Over a 2-year period from January 1991 to December 1992, second-trimester maternal serum screening for Down's syndrome using alpha-fetoprotein (alpha FP), human chorionic gonadotrophin (hCG), and unconjugated oestriol (uE3) was made available to five health districts in East Anglia, with a total population of 1.2 million. Amniocentesis was offered when the risk of Down's syndrome at term was 1:200 or greater. 25,359 singleton pregnancies were screened, representing an uptake of 77 per cent. The recall rate for the 24 per cent of women who had not had a dating scan prior to the test was 9.4 per cent compared with 3.9 per cent for those who had been scanned (P < 0.0005). Seventy-five per cent (36/48) of Down's syndrome pregnancies were detected for a false-positive rate of 4.0 per cent. Twenty-five out of 36 of detected Down's syndrome pregnancies were dated by scan prior to sampling, and in the 11 remaining cases, the dates were confirmed by scan after a high-risk result was obtained. The exclusion of uE3 from the screening protocol would have reduced the detection rate to 52 per cent (25/48) for the same false-positive rate. Eighty-five per cent of women identified at high risk accepted the offer of an amniocentesis. Other fetal abnormalities detected were trisomy 18 (3), trisomy 13 (2), 45,X (6), 69,XXX (5), other chromosome abnormalities (9), open neural tube defects (26), hydrocephalus (7), abdominal wall defects (4), and steroid sulphatase deficiency (6).
Buccal glucose gel is an established treatment for hypoglycaemia in term and late preterm babies, and reduces admission to neonatal units. 1,2 Prophylactic use at 1 h of age in at-risk babies ≥35 weeks of results in less hypoglycaemia. 3 A Cochrane review has reported on
therefore could help in implementing rational antibiotics use. But studies determining viral etiologies have not been studied much in developing countries like India. Objectives To study viral etiology in children hospitalized with moderate to severe Acute Lower Respiratory Tract Infection (ALRTI) over a period of two years and to detect impact of co-infection on severity and duration of hospitalization. Methods We performed a study in children of age group one month to five years admitted in PICU and HDU of a tertiary care hospital of eastern India, with moderate to severe respiratory symptoms from march 2018 to march 2020. Nasopharyngeal swabs were collected at the time of admission and analyzed by using Real time PCR. Eighty two children were enrolled for study, out of which 51 were detected positive for viral infections and they were analyzed for etiological, clinical and laboratory parameters. Results The highest positivity rate was observed in children in age group 1-12 months (58.8%), 1-5 years (42.2%). Our study confirmed 62 percent viral etiology. Adenovirus was detected in 35.5% of samples; RSV in 25.5%, rhinovirus in 10%, co-infection in (17%) and remaining 18% included metapneumovirus, influenza, human corona and parainfluenza virus. Clustering of cases were observed in the months of september-october and january-february. Comparison between single and co-infection in terms of complications(p value 0.06), average duration of stay( p value 0.2) and inflammatory parameters ( p value 0.47) were not significant. Conclusions Adenovirus and RSV are the leading viral pathogens for ALRTI requiring HDU care. Vaccine and antiviral agents are required to reduce ARTI hospitalization.
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