Background: Poisoning is one of the most common causes for emergency hospitalization and mortality in children. Mostly it is accidental in nature and can be prevented by awareness in caregivers. Recently due to increased use of many new chemicals in homes and agriculture clinic etiological profile of poisoning is also changed. Aims and Objectives: To study clinic-epidemiological pattern of acute poisoning in hospitalized children and To evaluate association of clinicodemographic factors to age of intoxicated children to evaluate association of clinicodemographic factors to age of intoxicated children. Material and Methods: A cross sectional study was conducted from October 2019 to February 2020 in pediatric department of a tertiary care center. Child admitted with alleged history of poisoning included in study. Type and amount of poison, clinical presentation, outcome and demographic profile were recorded from medical records of patients. Results: Study was conducted among 50 patients of poisoning. 74% patients were under 5 year of age while 56% were boys and 44% were girls. Patients admitted due to ingestion of Insecticides and pesticides (18%), hydrocarbons (14%), medicines (12%) and agricultural products (8%), plant products ((16%) and others. Maximum number of patients intoxicated with household products (56%). Age was significantly associated with residence (p = 0.02) and place of exposure (p = 0.01) and nature of poisoning (p = 0.05). Conclusion: In children below 5 year of age incidences of poisoning are more frequent, most of the cases are accidental in nature and easily preventable. Proper care in this tender age is very important in order to prevent morbidity and mortality due to poisoning.
Background and Objectives:The most severe manifestation of pneumonia is hypoxemia has been shown to be a risk factor for morbidity and mortality. Authors investigated associating factors and determinants of hypoxemia in children with pneumonia. Materials and Methods: A crosssectional study is designed among children of pediatric outpatient and emergency department that enrolled at Government Multi-Speciality Hospital, Chandigarh. One hundred fi fty children recruited for study. The demographic and clinical parameters were recorded. Oxygen saturation measured by pulse oximeter. Results: The prevalence of hypoxemia was 48% and 61 (84.7%) infants aged 1 year found with hypoxemia. Age (p=0.006), respiratory rate (p=0.001) and severity of pneumonia (p=0.001) were strongly associated with hypoxemia. The prevalence of severe and very severe pneumonia among hypoxemic were 56.1% and 73.7% respectively. Central cyanosis (98.7%), peripheral (98.7%) cyanosis, head nodding (97.4%) grunting (96.15%) were highly specifi c but suprasternal (62.82%), subcostal (43.58%) and intercostal retractions (44.87%) were fairly specifi c sign. Sensitivity for subcostal (81.94%) and intercostal retractions (83.33%) was very high but was fair for intercostal (83.33%) retraction. Grunting (p=0.009), nasal fl aring (p=0.008), subcostal (p=0.001) and intercostal (p=0.000) retractions were strongly but suprasternal retraction was signifi cantly (p=0.024) associated with hypoxemia. Dyspnea (97.22%) was very sensitive while decrease feeding (84.61%) and irritability (83.33%) was highly but lethargy (58.97%) was fairly specifi c symptom. Conclusions: Study suggested that clinical signs and symptoms such as chest wall retraction, decrease feeding, dyspnea, grunting and nasal fl aring in children with pneumonia may be utilized as markers for hypoxemia in conditions where pulse-oximeter isn't available. This study supports the view of hypoxemia was disabling factor in better functional recovery in severity of pneumonia.
Back ground: Child morbidity and mortality is an issue of great concern for policy makers because in spite of good efforts still less than 5 years mortality rate is very high and many babies could not survive beyond infancy. Majority of pediatric deaths occurred due to preventable and treatable causes. An emphasis needed on early diagnosis and timely interventions in pediatric patients associated with high risk factors. Aims and Objectives: To study clinical spectrum, morbidity and mortality profile in hospitalized children and to evaluate association of clinicodemographic variable with outcome. Materials and Methods: A cross sectional study was conducted among 2315 patients admitted during study period to evaluate morbidity and mortality profile of patients in pediatric department. Data was collected between January to December 2018 and analyzed for demography, clinical profile including diagnosis, hospital and pediatric intensive care stay, management and outcome. Results: Mean age (mean ± SD) reported was 42.35 ± 35.85 months. Under 5 years children were admitted in majority (62.5%). Respiratory system (21.9%) and nervous system diseases (21.7%) were leading reasons for admission followed by gastrointestinal (11.2%) and hematological disorders (10.8%). Based on etiology infection was leading cause, most common infection in hospitalized children lower respiratory tract infections (19.5%). Vaccine preventable diseases were present in 3.7% patients. 2.5% children admitted due to severe acute malnutrition (SAM). Nervous system diseases (18.2%) associated with highest mortality followed by cardiac (11.7%) and respiratory diseases (11.2%) Mortality rate was 8.07%. Significant association was found between gender, duration of PICU stay, condition at admission, under nutrition and severe anemia to outcome (p <0.01). Conclusion: Early diagnosis and timely interventions can improve outcome in patients with co morbidities and high risk factors. Social awareness is very important to prevent gender discrimination. Emphasis on simple hygiene measures, vaccination and nutrition improvement can decrease the disease burden in pediatric population. Vaccine preventable diseases still occurring and needed hospitalization so strengthening of awareness program for vaccination required, especially in remote rural areas.
Introduction: Therapeutic Hypothermia (TH) is now a proven model of treatment to prevent complications in asphyxiated newborns. Perinatal asphyxia is the leading cause of mortality and disability in India and developing countries. The TH is still not the standard treatment protocol in developing India, and data regarding early neurological outcomes after TH is lacking. Aim: To evaluate the early neurological outcome at 3, 6, and 9 months of asphyxiated newborns who received TH compared to non recipients. Materials and Methods: This was a non randomised cohort study conducted at the tertiary care teaching hospital. A total of 190 asphyxiated newborns admitted to Neonatal Intensive Care Unit (NICU) within 24 hours of life, meeting the laboratory and/ or clinical criteria of perinatal asphyxia were enrolled. Eligible newborns admitted within 6 hours of birth receiving TH were labelled as recipients, and those who received standard care were labelled as non-recipients. Neonates were assessed at 3, 6, and 9 months and compared for neurodevelopment using the Hammersmith Infant Neurological Examination (HINE) optimality score and Denver Developmental Screening Test II. Both groups were compared using t-test and chi-square test. Results: Out of the total 190 enrolled participants, 14 were excluded and 176 newborns were further divided into recipients and non recipients groups. Baseline demographic characters were similar in both groups. Seventy-five recipients were followed up till three months, 72 at six months, and 69 at nine months vs 62, 60, and 56 non recipients, respectively. Lesser number of recipients scored suboptimal scores (HINE score <67) at 3 months vs non recipients (20% vs 35.4%, mean/ SD 63 [3.43] vs 57 [4.55], [p<0.001]). At six months (HINE score<70), the incidence was 18% vs 21% (p=0.02), mean score 67 vs 61 (p<0.0001); and at 9 months (HINE score<73) the incidence was 14.4% vs 30.3% (p=0.048), mean score 72 vs 65 among recipient vs non recipients (p<0.0001). Recipients also had less incidence of severe disability (HINE score< 40) at 6 (8.3%vs 21.6% p<0.02), and 9 months (8.3% vs. 19.6%, p<0.04) as compared to non recipients. More recipients had a normal developmental screening at 3,6, and 9 months on the DDST scale. Recipients required fewer anti-epileptics at 3 and 6 months (3 vs 11) as compared to non recipients (p<0.05). Mortality was also less in recipients (7.8% vs 20.9%, p<0.05) as compared to non recipients. Conclusion: There was a significant developmental and neurological improvement with decreased mortality, less episode of seizures, reduction in the need for antiepileptic among recipients of TH compared to non recipients at 3, 6, and 9 months of age.
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