Open Access Original Research Article

Study of Clinical Manifestations of HIV Infected Children in Relation to CD4 Count

Archana Mishra, Narendra Nath Soren, Sristi Ganguly

Asian Journal of Pediatric Research, Page 1-8
DOI: 10.9734/ajpr/2020/v4i230143

Aims: To study the clinical profile of HIV infected children and correlate them with the CD4 count at the time of presentation.

Study Design: Hospital based observational study

Place and Duration of Study: ART centre of SCBMCH and Department of Pediatrics, SVPPGIP, Cuttack, Odisha during the period October 2017 to September 2019.

Methodology: All children aged between 1.5 to 15 years who were confirmed to be HIV positive by ELISA or immunocomb II, either at present or past were included in the study. They were subjected to CD4 count testing, along with nutritional assessment and screened for opportunistic infections, apart from their socio-demographic details. All quantitative variables including age, weight, height, were compared by unpaired t-test. Categorical variables like sex mode of transmission were compared by chi-square test. Variables like clinical staging, immunological staging and CD4 counts were measured at presentation and analyzed with repeated ANOVA at 5% level of significance to allow for multiple comparisons. P<0.05 was considered significant and inferences were drawn.

Results: Out of 103 cases, majority belonged to age 4- 7 years and 59.2% were malnourished. 24.3% were asymptomatic, with the most common clinical features noted were fever (65%), cough (47.8%), recurrent diarrhoea (41.8%) and weight loss (40.8%). The incidence of opportunistic infections was 24.3%, with tuberculosis (40%) and herpes zoster (36%) leading the list. Most cases (37.87%) came under WHO clinical stage-III. A significant correlation was found between CD4 count and age, WHO clinical staging, opportunistic infections in the population. Lower CD4 counts were associated with younger age, lower staging and less risk for symptoms and infections.

Conclusion: CD4 count is a reliable market to assess the staging and risk for opportunistic infections in pediatric HIV and thus can be used as screening tool for complications/ deterioration in the child, for better management.

Open Access Original Research Article

Analysis of Mothers' Knowledge, Beliefs and Practice towards Neonatal Jaundice in Bingham University Teaching Hospital Jos, Plateau State, Nigeria

M. Shehu, H. Shehu, T. O. Ubanyi

Asian Journal of Pediatric Research, Page 9-19
DOI: 10.9734/ajpr/2020/v4i230144

Neonatal jaundice is defined as the yellowish discoloration of the skin and sclera due to accumulation of unconjugated bilirubin. This is common in newborns and if not detected and treated early can lead to severe morbidity and mortality.

Aim: The aim of the study was to analyze the knowledge, attitude and practices of mothers in Bingham University Teaching Hospital on Neonatal Jaundice.

Method: This was a descriptive cross-sectional study which was carried out among mothers coming for ante and post-natal clinics in Bingham University Teaching Hospital from March to June 2019, using consecutive sampling of mothers that came for ante and post-natal services that consented to the study. The knowledge, attitude and practice of Neonatal Jaundice (NNJ) was assessed using a pretested questionnaire which was analyzed using SPSS version 22.

Results: The results showed that 80% of mothers >40 years are able to define jaundice correctly compared to the 30% in mothers <26 years. Thirty-seven percent of mothers did not know any single cause of NNJ. Knowledge on NNJ was significantly associated with occupation, education and parity with fisher’s exact test of 0.045, 0.034 and 0.026 respectively.  Only 16% of the mothers knew that phototherapy is the major form of treatment for NNJ, most will expose their babies to sunlight. Some traditional beliefs about the cause of NNJ includes bad blood, bad breastmilk, change in weather and evil eye.

Conclusion: There is need for more health education talks, campaigns and enlightenment of mothers on NNJ.

Open Access Original Research Article

The Frequency of Familial Mediterranean Fever Gene Mutations and the Correlations between Phenotype and Genotype in Turkish Children

Hakan Erdogan, Ayse Cavidan Sonkur, Orhan Görükmez, Ayse Erdogan, Dilek Damla Saymazlar, Fatih Unal

Asian Journal of Pediatric Research, Page 20-26
DOI: 10.9734/ajpr/2020/v4i230145

Aim: Familial Mediterranian Fever is an autosomal recessive disease characterized by recurrent inflammatory attacks of serosal membranes. The aim of the current study was to determine the frequency of the Mediterranean fever (MEFV) gene pathogenic variants in 158 children (78 male, 80 female) diagnosed with Familial Mediterranean Fever (FMF) and to compare the phenotype-genotype correlation.

Methods: In our retrospective case-control study, 158 FMF patients (78 males, 80 females) who were diagnosed with MEFV gene mutation in Bursa Yuksek Ihtisas Training and Research Hospital, Department of Pediatrics between January 2018 and June 2019 were included in the study.  Mutation screening of the MEFV gene was performed for 12 mutations and the 8 most common mutations were taken into the study.

Results: Abdominal pain (77.8%), fever (74%) and arthralgia (46.2%) were the most prevalent clinical features in our patients. The most frequent mutations were M694V, E148Q, V726A, M680I and P369S. In cases with M694 mutation, it was noted that the incidence of arthritis was 2.5 times, appendectomy frequency 3.1 times higher, and early diagnosis probability 3.2 times higher. The frequency of chest pain was 2.9 times higher in the M680I mutation, and the frequency of arthralgia was 2.2 times higher in the P369S mutation.

Conclusion: Patient’s mutations in FMF patients are important for clinical expectations, and some mutations such as P369S are not as innocent as expected. However, reevaluation of phenotypes of mutations that are rare with more patients will be significant. 

Open Access Original Research Article

Comparison of Socio-economic and Health Status in Rural Primary School Students: A Case of Bangladesh

Md. Abdullah Al Farooq, Mohammad Nazmul Haq, Tania Tajreen, Md. Minhajuddin Sajid, Tanvir Kabir Chowdhury

Asian Journal of Pediatric Research, Page 27-36
DOI: 10.9734/ajpr/2020/v4i230146

Objective: Although Bangladesh is rapidly gaining economic development, education and health related indices are not equally developed in all parts of the country. The objective of the study was to compare the socio-economic and health status of students in public and private primary schools.

Methods: This was a cross sectional study conducted among 99 public and 128 private primary school children during 2018. Two public and two private primary schools were selected purposively from 2 villages of Chandpur. Subjects were divided into 2 groups: public primary school students and private primary school students. During a ‘free health check-up and treatment program’, guardians were asked to participate in the study. After taking informed written consent, students and guardians were asked about demographic, socioeconomic (such as, education, occupation, monthly income), and health related factors (such as, antenatal checkup, mode of delivery, immunization, deworming); then, anthropometric measurements (height, weight) and physical examinations of the children were done. Comparison was done between groups.

Results: On socioeconomic status, monthly family income was more and paternal education was higher in private-school students than the public-school students. On health indices, antenatal care (ANC), Caesarian section (CS), living standard, use of sanitary latrine, and nutritional status of private school students were significantly better than public-school students. However, Public school students had higher deworming rate.

Conclusion: Students in private schools had better socio-economic and health status in Bangladesh. Health-related indices are comparable to national parameters. It is recommended that socio-economic and education status needs further improvements for sustainable health and well-being.

Open Access Original Research Article

Efficacy and Safety of Fenofibrate in Uncomplicated Hyperbilirubinemia in Newborn: A Randomized Trial, with a 6-month Follow-up

Jayendra R. Gohil, Vishal S. Rathod, Bhoomika D. Rathod

Asian Journal of Pediatric Research, Page 37-42
DOI: 10.9734/ajpr/2020/v4i230147

Objective: To study the effect and safety of Fenofibrate in uncomplicated hyperbilirubinemia in newborn with 6-month follow-up.

Materials and Methods: This is a randomized controlled clinical trial conducted in 60 normal term neonates admitted for uncomplicated hyperbilirubinemia in NICU at Sir T G Hospital, Bhavnagar from January 2012 to December 2012. The data included: age, sex, total serum bilirubin (TSB), weight and duration of phototherapy. All neonates enrolled in the study received phototherapy. They were divided in two groups of 30 each: control group A and group B receiving Fenofibrate (100 mg/kg single dose). There was statistically insignificant difference between the parameters of age, sex, weight and TSB between the two groups at hospitalization. Data was analyzed by using appropriate statistical methods.

Results: Mean values for total serum bilirubin in Fenofibrate group B at 24 and 48 hours after admission were significantly lower than those for control group A (p<0.0001,  p=0.0001). There was no significant difference in fall of TSB between 24 and 48 hours. The mean duration of phototherapy in Fenofibrate group (44.8h: 24-72h) was significantly shorter than that in control group (55.2 h: 24‐96 h) (P=0.02). There were no side effects of the drug observed during the study and during 6 months follow up period.

Conclusion: Fenofibrate as a single 100 mg/kg dose in healthy full term neonates, is effective and a safe drug (till six-month follow-up) for neonatal hyperbilirubinemia, that can decrease the time needed for phototherapy and hence hospitalization. Effect of a single dose seems to wane after 24 hours.