BLOOD PRESSURE VARIATION IN CHILDREN AT 5 MINUTE INTERVAL FOR IDENTIFICATION OF WHITE COAT HYPERTENSION

White-coat hypertension is a condition when a person’s blood pressure tends to increase only when they are at the doctor's office. In children, blood pressure between the 90th and 95th percentile is labelled as pre-hypertension and above the 95thcentile it is classified as hypertension. The difference between 90th and 95th centiles for both systolic and diastolic blood pressure is only 4 mm of Hg. Methods: Children between ages 5 to 10 years admitted in the children ward of Shri Krishna Medical College and Hospital, Muzaffarpur, Bihar, India from February to April 2020 included in the study. We record blood pressure by oscillometer 4 times a day, over 4 days of hospital stay and each time two readings were taken at 5 minute intervals. Results: During 4 days of hospital stay blood pressure varied widely. In addition second reading of BP were always less than the first reading BP, but second readings data also varied widely just as first readings. Conclusion: White coat’ hypertension is the phenomenon where BP is exaggerated by act of measuring BP. This is initiated by anxiety. Children are particularly susceptible and distressed by the circumstances of hospitalization, stranger anxiety and fear to painful intervention. We should take multiple readings before reach a conclusion of hypertension. Key words: Blood pressure, White-coat Hypertension, Ambulatory BP, Hypertension

DEVELOPMENTAL DELAY IN 14 MONTH OLD BOY WITH GRADE I MALNUTRITION

When a child does not meet his or her developmental milestones within the predicted time or age, this is referred to as developmental delay. Developmental milestones are activities that certain children master or acquire at specific ages. Head balance, rolling, crawling, driving, and talking are a few examples. The mechanism of growth and the completion of such developmental milestones are referred to as child development. The patient was a 14 months old male child came to the hospital with complaint of inability to sit also he is unable to hold anything in his hand. As narrated by the mother the child was born to G2P1L1A1 mother at 9 months 5 days of gestation. The child has not yet attained gross motor milestone such as rolling over and no sit with support. The child attained immature pincer grasp at 12 months of age and has not attained mature pincer grasp. Social smile was attained at 6 months, stranger anxiety at 12 months and the child has not attained bye-bye. The child was alert to sounds by the age of 9 months .babbles at 10 months and says mama-dada at 12 months. The child is immunized till age. The marriage of the parents was non-consanguineous marriage. The child was born with a weight of 2.5 kg the mother had LSCS and breech delivery. The child did not cry immediately after birth. The child has history of fever after 3 months of delivery. The child is also interpreted as grade 1 mild malnutritious (71-80) %. Developmental delay and grade 1 mild malnutrition. The above study shows that Neck facilitation exercises in prone lying, Ice technique and proper brush technique for neck facilitation improves neck holding. Rolling facilitation in side lying position and proper handling positions helps in attaining milestones such as Rolling over. Facilitation of extension tone with vestibular rehabilitation helps to facilitate extensors. Family plays an important role in the management of such cases all the exercises should be properly explained to them for more improvement. Supporting the child while sitting, for example, might help him or her develop weight shifting, rotation, coordination, and balance.

Parental Beliefs about Child’s Experience of Anxiety in Saqr Hospital Ras Al-Khaimah, U.A.E

Anxiety is a reaction of an individual to change or a stressful event. Separation anxiety, fear of darkness, stranger anxiety etc., are normal features of development during the initial part of life. However, if it persists and not identified at an early stage can lead to anxiety disorders in children. Parents play an important role in its identification at an early stage and management to protect the child from long term consequences of anxiety disorders. It imposes them to have an appropriate belief about the experience of their child’s anxiety. Cross sectional survey was conducted among 252 parents who visited Saqr hospital for various health care issues. Participants were selected using a convenience sampling technique. Data was collected with the use of a self-reported Parental Belief about child's anxiety questionnaire (PBA-Q). Majority (93.7%) of parents had a moderate level and 5.6% had a highly negative belief about the experience of their child’s anxiety. No significant association was observed between Parental Belief about a child's anxiety and demographic variables like age, gender, education. However, a significant association was observed with the household income of the family. Parents being the primary and most influential caregiver, play a significant role in the emotional health of the children. Findings of the present study strongly recommend regular assessment of parents belief about the experience of anxiety in children and provide guidance to minimize anxiety disorders in children. PBA-Q is a simple tool that can be used in day to day practice.

Hambatan komunikasi terapeutik psikiater, perawat, kader jiwa, dan keluarga pada pasien gangguan jiwa pasca pasung

Tenaga kesehatan, kader jiwa, dan keluarga dalam melakukan komunikasi terapeutik pada pasien ODGJ pasca pasung menemukan beberapa hambatan dari faktor internal maupun eksternal. Tujuan penelitian untuk menggali dan mengungkapkan hambatan-hambatan yang terjadi dalam proses komunikasi terapuetik tenaga kesehatan, kader jiwa, keluarga terhadappasien ODGJ pasca pasung. Jenis penelitian kualitatif, menggunakan paradigma konstruktivistik, dan pendekatan studi kasus. Pengumpulan data melalui observasi, wawancara mendalam, dokumentasi, dan bahan audio visual. Pengambilan sampel dengan menggunakan purposive sampling, dengan subjek penelitian 1 psikiater, 3 perawat, 2 kader jiwa, 7 keluarga pasien. Objek penelitiannya adalah hambatan-hambatan komunikasi terapeutik tenaga kesehatan, kader jiwa, keluarga kepada pasien ODGJ pasca pasung desa Wonorejo. Validasi datanya menggunakan triangulasi dan member check. Penelitian dilakukan bulan April sampai dengan November 2018. Lokasi penelitian desa Wonorejo Kecamatan Singosari Kabuputen Malang Provinsi Jawa Timur. Adanya hambatan yang terjadi pada proses komunikasi terapeutik antara tenaga kesehatan, kader jiwa, keluarga pada pasien ODGJ pasca pasung, yaitu lemahnya jaringan internet, bahasa, inkoherensi, stranger anciety, pendidikan rendah, penampilan perawat, noise suara, dan emosional keluarga, sehingga komunikasi terapeutik kurang lancar. Kata kunci: hambatan, tenaga kesehatan, ODGJ, keluarga, komunikasi terapeutik BARRIERS OF THERAPEUTIC COMMUNICATION PSYCHIATER, NURSE, MENTAL CADRES, AND FAMILY FOR THE PEOPLE WITH POST PASUNG MENTAL DISORDERS ABSTRACTHealth workers, soul cadres, and families in conducting therapeutic communication in post-passive ODG patients found several obstacles from internal and external factors. The purpose of this study is to explore and reveal the barriers that occur in the process of the most therapeutic communication by health workers, mental cadres, families to post ODGJ patients. The research method uses qualitative research, constructivist paradigms, and case study approaches. Data collection methods use, observation, in-depth interviews, documentation, and audio-visual material. Sampling by using purposive sampling, with research subjects 1 psychiatrist, 3 nurses, 2 mental cadres, 7 families of patients. The object of his research is the barriers of therapeutic communication of health workers, mental cadres, families to ODGJ patients postpasung Wonorejo village. Data validation uses triangulation and member check. The study was conducted from April to November 2018. The location of the research was Wonorejo village, Singosari District, Malang Regency, East Java Province. The results are the barriers that occur in the process of therapeutic communication between health workers, mental cadres, families in post-pasung ODGJ patients in Wonorejo village. The barriers to therapeutic communication in postpasung ODGJ in Wonorejo village is the lack of internet, language, incoherence, stranger anxiety, low education, nurse performance, noise noise, and emotional family, so therapeutic communication is less smooth. Keywords: obstacles, health workers, ODGJ, family, therapeutic communication