Indian Journal of Child Health http://atharvapub.net/index.php/IJCH <p><strong>Indian Journal of Child Health (IJCH)</strong> is a monthly, peer-reviewed, international journal, published by <strong>Atharva Scientific Publications,</strong>&nbsp;Bhopal, India. <strong>IJCH</strong> is both online and print, open access journal and it allows free access to its contents and permits authors to self-archive the final accepted version of their articles. The journal publishes articles covering various aspects of child health including basic research and clinical investigations in different fields of pediatrics covering perinatal and neonatal to adolescent age group.</p> <p>&nbsp;</p> Atharva Scientific Publications en-US Indian Journal of Child Health 2349-6118 Breastfeeding promotion network of India and beyond: A commentary on the breastfeeding http://atharvapub.net/index.php/IJCH/article/view/919 <p>Breast milk promotion network of India and the infant milk substitute Act (IMS Act) 1992 have prevented the slide down in the rates that existed at the time of their inception but there has only been a modest 5.8% increase in the exclusive breastfeeding rate at 6 months from 1992 Karthikeyan Gengaimuthu ##submission.copyrightStatement## http://creativecommons.org/licenses/by-nc-nd/4.0 2018-06-05 2018-06-05 5 5 315 318 Prevalence of seroprotective antibodies against hepatitis B virus in immunized children in a community hospital http://atharvapub.net/index.php/IJCH/article/view/945 <p><strong>Background:</strong> The potential problem of hepatitis B (HB) vaccination is the declining levels of antibody to HB surface (anti-HBs) antigen causing concern regarding its protective efficacy. <strong>Objectives:</strong> The objectives were to study the rate of seroconversion of children of age 1 Nandhini Ramachandran Ganavi Ramagopal ##submission.copyrightStatement## 2018-06-05 2018-06-05 5 5 319 323 Study of azithromycin sensitivity in enteric fever in pediatric population http://atharvapub.net/index.php/IJCH/article/view/947 <p><strong>Background:</strong> Enteric fever is a major human infectious disease in Southeast Asia. It is exacerbated by a high level of resistance<br>some isolates display to the drugs routinely used in treatment. Azithromycin may be a treatment option for such isolates.<br><strong>Objective:</strong> The objective of this study was to analyze the azithromycin susceptibility in culture positive enteric fever and to<br>evaluate the relationship between ciprofloxacin and azithromycin sensitivity and resistance patterns. <strong>Methods:</strong> This retrospective<br>study was conducted at a tertiary care hospital, Bengaluru, India, between June 2012 and June 2016. Case records of 363 children<br>in the age group of 0 Archana M Bhaskar Shenoy Ranjeeta Adhikary Bhavana V Malavalli ##submission.copyrightStatement## 2018-06-05 2018-06-05 5 5 324 327 Comparison of feeding practices among rural and urban mothers and their effect on nutritional status of children http://atharvapub.net/index.php/IJCH/article/view/896 <p><strong>Objective:</strong> The objective of this study was to compare the nutritional status in infants based on infant feeding practices among<br>rural and urban areas. <strong>Methods:</strong> An observational study was carried out in the Department of Paediatrics of a tertiary care hospital<br>of New Delhi. The present study included a total of 1000 children, of which 500 were from rural and 500 from urban background<br>over a period of 1 year. Information on breastfeeding and complementary feeding practices was recorded. <strong>Results:</strong> In this study, we<br>found that early initiation of breastfeeding (within 1 h after birth) was significantly more common in urban area as compared to rural<br>(71.8% vs. 54.2%; p=0.001). Significantly higher proportion of mothers in urban population (88.0%) was frequently breastfeeding<br>their children than rural ones 76.0% (p=0.001). Practice of night feeding was same in both the groups. Practices of giving prelacteal<br>feeding were significantly higher in rural than in urban area (50.2% vs. 18.4%; p=0.001). Children in whom complementary<br>feeding was introduced beyond 6 months had significantly higher occurrence of malnutrition (68.6% vs. 55.4%; p=0.004). Type of<br>complementary feed did not affect the occurrence of malnutrition. <strong>Conclusion:</strong> Exclusively, breastfed children below 6 months of<br>age and children where complementary feeding is introduced timely at 6 months have lower incidence of malnutrition as compared<br>to those given top feeding before 6 months and inappropriate complementary feeding beyond 6 months of age.</p> Shweta Gautam Gunvant Singh Eske Poonam Singh Archana Kashyap ##submission.copyrightStatement## http://creativecommons.org/licenses/by-nc-nd/4.0 2018-06-05 2018-06-05 5 5 328 331 A prospective study to compare morbidity and mortality profile between late preterm and term neonates from a hospital in Indore http://atharvapub.net/index.php/IJCH/article/view/903 <p><strong>Background:</strong> Late preterm babies born between 34 and &lt;37 weeks of gestation have documented various short-term and long-term adverse outcomes, extra burden on health care, and increased hospitalization rate. <strong>Objective:</strong> The objective of this study was to evaluate the immediate outcome of late preterm neonates and to compare their morbidity and mortality with term neonates. <strong>Materials and Methods:</strong> A prospective observational study was conducted among late preterm babies and term babies from January 2015 to July 2016 in a hospital of Indore. A pre-structured pro forma was used to record data on antenatal care, maternal risk factors, mode of delivery, birth weight, gestational age, gender, diagnosis, relevant investigations, duration of stay, and outcome. Their mortality and morbidity pattern were compared with the term counterparts. <strong>Results:</strong> The total number of live births during the study period was 14,372, of which 2602 were late preterm neonates (16%). Neonatal intensive care unit admission rate was 24.7% among late preterm while 8.87% in term neonates. Jaundice (9%), septicemia (7.8%), respiratory distress (7.6%), and hypoglycemia (6%) were among the common morbidities in late preterm babies, while in term group the incidence rates of these complications were 3.34%, 3.38%, 3.41%, and 2.56%, respectively. <strong>Conclusion:</strong> The mortality and morbidity among late preterm neonates were higher as compared to their term counterparts, implying the need for special attention to these babies because they may be overlooked among other preterm and sick babies.</p> Nirbhay Mehta Ankush Jain ##submission.copyrightStatement## http://creativecommons.org/licenses/by-nc-nd/4.0 2018-06-05 2018-06-05 5 5 332 335 Comparison of electrolyte and electrocardiographic changes in patients with protein http://atharvapub.net/index.php/IJCH/article/view/943 <p>Introduction: Protein Vijay Gupta Bharati P Choubey Arvind G Shingwekar ##submission.copyrightStatement## 2018-06-05 2018-06-05 5 5 336 339 A prospective observational study of morbidity and mortality profile of neonates admitted to neonatal intensive care unit in a tribal area of central India http://atharvapub.net/index.php/IJCH/article/view/949 <p><strong>Introduction:</strong> Globally, 2.6 (2.5 Manindersingh charansingh Juneja Hemant Adikane Ashish Lothe Ambrish Mohabey ##submission.copyrightStatement## 2018-06-05 2018-06-05 5 5 340 344 Diagnostic utility of neutrophil CD64 as a marker of early-onset sepsis in very low birth weight neonates http://atharvapub.net/index.php/IJCH/article/view/950 <p><strong>Background:</strong> Sepsis is a major cause of neonatal morbidity and mortality. It is extremely important to make an early diagnosis of sepsis, as early recognition and prompt institution of treatment is critical for improved outcome. <strong>Objectives:</strong> This prospective observational study was aimed to evaluate the diagnostic utility of neutrophil CD64 expression for the identification of early-onset sepsis in very low birth weight (VLBW) neonates. <strong>Methods:</strong> All VLBW neonates with signs and symptoms of sepsis before 72 h of age, born to mother with or without risk factors for sepsis were enrolled. Complete blood cells count, C-reactive protein, absolute neutrophil count, I/T ratio, blood culture, and neutrophil CD64 assessment were performed. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of neutrophil CD64 and its combination with other hematological makers for sepsis were measured. <strong>Results:</strong> A total of 302 VLBW neonates were enrolled; of which, 151 were cases and 151 were controls. Neutrophil CD64 was significantly increased in cases than in controls (p&lt;0.001). The highest performance of CD64 was at 0 Kessh Ram Meena Priyanka Tiwari Pradeep Debata ##submission.copyrightStatement## 2018-06-05 2018-06-05 5 5 345 349 Breastfeeding-related problems in primigravida mothers at the time of hospital discharge from a tertiary care hospital http://atharvapub.net/index.php/IJCH/article/view/951 <p><strong>Background:</strong> Breastfeeding-related problems are common in primigravida mothers. There is a lacuna in the knowledge about<br>these problems in Indian population. <strong>Objective:</strong> The present study is undertaken to study the prevalence of breastfeeding-related<br>problems in the first-time mothers in a tertiary care hospital at the time of discharge. <strong>Methods:</strong> Consecutive primigravida mothers,<br>who delivered term babies, were interviewed at the time of hospital discharge about breastfeeding-related problems based on a<br>validated questionnaire. The pre-determined predictors were educational status of mother, mode of delivery, and prior knowledge<br>about breastfeeding. <strong>Results:</strong> Between March 2015 and June 2015, 171 mothers were interviewed. The following were demographic<br>profile of mothers: Average age: 24 years, education above matriculation: 55%, and vaginal delivery: 70%. The common problems<br>were pain while feeding (n=50, 29%), improper latching (n=20, 12%), and feeling of inadequate milk (n=29, 17%). Cesarean<br>section was associated with lower confidence levels for breastfeeding (odds ratio [OR] 2.68 [1.04-6.91], p=0.041), delayed onset of<br>first breastfeed (OR 33.4 [12.67-88], p=0.0001), and feeling of inadequacy of breast milk quantity (OR 3.76 [1.64-8.58], p=0.001).<br>Illiterate mothers were at higher risk of having these problems. Prior knowledge about breastfeeding was associated with fewer<br>problems. <strong>Conclusion:</strong> The study presents the existing problems related to breastfeeding at the time of discharge from a tertiary<br>care hospital.</p> Saumya Rawat (Col) Kannan Venkatnarayan (Lt Col) H Ravi Ramamurthy (Lt Col) Suprita Kalra ##submission.copyrightStatement## 2018-06-05 2018-06-05 5 5 350 354 Prevalence of specific learning disability among schoolchildren between 8 and 12 years http://atharvapub.net/index.php/IJCH/article/view/952 <p><strong>Background:</strong> Specific learning disability (SLD) is known to cause a great amount of psychological and mental stress to the children and their parents. <strong>Objectives:</strong> To find out the prevalence of SLD among children in Gwalior and to find out the risk factors associated with SLD. <strong>Method:</strong> This cross-sectional study was conducted between 2016 and 2017 in two government and two private schools of Gwalior. A total of 800 students from the 3rd to 6th standard were included in the study. The details of every student were filled in a pro forma which included their academic performance. Based on this, last 10% of the low-performing students from each class were recruited and they were subjected to visual, hearing, IQ assessment, and NIMHANS index for SLD. <strong>Results:</strong> A total of 23 students were identified as having SLD, with a prevalence of 2.87%. The most common type was combined type (dyslexia and dyscalculia). The prevalence of arithmetic disability was found to be around 2.25%, reading disability was 2.5%, and that of writing disability was around 1.37%. The mean age of students diagnosed as SLD was 9.8. Among the learning-disabled students, 19 students (82%) were having only one sibling. SLD was diagnosed mostly in class IV students (p=0.023). Among SLD students, a history of prematurity was found in 11 students (48%), low birth weight in 13 students (57%), and head trauma in 13 students (57%) with SLD. Among SLD students, 7 were having attention-deficit hyperactivity disorder (ADHD). No students were identified as having ADHD in the remaining students and it was highly significant (p&lt;0.001). <strong>Conclusion:</strong> The prevalence of SLD was 2.87%, with the most common type being combined type. The antenatal risk factors associated with SLD were prematurity, low birth weight, and a history of head trauma. The most common comorbid condition associated with SLD was attention-deficit hyperactivity disorder.</p> Neetu Sharma Prakash Petchimuthu Ajay Gaur Ranjeet Kumar ##submission.copyrightStatement## 2018-06-05 2018-06-05 5 5 355 358 Prevalence of non-alcoholic fatty liver disease and its correlation with anthropometric measures and laboratory parameters in overweight and obese children and adolescents http://atharvapub.net/index.php/IJCH/article/view/953 <p><strong>Introduction:</strong> Non-alcoholic fatty liver disease (NAFLD) is the most common cause of liver disease in children and its primary cause is obesity. In addition, children with NAFLD may be at increased risk for cardiovascular disease.<strong> Objective:</strong> The objective of this study was to estimate the prevalence of NAFLD in overweight and obese children and to study its correlation with various anthropometric measures and laboratory parameters in overweight and obese children and adolescents. <strong>Materials and Methods:</strong> This cross-sectional observational study was conducted in the Department of Pediatrics of a teaching institution of central India. The study included 30 overweight and obese children and adolescents between 6 and 18 years of age. Subjects Pawan Ghanghoriya Shipra Mandraha Chandan Kumar Mishra ##submission.copyrightStatement## 2018-06-05 2018-06-05 5 5 359 362 A methodological study to develop standard operational protocol for feeding preterm neonates with expressed breast milk http://atharvapub.net/index.php/IJCH/article/view/954 <p><strong>Objectives:</strong> The objectives of this study were to assess the current practices, to identify barriers and facilitators for feeding preterm neonates with expressed breast milk (EBM), and to develop standard operational protocol (SOP) and checklist for feeding preterm neonates with EBM. <strong>Materials and Methods:</strong> The methodological research design was used in the present study, and it was conducted in a tertiary level neonatal unit, North India. Sample population was nursing staff, preterm neonates, and their mothers, admitted in neonatal unit. To enroll nursing staff and preterm neonates, total enumeration sampling technique was used, whereas purposive sampling technique was used to select mothers of preterm neonates. Research project was carried out in five phases. <strong>Results:</strong> After assessment of the current practices, focus group discussions were conducted with nursing staff and mothers to know the barriers and facilitators. Findings of discussions were used to develop SOP and checklists. Three Delphi rounds were conducted to finalize the content and calculate content validity index (CVI). After the 3rd round, the CVI was 0.99 for SOP and 1.00 for checklists. Cronbach Daljeet Kaur Avinash Kaur Rana Geetanjli Kalyan Praveen Kumar ##submission.copyrightStatement## 2018-06-05 2018-06-05 5 5 363 367 Magnitude and factors contributing school absenteeism among adolescents of Ujjain city http://atharvapub.net/index.php/IJCH/article/view/955 <p><strong>Background:</strong> School absenteeism is prevalent in Madhya Pradesh and other states of India. Various psychosocial, domestic, and<br>health-related factors have been implicated for absenteeism. <strong>Objectives:</strong> The objectives of this study were to determine the magnitude<br>of school absenteeism and its contributing factors among adolescent students of Ujjain city.<strong> Methods:</strong> An observational study was<br>conducted in government schools of Ujjain district. Students studying in 6th Gunvant Singh Eske Poonam Singh Kamna Nigam Mamta Dhaneria ##submission.copyrightStatement## 2018-06-05 2018-06-05 5 5 368 371 Role of female birth attendants to enhance breastfeeding rates and essential newborn care http://atharvapub.net/index.php/IJCH/article/view/909 <p><strong>Background:</strong> Women who received support during labor are more likely to give birth Asha Benakappa Vykuntaraju K Gowda Vishwanath Gowda Naveen Benakappa ##submission.copyrightStatement## http://creativecommons.org/licenses/by-nc-nd/4.0 2018-06-05 2018-06-05 5 5 372 375 Assessment of modifiable risk factors for acute lower Respiratory tract infections in under-five children http://atharvapub.net/index.php/IJCH/article/view/956 <p><strong>Background:</strong> Acute lower respiratory tract infection (ALRTI) continues to be the biggest killer worldwide of children under 5 years<br>of age. <strong>Objective:</strong> The objective of this study is to identify and assess the modifiable risk factors for ALRTI in children under<br>5 years of age. <strong>Materials and Methods:</strong> This prospective case Syed M Azad Rohit Bannerji Jaydeb Ray Monjori Mitra Anwesha Mukherjee Garima Biyani ##submission.copyrightStatement## 2018-06-05 2018-06-05 5 5 376 380 Knowledge, attitude, and perception regarding breastfeeding practices among mothers of Indore city: A cross-sectional study http://atharvapub.net/index.php/IJCH/article/view/957 <p><strong>Introduction:</strong> Breast milk is planned for nursing young ones and therefore considered as nature Upendra Ghure Shachi Jain Taran Kewal Kishore Arora Chandan Kumar Shaw ##submission.copyrightStatement## 2018-06-05 2018-06-05 5 5 381 385 Kangaroo mother care and its physiological effects in low birth weight and preterm neonates http://atharvapub.net/index.php/IJCH/article/view/958 <p><strong>Objectives:</strong> The present study was undertaken to study and compare anthropometry and physiological parameters in preterm and<br>low birth weight infants during conventional care and Kangaroo Mother Care (KMC). <strong>Methods:</strong> This prospective case Gunjita Jain Preeti Malpani Manju Biswas ##submission.copyrightStatement## 2018-06-05 2018-06-05 5 5 386 389 Antenatal parameters to predict mortality and major morbidity in very low birth weight preterm neonates http://atharvapub.net/index.php/IJCH/article/view/959 <p><strong>Objectives:</strong> The objective of this study was to determine effect of maternal factors and abnormal antenatal color Doppler of umbilical<br>artery on mortality and major morbidity in very low birth weight (VLBW) neonates. <strong>Materials and Methods:</strong> This prospective<br>study was conducted in the Department of Pediatrics, of a teaching institution of central India. All consecutive intramural live-born<br>preterm neonates, delivered with BW of 1000 Ghanshyam Das Shweta Gautam ##submission.copyrightStatement## 2018-06-05 2018-06-05 5 5 390 392