Pediatric Education and Research

Background: The hill state of Himachal Pradesh with a varied geographical terrain has a higher incidence of smoking for men (33.6%) as compared to the national average (32.7%). As per Global Adult Tobacco Survey (GATS 2010), 21.2% of adults consume tobacco in some form or other. About 40% of the adult males and adolescents consume tobacco of which 33% smoke and 3.8% women of adult women consume tobacco with majority smoking. The exposure to second hand smoke at home is 83% in HP and is among the highest in India. Interventions: For creating an environment of safe and fresh air, Health department with budding Himachal Pradesh Voluntary Health Association (HPVHA) focused on capacity building/empowering of stakeholders for inter sectoral collaborations, creation of effective coalitions. It initiated policy advocacy for formation of Steering Committees at State and District level, creation of flying squads and advocated for notification of courts for compounding the fines and trial for offence on tobacco advertising. It focused on stakeholder sensitization on smoke free laws and conducted about 100 workshop/trainings amongst the authorized personnel. The momentum has now been taken to all district/ sub district levels and through rural penetration, panchayat resolutions of smoke free are being passed. Results and Lessons learnt: Micro level networks and collaborations upto the grassroots with cross sectional stakeholders formed. All district/ development blocks are complying with the smoke free provisions, more than 40000 violators fined in the state in 2 years and about Rs. 5 million amount have been collected as fine by the enforcement officials. About 36000 stakeholders/enforcement officials sensitized at workshops and meetings. 90% Panchayats have passed smoke free resolutions and compliance of smoke free in the state reached to 83%.  A cadre of sensitized stakeholders from cross section departments, community based institutions has been formed and combined effect of health department and HPVHA have realized that the social legislation of smoke free laws has to be initiated from the top focusing on policy advocacy and go down gradually in the hierarchy by strengthening the enforcement mechanism and community awareness. Conclusions: Unless a resolute effort is made to implement smoke free laws, it will have no concrete consequence. It needs to be efficiently executed and enforced with cross sectional stakeholders with an incorporation of knowledge sharing, information exchange, coalition-building, networking, advocacy with policymakers and enforcement agencies, capacity building, monitoring and reporting, media advocacy.

Keywords: Smoke free; Second hand smoker; COTPA; Networking; Himachal Pradesh.

Methemoglobinemia refers to the oxidation of ferrous iron (Fe++) to ferric iron (Fe+++) within the hemoglobin molecule.[1] This reaction impairs the ability of hemoglobin to transport oxygen and carbon dioxide, leading to tissue hypoxemia and in severe cases, death. Methemoglobinemia most commonly results from exposure to an oxidizing chemical, but may also arise from genetic, dietary, or even idiopathic etiologies.[2,3]

This case report describes the development of acquired methemoglobinemia in a 2 years old boy after accidental ingestion of Blue Detergent Dye , we are reporting this case because of these disparate causes, confusion may arise in the recognition and management of methemoglobinemia. Physicians may be aware of one etiology, such as dietary nitrites in well water, but may be unfamiliar with others, such as the ingestion Blue dye- ultramarine blue, chemical composition sodium aluminosulfosilcate, commonly used as fabric whitener in India.

Key words: Methemoglobinemia; Blue dye;Ultramarine blue; Methylene blue. 

Objectives : (1)To know the prevalence of hypertension in school children in Gulbarga city.(2)To know the relation of blood pressure with variable like sex, weight, height, socioeconomic status and family history. Methods: Two readings of blood pressure were recorded and mean was calculated. The children were labelled as hypertensive, if the blood pressure was above 95th percentile for that age, height and sex. Results: The overall prevalence of hypertension was found to be 3.9%. Blood pressure found to increase with age, weight and Height. Conclusion: Children with risk factors should be followed up for modification of risk factors.

Keywords: Hypertension; School children; Larger weight; Socioeconomic status; Family history. 

In any community, mothers and children constitute a priority group. They comprise approximately 70% of the population of the developing countries. In India women of the child bearing age (15-44yrs) constitute 19% and children less than 15yrs of age about 40% of the total population. The experimental study was conducted to evaluate the effectiveness of structured teaching programme on knowledge, attitude and practices regarding prevention of acute respiratory tract infection among mothers of under-five children. The study was conducted at Hebballi agasi and Rayapur urban slums, comes under UHC, Dharwad district, Karnataka. Totally 60 mothers of under five children were selected by non-probability convenient sampling technique. The knowledge was assessed by using structured interview schedule. The study results reveals that the percentage of gain in knowledge, attitude and practice scores was 24.59%, 29.95%, and 34.33% in experimental group and 0.7 %, 0.42%, and 2.6% in control group respectively. There was no significant association between pretest knowledge, attitude and practice and socio-demographic variables. The study concludes that structured teaching programme was effective in improving the knowledge, attitude and practice of mothers of under-five children.

Keywords: Mothers of under-five children; Respiratory tract infection; Structured teaching programme.  

Paediatric Twenty 20 is Latest concept enlighting on problems that paediatrician is going to face in upcoming years till 2020. Paediatric Twenty 20 encircles all age group starting from birth as neonate and includes toddler, preschool, school, and adolescent children Because of fast and competitive life, westernization, free money, effect of media, lack of parental space the problems in coming years in pediatrics population will be brain storming to the parents, pediatricians and to the nation also. So in this topic we will see the next ten years (2020) of pediatrics practice. 

Keywords: Pediatrics; Year-2020; Child; Problems; Parenting.  

Context: Glucose – 6 – phosphate dehydrogenase (G-6-PD) is an enzyme that participates in the first step of Hexose monophosphate pathway of glucose metabolism. Deficiency of this enzyme is most common genetic disorder in India. Its deficiency causes hemolysis which eventually lead to acute hemolytic anemia and neonatal jaundice. The hemolysis in these deficient patients are triggered by bacterial, viral infections, drugs like aspirin and chloroquine, foods like fava beans Period from after birth to first 4 weeks is the neonatal period and the child is called a neonate.There is no cure for G-6-PD.Early detection and prevention of hemolytic episodes by avoiding the triggers is the only cure for this deficiency. Aim: To screen the neonates for glucose -6-Phosphate dehydrogenase deficiency so as to prevent the morbidity and mortality occurring due to this deficiency. Material and Methods: Hundred neonatal blood sample were obtained from the Labour room, of the Hospital.The samples were analysed by Dye Decolourization method. Statistical Analysis: Pie Diagram is used to show the number of affected neonates found in screening. Results: Of the hundred samples, one was found to be G-6- PD deficient and two were found to be G-6-PD deficiency carriers. Conclusion: G-6-PD deficiency testing should be done as a screening procedure in the whole country as early diagnosis and prevention is the only way of treating this deficiency disorder and avoiding its complications.

Keywords: Glucose – 6 – phosphate dehydrogenase (G-6-PD); Deficiency; Neonate; Hemolysis; Screening.