Open Access Case Study

Successfully Treated Case of Non-Typhoidal Salmonella Meningitis in an Otherwise Healthy 5 Months Old Infant: A Case Report

Sana Hannan, Abdul Ahad Sohail

Asian Journal of Pediatric Research, Page 1-6
DOI: 10.9734/ajpr/2019/v2i330106

Acute bacterial meningitis in infants is a medical emergency requiring prompt diagnosis and early institution of empirical antibiotic therapy. Non-typhoidal salmonella (NTS) is a major cause of uncomplicated infectious diarrhoea worldwide; however NTS meningitis is extremely uncommon beyond the neonatal period with very few cases being reported in the literature and has been associated with increased mortality and morbidity with mortality rates of up to 40-70% reported in recent studies. NTS being a facultative intracellular organism does not respond to conventional antibiotic therapy and therefore failure and relapse rates are higher particularly with meningitis. We report a rare case of a five month old infant with non-typhoidal salmonella meningitis who was successfully treated with prolonged duration of antibiotic therapy.

Open Access Case Study

The Assessment of the Acceptability of Behavior Management Techniques for Pediatric Patients by Their Mothers Referred to a Pediatric Dental Clinic in Tehran

Nazanin Forghani

Asian Journal of Pediatric Research, Page 1-5
DOI: 10.9734/ajpr/2019/v2i330109

The use of behavior management techniques for the treatment of children who are uncooperative with a dentist is inevitable. Behavior management techniques are the methods that the dental health team could effectively treat the child and inspires a constructive dental attitude.

Objective: Determining the acceptability of behavior management techniques by mothers referred to a pediatric dental clinic in Tehran (2017).

Materials and Methods: This cross-sectional descriptive study was conducted in a pediatric dental clinic in Tehran. A film, including 4 different behavior management techniques such as general anesthesia(GA), parents’ separation(PS), Tell-Do-Show and voice control(VC) was produced. Before showing each method, a brief explanation of the characteristics and purposes of methods was given by a pediatric dentist in the film. A total of 50 mothers, referred to this private dental clinic, completed a questionnaire after observing any method in this film. The data were analyzed using t-test and Chi-square

Results: 56% of the children were boys and 44% were girls, and they were in the age group of 3 to 10 years old, and children are ranked from first to fifth in the family. Mothers with a primary to postgraduate education were between the ages of 23-50 and had up to 5 kids. The acceptance of Tell-Do-Show by mothers was 100%, Voice Control was 92%, separating the child from parents was 50%, and General Anesthesia was 30%. There was a significant correlation between acceptance of voice control method with child's order, child's age and the number of children in a family, and also between the acceptance of general anesthesia by mothers with mother's education level and child's order (p <0.05).

Conclusion: According to the findings, Tell-Do-Show method was the most common method which was accepted by mothers, and general anesthesia was the least accepted method by the mothers.

Open Access Original Research Article

Impact of Nutrition Education Program on Diet Quality Score amongst Adolescent Girls between Age Group of 16 to 17 Years in Mumbai

Miloni Nandu, Rupali Sengupta

Asian Journal of Pediatric Research, Page 1-8
DOI: 10.9734/ajpr/2019/v2i330107

Aim: To See The Impact Of Nutrition Education Program On Diet Quality Score Amongst Adolescent Girls Between Age Group Of 16 To 17 Years In Mumbai.

Place and Duration of the Study: The study was conducted at Dr B.M.N. College of Home Science (Mumbai) in India between November 2018 to February 2019.

Methodology: 3 Day 24 hour Diet record was taken where energy, carbohydrate, protein and fat were calculated and with the help of 3 day diet record Healthy Eating Index Score of Adolescent was assessed and Nutrition Education Program was imparted for the duration of 2 months.

Results: The results of the study showed that consumption of Energy was 1715 Kcal, Carbohydrate 226 gm and Protein 43 gm was low in pre tests which significantly increased in post tests i.e Energy was 1959 kcal, Carbohydrate was 250 gm and Protein was 49 gm, hence showed significant results (p=0.05). However consumption of fat was high in pre test i.e 41.25 gm which significantly reduced in post test i.e 39 gm which showed no significant results (p= 0.05). It was observed that the Healthy Eating Index score for pre test was 45.15 which was considered as “Poor Diet” and Healthy Eating Index score for post test was 52.45 considered as “ Need for Improvement” and high significant difference was observed (p= 0.05).

Conclusion: Thus the study concluded that after giving Nutrition Education Program to the subjects there was increase in the Healthy Eating Index Score. There was also increase in the consumption of energy, carbohydrate, protein and decrease in fat consumption and thus Nutrition Education Program had positive effect on the subjects.

Open Access Original Research Article

Comparison of Caudal Block vs. Penile Block in Terms of Surgical Incision Response for Circumcision and Postoperative Analgesia Requirements

Mohammad Asim Bajwa, Aziz-Ur- Rahman, Amir Majeed, Muhammad Imran Azeem

Asian Journal of Pediatric Research, Page 1-5
DOI: 10.9734/ajpr/2019/v2i330108

Circumcision is a frequently performed surgery in children worldwide. For circumcision, penile and caudal epidural blocks are commonly used. Nerve blocks not only decrease the systemic analgesia requirements intra-operatively but also increase the length of pain relief postoperatively. The aim of the present study was to compare the surgical incision response in circumcision, in children with a caudal block and penile block. We also compared the systemic analgesic requirements postoperatively in both groups.

Materials and Methods: The study was conducted in pediatric patients. Total of 30 samples (n = 30) was taken and divided into two groups of 15 each. The group A received caudal block and group B received penile block. The blocks were performed after general anesthesia. We tried our best to eliminate all the factors which can lead to tachycardia (such as hypoxia, light plane of anesthesia, hyperthermia and hypothermia, hypercarbia, hypovolemia etc). The patients were keenly observed for change in heart rate on incision, the heart rates were recorded before and at incision (surgical incision response) in both groups. The postoperative consumption of the pain killers were also noted in both the groups.

Results: We observed that the patients in group A with caudal block did not show any significant surgical response, whereas in group B patients with penile block showed increased heart rate at the incision. There was no complain of pain in group A in the recovery period. Whereas complains of pain were recorded in most of the children in group B, hence pain killers were given to the patients in this group.

Conclusion: Our data proved that the caudal block was better than the penile block in terms of pain relief.

Open Access Review Article

A Review on Sleep-disorders in Children and Adolescents

A. M. Meer Ahmad, D. Sinniah, Mohamed Hussain Habil, Sharon L. How

Asian Journal of Pediatric Research, Page 1-20
DOI: 10.9734/ajpr/2019/v2i330110

Introduction: A considerable amount of knowledge has accumulated in recent years regarding the pediatric aspects of sleep with its associated disorders being understood.

Health education for parents and prospective-parents frequently pay little attention to sleep.

In addition medical students and specialist-trainers receive little instruction about sleep disorders despite the fact that many of them have contact with children and adolescents who have sleep disturbances.

The ICSD-2 describes nearly 100 sleep-disorders many of which are seen among children and adolescents.

Aim: The aim of this Article is to review sleep-disorders in children and adolescents, in the clinical-aspect beside epidemiology and disease-burden.

Methodology: Literature retrieved through Google Scholar, EMBASE, Medline and PubMed were reviewed independently by the authors towards a consensus.

Results: Sleep-disorders treatable, yet a large proportion remains of cases remain undiagnosed. Sleep-disorders are not uncommon among children and adolescents. Factors which contribute to sleep-disorders include extensive television viewing increased social recreational activities as well as academic demands all of which may contribute to sleep deprivation and sleep problems.

Patterns of sleep behaviours and disorders differ between children and adults.

Additionally some sleep-disorders previously thought to be seen mainly or exclusively in adults are now being recognized in children.

Explanations of the causes of sleep-problems at any age, both physical and psychological possibilities should be considered whilst at the same acknowledging that parenting practices play a major role part in children's sleep-problems.

This is important because persistent sleep disturbance can have harmful outcomes which can impact on mood, behavior, performance, social-function and physical health.

The treatment of most sleep disorders in children is, in principle, straight-forward and is more likely to be effective if it is appropriate and carefully implemented.

Medication should not be the first line treatment for a sleep disorder but instead should be used as a last resort. Behavioual methods such as sleep hygiene and counselling is preferable.

There is evidence to suggest that insufficient sleep might impair motor skills and reaction time as well as decision making and general concentration levels leading to an impact on academic achievement.

Persistent sleep-loss is becoming increasingly associated with an adult’s physical health

The authors mainly discuss:

  1. Insomnia of childhood
  2. Obstructive sleep apnea
  3. Parasomnias
  4. Sleep-related movement disorders: Restless legs syndrome/periodic limb movement

      disorder and rhythmic movements

  1. Narcolepsy
  2. Delayed sleep phase disorder

Conclusion and Recommendations: In view of the morbidity, mortality, loss of Quality of Life, and the disease burden including the economic cost of sleep-disorders, cost-effective Prevention Programs are needed. Such Programs should educate parents, parents-to-be, teachers and healthcare professionals.