BACKGROUNDSocial factors in CLHA play important role in growth indicators. Both parents alive, loss of breadwinner of the family, widows working for children, orphaned CLHA, guardian and NGO's taking care of CLHA, below poverty line status are some of the social factors that will have impact on growth indicators. This study was done to study these factors influence on growth indicators. MATERIALS AND METHODSProspective study from April 2014 to March 2015. All children on ART. Consent was obtained. Demographic data, height and weight measured monthly. Nutritional counseling and adherence counseling was given to all CLHA and caretakers. Gain in mean weight and height were tabulated. Data were grouped with both parents alive, mother alive, father alive, both parent dead, under guardian care, under NGO or GO care, two sibling families, below and above poverty line, sibling with HIV, at least one family member earning and two family members earning. Results were analysed. RESULTSSubjects 212. Male:female ratio 126:86. Mean age 9.6 years. (Males 9.8 and females 9.4 years). Mean duration of ART 45.5 months. 35% had both parents alive, 38% only mother alive, 8% only father alive and 17% both parents dead. 40% of orphaned taken care by guardians, rest by NGO's. 9 families had more than 2 siblings. 21% had no earning family members. 80% were below poverty line. Mean increase in height was 5.75cms and weight was 2.87kgs during one year. No difference in gain in height in social groups. Orphaned children taken care by NGO's and guardians have high gain in weight. Number of earning member does not influence in gain in weight. Gain in weight in above poverty line is better than below poverty line. CLHA under father's care gained only 2.47kgs. CLHA with mother's care gained more weight than father's care. CONCLUSION20% CLHA were orphaned and without earning member. Mothers, income of the family, NGO's homes and guardians improve growth indicators. Both parent alive and CLHA without mother have less gain in weight. No social factors play significant role in height gain.
BACKGROUND: Air pollution is an important environmental risk factor for human health. Evidence is mounting that ambient air pollution exposure is signicantly associated with respiratory diseases. Ambient air pollution, such as nitrogen dioxide (NO2), sulfur dioxide (SO2), and particulate matter (PM), is associated with mortality and morbidity induced by respiratory diseases. The relationship between air pollutants and respiratory hospital admissions has been reported both in developed countries and in developing countries. Other studies have shown an adverse effect of ambient air pollution exposure on morbidity and mortality, as well as on healthcare costs. AIM OF THE STUDY: To investigate the association between ambient air pollutant exposure and daily hospital admissions for respiratory diseases in both childrens and Adults. METHODOLOGY: The daily emergency hospital admissions for respiratory conditions in the north part of Chennai during 2019- 2020 were recorded. Daily counts of hospital admissions for total respiratory conditions (43 admissions day(-1)), acute respiratory infections including pneumonia (18 day(-1)), chronic obstructive pulmonary disease (COPD) (13 day(-1)), and asthma (4.5 day(-1)) among residents of all ages and among children (0-14 yrs) were analysed. The generalized additive models included spline smooth functions of the day of study, mean temperature, mean humidity, inuenza epidemics, and indicator variables for days of the week and holidays. Total respiratory admissions were signicantly associated with the same-day level of NO2 (2.5% increase per interquartile range (IQR) change, 22.3 microg x m(-3)) and CO (2.8% increase per IQR, 1.5 mg x m(-3)). RESULTS: The daily mean concentrations of pollutants across all studies were 65.2 µg/m3 for PM10, 45.8 µg/m3 for PM2.5, 27.7 µg/m3 for SO2, 35.0 µg/m3 forNO2and1698µg/m3for CO, and 81.1µg/m3for O3. For the single variable models, the linear effect of PM10, PM2.5, and PM1 was evaluated by adjusting for the inuence of temperature. The association between hospital admissions for respiratory disease and the level of particulate matter was statistically signicant at 0-3 daylag in females and overall. In males, no statistically signicant effect was found at lag 3 for PM10 or at lag2-3 for PM2.5 and PM1.The associations between PM2.5 and PM1, and risk of admission were no longer signicant at some lags after adjusting for NO2, SO2, CO, and O3 separately. No associations were found at lag 3 after adjusting for NO2 or at lag 2 and 3 after adjusting for O3. The effects of PM2.5 and PM1 were not changed after adjusting for CO but were weaker after adjusting for other air pollutants (NO2, SO2,and O3). CONCLUSION: The ndings of this study demonstrated that O3 was associated with an increased risk of respiratory-related admissions, especially for children <5years old. The effect was stronger in the winter than in the summer with each increase of 10 µg/m3 of O3 in winter, the risk of admissions for respiratory diseases after 5 days of exposure increased by 6.2% (95% CI3.7% - 8.8%). No signicant association between O3 and hospital admissions for wheeze-associated disorders specically was observed in children.
BACKGROUND: SARI is one of the clinical manifestations of COVID-19 disease. As per WHO SARI is dened as an acute respiratory infection with a history of fever or measured fever of ≥ 38 C°; and cough with onset within the last 10 days and requires hospitalization. AIMS/OBJECTIVES: To describe clinical characteristics and factors associated with the clinical outcome of patients presenting with SARI at our hospital. METHODOLOGY: This is a record-based cross-sectional study that included all cases admitted in the SARI ward in Government Stanley Hospital, a tertiary care center in Chennai designated for the management of case denition and screened for SARS-CoV-2/COVID-19 between 15th March 2020 and 15th December 2020.RESULTS:Atotal of 246 patients were included in the study period from 15th March to 15th May 2020. The median age was 49.4 years and 56.9% were males. The most common symptom was fever (69.1%) followed by cough (62.6% ), Breathlessness (62.6%), and sore throat (52.8%) in our study. Of this 4 (1.8%) were tested positive for COVID-19. Of the 5 (2.1 %) patients who expired. CONCLUSION: In our single-center tertiary the incidence of COVID-19 among the SARI patients done between March-May 2020 showed an incidence rate of 1.8%
BACKGROUND Spirometric measurement of post-bronchodilator FEV1 is essential for establishing the diagnosis, assessment of severity, to predict the outcome and to assess response to treatment in COPD. Measurement of the walking distance is used to assess functional capacity of patients with COPD. Six-minute walk test (6MWT) is a simple, objective, and reproducible test. The facility of spirometry is not available in many rural areas of India because of lack of infrastructure where 6MWT can be done easily. The COPD assessment test (CAT) is a validated test for evaluation of COPD impact on health status. Therefore, in this study, we aim to find relationship between Six-minute walk test, Spirometry and COPD Assessment Test (CAT) scores in chronic obstructive pulmonary disease patients. MATERIALS AND METHODSSeventy-five patients of COPD were enrolled for the study after applying inclusion and exclusion criteria. The impact of COPD on health status was assessed using CAT score. All patients underwent spirometric measurement of FEV1, FVC, and ratio of FEV1 and FVC and test repeated after bronchodilation by 200-400 μg of salbutamol. 6MWT was performed following American Thoracic Society (ATS) protocol of 6MWT and distance was measured in metres. The results were analysed using SPSS software version 19. RESULTSWe found significant linear correlation of 6MWD with post-FEV1(r=0.561, P<0.001), post-FVC (r=0.341, P=0.003), and FEV1/FVC (r = 0.476, P < 0.001). The mean CAT score was 20.49 ± 5.34 SD. There was a significant association between post-FEV1 and total CAT score (P< 0.001). The correlation between mean post-FEV1 and mean score of CAT groups 1,2, 3, and 4 was statistically significant (P<0.001). CONCLUSION6MWT can be a useful replacement of spirometry in assessment of severity of COPD. The relationship between CAT score and post-FEV1 suggests that CAT is linked to severity of airflow limitation and GOLD classification in stable COPD patients. Spirometry is not needed every time to assess the severity of COPD. However, Spirometry is necessary to diagnose COPD. CAT score can be used to assess the impact of COPD on health status and quality of life. Both 6MWT and CAT score can be used even in a rural setting where most of the COPD patients have no access to spirometry. KEYWORDSChronic Obstructive Pulmonary Disease (COPD), Spirometry, Six-minute Walk Test (6MWT), CAT Score.HOW TO CITE THIS ARTICLE: Krishnaraj VSP, Pugazhendhi A, Viswanathan VK, et al. Correlation of six-minute walk test and COPD assessment test (CAT) scores with spirometric indices in chronic obstructive pulmonary disease patients in a tertiary care hospital in Chennai.
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