A Study on the Effectiveness of an Educational Package on the Knowledge of Mothers of Asthmatic Children on Bronchial Asthma

An evaluative study was conducted to determine the level of knowledge of mothers of asthmatic children on asthma and to determine the effectiveness of an educational package in terms of improvement in knowledge of mothers. A quasi experimental pretest posttest control group design was used. Purposive sampling technique was employed to select the subjects and they were randomized into either the experimental or control group using block randomization. Each group consisted of 40 mothers who fulfilled the sampling criteria. Baseline characteristics and a structured knowledge questionnaire on asthma were used to collect data. The findings of the study revealed that the difference from pretest to posttest knowledge scores in the experimental and control group was statistically significant (F = 444.35, p<0.01) and the difference between the experimental and control group was statistically significant (F= 223.663, p< 0.01). The Post Hoc Bonferroni test showed significant difference within the groups and also between the experimental and control groups (p< 0.01). There was significant improvement in knowledge among mothers in the experimental group than in the control group. Hence empowering mothers about asthma will help in adopting appropriate preventive measures and reduce asthma exacerbations in children. Keywords: Knowledge, Mothers of asthmatic children, Educational packag

Pediatric urolithiasis: What role does metabolic evaluation has to play?

Background Pediatric urolithiasis is a perplexing problem faced by pediatricians as well as urologists across the globe. By early diagnosis and treatment of these risk factors, future stone formation may be prevented. Aim: To evaluate the clinical, biochemical and metabolic characteristics of the patients and the interventions required to prevent recurrence.Methods: In this retrospective study, cohort of pediatric patients presenting with urolithiasis at Kasturba Medical College, Manipal formed the study population. Patient’s records served as study tools. Medical records department was approached and data was collected. Metabolic evaluation was done in all children. Urine tests included urinalysis, urine culture, 24 hours urinary pH, volume, calcium, oxalate, citrate, uric acid, and creatinine. Finally a total of 58 pediatric urolithiasis cases were included in this study.Results: Mean age of study subjects was 6.85±1.27 years. Top three presentations of pediatric urolithiasis were symptoms of Urinary tract infection (UTI), abdominal pain and flank pain in 29.3%, 24.1% and 17.2% children respectively. Gross hematuria was observed in 15.5% of cases. 82.6% of stones were renal stones. Calcium oxalate stone was most common (50%) variety found. Hyperoxaluria was the most common (79.3%) metabolic abnormality detected. 31% had stone recurrence during follow up and 8 of these had >1 metabolic abnormality. Only 6/28 (21.4%) patients managed conservatively had stone recurrence whereas 12/30 (40%) managed with a procedure had stone recurrence.Conclusions: Metabolic evaluation for urolithiasis helps us to identify children those at increased risk for recurrent stone disease. Thus metabolic evaluation is a must in all pediatric patients as it helps in segregating patients needing medical therapy.

PROGRESSIVE VARICELLA SYNDROME WITH VARICELLA GANGRENOSA IN AN IMMUNE- COMPETENT INFANT

Varicella is common and highly contagious and affects nearly all susceptible children before adolescence. Progressive varicella syndrome is a severe complication of primary Varicella Zoster Virus (VZV) infection, with visceral organ involvement, coagulopathy, severe hemorrhage, and continued vesicular lesion development. We report a rare case of progressive varicella syndrome with varicella gangrenosa in a previously well female child of ten months. She presented with history of recurrent vesiculo-bullous skin lesions involving the chest, back and extremities since two months with dry gangrene of 1st, 3rd and right great toe. VZV Polymerase Chain Reaction (PCR) of vesicle fluid was positive. Workup for immunodeficiency state was negative. She responded dramatically to intravenous acyclovir.

Fracture neck of femur in Factor XIII deficiency: Was better outcome possible?

The fracture in a Factor XIII deficiency patient is being reported for the first time in the literature. We report a displaced fracture neck of femur in a 17-year-old boy with Factor XIII deficiency. Open reduction and internal fixation was done 8 days after the following the initial injury. Two units each of fresh frozen plasma and cryoprecipitate were given perioperatively to prevent excessive bleeding. No perioperative bleeding complications were encountered. At 18-months follow-up, the fracture had united with evidence of avascular necrosis. The fracture neck of femur in a child or young adult needs to be reduced and stabilized at the earliest to prevent devastating complications. Its occurrence in a patient with Factor XIII deficiency is to be managed like in a normal patient, but with extra perioperative care. Undue delay in fixation as happened in this case should be avoided for a better outcome