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July-September 2016 Volume 1 | Issue 3
Page Nos. 1-48
Online since Saturday, May 8, 2021
Accessed 9,564 times.
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EDITORIAL |
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Review Human milk banking: Indian perspective |
p. 1 |
Balraj Yadav, Satish Tiwari
Getting the best possible start in life is birth right of each and every newborn. The choice of feeding is direct at mother’s breast, if not possible then expressed Mother’s Own Milk, then donated fresh milk, then pasteurized donated human milk and lastly animal milk. The unregulated and uncontrolled use of animal or formula milk continues in our society endangering health of the future generation. Though wet nursing had been in practice since mythological ages, modern human milk banking is in infancy in India. In India burden of LBW babies in various hospitals is about 30% to 40% with significant mortality and morbidities. Human milk banks are primarily focused to provide donor milk to high risk newborns. Human Milk dispensing strategy for sick babies is an innovative strategy that has been implemented with much success in reducing hospital stay, improved outcome, low infection rates and enhancement of Intellectual and emotional quotient. At present there are no laws governing human milk banks in India. The various stakeholders agreed that human milk banks are “need of the hour” and must be promoted, established and maintained preferably in all neonatal set-ups or critical care units. There is need for government and policy makers to frame guidelines, legislations, rules so as to protect the rights of mother and child. Human Milk Banking is an important medical-social initiative as far as future of human race is concerned. Hence Government, health experts and civil society must join hands to propagate concept of human milk banking for sake of thousands of LBW and preterm babies.
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ORIGINAL ARTICLES |
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Anthropometric and metabolic profile of obesity |
p. 5 |
Ghouini Ahmed, Djoghlaf Djamel El Harb, Rahal Lotfi
Introduction: Obesity is excess fat with adverse health consequences, because of the many complications that it generates during its evolution. Objective: We aim to establish the correlation between anthropometric parameters and metabolic profile. In Algeria, the correlations between the morphological and metabolic and nutritional status are not enough documented. Material and methods: Our study included a cohort of 208 subjects aged between 40 and 60 including 67 subjects at normal weight and 141 subjects with an overweight of a body mass index BMI (weight in kg/height in m2) at 26 to 35. Assessment of anthropometric profile took into account the BMI and waist circumference. Body composition and energy expenditure were determined by bioelectrical impedance kind QUADSCAN 4000. Measurements of blood glucose and insulin were performed on COBAS INTEGRA 400 plus ROCHE; HOMA index was calculated by the following formula: insulin (mU / L) X glucose (mmol / L) /22.5, The Statistical Package of Social Sciences (SPSS 17.0) was used to perform statistical analysis. Results: It is found in our study, an increase in basal energy expenditure in obese subjects compared to other statutes weight is 1827 Kcal / versus 1570 kcal / (P < 0.001). It is also observed an increase in lean body mass in obese subjects (59 kg) compared to overweight subjects (51 kg) and normal weight subjects (47 kg); the difference is significant at P < 0.001. On the other hand, there is a significant difference between insulin levels in overweight subjects compared to controls (P <0.05). Conclusion: The results of our study support the following assumptions: lean mass rate is proportional to the weight., the distribution of body fat has no direct influence on the basis of energy expenditure. furthermore, there is a positive correlation between HOMA insulin resistance index and anthropometric parameters. Therefore, a nutrition and sports education program could positively impact on comorbidities accompanying this disease that poses a major public health problem.
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Association of vitamin D levels with physical and sociocultural factors among selected Filipino high school students in Quezon City |
p. 8 |
Hazel V Arnaldo, Randy P Urtula, Maria Estela R Nolasco
Aim: To determine the vitamin D status and its association with physical and sociocultural factors among Filipino high school students in selected schools in Quezon City. Methods: A cross-sectional study of Filipino high school students was undertaken. Ninety-seven boys and girls, 11- 18 years old, attending selected private and public secondary schools in Quezon City participated in the study. Serum 25-hydroxyvitamin D levels were determined by electrochemiluminescence immunoassay. Results: The total serum 25-hydroxyvitamin D levels of the students ranged from 19.92 nmol/L to 88.63 nmol/L with a mean of 52.43 nmol/L. There was a prevalence of hypovitaminosis D (serum 25-hydroxyvitamin D levels <50nmol/L) of 41.2% with 20.6% having deficient (<37.5 nmol/L) and 20.6% insufficient (37.5 - <50 nmol/L) serum 25-hydroxyvitamin D levels. Low vitamin D intake (p=0.019), Body mass index Z-score outside the normal range of 0 to <1SD (p=0.012) and upper socioeconomic status (p=0.001) were significantly associated with hypovitaminosis D. Conclusion: Hypovitaminosis D is highly prevalent among Filipino high school students in selected schools in Quezon City despite abundance of sunlight. Low vitamin D intake, Body mass index Z-score outside the normal range of 0 to <1SD and upper socioeconomic status were significantly associated with hypovitaminosis D. Given the characteristics of the adolescent population, appropriate interventions are needed to address the problem of poor vitamin D status in schoolchildren.
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The H-type anorectal malformations in girls |
p. 16 |
FA Otamuradov, N Sh Ergashev
The anorectal malformations are presented by wide spectrum of nosological forms. Many aspects of the surgical treatment of the rectogenital fistulas in normally formed anus remain to be debatable because they are described insufficiency in the literature. Material and methods: During the period from 2004 to 2015 in the clinic there were treated 210 girls of the age from one day to 15 years with ARM, of them 17 (8,1%) girls were with H-type. The patients were examined and underwent the operative treatment by the developed technique. Results: In 4 (23.5%) patients localization of the malformation was related to the anovestibular type, in 8(47,1%) – to rectovestibular –intermediate form, in 5 (29,4%) –high form of which 2 had rectovaginal fistula. Invaginational extirpation by A.I.Lyonushkin was performed in 3 (17,6%) patients, fistula liquidation by anterior-sagittal approach – 5 (29,4%). In 8(47,1%) patients including repeated surgeries in the recurrences were carried out by the technique developed in the clinic. Conclusion: In intermediate forms and lower localizations of the fistulas there were indicated one-step correction, comparatively better results were obtained in liquidation of the fistula with pulling-through of the anterior wall of the rectum. In high (rectovaginal) fistulas this type of operation should be performed after application of the preventive double sigmostoma.
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To study the prevalence of iron deficiency anemia in children aged 6 months – 6 years presenting with febrile seizures in Department of Pediatrics |
p. 20 |
Balram Meena, Jaswir Singh, Maninder Kaur
Background: Febrile seizure is a common cause of seizures in young children but with an excellent prognosis. In addition to genetic predisposition, febrile seizures are generally thought to be induced by elemental changes such as iron deficiency. Regarding the high prevalence of febrile seizures with iron deficiency anemia in children, the aim of our study is to investigate the role of iron deficiency anemia in febrile seizures patients. Iron deficiency (ID) is the most common nutritional deficiency. The peak age for ID is between 1 and 2 years, which coincides with the peak incidence for febrile seizures. Aim: To study the prevalence of iron deficiency anemia in children aged 6 months to 6 years having febrile seizures. Study design: It is a prospective observational case control study. Material & Method: The present study was included 50 children aged 6 months to 6 years with febrile seizures (cases) and 30 febrile children without seizures (controls), coming to Pediatrics OPD and emergency, RAJINDRA HOSPITAL PATIALA. Hemoglobin level (Hb) and serum ferritin levels were estimated in all the patients. Results: In cases the mean serum ferritin levels was25.52±29.8 ng/dl and in controls was61.36±77.5 ng/dl. It was seen that serum ferritin levels were significantly low in children with febrile seizures as compared to controls (p < 0.004). Conclusion: Prophylactic iron supplementation should be considered in all children who are anemic as it may have a preventable role in febrile seizures.
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CASE REPORTS |
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Brunner’s gland hyperplasia with dysplasia: A case report with a review of the literature |
p. 24 |
FZ Chabib, A Essaid
The hyperplasia of Brunner’s glands, also called Brunner’s Gland Hamartoma or Brunneroma is a rare proliferative lesion from Brunner’s glands of the duodenum. These lesions previously were described as benign, without malignant potential. Endoscopy has revolutionized the care of these polyps: it allows the macroscopic and histological diagnosis; it also allows curative treatment and monitoring at short term. We report a rare case of a large brunners hamartoma (BH), localized in the duodenal bulb who discovered at the occasion of upper gastrointestinal hemorrhage.
This observation has two special particularities: Histopathological examination of this Brunner’s gland hyperplasia revealed, foci of low-grade dysplasia : Complete excision successfully despite its size and its delicate location.
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Ulcerative colitis in a Nigerian child: a case report |
p. 29 |
R Ewah-Odiase, I Omoike, G Akpede, R Udaze, C Omuemu, D Obaseki
Background: Ulcerative colitis (UC) is an idiopathic chronic inflammatory disorder characterized by unpredictable exacerbations and remissions. It is thought to be rare in Africans especially amongst paediatric age group and there has been only one presumed paediatric case report from Nigeria. Case Presentation: We report the case of a 13.5 year old boy who presented with typical symptoms and in whom the diagnosis of UC was confirmed by endoscopic examination and histology. He responded well to treatment with sulfasalazine tablets. Conclusion: This plus an earlier report suggest that UC may not be as rare in Nigeria as it was previously thought to be perhaps due to under-diagnosis caused by a lack of diagnostic facilities. A high index of suspicion is required in diagnosis and epidemiologic studies are required to determine its actual prevalence.
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A child with brain abscess due to Gemella haemolysans |
p. 32 |
Sirin Mneimneh, Hussein Awada, Ahmad Shatila
Gemella Haemolysans, are Gram positive cocci that are considered to be normal inhabitants of the mucous membranes of the oropharynx, but are considered rare pathogens in case of bacterial brain abscess. We report, to our knowledge, the second pediatric case of Gemella Haemolysans brain abscess in an 8-year-old child, with no previous medical problems. Because of its similarity with Streptococcus viridans group, Gemella Haemolysans often remains under diagnosed in the laboratory, constituting a great challenge for many microbiologists in its correct identification.
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Impaction of a Rupees 2 coin in the duodenal bulb |
p. 34 |
Rimjhim Shrivastava, Sanwar Agrawal
Foreign bodies in the gastrointestinal tract are common in the pediatric age group and coins account for the majority. Most coins after passing through the esophagus will eventually leave the stomach and pass through the gastrointestinal tract without obstruction. We report a case of impacted Rs 2 coin in the duodenal bulb in a 9 years old boy which was in that position for 5 months and was retrieved endoscopically.
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REVIEW ARTICLES |
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How well do we understand biliary atresia? |
p. 37 |
G Krishna Kumar
Biliary atresia forms the prime surgical cause for neonatal jaundice, although the differential diagnoses of jaundice in the neonatal and infantile age group includes an exhaustive list of several medical causes. Despite various studies looking at the aspects of the pathology of the condition, it is not clear as to how exactly Biliary atresia is caused. The review attempts to look at the current literature concerning the etio-pathogenesis of Biliary atresia.
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Nutrition in cystic fibrosis |
p. 40 |
Dra Adriana Fernández
Life expectancy in Cystic fibrosis patients has significantly increased in recent years. Nutrition is considered one of the key targets of management. To achieve and maintain an adequate nutritional status results in a milder decline of pulmonary function, better prognosis and improvement in quality of life. In spite of great advances in knowledge, a significant number of individuals living with cystic fibrosis remain, according to different international registries, under proposed nutritional goals. Several nutritional aspects of the disease must be addressed: intake evaluation, behavioral issues and enrichment of diet. Likewise, a number of patients persist with vitamin and mineral deficit, despite correct supplementation as stated in available international consensus reports. Nutritional interventions are indicated when patients fail to achieve an adequate nutritional status and previous strategies were implemented. Enteral tubefeeds are indicated in around 10% of cystic fibrosis patients being evaluated and treated in different CF centers, showing favorable impact on nutritional status and lung function decline. Nevertheless, nutritional recovery as reflected by body mass index(BMI), is not an adequate measure of body composition. Cystic fibrosis related diabetes develops in nearly half of adult patients. It is necessary to highlight the importance of screening, early diagnosis and implementation of insulin treatment in order to prevent lung function and nutritional deterioration and higher mortality rates. Adherence to treatment and therapies results in better outcome, as occurs in other chronic diseases.
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SHORT COMMUNICATION |
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Pediatric medicines – a hidden risk for dental caries |
p. 47 |
Deepesh Prajapati, Damodhar Kappadi, Ullal Anand Nayak, Nancy Srivastva |
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