Pediatric OPD Research Articles

Vitamin D status in 5-15 years old children attending pediatric OPD in tertiary care hospital in Jammu and Kashmir, North India: a cross sectional study

Background: Vitamin D is vital in children mainly because of its profound effect on growth, development, immune system and importantly bone health. Recent evidence suggests maintaining 25 (OH) D levels above 20 ng/ml for maximizing health benefits. Objectives were to assess the vitamin D status in children in the age group of 5-15 years attending a tertiary care teaching institute of North India and to analyze the factors which can contribute to vitamin D deficiency in these children. Methods: It was a cross-sectional study. 5-15 years old children attending the outpatient department were included in the study. Children with co morbid conditions that affect vitamin D metabolism and those children on chronic drug treatment and on vitamin D supplementation were excluded from the study. Results: Average age of study population was 8.93±2.02. In the study 170 (18.47%) children among a total of 920 had a normal vitamin D status while the rest 750 children (81.52%) had insufficient vitamin D status (25 hydroxy vitamin D <30 ng/ml). Among these children 190 (26.38%) had suboptimal vitamin D levels, 300 (40%) were deficient, 143 (19.06%) had severe and 117 (15.6%) had very severe deficiency of vitamin D. The average vitamin D level among the study population was 12.33±11.13 ng/ml. There was significant statistical association between vitamin D deficiency and stunting (p=0.003). No statistically significant association was found between outdoor activity. Conclusions: Vitamin D insufficiency was documented in 81.52% of 5-15 years old children and there was a significant association between stunting and vitamin D deficiency.

Children at the Risk of Recurrent Wheezing: A Matched Case-Control Study in a Tertiary Care Center.

Introduction Wheezing is a common symptom in early childhood. Recurrent wheezing is defined as more than three episodes of wheezing in the past year. Many studies have been conducted to delineate the risk factors for recurrent wheezing and to predict which of these children will progress to asthma. Most studies about risk factors and the clinicodemographic profile of children with recurrent wheeze have been carried out in developed nations. Data in developing countries may differ. This study was carried out to identify risk factors associated with recurrent wheezing in children in a tertiary care center. Materials and methods It was a retrospective, matched case-control study conducted over a period of two years (July 2019 to July 2021). Records of children aged one month to 12 years who came to pediatric OPD or were admitted to a pediatric ward with a history of recurrent wheezing were included in the study. Cases with uncontrolled recurrent wheezing diagnosed by examination with an unreliable history and those with a global developmental delay were excluded from the study. The study involved the hospital records of 60 children. Of these, 30 were recurrent wheezers, and 30 were non-wheezers (controls). Data were collected with detailed proformas from case histories and examination sheets. The proforma had several known and suspected risk factors associated with wheezes. Each risk factor was studied and compared with the control group. The risk factors included in this study were male gender, not exclusively breastfed, history of bottle feeding, exposure to vehicles; exposure to pollen; exposure to animals; using an agarbatti or dhoop, passive smoking, or playing with a soft toy. Data were entered in an Excel sheet, and appropriate statistical analyses were done. Results The male-to-female ratio was 2:1. Out of the number of cases, 73.33% were younger than six years; 56.66% of cases were not exclusively breastfed, and 43.33% were exclusively breastfed for six months; 20% of the cases were bottle-fed, and 40% of the controls were bottle-fed. The percentage of cases exposed to vehicle smoke was 26.66%, while 20% of cases had exposure to pollen and 16% of controls were exposed to pollen. 30% of cases were exposed to animals, and 23% of controls were exposed to animals. With regard to passive smoking, 16.66% of cases were exposed to passive smoking, and 20% of controls were not exposed to passive smoking. Out of the study group, 26.66% of the children played with soft toys. Of all these risk factors, a significant difference between cases and controls was found in only one factor: not being exclusively breastfed for six months. All other risk factors showed no significant difference between cases and controls. Conclusion The present study concluded that the significant risk factor that was associated with recurrent wheezing was "not exclusively breastfeeding." The other factors studied that were suspected to be associated with recurrent wheezing cannot be ruled out entirely due to the relatively small size of the sample and the need to be studied further in detail.

Assessment of tele dentistry usage in pediatric patients.

Abstract:
 Introduction: Tele medicine is a form of tele-health that involves synergy between telecommunication and dentistry which involves exchange of clinical details and of appropriate pictures for counseling of the patient and treatment plan accordingly.
 Methodology: This cross-sectional descriptive study was conducted from February 2022 to March 2022 at pediatric patients of Jamshoro and Hyderabad districts coming to pediatric OPD and were having oral health problems too. 200 pediatric patients were selected, questionnaire was made in English, Urdu and Sindhi languages. Parents of pediatric patients were asked various questions regarding usage of tele-dentistry. Data was analyzed using SPSS version 22.
 Results: 60% of the patients were with tele-dentistry while 40% were not aware about tele-dentistry. according to benefits of using tele-dentistry 40% patients said that it reduces travel time, while 30% said that it reduces time spend or save time while 30% also said that it is convenient.
 Conclusion: Study showed good patient acceptance towards the use of tele dentistry.
 
 Key words: Covid-19, tele dentistry, oral health.

A Study to Assess the Knowledge on Cause, Spread, Prevention and Management of Diarrhoeal Diseases Among Mothers of Under-five Attending SDM Paediatric OPD, Dharwad

Background and Objectives Diarrhoea is a leading cause of illness and death among children in developing countries. About 80 of deaths in the first two years of life are due to diarrhoeal diseases. To assess the knowledge of mothers on cause spread prevention and management of diarrhoeal diseases and to determine the association between the knowledge of mothers and selected socio demographic variables.Methods A descriptive survey research design was used to study the population of mothers with children under-five years of age. The sample size was 60 and the subjects were selected using non-probability purposive sampling method. The Pediatric OPD at SDM College of Medical Sciences amp Hospital in Dharwad served as the studyrsquos location. Data was collected with the help of a structured knowledge questionnaire.Results The mean knowledge score of mothers regarding diarrhoea was 9.87 with a standard deviation of 2.65 and a median of 9.50. According to the findings 50 of mothers had adequate awareness of diarrhoea 48.33 had moderate knowledge and just 1.67 had poor information. Knowledge significantly correlated with socio-demographic status family income and the number of children.Conclusion The present study concluded that mothers have adequate knowledge regarding the diarrhoeal episodes

Correlation between screen time and psychosomatic symptoms in children during COVID-19 pandemic-related lockdown.

This study was planned to estimate the effect of lockdown on psychosomatic problems and sleep of children and their association with screen the time during the lockdown. A cross-sectional study was conducted among 1-12-year-old children at a tertiary care hospital in South India. A pre-validated questionnaire with 20 related questions was disseminated through pediatric OPD, telemedicine service, and social media to eligible parents. A total of 278 children aged 1-12 years with a mean (SD) age of 6.92 (3.01) years were studied. Most under 5-year-oldchildren had screen time of ≤2 hours/day, whereas 58.16% of children between 5 and 12 years spent >4 hours/day (P < 0.000). A significant proportion of participants aged 5-12 years had vision problems (P = 0.019), whereas under 5-year-old children had significant associated behavioral changes (P = 0.016) and sleep problems (P = 0.043). Behavioral and sleep problems were significantly high and correlated with an increase in screen time among under 5-year-old children. Vision problems were more in 5-12-year-old children.

Juvenile Idiopathic Arthritis and Its HLA Association: A Study from Bangladesh

Background: HLA alleles may have association with overall JIA including specific sub-types. Determation of HLA DRB1, DPB1, DQA1, DQB1 and B27, may be helpful to diagnose JIA cases where diagnostic dilemma is present. The aim of the study was to find out the association of HLA alleles with JIA and its subtypes. Methods: This cross sectional study was conducted in the department of Pediatrics, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, from April 2020 to March 2021. A total of 50 cases and 25 controls attending pediatric rheumatology clinic and pediatric OPD were enrolled in the study. Data were collected by a pre-designed questionnaire containing socio-demographic, clinical and laboratory parameters. HLA DR-B1, DQ-A1, DQ-B1 and B27 typing were done for the cases and controls from blood samples by polymerase chain reaction sequence specific primer (PCR-SSP) method. Data were analyzed by SPSS version 26. Frequency, percentage, chi square test and Fisher exact tests were done for statistical analysis. Results: HLA DR-B1_10 had significant positive association whereas HLA DR-B1_03 and B1_16 had negative association with overall JIA cases. Poly-articular JIA, oligo-articular JIA and ERA had association with HLA DRB1_01, B1_08 and B1_12 respectively. HLA DQA1-01 and A1_02 had positive association. However, DQ-A1_06 was negatively associated with JIA cases. Oligo JIA was positively associated with HLA DQ-A1_01, whereas poly JIA and ERA had association with A1_02. Though, HLA DQ_B1 had no association with overall JIA cases, analysis showed association of poly JIA with DQ-B1_04. Frequency of HLA DQ-B1_02 and 03 were higher among ERA cases, though not significant, but they had strong association with HLA B27. Conclusion: HLA associations were present with overall JIA and each sub-groups had different patterns of HLA associations including some protective roles.

Measles Related Complications: A Hospital-Based Study in Kumaon Region of Uttarakhand

Background: Measles is a contagious vaccine-preventable illness caused by the measles virus.1Aim: To study complications of measles in pediatric patients &amp; to determine the course of measles based onvarious factors i.e. age, nutritional status, socio-economic status, immunization status, other host factors.Methods: It is a prospective descriptive study done in pediatric OPD &amp; IPD over one yearResults: The average age of a child with confirmed measles is 21 months &amp; 15.8 months in complicated measleswith a male predisposition. Patients in 2nd degree PEM had a risk of developing complicated measles. There existsa positive correlation between lack of vaccination and the development of complications due to measles.Conclusion: Universal implementation of two doses of MMR Vaccine and screening &amp; management of malnutritioncan prevent the severity of complications associated with measles.

An exceptional case of bladder exstrophy with pubic symphysis diastasis in a 3-year-old male child

Bladder exstrophy is a rare birth defect in which the anterior wall of the abdomen over the bladder is not closed in the intrauterine period, hence the child born with exposed bladder. Incidence of bladder exstrophy is 1/10,000 childbirths. Complaints would vary from exposed bladder, incontinence or leakage of urine, defect in genitals and pelvic bones as well as defect in intestine and reproductive organs. Mostly patient get operated with bladder exstrophy repair in infant age. If it gets neglected, it needs stage wise surgery in this case. Parents of a 3-year-old male child came to Paediatric surgeon OPD with congenital bladder exstrophy. Orthopaedic surgeons´ opinion was taken in view of pubic diastasis. In infant age, there is no need of additional concern of pubic diastasis. At age of 3 acetabulo-pelvic surgeon advice for External fixator application if pelvic wings to decrease tension on reconstructed bladder wall and inter-pubic ligament. Patient managed as neglected bladder exstrophy. Reconstruction of abdominal wall and urethra reconstruction done and application of external fixator application done.

How the Birth of a Girl Child with Congenital Adrenal Hyperplasia Changed the Mother’s Life: A Case Study

Congenital adrenal hyperplasia (CAH) is an autosomal recessive disorder that disturbs the process of adrenal steroidogenesis. A variety of symptoms are produced in the body of children born with this disease. In a girl child, the genitalia is ambiguous with an elongated clitoris and fusion of labia which makes it difficult to declare the gender at birth or mistakenly declared as male. Parents often go through a variable period of uncertainty about the gender of their child. Although most families adjust with time, some blame the mother for giving birth to a child with such abnormality. The present study was undertaken in the form of a case study on the mother of a girl child with CAH enrolled from Pediatric Endocrinology OPD, PGIMER, Chandigarh. The current case study highlights the effect of a female born with CAH on the life of a mother. Although the child was well managed on treatment, due to the stigma attached to the condition, was abandoned by the father.

SLEEP QUALITY ASSESSMENT IN ADOLESCENTS WITH TYPE 1 DIABETES MELLITUS

Background and Aims: Diabetes has been reported to be a risk factor for sleep disturbances in adolescent age groups. Although the impact of type1 diabetes mellitus (T1DM) on sleep patterns of children is well recognized, data about its prevalence is scant. This study aims to determine the quality of sleep among adolescents with T1DM and factors inuencing it. Methods: This is a cross-sectional study collected data from 30 adolescent diagnosed with T1DM at least 6 months earlier. They presented to Paediatric endocrine OPD from May 2021 to May 2022. Subjects were asked to complete the Pittsburgh Sleep Quality Index (PSQI) 19-item self-report questionnaire. Children with T1DM being under treatment for sleep disorder were excluded. The combined score of the 7 components (subjective sleep quality, sleep latency, sleep duration, habitual sleep efciency, sleep disturbances, use of sleeping medication, and daytime dysfunction) was used for analysis and the score ranged from 0 to 21. Atotal score &gt;5 was considered as “poor sleep quality”. The quality of sleep was correlated with drug, dietary compliance and metabolic control. p-value &lt;0.05 was considered signicant. Results: The mean age of study population was 14.3±1.7 years. 18 were boys and 12 were girls. Total 8 patients showed poor sleep quality (PQSI score &gt;5). No signicant relationship was found between sleep quality, duration of diabetes and HbA1c levels in the diabetes group (P= 0.59, P= 0.41, respectively). The total sleep time of boys (8.4 ± 1.2 h) was longer than girls (7.6 ± 1.7 h), but the overall total sleep time per night did not differ signicantly between boys and girls (P= 0.053). Conclusion: The present study shows that diabetes control may affect sleep quality in adolescents. Optimal diabetes management can positively affect sleep patterns in these adolescents. Further larger studies are needed to validate our results

A Cross Sectional Study on Prevalence and Pattern of Murmur and CHD in Children of District Shopian

Background: Congenital heart defects (CHD) are among the common congenital birth defects with an estimated incidence of 8–10/1000 live births which can be easily identified on occasions on routine checkup visits on auscultation and confirmed by echocardiography. With the advanced diagnostics and corrective therapies for CHDs, the percentage of individuals surviving to adulthood has increased over past few decades, it is imperative to identify the disease at the earliest. Methods: This was a hospital-based outpatient study conducted in the pediatric OPD of the hospital in children aged 12 years or less with no previous known heart disease. Children were seen for any murmur or features of heart disease. A total of 14000 patients were attended with 100 having murmur and an echocardiogram was advised.Results: Of the 14000 children seen in the OPD, 100 had a murmur on auscultation accounting for about 0.714% patientsi.e 7 per 1000 children. Of the 100 patients with murmur, 60 patients came back with an echocardiogram of which38 had an abnormal echo corresponding to 63.33% cases. Hence the murmur was present in approximately 7 per 1000 children and the incidence of heart lesions among those with murmur was 63.33% with VSD &amp; ASD in combination as the most occurring lesion.Conclusion: The prevalence of murmur in children was approximately 7 per 1000 and the sensitivity of auscultation in finding a heart disease was 63.33%. However, a large study over a greater period of time with a good follow up of the patients is recommended.

FEV1 (FORCED EXPIRATORY VOLUME IN THE 1ST SECOND) REVERSIBILITY AFTER NEBULISATION WITH SABA (SHORT ACTING BETA AGONIST) AS A MARKER OF CONTROL OF ASTHMA

INTRODUCTION: Variable expiratory airow due to bronchoconstriction, airway wall thickening and increased mucus is an obvious feature in asthma. Variable airow obstruction is evidenced by reversibility of FEV1 following a bronchodilator inhalation. PFT (Pulmonary Function Testing) using spirometry is often used for the estimation of FEV1. Reversibility is not uniform in all cases and vary with respect to severity and control of asthma. AIMS &amp; OBJECTIVES: 1) To determine the control of asthma in 5-15-year-old children using GINA checklist and estimate FEV1 before and after SABA nebulisation. 2) To nd out the association between FEV1 reversibility and control of asthma. MATERIALS &amp; METHODS: This cross-sectional study included 90 consecutive 5-15-year-old-children with a clinical diagnosis of asthma attending the Paediatric OPD of a teaching hospital from October-May 2021. The symptoms, signs, comorbidities, treatment, compliance and assessment of control of asthma into 2 subgroups: Well-controlled and Partly-controlled/Uncontrolled asthma, as per GINA 2020 were recorded. All were subjected to spirometry for assessment of FEV1 before and 20 minutes after nebulisation with SABA. Depending upon FEV1, they were grouped as those with &gt;12% reversibility and &lt;12% reversibility. Data analysed using SPSS 20.0, Paired t test for comparison of means, Chi-square test for statistical difference in proportion, and post hoc tests. The RESULTS: M:F ratio was 1.2:1, 52.2% were 10-15 years and 47.8% 5-10 years. 68.9% had partly/uncontrolled, the rest well-controlled asthma (38.1%). The difference between mean FEV1 before (67.9±10.6) and after nebulisation (80.6±9.7) was statistically signicant (p&lt;0.00*). Among those with &gt;12 reversibility, 64.5% were in partly/uncontrolled and 35.5% in well-controlled asthma and the difference was statistically signicant (p -0.013*). The CONCLUSION: nding in the study that 68.9% had partly/uncontrolled asthma is an eye-opener to optimise protocol-based treatment among children. The statistically signicant difference of &gt;12% before and after nebulisation a marker of poor control was observed in 64.5% of partly/uncontrolled asthma compared to 35.5% of well controlled asthma. Hence, the persistence of a signicant degree of bronchodilator response noted in those with partly/uncontrolled asthma is recommended as an objective surrogate of poor asthma control in children who can co-operate for a PFT in order to optimise protocol-based treatment.

A Study to Assess the Knowledge Regarding Legal Aspects of Child Abuse among Care Takers of Children With A View to Develop an Information Pamphlet on Child Abuse in A Selected Hospital, Bangalore

Child abuse or child maltreatment is any kind of physical, sexual or psychological maltreatment or neglect of a child or children, especially by a parent or other caregiver. The prevalence of child abuse globally is estimated up to 1 billion children aged between 2-17 years have experienced physical, sexual or emotional violence or neglect as per the statistics of 2020 by WHO. It is the responsibility of the caretakers to protect their child and be aware of all the legal aid which is available for children afflicted with child abuse. So the study was conducted with the objectives as follows: • To assess the knowledge of caretakers regarding legal aspects on child abuse. • To determine the association between knowledge regarding legal aspects of child abuse and selected demographic variables. A descriptive cross-sectional study was conducted among the caregivers of children below 15 years of age visiting paediatric OPD of SJMCH, Bangalore. A structured questionnaire was used to assess the knowledge regarding legal aspects of child abuse. The data was analysed by using descriptive and inferential statistics. In our study, only 4.2% of parents had good knowledge about the topic whereas 50.9% had moderate knowledge. Therefore, the researcher felt a strong need to educate and spread awareness to the parents regarding the topic of child abuse.

Impact of COVID-19 pandemic on educational, psychosocial and behavioral aspects of children: a cross sectional survey

Background: The outbreak of COVID-19 appeared first in China and then, rapidly, spread to the rest of the world, and WHO declared it as a pandemic.A nation-wide closure of educational institutions was implemented as an emergency measure in India in March 2020. Meanwhile the traditional classroom instructions were replaced by online classes and home-based learning. Pandemic stressors such as boredom, being in isolation, one of the family members hospitalized/ succumbed to covid, etc, may have even more negative impact on children’s behaviour and emotions. Objectives were to study the impact of covid 19 pandemic on psychosocial, educational and behavioral aspects of children.Methods: The current study was a questionnaire based cross-sectional survey conducted among the parents attending paediatric OPD in NRI general and superspeciality hospital, Mangalagiri, between September 2021 to December 2021 over a period of 70 day along with their children of age group between 3 years to 18 years with an aim to explore various psychosocial, educational and behavioral aspects of children and their correlation.Results: The results showed that, during the COVID-19 outbreak, the children tended to increase their use of screens, and were less active physically. Majority of children who had physical activity &lt;2 hours and increase in sleeping hours during the pandemic, reported weight gain. In the present study screen time usage is more in adolescents (55%). Behavioural problems associated with screen time is 61% in the present study. The results suggest that children are vulnerable to the COVID-19 outbreak psychological effects and highlight the need to reduce the psychological burden of this pandemic and the necessity of immediate intervention.Conclusions: Children are vulnerable to psychological stressors like social isolation, home confinement, closure of schools and activity centers for longer periods, which has debilitating effects on educational, psychological and developmental attainment.

Speech Development and Nutritional Status Outcomes of Complimentary Feeding Practices in 12-to 36-Month-Old Children: An Observational Study in Northern Haryana

To study the impact of Complimentary feeding practices on Nutritional status and Speech of 12 to 36 months of well nourished children. We took children aged 12 to 36 months who visited paediatric OPD from the month of January to April 2019. Mothers of children who were willing to participate in the study were interviewed on a pre-designed questionnaire which had questions pertaining to socio-demographic characteristics of parents, infants and toddlers characteristics, breastfeeding and complimentary feeding details, infants and toddler environment (Annexure1). Weight, height, head circumference (on WHO Growth charts) and speech development of the child (on LEST scale) were recorded by the paediatrician. Prevalence of malnutrition in our study is 9.2% and speech delay is 29.2%. Malnourished children was significantly associated with maternal education (p 0.016), Annual income of parents (p=0.002), time of introduction of complimentary feeding (p=0.040), food diversity (p=0.000) and food frequency (p=0.000) (Table 3). Children with speech delay was significantly associated with change of texture of food (p 0.000). Maternal education, Annual income of parents, time of introduction of feeding, food diversity and food frequency of complimentary feeding significantly impacts Nutritional status and change of texture of complimentary feeding significantly impacts speech of infants between 12 and 36 months. Keywords: Complimentary feeding, Speech, Malnutrition

Factors Affecting Non Compliance with Exclusive Breastfeeding Among Mothers: A Survey at District Hospital Dadu

Background: According to standard guideline for breastfeeding, t is mandatory to practice exclusive breastfeeding during the first six months of a baby's life to provide the finest physiological support for all neonates. In Pakistan there is visible underuse of exclusive breastfeeding among lactating mothers. This study aims to assess the variables affecting the non-compliance to exclusive breastfeeding among mothers at a district hospital in Pakistan. Materials and methods: A descriptive cross sectional study design was conducted to in Pediatric OPD at the district hospital Dadu from January to June 2022, breast feeding mothers were the study population, Using a total population sampling method, 224 breastfeeding mothers were interviewed regarding their practice towards exclusive breast feeding. Chi square test of association was used to evaluate the association of variables. Results: We observed that only 29. 5% mothers practiced exclusive breast feeding. All the mothers in the study had a breastfeeding child. Most of the mothers in this study were aged between 20 to 40 years (62%). Nearly 2/3rd of the mothers in the study had no formal education, only 5.8% mothers had higher secondary education. More than 1/5th of the mothers had more than 5 children. The most common reason for non-compliance with the exclusive breastfeeding was the use of formula milk by the mothers followed by insufficient breast milk Conclusion: Inclination to use formula milk, insufficient breast milk, early weaning and lack of the education among mothers were most common causes of non-compliance towards exclusive breastfeeding. Maternal education level was significantly associated with exclusive breastfeeding. Mass level health education for maternal and child health are recommended. Keywords Breast feeding, Exclusive breastfeeding, Neonate, Maternal factors,

Knowledge of mothers regarding developmental milestones of infants: A Descriptive Cross-sectional study

Developmental milestones in children or infants are a certain set of skills or age-specific tasks. Missed or delayed milestones in infancy can be symptoms of serious medical conditions. If parents understand their children’s development, they can tailor their expectations and provide stimulation. This study was conducted to assess the level of knowledge regarding the development milestones of infants among mothers. A descriptive study was conducted on 100 mothers of neonates visiting pediatric OPD and gynecological unit (Postnatal Ward).A convenience sampling technique was used to collect data. More than half of mother’s i.e. 60% had an average level of knowledge, 22% of mothers had a poor level of knowledge and 18% of mothers had a good level of knowledge. Mothers had the highest (75.25%) mean knowledge percentage in general information followed by 53.33%, in developmental delay and least (37.50%) mean knowledge percentage in language development. The overall mean knowledge score is 10.240±2.40 and there is no association (p&gt;0.05) between the knowledge level of mothers with selected demographic variables. It is concluded that the majority of the mothers of neonates had average knowledge regarding developmental milestones.

Father’s Perspective on Breast Feeding: A Cross-Sectional Questionnaire Based Study

Introduction Despite global efforts to promote exclusive breastfeeding, the rates in India have been in the sub-optimal range. Higher levels of paternal support and encouragement are linked to better maternal confidence in breastfeeding. This study was aimed to assess the knowledge, attitude, and practice of fathers of infants towards the importance of breastfeeding practices. Method Fathers of infants visiting the Pediatric OPD, were interviewed with a structured, pre-tested questionnaire after obtaining written informed consent. This is a cross-sectional study where 158 fathers were given the questionnaire on knowledge, attitude, and practice about breastfeeding along with the sociodemographic details. The sections of the questionnaire were scored using the five-point Likert scale. Results Among the 158 fathers who participated in the study, majority (51%) had moderate scores in knowledge, attitude, and practice about breastfeeding. Around 131 fathers (83%) have not received any counseling about support and their role in breastfeeding and majority (58%) fathers felt the need to get education and training regarding parenting skills. Around 66% of the fathers were aware of the ideal duration of exclusive breastfeeding. About 35% of the fathers were not comfortable letting their wives breastfeed the child in public places. Around 25% of the participants had the idea that breastmilk production is reduced after child delivery through Cesarean section. Conclusion Fathers should have active participation during maternal check-ups, delivery, and antenatal counselling. This will help a better bonding and may lead to successful and prolonged breastfeeding. Educating fathers may help in increasing breastfeeding rates and duration.

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.&#x0D; 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. &#x0D; 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 &lt; 12 µg/L was considered as deficiency. The statistical analysis was conducted using SPSS version 20.&#x0D; 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.&#x0D; 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.

Queuing Dynamics and Beneficiary Satisfaction in The OPD Of a Tertiary Care Centre in Bankura, West Bengal

Context/Background: Queuing, a major problem faced by beneficiaries availing services in public health care system, may also have influence on the level of satisfaction among beneficiaries. Aims/Objectives: To describe the queuing dynamics in the OPD, to explore different factors influencing the level of satisfaction among the beneficiaries and their perception regarding possible ways to improve the queuing situation. Methodology: A hospital-based analytical study was conducted in an OPD of Bankura Sammilani Medical College and Hospital, West Bengal, among 202 beneficiaries. Data were collected from subjects, selected from random queue in total 30 shifts (30 minutes each) on different working days, using predesigned, pretested, questionnaire. Results: Queuing dynamics revealed utilization factor of 75%, while 25% probability of the system being idle. Only 39.1% of the subjects were satisfied with the service in Paediatric OPD, in context of waiting in queue. MLR revealed subjects waiting in queue for a duration ≤ 1 hour and those with &gt; 4 minutes consultation time were found to be more satisfied. Conclusions: Considering variable consultation time, arrival and service rates at the OPDs and resources, a well-planned system can minimize the waiting time and thus improve the level of satisfaction among the beneficiaries.