1.Knowledge and practice of care-givers who have under-five diarrhoeal children:a quantitative cross-sectional study in Mataniko settlements in Honiara, Solomon Islands, 2016
Gali AMBROSE ; N.Krishna KESHWA ; Khan SABIHA ; Lowry JOHN ; Mangum TAMARA ; Mohammadnezhad MASOUD
Global Health Journal 2017;1(2):12-22
Introduction:Diarrhoea remains the second most serious health problem among children below five years old in Solomon Islands and is one of the leading causes of infant mortality,which caused about one in every ten children dying before the age of five years.Globally,around 6 million children (<5 years) suffer from diarrhoea each year.Because of lack of previous studies,this study aims to assess the predictors of knowledge and practice of caregivers towards diarrhoea among under-five children in Mataniko informal settlements in Honiara,Solomon Islands,2016.Methods:This quantitative study was conducted at three randomly selected settlements in Honiara,Solomon Islands from June to July 2016.This study was conducted among both male and female caregivers who had children under five years of age,were aged 18 and over,live in Solomon Islands and were willing to participate in the study.A validated structured questionnaire was used to collect the data based on a 2-week recall of diarrhoea episodes.To avoid double-counting,each surveyed household was geo-referenced using global positioning system (GPS).The collected data were entered and analysed using SPSS (version 23.0) and descriptive and analytical statistics.P<0.05 was considered as statistically significant.This study was approved by relevant ethical committees.Results:A total of 205 caregivers with at least one child under-five years participated in the study.The mean ages of caregivers and the under-five children were (30.7+8.2) years and (2.6+1.5) years,respectively.Among 205 caregivers,94 of them had reported that their children (<5 years) had suffered with at least one episode of diarrhoea within the last 2 weeks prior to the survey.This gave a prevalence rate of 45.9%.The caregiver's knowledge about the causes (99.0%) and prevention (98.0%) of under-five diarrhoea was extremely high.Nevertheless,less than half had regularly practiced essential hygiene habits.The factors which appeared to be significantly associated with under-five diarrhoea were irregular hand washing (odds ratio [OR] 2.07,95% confidence interval [CI]:1.12-3.81,P=0.020),inappropriate methods of disposing of children's fecal waste (OR 1.88,95% CIL 1.06-3.33,P=0.030),and using the river for bathing (OR 1.83,95% CI:1.04-3.23,P=0.036),and laundry (OR 2.17,95% CI:1.23-3.84,P=0.008).Conclusion:Diarrhoea is a major public health problem among children below five years in Mataniko informal settlements.To address these exposures,relevant programs and projects should be designed,especially in areas like family planning,household economic allocation and political commitment.Awareness and advocacy programs on birth spacing,food hygiene and potential health risks about the river should be ongoing at the community level.
3.Neonatal seizures: diagnosis and management.
Shashikant Subramani SESHIA ; Richard James HUNTSMAN ; Noel John LOWRY ; Mary SESHIA ; Jerome Yale YAGER ; Koravangattu SANKARAN
Chinese Journal of Contemporary Pediatrics 2011;13(2):81-100
The recognition of epileptic seizures in newborns is challenging as neonates exhibit a variety of paroxysmal motor phenomena, some epileptic but others not. The distinction, frequently requiring video-EEG monitoring, is crucial for management. Causes are often multi-factorial, specific to country/region, and change over time. Hypoxia-ischemia and infection are still common in both developed and developing countries. Venous and arterial strokes are being increasingly recognized. Treatable conditions, including inborn errors of metabolism, must be anticipated and considered early in the course. Etiology is the principal determinant of outcome. Management is based on uncontrolled studies and expert opinions. Information on neonatal seizures is reviewed, and suggestions for management provided. Phenobarbital remains the first anti-epileptic drug of choice, worldwide. Pharmacogenetic information and hepatic or renal dysfunction will influence doses of all drugs. The toxicity of excipients present in intravenous medicines should be kept in mind, especially when infusions are given to critically ill neonates. Therapeutic trials with pyridoxine or ideally pyridoxal phosphate, folinic acid and biotin should be considered early, if seizures are intractable. The management of electrographic seizures without clinical seizures needs critical study. When anti-epileptic drug treatment is required, maintenance should be for a short duration if seizures are of an acute symptomatic nature.
Anticonvulsants
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therapeutic use
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Diagnosis, Differential
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Electroencephalography
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Humans
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Infant, Newborn
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Seizures
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diagnosis
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drug therapy
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etiology
4.A Pilot Study Exploring Temporal Development of Gut Microbiome/ Metabolome in Breastfed Neonates during the First Week of Life
Imad AWAN ; Emily SCHULTZ ; John D. STERRETT ; Lamya’a M. DAWUD ; Lyanna R. KESSLER ; Deborah SCHOCH ; Christopher A. LOWRY ; Lori FELDMAN-WINTER ; Sangita PHADTARE
Pediatric Gastroenterology, Hepatology & Nutrition 2023;26(2):99-115
Purpose:
Exclusive breastfeeding promotes gut microbial compositions associated with lower rates of metabolic and autoimmune diseases. Its cessation is implicated in increased microbiome-metabolome discordance, suggesting a vulnerability to dietary changes.Formula supplementation is common within our low-income, ethnic-minority community.We studied exclusively breastfed (EBF) neonates’ early microbiome-metabolome coupling in efforts to build foundational knowledge needed to target this inequality.
Methods:
Maternal surveys and stool samples from seven EBF neonates at first transitional stool (0–24 hours), discharge (30–48 hours), and at first appointment (days 3–5) were collected. Survey included demographics, feeding method, medications, medical history and tobacco and alcohol use. Stool samples were processed for 16S rRNA gene sequencing and lipid analysis by gas chromatography-mass spectrometry. Alpha and beta diversity analyses and Procrustes randomization for associations were carried out.
Results:
Firmicutes, Proteobacteria, Bacteroidetes and Actinobacteria were the most abundant taxa. Variation in microbiome composition was greater between individuals than within (p=0.001). Palmitic, oleic, stearic, and linoleic acids were the most abundant lipids. Variation in lipid composition was greater between individuals than within (p=0.040). Multivariate composition of the metabolome, but not microbiome, correlated with time (p=0.030). Total lipids, saturated lipids, and unsaturated lipids concentrations increased over time (p=0.012, p=0.008, p=0.023). Alpha diversity did not correlate with time (p=0.403). Microbiome composition was not associated with each samples’ metabolome (p=0.450).
Conclusion
Neonate gut microbiomes were unique to each neonate; respective metabolome profiles demonstrated generalizable temporal developments. The overall variability suggests potential interplay between influences including maternal breastmilk composition, amount consumed and living environment.