Open Access Case Study

Acute Onset Flaccid Paralysis as Presentation of Combined Central and Peripheral Demyelination in a Child: A Case Report

Avishikta Das, Arnab Nandy, Dipankar Gupta, Rakesh Mondal

Asian Journal of Pediatric Research, Page 37-42
DOI: 10.9734/ajpr/2021/v5i430182

Introduction: Inflammatory demyelinating disease like combined central and peripheral demyelination (CCPD) could have varied clinical presentation depending upon the topographical distribution of neural involvement.

Case presentation: A seven-year-old child had presented with fever followed by acute onset flaccid paralysis and urinary retention. Weakness in the lower limbs as reported was ascending and symmetric in nature, while no history of trauma, band-like sensation or altered sensorium were documented. Superficial and deep tendon reflexes of both the lower limbs were absent. Routine blood investigations had revealed neutrophilic leucocytosis only. Serum IgM antibody for scrub typhus was found positive. CSF study didn’t show cyto-protein dissociation. NCV had demonstrated absence of F wave and H reflex in the peripheral nerves of lower limbs. Anti-ganglioside antibody profiles were negative. Subsequent investigations including MRI brain and spinal cord had revealed acute onset CCPD.

Conclusion: Acute onset combined central and peripheral demyelination in a child had presented as acute flaccid paralysis of the lower limbs and the condition was temporally association with scrub typhus.

Open Access Original Research Article

Proficiency, Attitudes, and Practices in Breastfeeding of Participants in a Pediatric Congress

Cynthia Francisca Xavier Costa de Assis Silva, Maria do Carmo Barros de Melo, Roberto Gomes Chaves, Maria Cândida Ferrarez Bouzada

Asian Journal of Pediatric Research, Page 1-9
DOI: 10.9734/ajpr/2021/v5i430178

Objective: To investigate the proficiency, practices, and attitudes about breastfeeding of participants in a Pediatrics Congress.

Methods: Cross-sectional study in which an online questionnaire was applied, using a specific QRcode, for each study participant, in June 2018. The questions were formulated according to the World Health Organization (WHO). Among the 39 questions, 13 identified the profile of the participants, 19 questions assessed the proficiency in breastfeeding and 7 questions the practices and attitudes.

Results: Responses to 296 questionnaires were evaluated, 62.5% of which were health professionals and 37.5% were undergraduate health students. In assessing proficiency, the global average did not reach the expected minimum of 70%. But the highest proficiency averages were found among health professionals (p: 0.0136), among professionals with more recent degrees (p <0.0001), and those who performed most of their activity in the public sector (p: 0.018). 77% of health professionals and 73% of students assessed attitudes and practices about breastfeeding as appropriate.

Conclusion: The low proficiency in the population studied points to the need for periodic training of professionals in breastfeeding and greater emphasis on undergraduate curricula in the health area on the subject.

Open Access Original Research Article

Prevalence of Malaria among Children under Five Years in the Niger Delta Region of Nigeria

I. L. Oboro, M. Bob-Manuel, I. N. Chijioke-Nwauche, O. Maduka, T. Kasso, A. T. O. Awopeju, N. I. Paul, L. E. Yaguo-Ide, M. Ogoro, I. M. Siminialayi, C. I. Abam, A. R. Nte, F. O. Nduka, O. K. Obunge, C. A. Nwauche

Asian Journal of Pediatric Research, Page 10-17
DOI: 10.9734/ajpr/2021/v5i430179

Background: Malaria still remains an overwhelming cause of morbidity and mortality among children under five years of age, especially in sub-Saharan Africa. The aim of this study was to determine the prevalence of Plasmodium parasitemia among children below 5 years of age in Akwa-Ibom, Delta and Rivers States, located in the Niger Delta region of Nigeria.

Methodology: A cross sectional study of 2630 children, selected by multistage sampling from Akwa-Ibom, Delta and Rivers States of Nigeria between April and June 2019. Parasitological diagnosis was by Plasmodium falciparum histidine-rich protein 2-based malaria rapid diagnostic test (RDT) and microscopy of giemsa-stained blood smears. Demographic information was collected using soft copies of pretested interviewer-administered questionnaires via the Open Data Kit application installed on android phones. Data analysis was performed using the statistical software SPSS version 25. Frequency, percentages, and Chi-square test were used to interpret data at a confidence interval of 95% and a p-value less than 0.05 was regarded as statistically significant.

Results: A total of 2630 children less than 5 years old were included in the study, 1016 from Akwa-Ibom and 807 each from Delta and Rivers states respectively. Malaria parasitaemia was detected in 230 (8.6%) and 198 (7.4%) children by RDT and microscopy, respectively. RDT used in this survey has high diagnostic accuracy (98.8%) compared to microscopy.

Conclusion: The study shows a decline in the prevalence of malaria in children under 5 years. It also demonstrates the reliability of the RDTs in the diagnosis of malaria. The use of RDTs is thus further recommended especially in peripheral centers where the access to skilled microscopists and laboratory infrastructure may be lacking.

Open Access Original Research Article

Health Related Quality of Life of Children Infected with HIV in Agra Region, India

Abhishek Kumar, Dipti Agarwal, N.C. Prajapati

Asian Journal of Pediatric Research, Page 18-26
DOI: 10.9734/ajpr/2021/v5i430180

Objective and Methods: HIV specific health related quality of life (HRQOL) instrument based on PedQLTM4.0 generic scale was prepared and named HIV-QOL. It was validated and used to evaluate HRQOL in HIV infected children in an observational,crossectional study conducted in the Department of Pediatrics, Sarojini Naidu Medical College, Agra, India.

Results:Cronbach’s alpha score > 0.7,supported acceptable internal consistency of the instrument.The correlation coefficient of more than 0.8 indicated that the instrument was valid for application. Study included 40 HIV infected children between age 8 to 18 years.Their mean scores were calculated in all four domains (viz physical, social, emotional and school functioning) and comparison of HRQOL scores was done with respect to various social and demographic parameters. CD4 counts, clinical stage of the disease and living status of the parents and anti retroviral therapy (ART) had significant influence on the HRQOL scores.

Conclusion: HIV QOL is a valid instrument to assess the health related quality of life of HIV infected children in India. It can help in assessing their health status, as well as in evaluating the impact of various medical and social programmes aimed at improving their quality of life.

Open Access Original Research Article

Acute Post Streptococcal Glomerulonephritis among Children from Sokoto, North-Western Nigeria

Fatima Bello Jiya, Paul Kehinde Ibitoye, Nma Muhammed Jiya, Mohammed Hassan Abba

Asian Journal of Pediatric Research, Page 27-36
DOI: 10.9734/ajpr/2021/v5i430181

Aims: To determine the clinical and laboratory profile of children with acute post streptococcal glomerulonephritis (APSGN) admitted into Usmanu Danfodiyo University Teaching Hospital (UDUTH) Sokoto, the outcome, and factors associated with in-hospital mortality.

Study Design: A 5- year retrospective study.

Place of Study: Emergency Paediatric Unit (EPU) and Paediatric Medical Ward (PMW) of the Department of Paediatrics, UDUTH Sokoto.

Methodology: The records of children aged 4 to 14 years with the diagnosis of APSGN were reviewed. Relevant history, physical examination findings, laboratory and radiologic investigation findings were extracted from their case folders and recorded into a proforma sheet. Data was analyzed using SPSS version 23. (IBM SPSS Inc., USA). The level of statistical significance was set at 5%, which is p-value < 0.05.

Results: Fifty-four (0.9%) of the 6128 children were managed for APSGN giving a prevalence of 10.8 APSGN cases per 1000 children. Forty-one folders were utilized for the study. There were 21(51.2%) females and 20(48.8%) males, with F:M ratio of 1.1:1. Mean age at presentation was 9.1± 3.1 years. Majority (92.6%) were ≥5 years and mainly 22(53.7%) of low socio-economic status. The main features were body swelling 40(97.6%), fever 25(61.0%), oliguria 24(58.5%), systemic hypertension 37(90.2%), proteinuria 41(100.0%), and haematuria 41(100.0%). Acute kidney injury was the commonest 25(61.0%) complication. Thirty (73.2%) cases were discharged, 5 (12.2%) died, 6(14.6%) left against medical advice. Low social status (0.03), requirement for dialysis (p=0.003), congestive cardiac failure (p=0.01), and pulmonary oedema (p=0.04) were significantly associated with in-hospital mortality. Requirement for dialysis (p=0.005) was the independent predictor of in-hospital mortality. At three months post discharge, 20(48.8%) of the 31 cases had achieved complete resolution of APSGN.

Conclusion: APSGN is common in Sokoto and similar in pattern to other reports from Nigeria. The presence of complications at presentation increases the risk of in-hospital mortality.