Indian Journal of Child Health <p align="justify"><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> Atharva Scientific Publications en-US Indian Journal of Child Health 2349-6118 Measles rubella campaign - India’s journey from expanded program on immunization to measles elimination <p>Infectious diseases have always been a major cause of mortality and morbidity in children under 5 years of age and more so in developing countries like India. Steps toward control of these infectious diseases, especially the vaccine-preventable diseases, have been the priority of Indian Government. Smallpox was eliminated followed by polio and next target being measles. Although the journey has been tough, finally, the results are appreciable considering the large population and limited resources of the country. India has traveled a very long distance from the introduction of vaccination and acquiring country’s vaccine manufacturing to finally eliminating measles.</p> Amarpreet Kaur Gurmeet Kaur Preeti Padda Amanpreet Sethi Seema Rai Harshvardhan Gupta Varun Kaul ##submission.copyrightStatement## 2019-04-22 2019-04-22 51 55 10.32677/IJCH.2019.v06.i02.001 Impact of vitamin D fortified food on quality of life and emotional difficulties among adolescents – A randomized controlled trial <p><strong>Background:</strong> The action of vitamin D on health related quality of life (HRQoL) and emotional difficulties of individuals has been extensively studied in several epidemiological studies. However, studies focusing on the effect of vitamin D fortification on these aspects among adolescents are limited.<strong> Aim:</strong> This study aims to explore the influence of vitamin D fortification on the vitamin D status and the HRQoL and emotional difficulties among adolescents.<strong> Methods:</strong> A total of 71 healthy adolescents consented to be a part of the randomized controlled trial conducted in two schools in Chennai, India. They were allocated and blinded into two groups: experimental (one vitamin D fortified ladduu (a homemade eatable with natural supplements) daily, containing 1000 IU vitamin D3) or the control group (one unfortified ladduu daily) for 12 weeks following random assignment. The vitamin D status, HRQoL and emotional difficulty parameters of anxiety and stress of the participants were evaluated both at baseline and at 12 weeks. Data were analyzed using SPSS version 12. <strong>Results:</strong> Vitamin D status of the adolescents significantly improved post supplementation (Z=-6.28; P =0.00). However, despite of significant improvement, no significant changes were observed in the other parameters.<strong> Conclusion:</strong> These findings demonstrate that although vitamin D fortification helps in improving the vitamin D status of adolescents, it does not particularly benefit their HRQoL and emotional difficulties of anxiety and stress of adolescents.</p> Hima Ann Isaac Arambakkam Janardhanam Hemamalini Krishna Seshadri Latha Ravichandran ##submission.copyrightStatement## 2019-04-22 2019-04-22 56 60 10.32677/IJCH.2019.v06.i02.002 Comparison of the analgesic efficacy of expressed breast milk and 25% dextrose during the first hepatitis B vaccination <p><strong>Background:</strong> Injectable vaccines are a common source of pain and distress for newborn babies. Sweet-tasting solutions such as<br>sucrose and 25% dextrose (25D) are described as effective strategies for pain relief in newborns. <strong>Objective:</strong> This study was done<br>to compare the analgesic efficacy of expressed breast milk (EBM) and 25D solution during vaccination with hepatitis B (Hep B)<br>vaccine at birth. <strong>Materials and Methods:</strong> This study was conducted at the vaccination clinic in the pediatrics department of a<br>tertiary care hospital in southern India. The participants included healthy term babies and late preterm babies at the clinic during<br>their routine dose of Hep B at birth, during the study period from June 2017 to December 2017. A total of 70 consecutive neonates<br>were randomly allocated into two groups. 2 ml of either EBM or 2 ml of 25D solution was given 1 min before the injection. The<br>outcome variables recorded were the duration of cry after injection and Neonatal Infant Pain Scale (NIPS) scores for both the<br>groups. <strong>Results:</strong> The duration of cry was found to be slightly higher in the group receiving EBM than those receiving 25D, although<br>it was not found to be statistically significant. The neonates in the 25D group had lower NIPS scores than those in the EBM group.<br><strong>Conclusions:</strong> 25D appears to be a slightly better analgesic when compared to EBM during Hep B injection at birth.</p> Hameed Uddin Ahmed Praveen S. Sindhoor ##submission.copyrightStatement## 2019-04-22 2019-04-22 61 64 10.32677/IJCH.2019.v06.i02.003 Clinico-epidemiological profile and predictors of in-hospital outcome of acute poisoning cases in children of Northern India <p><strong>Background:</strong> Childhood poisoning is a common but preventable problem worldwide with incidence varying from 0.3% to 7.6%. Demography, socioeconomic status, education, local belief and customs, occupation, religious, and cultural influences determine the cause of poisoning. <strong>Aim:</strong> This study was conducted to understand the recent changes increasing urbanization and rapid socioeconomic development in India during the past decade and to find out the change in pediatric due to poisoning profile. <strong>Materials and Methods:</strong> This study was conducted in a pediatric ward of a tertiary care hospital in North India during the period of January 2016–December 2016. A total of 174 children admitted with acute poisoning in the hospital during the study tenure were enrolled for the study. Clinical and demographic data were recorded in a predesigned proforma and results were compared with the previous studies from the region.<strong> Results:</strong> Mean age at presentation was 3.7 years, wherein males outnumbered females. Accidental mode (97%) was the most common mode of poisoning while ingestion (99%) was the most common route of exposure. The common agents incriminated in decreasing order of frequency were corrosives (24.71%), pyrethroids (12.64%), and kerosene (9.77%). Majority of patients belongs to lower middle class (57%) and urban areas (61%). Most children present with mild symptoms, of them vomiting was the most common (65%) and 12.6% developed complications. Mean duration of hospital stay was 2.5±1.91 days with a mortality of 2.16%. <strong>Conclusion:</strong> There is changing pattern in acute poisoning in children with decline in incidence of kerosene and pesticide poisoning while increase in corrosives and parathyroid poisoning. Low Glasgow Coma Scale and time lapse between poisoning and presentation to the hospital can be a predictor of high mortality.</p> Muhammed Yasir K Ajay Kumar Kanika Kapoor Manish Kumath Kailash Chander Aggarwal ##submission.copyrightStatement## 2019-04-22 2019-04-22 65 68 10.32677/IJCH.2019.v06.i02.004 Impact of Integrated Child Development Scheme (ICDS) on morbidity status of children and knowledge, attitude, and practice of mothers towards ICDS: A comparative study <p><strong>Background:</strong> Nutrition during the early age of life has a prominent impact on growth and development during childhood period and serves as a key determinant of health and nutritional status in adolescent and adulthood life. <strong>Objectives:</strong> The objectives of the study were to assess the health status and morbidity pattern of children attending and not attending Integrated Child Development Services (ICDS) center and to find out the knowledge, attitude, and practice (KAP) of the respective mothers regarding ICDS scheme. <strong>Materials and Methods:</strong> A community-based cross-sectional study was carried among children between 0 and 6 years of age residing in an urban slum area of Karad Municipal Corporation of district Satara, attending and not attending Anganwadies. The study was conducted over a period of 6 months during the year 2017. A total of 500 children were studied for clinical examination and anthropometric measurements with pre-tested, self-administered, and structured questionnaire. The data were computerized in a rational database management system and analyzed using Chi-square tests for statistical significance. <strong>Results:</strong> Out of a total of 500 children, maximum 58.8% were from age group 37 to 72 months with apparent differences in male and female proportions. The prevalence of undernutrition was significantly high among children not attending Anganwadis (32.4%) and showed 1.8 times the risk of developing under-malnutrition as compared to Anganwadis attendance. The morbidities such as malnutrition (32.40%), anemia (42.40%), Vitamin A deficiency (39.20%), Vitamin B complex deficiency (28.80%), diarrhea (15.20%), and acute respiratory infections (11.60%) were significantly higher in children not attending Anganwadi as compared to those attending Anganwadis (p &lt; 0.05). The mothers of children attending Anganwadis had higher (18.40%) good KAP score regarding ICDS services as compared to those not attending Anganwadis. <strong>Conclusion:</strong> Children attending Anganwadis have lesser morbidities than those not attending Anganwadis and their mothers had better knowledge about these services.</p> Vinayak Yadavrao Kshirsagar Rajsinh Vishwasrao Mohite ##submission.copyrightStatement## 2019-04-22 2019-04-22 69 73 10.32677/IJCH.2019.v06.i02.005 Hoarseness of voice in the pediatric age group: Our experiences at an Indian teaching hospital <p><strong>Background:</strong> Hoarseness of the voice or dysphonia is a commonly encountered vocal symptom among children. The etiological profiles of dysphonia among children are variable, and laryngoscopic examination is required for identification of the lesions. <strong>Objective:</strong> The objective of the study was to study the etiology, clinical presentations, and diagnosis of the hoarseness of voice among children. <strong>Materials and Methods:</strong> The children aged from 3 to 16 years presenting with dysphonia/hoarseness, were included in this study from October 2015 to September 2018. All the 132 children presented with hoarseness of voice were subjected to video laryngoscopy for voice assessment. <strong>Results:</strong> The majority of this study was male children (59.09%). Vocal fold nodules (36.36%) were the major cause for dysphonia. Other attributing causes include vocal fold polyp, vocal fold cyst, laryngopharyngeal reflux, hemorrhagic vocal fold polyp, laryngeal papilloma, vocal fold sulcus, and vocal fold paralysis. Voice abuse was an important cause for dysphonia and history of vocal abuse was reported among 61 children (46.21%). The duration of hoarseness ranged from 1 month to 2 years with a mean duration of 3.63±2.31 months. The larynx was examined by laryngeal mirror alone in 23 children (17.42%), fiber-optic laryngoscopy in 88 children (66.66%), and direct laryngoscopy under general anesthesia in 21 cases (15.90%). Voice therapy was done in all children along with vocal hygiene care and micro-laryngeal surgery in 64 cases.<strong> Conclusion:</strong> Pediatric dysphonia is a common cause for referral to pediatric otolaryngologists and management sometimes variable. Flexible nasopharyngolaryngoscopy is suitable for making an accurate diagnosis.</p> Santosh Kumar Swain Ishwar Chandra Behera Loknath Sahoo ##submission.copyrightStatement## 2019-04-22 2019-04-22 74 78 10.32677/IJCH.2019.v06.i02.006 Neonatal and fetal effects of antithyroid peroxidase positivity in hypothyroidism in pregnancy - A hospital-based prospective analytical study <p><strong>Objectives:</strong> The objectives of this study were to evaluate the fetal and neonatal outcomes for pregnant women with autoimmune hypothyroidism and to compare them to hypothyroid and euthyroid women. <strong>Methods:</strong> A total of 309 women were included in the study. 159 hypothyroid women were categorized as “Cases” and 150 euthyroid women were “Controls.” Serum thyroid-stimulating hormone (TSH) was done for all women, and in hypothyroid women, antithyroid peroxidase (TPO) was also done for the mothers. Cases were subdivided on the basis of anti-TPO positivity. Fetal and neonatal complications were noted in all three groups along with basic parameters such as baby weight and Apgar scores. Meconium aspiration, neonatal intensive care unit (NICU) admission, jaundice, intrauterine growth retardation, intrauterine death (IUD), low or very low birth weight, congenital anomalies, hypothyroidism in the newborn, and neonatal death were the parameters noted. Testing of the babies was done with serum TSH on day of life 3 and serum bilirubin whenever clinically jaundice was suspected. The study period was 2 years.<strong> Results:</strong> Hypothyroidism is significantly associated with an increased risk of IUD (p=0.038), NICU admissions in babies (p=0.004), neonatal jaundice (p=0.027), low or very low birth weight babies (p=0.0003), congenital anomalies in the babies (p=0.026), and neonatal deaths (p=0.007). Anti-TPO positivity is significantly associated with increased risk of IUD (p=0.044) and hypothyroidism in the newborn of hypothyroid mothers (p=0.045). <strong>Conclusions:</strong> Anti-TPO positivity and hypothyroidism are both significantly associated with certain fetal complications such as IUD, neonatal jaundice, increased NICU admissions, and hypothyroidism in the newborn. Mothers with hypothyroidism who are TPO positive have a higher risk of neonatal mortality and morbidity, although small. Hence, screening should be done in all hypothyroid women in pregnancy and their babies. Universal screening with serum TSH is recommended in pregnancy and in the newborn on day 3 of life.</p> Tuhina Gupta Poonam Mani Abha Gupta Lalita Yadav ##submission.copyrightStatement## 2019-04-22 2019-04-22 79 82 10.32677/IJCH.2019.v06.i02.007 Prelacteal feeds: Prevalence and associated factors as seen at a University Teaching Hospital, Southeast Nigeria <p><strong>Background:</strong> Administration of prelacteal feeds (PLFs) is a common practice among mothers which has no scientific basis. It is<br>rather fraught with disadvantages, particularly to the newborn. It constitutes a major impediment to the commencement of exclusive<br>breastfeeding which is the foundation for proper infant nutrition. <strong>Aim:</strong> The objective of this study was to determine the prevalence,<br>types, and reasons for administration of PLF. <strong>Materials and Methods:</strong> A cross-sectional descriptive study was conducted in<br>the Well Baby Clinic of a Abia State University Teaching Hospital, Aba, Nigeria. Data on the sociodemographic characteristics,<br>utilization of health services, mode of delivery, and administration of PLF were obtained from mothers. <strong>Results:</strong> A total of 444<br>mothers were enrolled over the study period, of which 43.2% administered PLF. Cesarean section delivery and women aged<br>29–39 years were significantly associated with PLF administration. Glucose water constituted the predominant PLF administered.<br>Health workers were the most influential factor in the administration of PLF. Delayed lactation constituted the major reason for<br>the administration of PLF. <strong>Conclusion:</strong> Sustained education of the populace and the training and retraining of health workers,<br>particularly obstetric staff, could help to curb PLF administration.</p> Chukwuemeka Ngozi Onyearugha Nneka Chioma Okoronkwo ##submission.copyrightStatement## 2019-04-22 2019-04-22 83 86 10.32677/IJCH.2019.v06.i02.008 Neonatal hypoglycemia revisited: Incidence and clinical profile in a tertiary center hospital of Tripura <p><strong>Introduction:</strong> Hypoglycemia is a common but preventable metabolic abnormality in neonates associated with long-term sequelae. Controversies still exist about its definition, screening methodology, management, and outcome making it a subject for further exploration. <strong>Objectives:</strong> The study was taken up to find out the proportion of neonate developing hypoglycemia in the neonatal intensive care unit (NICU) and to study the clinical profile of hypoglycemia in neonates. <strong>Materials and Methods:</strong> All intramural and extramural neonates admitted in the NICU within 2 h of delivery were included in this study. They were screened for hypoglycemia using Accutrend-alpha glucometer. Results along with all neonatal and maternal variables were recorded and analyzed using the SPSS version 15.0. <strong>Results:</strong> The current study shows the prevalence of hypoglycemia as 32.2%. Proportion of hypoglycemia was more in small for gestational age, large for gestational age neonates, and neonates with prematurity, birth asphyxia, and maternal diabetes mellitus. Besides, hypoglycemia occurred more commonly within 24 h of life. Lethargy, convulsion, apnea, and jitteriness were common presenting symptom. <strong>Conclusion:</strong> The present study shows despite advances in obstetrical practices and increase in institutional deliveries over years, neonatal hypoglycemia continues to occur with almost same frequency along with the same maternal and neonatal variables.</p> Sarmistha Choudhury Sujit Kumar Chakrabarti Sanjib Kumar Debbarma ##submission.copyrightStatement## 2019-04-22 2019-04-22 87 90 10.32677/IJCH.2019.v06.i02.009 Identifying low birth weight babies using calf circumference among neonates in a semi-urban area <p><strong>Background:</strong> Low birth weight (LBW) still persists as a public health problem in low- and middle-income countries. There is a constant search to find newer methods to detect LBW babies so that early interventions can be taken. <strong>Objective:</strong> The objective&nbsp;of this study was to determine the critical limit and to assess the reliability of calf circumference (CaC) measurement in detecting&nbsp;LBW babies. <strong>Materials and Methods:</strong> This cross-sectional study was conducted in a tertiary care hospital between April 2018 and&nbsp;September 2018. In this study, a total of 185 newborns were included in the study. Anthropometric measurements (Calf Circumference&nbsp;[CaC], birth weight, head circumference, crown-rump length, chest circumference, and thigh circumference) were taken as per&nbsp;standard guidelines. Collected data were analyzed for determining the mean, standard deviation, critical limit, receiver operating&nbsp;characteristic curve, Pearson correlation coefficient, and regression analysis of the anthropometric measurements at birth in relation&nbsp;to birth weight. <strong>Results:</strong> The mean CaC of LBW babies was 9.16±0.11 cm and in normal weight babies, it was 10.86±0.09 cm. The&nbsp;mean values of CaC were significantly lower in LBW babies (p&lt;0.0001). The mean cutoff value of CaC of LBW babies is found to be&nbsp;9.90 cm, with a sensitivity of 85.6% and specificity of 82.2%. <strong>Conclusions:</strong> In our study, measuring CC is found to be a good method<br>in identifying LBW neonates. Hence, measuring CaC can be used as an alternative method to identify LBW babies in remote areas.</p> Sathyamoorthy Mani Karthikeyan Panneerselvam Sekar Pasupathy Sushmitha Goli Balaji Ramraj Subash Sundar ##submission.copyrightStatement## 2019-04-22 2019-04-22 91 94 10.32677/IJCH.2019.v06.i02.010 Massive hemorrhagic pleural effusion - A rare presentation of acute pancreatitis <p>Acute pancreatitis typically presents with a sudden-onset severe epigastric pain radiating to the back. Presentation with respiratory distress secondary to massive pleural effusion has been rarely reported. We report a 12-year-old girl presenting with complaints of fever, cough, dyspnea, and chest pain. Her chest radiograph showed massive pleural effusion and the pleural fluid amylase was markedly elevated. The patient recovered gradually with conservative medical management and the right side chest tube drainage. This report highlights the rare presentation of pancreatitis which requires a high index of suspicion for prompt diagnosis.</p> Javed Ismail Gautam Kamila Mullai Baalaaji ##submission.copyrightStatement## 2019-04-22 2019-04-22 95 96 10.32677/IJCH.2019.v06.i02.011 Late recovery of phrenic nerve palsy in a neonate: A case report <p>Hyperextension of the neck at birth can injure the phrenic nerve and/or brachial plexus usually at the point where the phrenic nerve crosses the brachial plexus. We present a case of the preterm baby, who had Erb’s palsy and diaphragmatic paralysis since birth after breech delivery. Persistent respiratory distress and chest X-ray gave a clue to diagnosis, which was confirmed on ultrasound. The baby recovered on the conservative approach at 2 months of life without surgical plication. This study describes that late spontaneous recovery up to 2 months is possible in a newborn with respiratory distress due to phrenic nerve palsy.</p> Anjali Bagaria Prerna Batra Deepika Harit Shuchi Bhatt ##submission.copyrightStatement## 2019-04-22 2019-04-22 97 98 10.32677/IJCH.2019.v06.i02.012