Pediatric Education and Research

Surfactant deficiency Causing respiratory failure is the major cause of morbidity and mortality in low birth weight premature infants. Surfactant therapy gradually reduces mortality and morbidity for this population.
Exogenous surfactant therapy is well established in new born babies with respiratory distress. Many aspects of its use have been well assessed in high-quality trials and systematic reviews. In late-preterm and term neonates with meconium aspiration syndrome, pneumonia/sepsis, and maybe pulmonary haemorrhage, secondary surfactant deficiency also leads to acute respiratory morbidity; surfactant substitution can be helpful for these babies. This paper reviews the evidence and provides guidelines for the use of respiratory distress syndrome (RDS) surfactant therapy in newborns.

Keywords: Surfactant therapy Distress Syndrome in newborn
 

Neonatal sonography of the brain is now an essential part of newborn care, particularly in high risk and unstable premature infants. Cranial ultrasound is the most available and easily repeatable imaging technique for the neonatal brain showing brain development and the most frequently occurring forms of cerebral injury in the preterm and
terms. This study aims to assess the importance of cranial ultrasound as an investigatory modality for high-risk neonates and to find out the morphology of various cerebral lesions and correlate clinically.

Materials and Methods: This was a Descriptive Longitudinal Prospective study conducted in Neonatal Intensive Care Unit at Paediatric Department of Dvvpf Medical College and Hospital, which is a tertiary care hospital forsurrounding districts, during the period of two years. In our period 155 neonates having perinatal asphyxia was
studied to evaluate the usefulness of Neurosonogram in diagnosis of various lesions in symptomatic neonates with
history of birth asphyxia.

Results: In our study 70 (45.1%) neonates had abnormal NSG findings of total of 155 neonates. In our study abnormal NSG among preterm neonates was maximum with weight in 1-1.5kg (88.5%). In our study abnormal NSG among term neonates was maximum in neonates with weight in 2-3kg (72%) range [2- 2.5kg (25%) and 2.5- 3kg (47%) range]. Among 70 abnormal NSG, 25 had mydriasis, 38 had normal anterior fontanelle,58 had negative transillumination test. Abnormal NSG finding were found when done after 72 hours.

Conclusion: This study shows that Neurosonography is a sensitive, easy, simple, non-invasive, value-effective, initial choice of investigation for detection of abnormal changes in brain among neonates. High efficacy of NSG in detecting presence of brain damage and evolution of brain lesions on regular follow up guides clinical decisions and prognosis of the neonate.

Keywords: Neurosonography; Asphyxia; Seizures; Anterior fontanelle; Newborn; Cranial sonography.
 

Background:Steroids are mainstay of the treatment of Nephrotic syndrome and their effect on growth of children studied by earlier workers for lack of consensus, presented conflicting views. Therefore, in this study, we attempted to study pattern of growth of Indian boys with steroid sensitive nephrotic syndrome in terms of some selected
anthropometric parameters.

Methods: 121 boys between 9 to 16 years of age diagnosed as cases of steroid sensitive Nephrotic syndrome were measured for Weight, Height, Chest Circumference, Biacromial diameter, Bicristal diameter, Triceps skinfold thickness and Subscapular skinfold thickness at half yearly age intervals following a mixed longitudinal growth research design. Tanner’s method was used to compute mean (±SD) distance and velocity growth values for different body parameters of boys.

Results: Growth of height, weight, chest circumference, biacromial diameter and bicristal diameter in boys with steroid sensitive Nephrotic syndrome in general, was found to be compromised as compared to their normal counterparts but was severely affected for height between 14 to 16 years of age and they became short statured individuals. Exceptions to this were triceps and subscapular skinfold thicknesses which in general, measured fatter than normal boys. Barring triceps skinfold thickness, peak growth velocity for all other body parameters measured amongst boys with SSNS was attained at the same age of 14.5 years. Attainment of peak height velocity (PHV) and peak weight
velocity (PWV) as compared to their normal Indian and western counterparts was found to be substantially delayed
and also measured lesser in magnitude.

Conclusions:The relatively impaired auxological status recorded amongst boys with SSNS appears to be due to influence of chronic nature of the disease itself as well as effect of steroid therapy which is known to impair growth of children. On the contrary, growth of subcutaneous fat measured in terms of triceps and subscapular skinfold
thicknesses exhibited relatively fatter attainments amongst boys with SSNS than their normal counterparts.

Keywords: Nephrotic Syndrome; Growth; Steroids.
 

Hypertension is a common disease associated with high mortality and morbidity. With globalization bringing more lifestyle modifications, adolescents are exposed to multiple risk factors like obesity, diet, academic stress,inactive lifestyle combined with hereditary risk factors. Early diagnosis of hypertension is an important strategy in its control, effective treatment and prevention of complications.

Keywords: Hypertension; Prehypertension; Parents; Blood Pressure.