Aims: The aim was to study the incidence, etiology, clinical features and the antibiotic sensitivity pattern of urinary tract infections (UTI) in children at presentation of nephrotic syndrome (NS) (first or recurrent episodes before starting immunosuppressive therapy). Methods: This was a prospective hospital-based study carried out in Basaveshwara hospital, Chitradurga. Fifty children with a diagnosis of NS were studied from June 2010 to October 2014. The cases with recurrence of NS or those with the first episode of NS were evaluated before placing on immunosuppressive therapy. A clean-catch midstream urine specimen was collected from all children to avoid contamination. For younger children, where collection of urine was difficult in the manner described above, suprapubic aspiration was done. Prompt plating of the urine specimen, within 1-h of a collection, was ensured. Identification of the organism and antibiotic sensitivity patterns was determined.Results: Among the fifty children studied, boys were affected more than the girls with a ratio of 1.5:1. The mean age was 4.75 years. Pyuria was noted in 64% of the patients. The most common organism isolated was Escherichia coli in 10 cases, followed by Klebsiella pneumoniae in 4 cases. About 75% of the organisms were sensitive to third-generation cephalosporins. Conclusions: UTI is a common infection accompanying NS. A high index of suspicion and early institution of appropriate antibiotics will help in attenuating morbidity and mortality.
Objective: To study the common bleeding manifestations in dengue and see whether there is a correlation between them and platelet counts less than 100,000/cu.mm. Method:Children below the age of 14 years with dengue seropositivity were included in the study. Relevant blood investigations were done and patients were managed according to World Health Organisation guidelines. Results:A total of 100 children with a mean age of 7.9 ± 3.7 years were included in the study. During the course of illness, bleeding occurred in 60% of children. It was found that 26% of children had melaena, 20% had petechiae, 8% had haematemesis, 4% had epistaxis and 2% had gum bleeding. All (100%) the patients who had platelet counts between 50,001-100,000/cu.mm developed haemorrhage and 95.8% of patients with platelet range between 20,001-50,000/cu.mm of blood had developed haemorrhage. However, of patients who had platelet counts less than 20,000/cu.mm, 41.8% developed haemorrhage and 58.2% did not have haemorrhagic manifestations (p =0.001). Conclusions:No correlation was found between platelet counts <100,000/cu mm and increase in incidence of bleeding manifestations in DHF.
Objective: The objective was to determine whether nebulized hypertonic (3%) saline with adrenaline is more effective than nebulized 0.9% saline with adrenaline in the treatment of acute bronchiolitis. Materials and Methods: In this randomized, double-blind, controlled study 100 patients were randomly allocated into two groups (50 patients in each group). In Group A (normal saline group), 4 ml of normal saline (0.9%) and 1 ml of 1:1,000 adrenaline was given as nebulization with oxygen flow of 6-8 L/min. In Group B (hypertonicsaline group), 4 ml of hypertonic saline (3%) and 1 ml of 1:1,000 adrenaline was given as nebulization with oxygen flow of 6-8 L/min. The nebulization was given at an interval of 4 h, 6 times daily till the patient was ready for discharge. Results: The percentage improvement in clinical severity scores after inhalation therapy was not significant in Group A on 1st-3rd day after admission (3.4%, 2.1%, and 4%, respectively). In Group B, significant improvement was observed on these days (7.4%, 8.7%, and 9.9%, respectively, p<0.001). Furthermore, the improvement in clinical severity scores differed significantly on each of these days between the two groups.Using 3% saline decreased the hospitalization stay by 25%, from 3.4±1.7 days in Group A to 2.5±1.4 days in Group B (p<0.05). Conclusion: In the treatment of acute bronchiolitis, 3% saline nebulization with adrenaline decreases the length of hospitalization and symptoms as compared to 0.9% saline nebulization.
Background: Upper respiratory tract infections are the most frequently occurring illness of childhood. The common types of upper respiratory tract infections are common cold, rhinitis, laryngitis, pharyngitis, otitis media and sinusitis. Common misuse of antimicrobial agents is seen in infections caused by viruses, which are self-limited and they do not respond to the currently available anti-infective agents. Methods: A prospective observational study was conducted at pediatric out-patient department of Basaveshwara Medical College Hospital and Research Centre, Chitradurga for a period of six months. The data was collected from outpatient record in a suitably designed individual case record form of the patients diagnosed with upper respiratory tract infection. Results: A total of 120 patients aged less than 13 years were collected from the paediatric outpatient department of a tertiary care teaching hospital. The most common diagnosis was nonspecific upper respiratory tract infections (49.1%). Only 10 drugs were prescribed from the essential drug list. Amongst all drug class, respiratory drugs were prescribed in more (29%), antihistamines (24.6%), antimicrobials (24.3%), Non-steroidal anti-inflammatory drugs (18%) and nasal drops (4.1%). In antimicrobials, amoxicillin + clavulanic acid (45.8%) was the highly prescribed combination. The main drug interactions were between chlorpheneramine and terbutaline. Conclusions: Antibiotic prescriptions were inappropriate in acute self-limiting upper respiratory tract infection. Antibiotics are over prescribed for paediatric upper respiratory tract infections. Amoxicillin with clavulanic acid combination were preferentially prescribed. Doctors should be educated on more appropriate and cost effective prescribing.
Objective: To assess the efficacy of intravenous (IV) magnesium sulphate in treating birth asphyxia and improving short term neurological outcome.
Background: Although survival of preterm neonates has improved in the surfactant era, necrotizing enterocolitis (NEC) continues to be a major cause of mortality and morbidity. A proposed strategy for the prevention of NEC is the administration of oral synbiotics. We evaluated the role of synbiotics in reducing the incidence and severity of NEC in preterm babies. Methods: A prospective randomized control trial was conducted in preterm neonates <34 weeks of gestation. They were randomized into two groups. The neonates in the test group were fed with synbiotic sachet with breast milk, twice daily till they reach full feeds. The neonates in the control group were fed with breast milk alone. The primary outcome was incidence and severity of NEC. Results: 200 preterm neonates were enrolled, 100 in the test group and 100 in the control group. The demographic and clinical variables were similar in both groups. The incidence of NEC was significantly lower in the test group (2 of 100 vs. 10 of 100). The incidence of stage 2 NEC was nil in the test group but 5 in control group. There were 2 cases of severe NEC (stage 3) in the control group and none in the test group. Incidence of sepsis was also significantly lower in the test group (28 of 100 vs. 42 of 100). Other secondary outcomes like age reached full feeds and duration of hospital stay were similar in both test and control groups. Conclusions: Synbiotics fed enterally with breast milk reduced both the incidence and severity of NEC.
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