Background: Bicytopenia and Pancytopenia are relatively common presentations in adults as compared to paediatric patients. Clinical features present in different manifestations in children with Pancytopenia/Bicytopenia, which can range from bone marrow suppression temporarily to marrow infiltration by life-threatening malignancies. Aim: To study the clinical and haematological profile in the paediatric age group withCytopenias. The study aims to analyze the severity of hematological findings as per causative factors in patients with Pancytopenia and Bicytopenia. Methods: Prospective Observational Study conducted in the Department of Paediatrics in Dr.RPGMC Tanda Himachal Pradesh (INDIA). The study included all patients except those falling in the exclusion criteria.It was performed after oral and written informed consent.A total of 50 children admitted with bicytopenia and pancytopenia were enrolled from March 2013 to March 2014. Results: Infection was the commonest etiology observed in 22(44%) patients with bicytopenia and pancytopenia. Bicytopenia was seen in 14 (20%) and pancytopenia in 8 (16%) cases with infection. Scrub typhus was the commonest Infection seen in 18(32%).Leukaemia was notedin 11(22%) cases. Conclusions: The commonest age group affected was 11-15 years with female domination with a Male: Female ratio of 0.78:1. The commonest symptom was fever 37(74%) then generalized weakness in 29 (58%) cases.Pallor was the most common sign in 43(86%) followed by Hepatomegaly 32(64%), Lymphadenopathy 30(60%), and Splenomeagly in 29 (58%) patients. Infection was the commonest etiology followed by leukemia and megaloblastic anaemia. Scrub typhus was the commonest infection encountered in the present study.
Background: Neonatal hyperbilirubinemia (NH) is the most prevalent aberrant physical finding in the first week of life, affecting about 60% of term and 80% of preterm neonates. Hyperbilirubinemia is more common in preterm infants due to a variety of causes, although it can also occur in healthy term infants. The liver produces albumin, which aids in the transport of unconjugated bilirubin. Hyperbilirubinemia can be predicted early, allowing newborns and mothers to be discharged sooner and stay in the hospital for less time. Objective were to study cord albumin levels, to study the proportion of newborn requiring intervention for neonatal jaundice (phototherapy or exchange transfusion) based on different levels of cord blood albumin (CBA) level at birth and thereby defining the critical cord blood albumins values with respect to significant neonatal jaundice.Method: The 200 cases who filled the inclusion and exclusion criteria were included into the study for predictive value of CBA for NH. Then the data was analyzed using epi info and descriptive and inferential statistics were used.Result: In the present study, term group had 49 males and 45 females, while preterm group had 62 males and 47 females respectively. There was no significant association between gender and NNHB in either of the two groups (0.75 in term; 0.09 in preterm). There was also no association found between NH and the mode of delivery, in both term and preterm neonates with p=0.88 in term group and 0.84 in preterm group respectively. In our study, in the term group, only 1 (100%) with birth weight less than 2.5 kg developed significant NH. Only 33 (35.5%) out of 93 newborns with birth weight more than 2.5 kg developed NH. With p=0.01, there was significant association between birth weight and significant NH. Among preterm newborns, there was a significant association between birth weight and development of significant NH (p=0.0001).Conclusions: In present study findings showed that CBA level can be used as a predictor of NH in a term as well as preterm newborn soon after birth. As cord blood is easily available in an institutional delivery and albumin estimation also easily done which can help in recognizing risk group (low CBA) and strict vigilance should be followed.
Background: Low birth weight (LBW) is a serious public health problem and a leading cause of death in the first month of life. The present study aimed to study the trends of low birth weight in Shimla district of Himachal Pradesh, India.Methods: Retrospective review of records of Kamla Nehru Hospital, Shimla covering the period January 2016 to December 2020 was done. The total number of low-birth-weight babies each year were retrieved.Results: A total of 34769 live births took place in Kamla Nehru Hospital, Shimla from 2016 to 2020. Among the total live births, 8479 (24.39%) were having low birth weight (<2500 gm) while 26290 (75.61%) were having normal birth weight (>2500 gm). Out of total 8479 LBW Babies, 7148 (84.3%) were LBW (<2500 gm),1167 (13.76%) were very low birth weight (1000-1500 gm) and 164 (1.93%) were of extremely low birth weight There was continuous decrease in low birth weight from 35.14% in 2016 to 17.51% in 2019. After that it start increasing slightly to 18.9% in 2020.Conclusions: Over the span of five years, there was continuous decrease in incidence of LBW. Nutritional education during pregnancy and proper Antenatal care (ANC) services needs to be addressed to reduce prevalence of LBW in Himachal Pradesh
Background: Pseudomonas aeruginosa is one of the most commonly encountered gram-negative aerobic bacilli in the differential diagnosis of several probable hospital-acquired infections. Hence, the present study is designed to determine the Pseudomonas positivity and sensitivity in Invasive bloodstream infections using automated Bactec systems as the Antibiotic Sensitivity Profiles differ from one clinical setting to another. Material and Methods: All the blood culture samples received in the Department of Microbiology for culture by Bactec Bd fx from July 2015 to June 2016 were included in the study. The blood culture was observed in the Bactec bd fx system for at least 5 days before they are reported as sterile. Results: Among the total 1275 cultures which were positive for bacteria, 931(73.02%) were positive for gram-negative bacteria. Among the total of 931culture which were positive for gram-negative bacteria, Pseudomonas aeruginosa was isolated in 120(12.89%) cultures. Maximum was found in the age group of 0-1 years 33(27.50%) followed by 19-45 years 26(21.67%). Pseudomonas spp isolates were 100.00% sensitive to Colistin followed by Levofloxacin 84.44%, Piperacillin Tazobactum 82.50%, PB 77.50%, Amikacin 75.00%, Cefepime 75.00% while Pseudomonas spp isolates were 90% resistant to Ampicillin followed by Ceftazidime clavulanic acid 82.64% and Aztreonam 70.31%. Conclusion: Pseudomonas aeruginosa is one of the most common organisms among Gram-Negative isolates and the most commonly isolated in the neonate and infant age group. All the Pseudomonas isolates showed maximum sensitivity to Colistin followed by Levofloxacin, Piperacillin Tazobactum, Amikacin while they were most resistant to Ampicillin followed by Ceftazidime clavulanic acid and Aztreonam. Some alternative novel techniques need to be developed to counter the increasing menace of antibiotic resistance in this particular pathogenic bacteria
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