Role of female birth attendants to enhance breastfeeding rates and essential newborn care

Background: Women who received support during labor are more likely to give birth “spontaneously.” The role of the female birth attendant (FBA) has not been very well established; hence, this study was planned. Objective: The objective of the study was to train, educate, assess, and evaluate the role of FBA before, during and after labor in terms of mother’s satisfaction, early initiation and continuation of breastfeeding and providing essential newborn care. Methods: In this prospective cohort study, 400 pregnant women, 200 cases and 200 controls in their third trimester were enrolled. FBAs were given training using flipchart. Thesenewborns were followed up at 1½ month at an immunization clinic. Data were collected and analyzed. Results: 88% (176) of cases initiated breastfeeding in the 1st h of birth compared to 14.5% (29) in controls. 57 (28.5%) of controls had given prelacteal feeds to newborns compared to 7% (14) of cases. 108 (59%) of cases put the baby skin-to-skin contact following delivery compared to none in controls. There was more number of hospital visits in neonates of controls 26.25% (52) compared to cases 12.5% (25). Conclusion: The presence of FBAs improves early initiation of breastfeeding, decreases prelacteal feeds, improves skin-to-skin contact indirectly preventing hypothermia, and decreases the number of hospital visits

Homocystinuria with Cerebral Venous Sinus Thrombosis: Excellent Recovery with Intravenous Recombinant Tissue Plasminogen Activator

How to Cite This Article: Gowda VK, Nanjundappa RC, Pendharkar H, Benakappa N. Homocystinuria with Cerebral Venous Sinus Thrombosis: Excellent Recovery with Intravenous Recombinant Tissue Plasminogen Activator. Iran J Child Neurol. Summer 2017; 11(3):48-52. AbstractHyperhomocysteinemia can cause cerebral venous thrombosis. Recombinant tissue plasminogen activator is one of the treatment options for cerebral venous thrombosis in selected cases. We present here a 7-year-old boy with homocysteinuria with stroke. MRI of brain showed cerebral venous sinus thrombosis. We successfully treated with intravenous recombinant tissue plasminogen activator. He recovered completely without any complications.Recombinant tissue plasminogen activator can be considered one of the treatment options in cerebral venous thrombosis in homocystinura.References1. Fernando D. Testai, MD, PhD; Philip B. Gorelick, MD,MPH. Inherited Metabolic disorders and stroke part 2-Homocystinuria, organic acidurias, and urea cycle disorders. Arch Neurol 2010; 67 (2):148-153.2. Herrmann E, Lorenzl S, Obeid R. Review of the role of hyperhomocysteinemia and B-vitamin deficiency in neurological and psychiatric disorders-current evidence and preliminary recommendations. Fortschr Neurol Psychiatr 2007; 75: 515-527.3. Online Mendelian Inheritance in Man. Homocystinuria. http://www.ncbi.nlm.nih.gov/entrez/dispomim. cgi?id=236200. Accessed March 27, 2009.4. udd SH, Skovby F, Levy HL, Pettigrew KD, Wilcken B, Pyeritz RE, et al. The natural history of homocysteinuria due to cystathionine beta synthase deficiency. Am J Hum Genet 1985; 37: 1-31.5. Hacke W, Doonnan G, Fieschi C, Kaste M, von Kummer R, Broderick JP, et al. Association of outcome with early stroke treatment: Pooled analysis of ATLANTIS, ECASS, and NINDS rt –PA stroke trials. Lancet 2004; 363: 768-774.,6. Roach ES, Golomb MR, Adams R, Biller J, Daniels S, Deveber G. et al. Management of stroke in infants and children: a scientific statement from a special writing group of the American Heart Association Stroke Council and the Council on cardiovascular disease in young. Stroke 2008; 39:2644-2691.7. Soleau SW, Schmidt R, Stevens S, Osborn A, MacDonald JD. Extensive experience with dural sinus thrombosis. Neurosurgery 2003; 52: 534-544; discussion 542-544.8. Janjua N, Nasar A, Lynch JK, Qureshi AI. Thrombolysis for ischemic stroke in children: data from the nationwide inpatient sample. Stroke 2007; 38:1850-1854.9. Amlie-Lefond C, deVeber G, Chan AK, Benedict S, Bernard T, Carpenter J et al. Use of alteplase in childhood arterial ischaemic stroke: a multicentre, observational, cohort study. Lancet Neurol 2008; 8:530-536

Clinical Profile and Outcome in Children with Post Diphtheritic Paralysis in a Tertiary Care Hospital in South India

Abstract Objectives Post-Diphtheritic Paralysis (PDP), one of the most severe complications of Diphtheria, is caused by exotoxin of Corynebacterium diphtheria. Since there has been a resurgence of diphtheria in India in the recent years attributed to a number of epidemiological factors, this study was planned. Materials & Methods Thirty-five children with Post-Diphtheritic paralysis (PDP) were studied in a tertiary care hospital in Southern India. Neurological complications occurred in 38.5% of 91 patients of faucial diphtheria. Thirteen (37.1%) children were unimmunized, 12 (34.3%) were partially immunized, two (5.7%) were completely immunized and unknown status in eight (22.6%). Isolated bulbar palsy in 20 (57.1%) and bulbar palsy followed by limb weakness was seen in 15(42.9%) of patients. The first symptoms of PDP occurred 5-34 days after the onset of local diphtheria infection. Eleven (31.4%) out of 35 patients had received anti-toxin between days 5-7 of illness. Ventilation dependent respiratory failure occurred in three (8.6%) patients with PDP. Nine patients (25.7%) had evidence of co-existent myocarditis while myocarditis with renal failure was seen in two (5.7%) patients. Four (11.4%) patients died, three from severe cardiomyopathy and one from aspiration. Demyelinating neuropathy was noted in 64%.  Bulbar palsy recovered by 4-7weeks, while limb symptoms improved by 6-17weeks. Conclusion Post-Diphtheritic paralysis should be considered in any child presenting with bulbar palsy/ quadriparesis following previous history of fever/ sore throat. Awareness and availability with timely administration of ADS within 48 hours is important to reduce PDP, as antitoxin seems ineffective if administered after the second day of diphtheritic symptoms

Caregiver-reported health-related quality of life of children with cerebral palsy and their families and its association with gross motor function: A South Indian study

Introduction: In children, health-related quality of life (HRQOL) includes parental impact and family functioning along with concepts of illness, functional status, mental health, and comfort. We are focusing on the impact of cerebral palsy (CP) on children's HRQOL and their families, and its relationship with gross motor dysfunction. Subjects and Methods: CP children aged 3–10 years under regular neurology follow-up were enrolled. The HRQOL and motor severity were prospectively assessed using lifestyle assessment questionnaire-CP and gross motor function classification systems, respectively. Results: One hundred children participated in this study. Thirty-three percent of children had good, 22% had mildly affected, whereas 45% had moderately to severely affected HRQOL. A significant association is present between gross motor function classification system and HRQOL. Conclusion: HRQOL in CP and their caregivers is highly impaired. The degree of impairment is associated with physical independence, mobility, clinical burden, and social integration dimensions. Therapies targeting these dimensions and associated comorbidities will improve the HRQOL. Gross motor function classification system is a good indicator of HRQOL

Caregiver-reported health-related quality of life of children with cerebral palsy and their families and its association with gross motor function: A South Indian study

Introduction: In children, health-related quality of life (HRQOL) includes parental impact and family functioning along with concepts of illness, functional status, mental health, and comfort. We are focusing on the impact of cerebral palsy (CP) on children's HRQOL and their families, and its relationship with gross motor dysfunction. Subjects and Methods: CP children aged 3–10 years under regular neurology follow-up were enrolled. The HRQOL and motor severity were prospectively assessed using lifestyle assessment questionnaire-CP and gross motor function classification systems, respectively. Results: One hundred children participated in this study. Thirty-three percent of children had good, 22% had mildly affected, whereas 45% had moderately to severely affected HRQOL. A significant association is present between gross motor function classification system and HRQOL. Conclusion: HRQOL in CP and their caregivers is highly impaired. The degree of impairment is associated with physical independence, mobility, clinical burden, and social integration dimensions. Therapies targeting these dimensions and associated comorbidities will improve the HRQOL. Gross motor function classification system is a good indicator of HRQOL

Disseminated congenital cutaneous candidiasis caused by Candida ciferri: A rare case report

Congenital cutaneous candidiasis (CCC) is an uncommon disease affecting newborns which manifests within first 6 days of life following an ascending infection from birth canal or as transplacental infection. Diagnosis is challenging due to its varied clinical manifestation ranging from mild asymptomatic illness to fatal disseminated disease. We describe a full-term newborn child with CCC with dissemination born to mother with vaginal candidiasis, positive for Candida ciferri by fungal culture. This highlights the importance of maternal history of vaginal discharge during pregnancy to diagnose and prevent neonatal disseminated infection which further aids for adequate early treatment to prevent subsequent mortality