Manjusha Goel

Relationship of body mass index and other life style factors with hypertension in adolescents

Background: Over the past two decades, it has been observed that hypertension shows an increasing trend in children and adolescents. Various factors are contributing to this upward trend, and they primarily include changes in lifestyle and dietary habits. Objectives: The aim of this study was to evaluate the prevalence of hypertension in school going adolescent children and to study the associated risk factors. Materials and Methods: This prospective cross-sectional observational study was conducted over a period of one year on apparently healthy adolescents of randomly selected urban schools of Bhopal district of Madhya Pradesh, Central India. A pretested and prevalidated questionnaire was used to collect the details including present or past history of illness, family history of hypertension, socioeconomic status, and sleep pattern and birth weight of the children. This was followed by anthropometric and blood pressure (BP) measurements and thorough systemic examination. Results: Out of 1221 children recruited in the study, 618 were boys, and 603 were girls. 22.7%, body mass index (BMI) of majority (85%) of the students was between 5 th and 84 th percentile, 5.65% were obese (BMI ≥95 th ) and 9.18% children were overweight (85 th -95 th percentile). Systolic and diastolic hypertension (BP >95 th percentile) was seen in 61 (4.1%) and 48 (3.9%) participants, respectively. Both systolic and diastolic hypertension was seen in 30 (2.45%) participants. Systolic and diastolic prehypertension (BP 90 th to <95 th percentile) was seen in 88 (7.3%) and 68 (5.6%) participants, respectively. A highly significant association (P < 0.01) of sex, BMI, systolic BP, family history of hypertension, and birth weight with diastolic BP was seen. Conclusion: There is a significant positive correlation of BMI with both systolic and diastolic BP. The family history of hypertension appears to be an important risk factor for the increase in both systolic and diastolic BP. Low birth weight and male sex seem to be risk factors for diastolic hypertension.

Nucleated red blood cell in cord blood as a marker of perinatal asphyxia.

Background: Perinatal asphyxia is a major cause of neurological morbidity and mortality in India. The purpose of this study was to investigate variations in nucleated red blood cell (NRBC) in blood associated with perinatal asphyxia and its relationship to both the severity and short term prognosis of asphyxia. Methods: A prospective (case-control) study was undertaken at Gandhi Medical College and Associated Hospitals. A total of 100 neonates were included in the study. Levels of NRBC/100 white blood cells (WBC) and absolute NRBC counts in cord blood were compared for 50 asphyxiated (case group) and 50 normal neonates (control group). These parameters were also related to the severity of asphyxia and clinical outcome. Results: The number of NRBC/100 WBC in the blood of 50 newborns each in the asphyxiated and in the control group were mean 29.5 ± 26.0, range 7-144 NRBCs/100 WBC and mean ± standard deviation 5.9 ± 2.6, range 3-14 NRBCs/100 WBC respectively (P < 0.01). Using quartile deviation, staging of hypoxic ischemic encephalopathy (HIE) was done on basis of NRBC count and there was 80% agreement between clinical and NRBC staging of HIE. There was a significant (P < 0.01) correlation of the number of NRBC\100 WBC with Apgar scoring, HIE staging and mortality. Conclusions: The NRBCs/100 WBCs can be used as a simple marker for the assessment of severity and early outcome of perinatal asphyxia.

Topical-steroid-induced iatrogenic Cushing syndrome in the pediatric age group: A rare case report

Cushing syndrome, a systemic disorder, is the result of abnormally high blood level of cortisol or other glucocorticoids. The most common cause of Cushing syndrome is prolonged exogenous administration of glucocorticoid hormones. Prolonged use of topical corticosteroids, particularly in children, may cause Cushing syndrome and suppression of the hypothalamopituitory-adrenal axis, which is less common than that of oral or parenteral route. However, iatrogenic Cushing syndrome in the infantile age group due to topical steroid is very rare and only a few patients have been reported to date in the literature. Here we report a case of iatrogenic Cushing syndrome due to topical steroid application in a 5-month-old female child admitted to the hospital for repeated episodes of fever and cough.

An Investigation on Breast Feeding Practices in Normal Newborn Babies During Institutional Deliveries in Bhopal District of Madhya Pradesh

The Present study makes an attempt to analyze the Breast feeding practices in normal Newborn babies in institutional Deliveries and also to investigate time of initiation of Breast feeding practices and type of feeds given to the normal newborn babies in Institutional Deliveries. The study was conducted in the Department of Paediatrics & Obstetric and Gynaecology, Gandhi Medical College, Bhopal. The study was based on primary data with help of observational study during the period from August 2008 to September 2009 with sample size 500 cases. The findings of the study revealed that, distribution of newborns according to the time of initiation of breast feeding was found to be in high within half an hour to five hours duration. The new born male babies were high (77.9 per cent) when compared to female babies (68.49 per cent) during half an hour to five hours duration. Further, study results on type of delivery revealed that, 82.6 percent of babies were delivered by normal vaginal delivery (NVD) and 17.4 percent of babies were delivered by lower segment caesarean section (LSCS). The Study also focused on type of pre-lacteal feeds given to the newborns, the outcome the study shows that, more than 50 percent of mothers practiced pre-lacteal feeds of one sort or the other which includes Cows milk (39.8%), Tea (27.2%), Honey (14.9%), Goats Milk (11.11%) and Glucose water (6.89%). Hence, the study suggests that, breastfeeding should be made to all normal newborns (including those born by caesarean section) as early as possible after birth, ideally within half an hour to five hours duration. The Colostrum, which is secreted within first 2-3 days, must not be leftover but should be fed to newborn as it contains high concentration of defensive immunoglobulins and cells which provides an optimal nutrition to child and prevent from infections. Health service providers have significant role in not only promoting optimal breast feeding practices but also in ensuring these practices are followed.

Design of wideband erbium doped fiber amplifier for WDM systems

The present lightwave system prefers to operate near the 1550 nm region. Wideband optical fibers compatible with wavelength division multiplexing (WDM) transmission systems are available which can operate near 1550 nm region, but what basically limits the high transmission capacity is the slow response of the conventional semiconductor amplifiers. To overcome this researchers have devised the optical amplifier, commonly known as erbium doped optical amplifier (EDFA) which can directly amplify in the optical domain near 1550 nm region. Existing EDFAs are available with a relatively narrowband of 25nm centred nearly at 1550 nm. This development has motivated researchers to devise EDFA with broad bandwidth capabilities. In this paper, we present here a technique known as gain cascading of EDFA for designing wideband EDFA centred around 1550nm region. Gain cascading of two EDFAs pumped separately at 980nm and 1480nm combines the advantage of high gain characteristics of 980 nm pumping and broad bandwidth characteristics of 1480 nm pumping. By using pumping at 980nm, we observe that the peak value of gain is around 69dB and gain bandwidth is around 10-15nm. From pumping at 1480nm, it is observed that the peak value of gain has although decreased as compared to 980nm pumping but the gain bandwidth is increased to around 30-32nm. However, by cascading two EDFAs pumped separately at 980nm and 1480nm, the overall peak value of gain is increased to a very high value of around 180dB and bandwidth obtained is about 35 nm. We thus obtain a broader gain-bandwidth product by using gain cascading.