The present study was undertaken to evaluate the knowledge, attitude and practices (KAP) regarding breast feeding among prescribers at various hospitals and clinics in Pondicherry and to get an insight into the reasons behind recent increase in the use of powdered milk among infants. A pretested KAP questionnaire comprising of 10 questions was administered to 150 prescribers. The questionnaires were assessed for the type of responses regarding breast feeding. Microsoft Excel worksheet (Microsoft Office 2007) was used for statistical analysis. A total of 150 (100%) prescribers completed the questionnaire. A majority of the respondents opined that they would like further training on usefulness of breast feeding The reasons cited for this were lack of latest information on when and how to wean a baby. The prescribers are aware of the usefulness of breast feeding but little aware about hazards of powdered milk, improper timing of weaning and type of weaning introduced. Since the lack of knowledge about the above were clearly evident, creating awareness and devising means to make breast feeding convenient may aid in improving the status of infant

An Evaluation of Knowledge, Attitude and Practice of Breast Feeding Among Prescribers at Various Hospitals and Clinics in Pondicherry

Epidemiological and clinical features of paediatric inpatients for scars: A retrospective study.

1. Seizure semiology of these patients was not included in the study. Semiology may be helpful to further classify these patients as benign partial epilepsy in infancy with complex partial seizures versus benign partial epilepsy in infancy with secondary generalized seizures (SGS). Though, proposal was made to combine these syndromes in the past, some subtle differences exist such as predominant seizures during wakefulness, and temporal ictal onset with the first entity, but mostly extratemporal seizure onset was noted with the latter.

Possible Benign Partial Epilepsy: Authors' Reply.

In-home unintentional injuries (IUIs) seriously threatened children's safety. Three factors, including risky behaviors, parental supervision, and home environmental risks, have been identified as major causes for IUIs. Studies considering the interrelations between the three were limited and no relative studies has been carried out among Chinese children. The purpose of this study is to fully explore the influences of behavioral, supervisory and environmental risk factors on IUIs and their associations among Chinese children on the bases of our self-developed scales.Through stratified cluster sampling, a cross-sectional survey was conducted with 798 parents of children aged 0 ~ 6 years in Changsha, China. Social demographics and IUIs history in the past year were collected by self-administered questionnaires. Three IUI-related scales, which had been developed and validated by our team, aimed to measure risks from children behavior, parental supervision and in-home environment. Structural equation models were constructed to analyze the relationship of these factors and their influences on IUIs using SPSS 26.0 and AMOS 22.0.Seven hundred ninety-eight parents were surveyed in total, and 33.58% of them reported with IUIs history of their children. X2/df, goodness-of-fit index (GFI), adjusted goodness-of-fit index (AGFI) and the root-mean-square error of approximation (RMSEA) for the model of the whole children were 4.832, 0.879, 0.856 and 0.069 respectively, indicating an acceptable level of model fit. Direct influences were discovered between risky behaviors and children's IUIs. Home environmental risks indirectly exerted impacts on IUIs by the mediating effect of risky behaviors, while the significant effect of parental supervision only existed in children aged 4-6 and girls.Risky behaviors played a mediating role in IUIs among children. Supervision and environmental risks affected IUIs indirectly by the exposure to risky behaviors. Parental supervision may not be able to offset the risks posed by the environmental and behavioral factors, so effective IUIs prevention strategies should focus on behavioral and environmental interventions, with appropriate supervision strategies based on the age and sex characteristics of the child. 

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Risk factors of in-home unintentional injuries among 0-6-year-old children in Changsha city of China: a cross-sectional survey based on Bronfenbrenner’s ecological system theory

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Prevention of Childhood Injuries.

BACKGROUND Children 0-14 years constitute about 31.4% of Indian population, among whom the magnitude and risk factors of childhood injuries have not been adequately studied. OBJECTIVE To study the prevalence of and assess the factors associated with unintentional injuries among children aged 6 month - 18 years in various regions. METHODOLOGY This multi-centric, cross-sectional, community-based study was conducted at 11 sites across India. States included were Gujarat, Karnataka, Madhya Pradesh, Punjab, Sikkim, Tamil Nadu, Uttarakhand, and West Bengal between March, 2018 and September, 2020. A total of 2341 urban and rural households from each site were selected based on probability proportionate to size. The World Health Organization (WHO) child injury questionnaire adapted to the Indian settings was used after validation. Information on injuries was collected for previous 12 months. Definitions for types (road traffic accidents, falls, burns, poisoning, drowning, animal-related injuries) and severity of injuries was adapted from the WHO study. Information was elicited from parents/primary caregivers. Data were collected electronically, and handled with a management information system. RESULTS In the 25751 households studied, there were 31020 children aged 6 months-18 years. A total of 1452 children (66.1% males) had 1535 unintentional injuries (excluding minor injuries) had occurred in the preceding one year. The overall prevalence of unintentional injuries excluding minor injuries was 4.7% (95% CI: 4.4-4.9). The commonest type of injury was fall-related (842, 54.8%) and the least common was drowning (3, 0.2%). Injuries in the home environment accounted for more than 50% of cases. CONCLUSIONS The findings of the study provide inputs for developing a comprehensive child injury prevention policy in the country. Child safe school with age-appropriate measures, a safe home environment, and road safety measures for children should be a three-pronged approach in minimizing the number and the severity of child injuries both in urban and rural areas.

Descriptive Epidemiology of Unintentional Childhood Injuries in India: An ICMR Taskforce Multisite Study.

Act was enacted by the Union government to ensure that uniform and acceptable standard of health care is meted to the citizens in the private sector [1]. Till date, only 5 States and 4 Union territories have implemented it. As a part of providing standard treatment by private hospitals, treatment guidelines have been formulated for most broad specialties and super specialties. The standard treatment policy is intended to provide a ring of protection for both patients and doctors [2]. For the patients, it assures the delivery of a rational, safe, standard and uniform treatment. For the doctors who follow standard guidelines, it offers protection against medico-legal issues arising out of non-standard treatment. For Pediatrics and Pediatric surgery, the standard treatment guidelines (published at www.clinicalestablishments.nic.in) cover only a limited number of conditions [3]. There is no mention of management of common ailments like respiratory infection, diarrhea, malaria, typhoid, hepatitis, HIV, tuberculosis, envenomations and chronic diseases like asthma, diabetes and epilepsy. Similarly, developmental disorders like cerebral palsy, attention deficit hyperactivity disorder and autism have not found a place. Delivery room management of perinatal asphyxia, Standard Treatment Guidelines for Pediatrics under Clinical Establishment Act 2010 neonatal sepsis and screening for metabolic diseases have also been ignored.

Benign infantile seizures with mild gastroenteritis.

INDIAN PEDIATRICS 88 VOLUME 42JANUARY 17, 2005 The Government of India, recognizing the need to protect and promote breastfeeding and to protect expectant and nursing mothers from adverse influences undermining the practice of exclusive breastfeeding; has amended the IMS act 1992 to make it more effective and eliminate all possible loopholes in this act. The new act, ‘The Infant milk Substitutes, Feeding Bottles and Infant Food (Regulation of Production, Supply and Distribution) Amendment Act 2003’ was enacted on 2nd June 2003. In addition to the provision of the previous act prohibiting promotion of infant milk substitutes and feeding bottles, the modified act also prohibits promotion of these products on the pretext of distribution of educational or informational material. Figure 1 shows a page from an article on ‘HIV and infant feeding’ in a quarterly newsletter published by a prominent baby care products manufacturer. The article has a picture of a baby bottlefeeding, although this has no relation whatsoever with the content of the article. This thus constitutes promotion of bottlefeeding and is in contravention to the act.

Devendra Mishra

Papers

Descriptive Epidemiology of Unintentional Childhood Injuries in India: An ICMR Taskforce Multisite Study.

Benign infantile seizures with mild gastroenteritis.

Infant milk Substitutes (IMS) Act 2003--surrogate promotion continues.