Maximum Number Of Children Research Articles

Screening for Iron Deficiency in Early Childhood Using Serum Ferritin

Introduction: The iron deficiency is an important public health problem widely prevalent in the early childhood period. Iron is very important for various body processes like monoamine metabolism, synthesis of myelin, and metabolic function of the brain. It has many detrimental effects on the cognition, emotional, social, and motor development.‍ Serum ferritin is an easily available, non invasive, inexpensive with high specificity for iron deficiency.
 Aim: The present study was conducted with the aim to estimate the levels of hemoglobin and serum ferritin in young children in the age group of 1-5 years irrespective of their sex. 
 Materials and Methods: Laboratory data of serum ferritin and hemoglobin levels were prospectively collected of apparently healthy children, 1 to 5 years of age coming to Pediatrics OPD of Acharya Shri Chander College of Medical Sciences, Jammu. The ferritin levels were estimated in roche chemiluminescent immunoassay. The haemoglobin levels were estimated. Children with serum ferritin level < 12 µg/L was considered as deficiency. The statistical analysis was conducted using SPSS version 20.
 Results: A total of 100 children, 1 to 5 years of age were enrolled in the study. The mean hemoglobin level in children is 12.2gm%. The mean serum ferritin level in children is 29.2µg/L. In our study, it was observed that the mean Hb levels are higher in the reference age group, than decreases in the 2-3 year age group and then again increases in the 3-5 years age group. It was further observed that the serum ferritin levels were higher in the reference age group and then decreases in the 2-3 year age group. The serum ferritin levels further rises in the 3-4 years, 4-5 years age group.
 Conclusion: In our study, it was observed that serum ferritin is a more reliable test than hemoglobin for screening iron deficiency in early childhood. The most favorable age group for screening for iron deficiency appears to be 2 to 3 years of age in which maximum number of children with iron deficiency was observed, but other associated conditions should also be kept in mind.

ŞERʿİYYE SİCİLLERİNE GÖRE ANTAKYA’DA AİLENİN SOSYO-EKONOMİK YAPISI (19. YÜZYILIN SONLARINDAN 20. YÜZYILIN BAŞLARINA KADAR)

Bulunduğu zamana ve coğrafyaya göre değişiklikler gösteren aile kurumu, bir taraftan toplumun kültür yapısına göre şekillenirken diğer taraftan da toplumun sosyal ve ekonomik yapısını şekillendirir. Bu nedenle bir devletin tarihini anlayabilmek için o devletin toplum yapısını, toplum yapısını anlayabilmek için ise aile yapısını anlamak gerekir. Farklı millet ve inanç sistemlerini, geniş bir coğrafyada yüzyıllarca bünyesinde barındıran Osmanlı Devleti’nin toplumsal yapısının incelenmesi de bu yönüyle önem kazanmaktadır. Yaklaşık 400 yıl Osmanlı Devleti’nin hâkimiyeti altında kalan, Müslüman nüfus yanında gayrimüslim nüfusu da barındıran Antakya’da ailenin sosyo-ekonomik yapısına ilişkin bazı çalışmalar yapılmıştır. Ancak bu çalışmalar, 18 yüzyıl ile 19. yüzyılın son çeyreği arasındaki dönemi kapsamaktadır. Bu tarihten sonrasına ait özgün bir çalışma bulunmamaktadır. Yapılan bu çalışmayla mevcut eksikliğin giderilmesi amaçlanmıştır. Araştırmanın temel kaynağını, 1876-1911 yılları arasını içeren 40 ile 53 numaralar arasındaki toplam 14 adet Antakya Şerʿiyye Sicili oluşturmaktadır. 19. yüzyılın sonu ile 20. yüzyılın başlarını kapsayan dönem içerisinde Antakya’da bulunan ailelerin sosyo-ekonomik yapıları; mahkeme kayıtlarına yansıyan nikâh, mehir, boşanma, çocuklar için vasi ve nafaka tayini gibi dava örneklerinden; ailelerin çocuk sayıları, eş durumları, gelir düzeyleri, bırakılan miras, yaşadıkları evler ve kullandıkları eşyalar ise tereke kayıtlarından örneklerle tespit edilmeye çalışılmıştır. Bu dönem içerisinde Antakya’da; birden fazla kadın ile evli olan kişiler olmakla birlikte evliliklerin genelde tek eşle yapıldığı, ailelerin ortalama 3-4 çocuk sahibi olup hane nüfusunun 5-6 kişiden oluştuğu, evliliklerin boşanma ile sonuçlanması durumunda genellikle çocukları ve kadınları koruyan nafaka gibi tedbirlerin bazen erkekler için de kullanıldığı, ailelerin daha çok orta düzeyde bir ekonomik yapıya sahip olup ortalama miras değerlerinin 7-8 bin kuruş arasında olduğu, gerek Müslüman gerekse gayrimüslim ailelerin, aynı yaşam alanlarında benzer yaşayış şekilleri sergiledikleri sonucuna varılmıştır.

A STUDY OF REFRACTIVE ERRORS IN CHILDREN AND UNMET NEED OF SPECTACLES IN THEM

AIM– to study causes of vision impairment in school going children, with focus on refractive errors and to study the unmet need of spectacles in them. Prospective analysis of 500 children (up to 14METHOD– years of age) visiting a tertiary care teaching Institute in Ahmedabad who were willing to comply with the procedure of the study were enrolled in the study. Refractive error was the main cause in 58.6% of eyes with vision impairment, amblyopia inRESULTS– 15.2% while other causes in 4.3%. Out of which, maximum number of children had astigmatism (200), followed by Myopia (160) and Hypermetropia (70). In the performed study, more than half of those in need of corrective spectacles were without them. Among different types of refractive error, the greatest likelihood for an unmet need was found with myopia followed by hyperopia, while the association with astigmatism, although signicant, was the weakest. There was a benetCONCLUSION– of spectacles in 70% (unmet need) of those who had visual acuity 6/12 or worse in the better eye at the initial examination. Only 18.6% of the children having refractive error were wearing appropriate glasses.

“IMMUNIZATION TRENDS IN SHIVRAM NATHUJI TAK GOVERNMENT SATELITE HOSPITAL, MANDORE, JODHPUR”

Background: Immunization is one of the most well-known and effective methods of preventing childhood diseases. With the implementation of the Universal Immunization Programme (UIP) by the Government of India, signicant achievements have been made in preventing and controlling vaccine-preventable diseases (VPDs). Aims & Objectives: The present study was undertaken:- 1. To know complete immunization of children against vaccine preventable diseases under Universal Immunization Programme. 2. To know month-wise trend of immunization of children against vaccine preventable diseases under UIP. Materials and methods: This is an Institutional based study and have been conducted in Shri Shivram Nathuji Tak Government Satellite Hospital st st Mandore, Jodhpur, Rajasthan from 1 January 01, 2020 to 31 December 2020. All the children who have been immunized during this period are included in the study. Results: During our study period of 12 months, a total of 575 children between the age of 0-1 year have been immunized. Minimum number of children (48) have been immunized in the month of February and March 2020. For the Pentavalent- 2, maximum number of children (82) have been immunized in the month of May 2020 and minimum number of children (43) have been immunized in the month of October 2020.

Testing the agreement of trees with internal labels

BackgroundA semi-labeled tree is a tree where all leaves as well as, possibly, some internal nodes are labeled with taxa. Semi-labeled trees encompass ordinary phylogenetic trees and taxonomies. Suppose we are given a collection {mathcal {P}}= {{mathcal {T}}_1, {mathcal {T}}_2, ldots , {mathcal {T}}_k} of semi-labeled trees, called input trees, over partially overlapping sets of taxa. The agreement problem asks whether there exists a tree {mathcal {T}}, called an agreement tree, whose taxon set is the union of the taxon sets of the input trees such that the restriction of {mathcal {T}} to the taxon set of {mathcal {T}}_i is isomorphic to {mathcal {T}}_i, for each i in {1, 2, ldots , k}. The agreement problems is a special case of the supertree problem, the problem of synthesizing a collection of phylogenetic trees with partially overlapping taxon sets into a single supertree that represents the information in the input trees. An obstacle to building large phylogenetic supertrees is the limited amount of taxonomic overlap among the phylogenetic studies from which the input trees are obtained. Incorporating taxonomies into supertree analyses can alleviate this issue. ResultsWe give a {mathcal {O}}(n k (sum _{i in [k]} d_i + log ^2(nk))) algorithm for the agreement problem, where n is the total number of distinct taxa in {mathcal {P}}, k is the number of trees in {mathcal {P}}, and d_i is the maximum number of children of a node in {mathcal {T}}_i.ConclusionOur algorithm can aid in integrating taxonomies into supertree analyses. Our computational experience with the algorithm suggests that its performance in practice is much better than its worst-case bound indicates.

Frequency and assessment of Nutritional Status of school going children in rural areas of Islamabad.

Background and Objectives:Nutritional status is considered a significant and positive health indicator. It determines anthropometric measurements of preschool children, the height of children at the time of school entry and prevalence of low birth weight. The objective of the study was to determine the frequency of nutritional status and socio-demographic factors influencing under nutrition among school children of rural Islamabad.Methods:A cross-sectional study was conducted among school children of the age (4-16 years) from January 2017 to September 2019. The Sample size was 1710. Schools were selected through convenient sampling technique. Frequency and percentages were calculated and inferential statistics were computed to analyze the association of health status with categorical variables by using chi-square by keeping the level of significance <0.05 through SPSS version 20.Results:The mean age of the sample was 9.38 ± 4.14 with the maximum number of children (49.1%) in the age bracket of 5-9. Out of 1710 children, 54.4% had normal weight for age, 25.3% were underweight, 7.5% overweight and 12.8% were found to be obese. Stunting was found to be 26%. Prevalence of being underweight was higher than overweight /obesity particularly in younger and higher age groups as indicated by p-value of 0.000. Comparing with females, male students had significantly higher frequency of being underweight and stunted as reflected by p-value of 0.004 and 0.000 respectively. Univariate analysis also showed a strong association between age and nutritional status as mean weight increased from 39.22 ±5.21 to 63.50± 4.66 and height from 35.67±5.76 to 113.73± 29.22 with advancing age.Conclusions:Undernutrition remains an ongoing health problem in school going children of rural Islamabad; particularly in male students of younger age groups. School health programs and nutritional interventions need to be strengthened particularly in rural areas of Islamabad.

Assessment of the clinical profile in the children with microcephaly: Random sampling study

Background and Aim: Primary Microcephaly is also associated with at least 7 gene loci, and 7single etiologic genes have been identified. Acquired microcephaly can be seen in conditions such asrett, seckel, and angel syndromes and encephalopathy syndrome associated with severe seizuredisorders. Hence the study was done to assess the clinical profile of microcephaly in children.Materials and Methods: A total of 104 children were included in the study. The children weredivided into different groups as per age distribution. Group A consist of children of age less than 1year, in group B there were children between age 1 – 5 years, in group C the age of childrenincluded was 5 to 10 years and in group D the age of children was more than 10 years. Results:There were 30 children with microcephaly in group A, in group B there were 52 children withmicrocephaly. For group C there were 20 children with microcephaly and for group D there were 2children with microcephaly. The maximum numbers of children were in the age group of 1 to 5years. Conclusion: Microcephaly is a frequent clinical sign which is common in many of the rarediseases, henceforth, as the exact diagnosis is important for counseling the patient and the affectedfamily, regarding the clinical course, possible complication, optimized medical support, and recurrentrisk.

Structure of Neurological Pathology in Children with Impaired Visual Functions

In children’s neurology, problems of diagnosis and correction of the effects of perinatal lesions of the central nervous system, having a different structure and severity depending on the age of patients, are relevant. Comorbid conditions, to which, to a certain extent, neurological diseases in children associated with functional and structural disorders of the visual system can be attributed.Aim. To study the features of neurological pathology, concomitant to violation of visual functions in children of different age groups.Methods. A neurological examination of 549 children from 3 to 16 years old with various diseases of the visual system was performed. To assess the age characteristics the patients were divided into three groups of preschool, junior and senior school age. The study included a retrospective analysis of ambulatory cards, an interview with parents and an assessment of objective neurological status. If there were indications, additional examination was prescribed (spondylography with functional tests, electroencephalography and others).Results. The features of the structural distribution of neurological pathology in children, which differed from those in the general population, were identified. The dominant disorders are neuro-orthopedic disorders in the form of dorsopathies at the level of the cervical spine.Conclusion. In the structure of neurological pathology in children with structural and functional changes in the visual system, the symptom complex prevails, which is typical for minimal effects of natal damage to the cervical spine, confirmed by X-ray studies. Also a certain relationship of neurological and ophthalmic pathology was identified. The consequences of perinatal central nervous system damage and peripheral cervical insufficiency, as manifestations of dorsopathy, were more often associated with strabismus. In the same group, the maximum number of children with partial atrophy of the optic nerve was revealed.

Information interaction of libraries with children at risk

The topic relevance is increasing due to the children number rise of homeless, dysfunctional, incomplete, low-income, left without parental care, from families using destructive methods, bringing to congenital disorders of the physical and psychological development, who could falling into unfavorable environment take the path of asocial behavior, disharmonious development and, as a result, getting into the «risk groups». The article objective is to determine the library involvement in preventing the children at risk neglect through multiformat forms of the work popularizing books and reading for the educational and cultural development of children. N. V. Stetsenko describes children at risk groups as exposed to biological, psychological, social influences, their tendency to offenses, violence and other types of antisocial behavior. Сhildren at risk include the following categories: gifted children; poorly educated; children with disabilities; children from problem and dysfunc­tional, asocial families; pedagogically neglected children; children from families in need of socio-economic and socio-psychological assistance and support. Currently, the work of a librarian with children at risk is an urgent problem related to growth of families and minors of the «special attention group», where the library task is to reach the maximum number of children attracted to the library. Difficult children is a complicated category; therefore, library and information workers need to know the characteristics of such children, effective methods and methods of educational and preven­tive work. Сhildren at risk need to adapt to the world around them, broaden their horizons, communicate with their peers, organize leisure activities, express themselves creatively, receive information and services, and satisfy their intellectual needs. The library has the staff, resources and means capable to form a harmoniously developed child personality , including children at risk. The library is designed to create for readers not only comfortable (it's important), but productive conditions with the point of intellectual growth, for example, the reader’s participation in organizing library activities (storytelling, makerspace, creative workshops, etc.). The modern library helps to reduce the number of «disadvantaged children», heals the social environment, makes it more friendly and safe for a child.

A study of prevalence and pattern of congenital heart disease at Sopore, Kashmir, North India

Background: Early detection of congenital heart disease is of paramount importance to improve the quality of life of children and prevent morbidity and mortality. Congenital heart disease (CHD) is one of the major causes of mortality and morbidity in the pediatric population of both the developing and developed countries. Present aim was to study the prevalence, age and sex wise distribution, and clinical spectrum of congenital heart disease (CHD) at Sopore, Kashmir, North India.Methods: Around 39829 children in the age group 0 months to 18 years were screened for Defects at birth, Diseases in children, Deficiency conditions and Developmental Delays including Disabilities over the period of 18 months under RBSK. Clinical examination, echocardiography and color Doppler were used as diagnostic tools.Results: A prevalence of 5.3 per 1000 population was observed. VSD (ventricular septal defect) was the commonest lesion (30.1%), followed by PDA (patent ductus arteriosus) in 21.6 % and ASD (atrial septal defect) in 20.2%. Tetralogy of Fallot was the commonest cyanotic heart disease (8.0%). Maximum numbers of children with heart disease were diagnosed in the age group 6 weeks to 6 years.Conclusions: For better estimation of prevalence of congenital heart diseases, more elaborate community-based studies are needed. Such community based studies can be easily done by collecting and analyzing data collected from screening programs like RBSK. Such community based screening programs helps in detecting silent cardiac ailments, their prevalence and pattern, and early therapeutic intervention. A few prevalence studies have been carried out piecemeal in different locations of India; and more such studies can be easily done by collecting and analyzing data collected under RBSK screening program.

Use of an animated emoji scale as a novel tool for anxiety assessment in children.

BackgroundDental anxiety in children is a major barrier in patient management. If dental anxiety in pediatric patients is assessed during the first visit, it will not only aid in management but also help to identify patients who are in need of special care to deal with their fear. Nowadays, children and adults are highly interested in multimedia and are closely associated with them. Children usually prefer motion pictures on electronic devices than still cartoons on paper. Therefore, this study was conducted to evaluate a newly designed scale, the animated emoji scale (AES), which uses motion emoticons/animojis to assess dental anxiety in children during their first dental visit, and compare it with the Venham picture test (VPT) and facial image scale (FIS).MethodsThe study included 102 healthy children aged 4–14 years, whose dental anxiety was measured using AES, VPT, and FIS during their first dental visit, and their scale preference was recorded.ResultsThe mean anxiety scores measured using AES, FIS, and VPT, represented as mean ± SD, were 1.78 ± 1.19, 1.93 ± 1.23, and 1.51 ± 1.84, respectively. There was significant difference in the mean anxiety scores between the three scales (Friedman test, P < 0.001). The Pearson's correlation test showed a very strong correlation (0.73) between AES and VPT, and a strong correlation between AES and FIS (0.88), and FIS and VPT (0.69), indicating good validity of AES. Maximum number of children (74.5%) preferred AES.ConclusionThe findings of this study suggest that the AES is a novel and child-friendly tool for assessing dental anxiety in children.

Nutritional Status and Associated Factors among Under Five Children of Slum and Non-Slum Area of Bharatpur Metropolitian City, Chitwan

A cross-sectional and comparative study design was used to evaluate the nutritional status and associated factors among under five years’ children in Bharatpur Metropolitan City's slum and non-slum area. A total of 246 children under the age of 5 (each of 123 from slum and non-slum) were collected from April 1 to 30; 2017 was interviewed by face to face. Height and weight were measured by anthropocentric measurement and age was reported by direct interview for evaluation of nutrition status. The prevalence of wasted, stunted and underweight in the slum area was 4.9%, 28.5% and 6.5% respectively, whereas 4.9% wasted, 21.0% stunted and 5.7% underweight in the non-slum area. The study revealed that in slum as well as non-slum areas, the proportion of wasted was the same. Although maximum number of children in the slum had become stunted and underweight as compared to non-slums, but it was no statistically significant. Factors related to children: sex, early breastfeeding, colostrum feeding, birth weight, breastfeeding exclusiveness and children's number were statistically significant factors for nutritional status in slum while childhood diseases condition was associated factor in non-slum area. Mother related factors: mother occupation, mother height, age of child were associated factors in both settlement. Also, it reveled that that the joint effect was much stronger than the single effect to explorer the predictors of malnuttrition in both settlements.

Pattern of Pediatric Morbidity in Hospital Admitted Patients in Western Region of Nepal

Background: Pediatric age group comprises the important fraction of hospital admissions in our health care settings and it is the major challenge to address in the developing countries like ours. This study was carried out to find out the significant epidemiological trends and disease patterns of the admitted children in a pediatric ward.Methods: This retrospective study was carried out by reviewing hospital records of the patients admitted in the pediatric ward from July 2015 to January 2016 in Gandaki Medical College Teaching Hospital. The disease pattern was analyzed on the basis of age, sex, final diagnosis of the disease, duration of hospital stay and months of admission.Results: Among the 1348 admitted children during the study period, majority were males (65%) and below five years (74%). Lower respiratory tract infections (30%), enteric fever (10%) and acute gastroenteritis (7.7%) were the three major causes for admission. The mean days of hospital stay was 4.43 and maximum number of children was admitted during August/September.Conclusion: Infectious diseases are the major cause for morbidity and more were during the rainy season.J-GMC-N | Volume 11 | Issue 01 | January-June 2018, Page: 61-63

Micronutrient deficiency status in children below 2 year of age with delayed milestones

Background: Micronutrient deficiency have strong association with delayed achievement of milestones. Objective of present study was to know the micronutrient deficiency status in children below 2 years of age with delayed milestones.Methods: Study was carried out among 50 children below 2year of age with delayed milestones without any known cause for it. These children were evaluated for hematopoietic micronutrient deficiency and they were compared with controls.Results: A total of 50 children (22 male and 28 female) of delayed milestone were enrolled. Maximum number of children were in age group 7-12 months. Majority of children (62%) were from BPL families. Majority of children had Wt/ Ht -1 to -2 SD. Breastfeeding was initiated late (2-6 hr) in 38%. Sixty four percent children were exclusively breast fed up to six month of age, in the rest top milk feeding was also given along with BF. No complimentary feeding was started in 51.1% children after 6 months of age. In 73% of those in whom complimentary feeding was started the amount was inadequate. Maximum children were given complimentary feeding at the age of 9-12 month. In this study significant number of patients (p = &lt;0.001) had low levels of serum vit. B12 (78% v/s 10% in control), iron deficiency (66% v/s 6% in control) and deficient folic acid level (16% v/s nil in control).Conclusions: Association was found between hematopoietic micronutrient deficiency and delayed milestone in children below 2 years age without any other risk factors.

A study on common clinical pattern of presentation of skin and hair changes in nutritional deficiencies associated with dietary fallacies in children 1 to 5 years of age

Background: Dermatological problems constitute atleast 30% of all outpatient visits to the paediatricians and 30% of all visits to dermatologists involving children. Skin diseases in the paediatric age group can be transitory or chronic and recurrent. The chronic dermatoses are associated with significant morbidity and psychological impact. Skin disorders caused by deficiency generally, or less often by an excess of one or more nutrients is called nutritional dermatoses. The objective of the present study was to assess the common clinical pattern of presentation of skin and hair changes in nutritional deficiencies associated with dietary fallacies in children 1 to 5 years of age.Methods: A hospital based cross sectional study consisting of all children between the age group of 1 to 5 years with Nutritional skin and hair lesions diagnosed with clinical examination in the OPD of the Pediatric Department were included in the study from the month of November 2012 to October 2013. A minimum sample size of 100 children is required for this study. However, author included 150 children.Results: In the present study, maximum numbers of children were in the age group of 12 – 24 months, 33.33 % (50) of study subjects. The proportion of males 58.00% (87) is higher than females 42.00% (63). Majority of children belonged to Class IV 60.66% (91) socioeconomic status. 76.00% (114) of children fall in the group of under nutrition and this can be attributed to the associated Dietary fallacies of 73.33% (110) children as causative factor. Nutritional anemia associated pallor and sparse hair were the common finding among all other nutritional deficiencies.Conclusions: Lower socio- economic condition and dietary fallacies were the two most causative factors which had an adverse effect on nutritional status of child causing dermatoses. In the present study, majority of children had nutritional anemia, vitamin A deficiency and vitamin B12 deficiency associated dermatoses with overlapping of the clinical features because of complex interlinking of different dietary factors.

Clinical profile of children with pneumonia admitted at tertiary care hospital, Belgaum: A prospective study

Background: Acute respiratory infections (ARIs) are a public health problem in India. Timely intervention, correct treatment, and referral service can save many deaths, particularly pneumonia. Objective: This study aimed to study the sociodemographic and clinical profile of children hospitalized with pneumonia and its relation to the duration of stay at a tertiary care center at Belgaum district, Karnataka. Methodology: The study was conducted in Belagavi Institute of Medical Sciences, a referral hospital, during 2013-2015. Sociodemographic and clinical features of children aged from more than 2 months to 18 years of age were studied. A total of 84 children who met the inclusion criteria for community-acquired pneumonia were studied. The patient population comprises mainly of the low-income group from rural areas, urban slums, referred patients from surrounding rural areas, and private clinics. Results: A total of 84 children were studied, 48 boys and 36 girls. Maximum numbers of children were in low socioeconomic group (43 in upper lower and 37 in lower group) according to modified Kuppuswamy classification. Passive smoking was present in 40.5% of studied and overcrowding was seen in 51% of children studied. 44% of children were breastfed for &lt;6 months, and 30.64% were partially immunized. There is a significant association between passive smoking, delayed medical attention, and duration of stay. Conclusion: With this study, we can conclude that children who got early medical attention (&lt;4 days) stayed for less period of time in the hospital (&lt;7 days). Children exposed to passive smoking had a longer duration of stay.

Maximum number of children per sperm donor based on false paternity rate.

The aim of this study is to estimate the weight of each relevant factor in such unions of inadvertent consanguinity and to determine a "reasonable" limit for the number of children per donor, matching the probability of inadvertent consanguinity arising from the use of sperm donor in assisted reproduction with that of such a union arising from false paternity. In this study, we applied to Spanish data a mathematical model of consanguineous unions, taking into account the following factors: maximum number of live births/donor, fertility rate, average number of births per donor in a pregnancy, donor success rate, matings per phenotype, number of newborns/year, and number of donors needed in the population/year and births by false paternity. In Spain, the number of inadvertent unions between descendants of the same donor in Spain has been estimated at 0.4/year (one every two and a half years), although this frequency decreases as the reference population increases. On the other hand, the frequency of unions between family members due to false paternity has been estimated at 6.1/year. Thus, only 6% of such unions are due to the use of donor sperm. A total of 25 children per sperm donor are needed to align the probability of inadvertant consanguinity arising from the use of assisted reproduction with that due to false paternity. Therefore, we consider this number to be the maximum "reasonable" number of children born per donor in Spain.

Childhood Acute Bacterial Meningitis: Clinical Spectrum, Bacteriological Profile and Outcome.

To determine the disease pattern, etiological agents and outcome of childhood acute bacterial meningitis. Adescriptive study. Department of Paediatric Medicine, The Children's Hospital, Lahore, from January to December 2012. Atotal of 199 children between the ages of 1 month and 5 years, admitted with the diagnosis of meningitis on the basis of clinical findings and positive cerebrospinal fluid (CSF), were included. In all patients, complete blood count (CBC), CSF culture sensitivity, and blood culture sensitivity were performed. Data was analysed using SPSS version 20. Out of 199 children, 127 (63.8%) were males with M:F ratio of 1.7:1. Mean age was 11.33 ±12 months. Maximum numbers of children were < 1 year of age, 136 (68.3%). Only 90 (45.2%) children were fully vaccinated according to Expanded Program of Immunisation (EPI) schedule. Presentations with refusal to take feed (p=0.008) and with impaired conscious state were independent predictors of death (p=0.002). Complications were noted in 34 (17%) and were significantly associated with severe malnutrition (p=0.006) and altered conscious level at presentation (p < 0.001). The common pathogens identified on CSF culture were coagulase negative staphylococci (CoNS) in 11 (5.5%) and streptococcus pneumoniaein 5 (2.5%). Overall mortality was 10.1%. The commonest pathogen isolated from children who died was streptococcus pneumoniae(p=0.039). Acute bacterial meningitis mostly affected children under the age of 1 year. CSF culture revealed both Grampositive and Gram-negative bacteria. The most common pathogen in children who died was streptococcus pneumoniae.

Clinical Profile of Children with Acute Febrile Encephalopathy in a Tertiary Health Care Center of Nepal

Background: Acute febrile encephalopathy is a common and severe neurological syndrome that is associated with significant morbidity and mortality in children. The etiologies differ according to geographical regions and appropriate and efficient protocols for investigations and management requires proper understanding of various potential etiologies.Methods: In this prospective observational study, 54 children of one month to 14 years presenting to the hospital with acute onset of fever with altered sensorium were clinically evaluated and investigated. Clinical examinations included temperature, pulse rate, heart rate, blood pressure, coma severity by GCS, respiratory pattern and detail systemic and CNS examination. Etiology of acute febrile encephalopathy was based on clinical history, examination and relevant laboratory investigations.Results: The incidence of acute febrile encephalopathy was 5.5% of the total hospital admissions. There were 35(64.8%) boys and 19(35.2%) girls. The maximum number of children 24(44.4%) were between one to five years of age. The most common presenting complains besides fever and altered sensorium were seizures and vomiting which was present in 59.3% and 46.3% of children respectively. Signs of meningeal irritation, hypertonia, brisk deep tendon reflexes and extensor plantar response was present in 50%, 24%, 29.6%, and 44.4% respectively. The diagnosis based on clinical findings and laboratory investigations were viral encephalitis 34(63%), bacterial meningitis 12(22.2%), cerebral malaria 4(7.4), enteric encephalopathy 3(5.6%) and hepatic encephalopathy 1(1.9%).Conclusion: Viral encephalitis and bacterial meningitis are the most common cause of acute febrile encephalopathy. Preventive strategies can be done to decrease the incidence.J Nepal Paediatr Soc 2015;35(3):224-230

Pattern of congenital heart diseases in a tertiary care teachinghospital, Chinna Kakani, Guntur

Objective: To evaluate the spectrum and pattern of congenital heart diseases in NRI general hospital, a tertiary care teaching hospital, Chinna Kakani, Andhra Pradesh. Methods: A retrospective hospital based analysis of children attending pediatric department over a period of two years during January, 2014 to December, 2015 was performed. Patients suspected to have cardiac symptoms or cardiac murmurs were referred for 2D echo and colour Doppler to confirm the diagnosis. Prevalence rate per 1000 patients was calculated. Relative frequencies of individual CHD types as a proportion of total CHDs were also calculated. Results: A total of 174 Echo confirmed cases of CHDs were identified from a total of 60,000 patients attending the hospital over a two year period with a calculated prevalence of 2.9/1000 patients. Of total cases 96 were female and 78 were male children. A total of 149 Acyanotic CHD cases (86.5%) were identified of which, Isolated ASD were 52 (35%), Isolated VSD were 42(28%), AVCD were 2 (1.34%), PS were 12(8%),AS were 4(2.7%), COA were 2(1.34%), PDA were22(14.7%), combination of ASD + VSD were 10(6.7%) and Dextrocardia with situs inversus were 3(2%). A total of 25 cases of Cyanotic CHD were identified, of which TOF and its variants were 16(64%), DORV+VSD+PS were 2(8%), rare complex CHDs like DORV+HLHS, TAPVC, Ebstien Anomaly, Cortriatrium, were one case(4%) each and TGA were 3(12%) cases. Conclusion: The calculated prevalence of CHD at 2.9 /1000 among hospital attending patients could be an underestimation of actual disease burden in our community. The maximum numbers of children with CHD were identified by 5 years of age. The most commonly found Acyanotic CHDs were ASD, VSD and PDA. The most common cyanotic CHD was TOF.