Comparative study of cord blood lipid profile in relation to gestational age, birth weight, and sex

Objectives: The objective of the study was to compare the cord blood lipid levels in healthy newborns according to gestational age (GA), weight, and sex. Methods: This study included 1000 healthy term and preterm neonates after obtaining parental consent at birth. The GA was confirmed using New Ballard Score. Fenton’s growth charts were utilized to classify study subjects as appropriate for GA, small for GA, and large for GA at birth. Lipid profile was measured by enzymatic colorimetric method. Serum low-density lipoprotein-cholesterol (LDL-C) was calculated by Friedewald’s formula. Results: Preterm neonates with GA of 28–36 weeks had higher mean total cholesterol, LDL, very LDL, and triglycerides levels than term neonates in contrast to their mean high-density lipoprotein (HDL) levels which was significantly lower as compared to that of term neonates. A statistically significant decline in all lipid fractions was observed with an increase in birth weight from <1.5 kg to ≥2.5 kg. Females had higher lipid fractions in comparison to male neonates; however, only the difference in HDL levels was statistically significant (p<0.001). Conclusion: Low birth weight neonates exhibit higher lipid levels at birth giving scope for future research and regular follow-up of these high-risk neonates

Utility of Gastric Lavage in Vigorous Neonates Delivered with Meconium Stained Liquor: A Randomized Controlled Trial

Objective. To determine the incidence of feed intolerance in vigorous babies with meconium stained liquor (MSL) who received prophylactic gastric lavage as compared to those who were not subjected to this procedure. Design. Randomized controlled trial. Setting. Tertiary care teaching hospital. Participants/Intervention. 330 vigorous babies delivered with MSL and satisfying the predefined inclusion criteria were randomized either to receive gastric lavage (group A, n=165) or to not receive gastric lavage (group B, n=153). Clinical monitoring was subsequently performed and recorded in prestructured proforma. Results. There was no significant statistical difference (P>0.05) in incidence of feed intolerance in “lavage” and “no lavage” groups. Secondary Outcome. There was no evidence of secondary respiratory distress in either group. None of the patients in the lavage group exhibited adverse effects owing to the procedure. Conclusions. There is no role of prophylactic gastric lavage in neonates born with MSL

Clinical profile of recurrent headache in rural children of Rajasthan: A cross-sectional study

Context: Recurrent headache is a commonly encountered clinical entity in rural children. Aims: This study aims to record the clinical profile of recurrent headache in rural children of Rajasthan. Settings and Design: A cross-sectional, observational study in a pediatric outpatient department of a tertiary care teaching hospital. Methods and Materials: A total of 164 children of either sex, between 5 and 17 years of age, presenting with complaints of a recurrent headache were included in the study. All relevant clinical details collected from patients and their relatives were recorded in a structured pro forma. A detailed examination was performed to rule out underlying problems associated with a headache. Headache subtypes were classified according to the International Classification of Headache Disorders, 3rd edition beta, 2013. Pediatric migraine disability assessment test score and Faces pain rating scale were utilized to assess the disability and severity, respectively. Statistical analysis involved summarizing the continuous variables as mean and standard deviation while nominal/categorical variables were expressed as percentages. Results: The mean age was 11.5 years and the M:F ratio was 1:1.1. Adolescents in 13–17 years age group constituted 61.5% (n=101) of the study sample with 58.4% (n=59) female subjects. Primary headaches - tension-type headache (n=77, 46.9%), migraine (n=43, 26.2%), and new daily persistent headache (n=5, 3%) were observed in 125 (76.1%) cases. Common causes of secondary headache were somatization disorder (n=27, 16.5%), ophthalmic problems (n=7, 4.3%), medication overuse (n=3, 1.9%), intracranial tumor (n=1, 0.6), and postictal (n=1, 0.6). Conclusions: Recurrent headache in rural children has distinct etiological profile which mandates a meticulous evaluation for initiating appropriate management

Anemia as a risk factor for lower respiratory tract infection in children of 6 months to 5 years of age

Objective: To determine whether anemia is a risk factor for acute lower respiratory tract infections (ALRTI) in children aging6 months–5 years. Materials and Methods: Observational case–control study was performed in 540 children in the age group of6 months–5 years who attended the outpatient and inpatient unit of the department of pediatrics of a tertiary care hospital of Jaipur,during the period from January 2017 to June 2018. 270 cases hospitalized for LRTI who fulfilled the inclusion criteria and 270 healthyage and sex matched controls without any respiratory problems attending outpatient department of the department of pediatrics. Childrenwith congenital anomalies, protein energy malnutrition, tuberculosis, congenital heart defects, HIV, and malignancies were excludedfrom the study. After a detailed history and anthropometric measurements, complete blood count, C-reactive protein, peripheral bloodfilm examination, reticulocyte count, chest skiagram, Mantoux test were done. Iron profile and detailed anemic investigations are doneif hemoglobin level was below 11 g/dl as per the WHO criteria. The sentence in abstract can be framed like this. The norms consideredfor ALRTI were also considered as per defined by the WHO criteria. Results: Male preponderance was observed (55.2%) in the studygroup. Most of the children were <2 years of age (59.6%). On auscultation, crepitations were a major finding (64.8%). Out of 270;240 (88.9%) patients were diagnosed as pneumonia and rest 30 (11.1%) cases as bronchiolitis. Anemic patients were found to be3.7 times more susceptible to ALRTI in this study (p=0.01). Iron deficiency anemia (IDA) was found in 63.7% of total anemic cases inthe study group. In the study group, the mean serum iron level 26.3±7.9 mcg/dl in the anemic cases and 29.11±8.95 mcg/dl in the nonanemiccases. It was observed that with an increase in the severity of anemia among the cases, a concomitant increase in the severityof pneumonia was also observed (p=0.04). Conclusion: Early detection, preventive measures, and aggressive treatment with propernutrition and medication of anemia; especially, IDA in all children are helpful for prevention of ALRTI