Background: In pediatrics, the season is one of the elements contributing to the etiological factors of community based diseases. Awareness of this variation can help the physicians for prevention and counseling of the patients. A cross-sectional observational study was designed with non-probability convenient sampling technique to determine the frequency of patients admitted to the paediatric ward of the hospital in a whole calendar year and to ascertain which disease presentation is most common. Methods: Study conducted at paediatric ward of Al-Tibri Medical College and Hospital Karachi, Pakistan having patients admitted during May 2018 to April 2019. After ethical approval and informed consent from their parents/ guardian, a total of 734 paediatric patients that were admitted from paediatric OPD/ emergency were selected for the study. Paediatric patients that were referred, in emergency/ ICU and surgical paediatric patients were excluded from the study. Chi-square test was applied to evaluate the statistical variation among the patients.Results: From the 734 patients, 357 (48.6%) patients were of acute gastroenteritis, 104 (14.2%) of respiratory illness, 86 (11.7%) of viral fever, 67 (9.1%) of urinary tract infection, 36 (4.9%) of neurological illness, 29 (4.0%) of protein calorie malnutrition, 25 (3.4%) of enteric fever, 20 (2.7%) of haematological illness and 10 (1.4%) patients were admitted due to sepsis.Conclusion: Our study concluded that majority of the patients admitted were of acute gastroenteritis / admitted due to gastric issues, therefore further studies in the vicinity would help to better understand the issues and help plan a strategy to combat the diseases.
Background:Patients with rheumatic diseases are at increased risk of contracting infection due to the disease itslef or because of the use of immunomodulatory medication. EULAR has developed recommendations and supports vaccination against influenza and pneumococcal infections in immunocompromised patents1. Despite convincing data regarding the efficacy of vaccination with the use of disease-modifying anti rheumatic drugs (DMARDs), previously published data from our trust in 2007 showed that uptake of vaccination was suboptimal especially in those aged <65 years2.Objectives:To establish the influenza or pneumococcal (pneumovax) vaccination uptake and explore reasons for reduced uptake in patients attending a rheumatology clinic.Methods:Prospective audit of 100 patients attending the Rheumatology clinic in a UK district hospital using an anonymised survey during November to December 2017 and comparison with the data of 10 years ago.Results:A total of 100 questionnaires were given out, with return rate of 98%. Female:male ratio was 3.8:1, mean age 55±17. Most patients were treated for RA (24%), Psoriatic arthritis (20%), Ankylosing spondylitis (14%) and others, see figure 1. Regarding immunosuppression 16% were on biologics and 78% on DMARDS. Most were on methotrexate (26%), Prednisolone (16%), hydroxychloroquinine (12%), sulfasalazine (12%) whereas biologics were <10 % each (see figure 1).With regards to vaccination for influenza, overall 47% had received the vaccine (see table 1). Of those who did not take the vaccine 35% had an allergy or did not believe it was effective, but 65% were not offered the vaccine. A total of 52% commented that a health professional had discussed influenza vaccination with them, 42% mentioned that this was never discussed and 6% were unsure. In RA population uptake was 48% compared to 44% 10 years ago (p=0.81).Regarding pneumovax 29% commented that a health professional had discussed pneumococcal vaccination and only 28% had received the vaccine. Of those who did not take the vaccine 12% had an allergy or did not believe it was effective, and 83% were not aware that the vaccine existed or were not offered the vaccine. In RA population uptake was 61% compared to 62% 10 years ago (p=0.62).RA patients had better vaccination than psoriatic patients for influenza (p=0.03), but not pneumovax (p=0.52).UPTAKE OF VACCINEInfluenza vaccinationPneumonia vaccination All patients -2017 47%28%RA patients- 200762%44%RA patients- 201716/23 (61%)11/23 (48%)Psoriatic Arthirtis6/18 (33%)6/18 (33%)Prednisolone10/14 (71%)9/14 (64%)Methotrexate14/22 (63%)11/19 (58%)Conclusions:Although this is a small audit conducted in a routine rheumatology clinic in the UK, it is of concern that with increased patient education seen in the last 10 years, vaccination for influenza and pneumococcus has not improved. Perhaps healthcare professionals are not discussing this with the patients sufficiently. Further patient and healthcare involvement is required to reverse the declining trend and protect our patients.References1...
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