 months of age admitted with chief complains of loose stools in the last 7 days over a period of one year. A pre-tested questionnaire was used as the data collection tool and face to face interviews were conducted on mothers of children.' All the data were analyzed using IBM SPSS version 20 software. Chi-square/Fisher Exact/ Student t-test and ANOVA test has been used. Significance was assessed at 5%.Results: Data showed the use of antibiotic in 55.9% cases, IV fluids in 50.3%, ORS in 6.7%, zinc in 2.0% and blood transfusion in 13.8% cases as an initial management of diarrhoea in peripheral health care centers. Of these, 37.6% cases were severely dehydrated, and 8.14% cases were in shock at the time of admission. 10.1% mothers did not intervene in the first 3 days of the disease whereas 45.2% consulted some health care center only in the later part. 4.5% cases expired after admission of which 69% were malnourished.Conclusions: This study summarizes the importance of initial management of a child with diarrhoea in defining the further course of the disease and also the failure of effective promotion and propagation of the most appropriate and cost-effective therapy (ORS and Zinc) for diarrhoea in this part of the country. Pre-existing malnutrition further complicates the situation.

Familial clustering of a rare syndrome.

Ectrodactyly, ectodermal dysplasia and cleft palate syndrome is a rare autosomal dominant multiple congenital anomaly syndrome with variable expressivity and reduced penetration. The cardinal features are cleft palate/lip, lobster hand deformity, sparse hypopigmented hair, dry scaly skin, and lacrimal and urogenital anomalies. A neonate presented to us with typical features, his mother and other two siblings were also affected.