8 research outputs found
Biochemical Markers in Perinatal Asphyxia
No full textEarly assessment of the severity of an acute cerebral lesion secondary to hypoxia-ischemia or other pathologic conditions may provide a very useful basis for preventive or therapeutic decisions in pediatric patients. In the present review, we discuss the diagnostic and prognostic value of a series of biochemical parameters, with special reference to the diagnosis of neonatal HIE. Currently many specific biochemical markers of brain injury are being investigated to assess regional brain damage after perinatal asphyxia in neonates of which serum protein S-100β, brain-specific creatine kinase, neuron-specific enolase, IL6 and urinary uric acid levels appear promising in identifying patients with a risk of developing hypoxic-ischemic encephalopathy. Whether detection of elevated serum concentrations of these proteins reflects long-term neurodevelopmental impairment remains to be investigated. Key words: S-100; Brain specific creatine kinase; neuron specific enolase; IL6; urinary uric acid; hypoxic ischaemic cerebral injury. DOI: 10.3126/jnps.v31i2.4155 J Nep Paedtr Soc 2010;31(2):151-156</jats:p
OPTIMIZING VEHICLE ROUTING WITH A HYBRID SWARM-INTELLIGENT FROG JUMPING OPTIMIZATION ALGORITHM
No full textThe issues in Vehicle Routing with Time Windows (VR-TW) are addressed in this study using a novel hybrid swarm-intelligent frog jumping optimisation (HSIFJO) algorithm. The method employs a diversity management strategy for developing memeplexes, which assists in preserving diversity and prevents the premature termination of the search. To increase population diversity and improve solution quality, an enhanced clone selection (CS) process is employed. To maximise the algorithm's potential, an enhanced and extended extremal optimisation (EO) strategy is used, coupled with different move operators. A proposed adaptive soft time windows (ASTW) surcharge approach acknowledges the possibility of impractical solutions during the evolution process. When compared to existing state-of-the-art heuristics, the suggested approach performs exceptionally well in performance evaluation
Breast Feeding as Analgesia in Neonates: A Randomized Controlled Trial
No full textIntroduction: Major myth regarding neonatal pain suggests that neonates because of their neurological immaturity do not experience pain. Although exact mechanism is not known, it is proposed that breast feeding through combination of various senses and the closeness of the infant’s mother, saturates the senses thus reducing perception of noxious stimuli. The objective of this study was to investigate the analgesic effect of breastfeeding during blood sampling through heel lance in healthy term neonates.Material and Methods: This was a Randomized controlled trial done in a Tertiary level Neonatal Intensive Care Unit. Sixty healthy term newborns, undergoing heel prick were included in study. Neonates were randomly assigned to two groups: Group I (breastfed) with; Group II (not breast fed). Babies were given heel prick and crying time, Heart rate, SpO2 and BP monitored. Changes in various physiological parameters following a heel prick were studied in two groups.Results: Neonates in both groups expressed pain by crying, increase in heart rate, fall in transcutaneous oxygen saturation and rise in blood pressure. Compared to control group, the babies who were breast fed were found to have lesser crying time (40.04 sec and 69.09 sec respectively, p<0.05) and lesser rise in heart rate (rise of 21.78 and 34.46 bpm respectively, p<0.03). In the breast fed group there was a trend to a lesser decrease in oxygen saturation and lesser rise in blood pressure though this was not statistically significant.Conclusion: Breast feeding offers a quick and effective means of reducing pain in neonates during routine neonatal procedures.J Nepal Paediatr Soc 2016;36(3):238-242</jats:p
Effects of lockdown during corona pandemic on children with neurodevelopmental disorders-A questionnaire-based survey
No full textBackground. Lockdown due to Corona pandemic is an unprecedented event, which has had a profound impact on the lives of children across all ages. Its effects on children with Neurodevelopmental Disorders (NDD) has not been adequately studied. This study was performed in order to explore the effects of lockdown during the Corona pandemic on children with NDD and their parents.
Methods. The survey was conducted in three Indian tertiary-care hospitals wherein parents of children with NDD were requested to respond to an online questionnaire. The questions attempted to elicit various aspects of the children`s therapies and behavioural profiles as well as their parents` experiences during the pandemic related lockdown.
Results. 135/188 (71.8%) parents of children with Autism Spectrum Disorder (ASD)(n=104), Attention Deficit Hyperactivity Disorder (ADHD) (n=26) and Learning Disability (LD)(n=5) responded. Pre-lockdown, 133 (99%) children were receiving regular institution-based therapy, which ceased intra-lockdown. Mean cumulative home-based therapy duration significantly increased during lockdown (p=0.03). Parents reported significantly increased temper tantrums in children (p=0.02). They perceived that during lockdown, their children were bored and their interactions and speech worsened. Majority of parents reported worsening of own qualities of life, but felt confident of taking care of their children during lockdown.
Conclusions. To conclude, children with NDD and their parents were significantly affected by Corona pandemicrelated lockdown. Institutional therapy discontinuation, behavioural deterioration (especially among ASD and ADHD) and parental stress were prominent challenges whereas parental motivation and reliance on homebased therapy were the positive highlights. The survey points to the role of regular parent-administered homebased therapy in children with NDD, especially to tide over similar unexpected adverse scenarios
Evaluation of referral documentation in pediatrics emergency transfers: A cross-sectional observational study
No full textBackground:
Inadequate handover documentation may result in delay and adverse outcomes during continuity of care. This is much more important in interfacility transfers where improper or missing documentation of prior events from a referring point may result in a break in the continuity of care.
Subjects and Methods:
This was a cross-sectional observational study done to evaluate the quality of referral documentation available with the patients who were referred to a tertiary care center after consultation in a peripheral center between March 2024 and May 2024. A semi-structured pro forma was used to collect transfer characteristics and quality of transfer documents at the time of admission.
Results:
A total of 156 children were enrolled in the study. The mean age of children was 6.81 ± 5.79 years. 68 (43.6%) were referred from a private nursing home. Healthcare workers accompanied only 19 (12.2%) children. Referral documentation was available in 121 (77.6%). 96/121 (61.5%) had handwritten referral papers. Pretransport communication was received only in one patient. Patients being referred by private physicians (70.8%) and smaller hospitals (80.9%) have better documentation than medical colleges (40.9%) (P = 0.03), patients being transported in an ambulance (87.23% vs. 73.4%, P = 0.05) have higher chances of having referral documentation.
Conclusions:
There is a lack of pretransfer referral communication and quality referral documents. Pediatric referral services in the region are fragmented and nonuniform. There is a need to improve pediatric referral documentation and transfer services
