scholarly journals Hypophosphataemia in severe acute malnutrition: a prospective observational study

2018 ◽  
Vol 121 (3) ◽  
pp. 306-311 ◽  
Author(s):  
Rana Chanchal ◽  
Sarika Gupta ◽  
Chandra Kanta ◽  
Kalpana Singh ◽  
Sciddhartha Koonwar
Keyword(s):  
Observational Study ◽  
Prospective Observational Study ◽  
Severe Acute Malnutrition ◽  
Tertiary Care ◽  
Uttar Pradesh ◽  
North India ◽  
Acute Malnutrition ◽  
Indian Children ◽  
Mortality And Morbidity ◽  
Growth Standards

AbstractSevere acute malnutrition (SAM) is a major cause of child mortality and morbidity. Children treated for SAM are at risk of refeeding hypophosphataemia (HP). The study was done to find out the incidence and various predictors of moderate/severe HP in SAM among North Indian children. This prospective observational study was conducted from August 2014 to July 2015 in the inpatients’ department of Department of Paediatrics at King George’s Medical University, Lucknow, Uttar Pradesh, North India, a tertiary care teaching hospital. Before inclusion, ethical approval and written informed consent was obtained. Included in the study were sixty-five children aged 6–59 months of age, who were admitted to the hospital with SAM as per the WHO guidelines. SAM was defined as a mid-upper arm circumference <115 mm and/or weight-for-height/length <–3z-scores of the WHO growth standards and/or have bilateral oedema. Serum P levels were measured on admission and for five consecutive days after starting feed. HP was defined as mild, moderate and severe with a cut-off of 1·19–0·65, 0·65–0·32 and <0·32 mmol/l, respectively. About 60 % children had HP, with 20 % having moderate/severe HP at admission. The proportion of HP increased to 83·1 %, with 38·5 % having moderate/severe HP on day 3 after feeding. It was concluded that HP is a common biochemical abnormality in SAM. Considering its impact on the health of the child, serum P levels should be monitored in patients with SAM who are treated with enteral feeding.

IMPACT OF GOVERNMENT SCHEMES ON MATERNAL HEALTH: AN OBSERVATIONAL STUDY IN A TERTIARY CARE HOSPITAL IN NORTH INDIA

2021 ◽  
pp. 63-65
Author(s):  
Neena Gupta ◽  
Uruj Jahan ◽  
Subhashini Singh
Keyword(s):  
Maternal Health ◽  
Observational Study ◽  
Maternal Mortality ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Uttar Pradesh ◽  
North India ◽  
Care Hospital ◽  
Mortality And Morbidity ◽  
Maternal Mortality And Morbidity

BACKGROUND: Maternal health is an important aspect for the development of any country in terms of increasing equity and reducing poverty. For reduction of maternal mortality and morbidity Government of India launched National health mission (NHM). Some of the major initiatives under NHM are– ASHA (Accredited Social Health Activist), JSY/JSSK (Janani Suraksha Yojana / Janani Shishu Suraksha Karyakaram), National mobile medical units, National ambulance services. METHODS: A retrospective observational study was performed in department of Obstetrics and Gynaecology, G.S.V.M Medical College, Kanpur, Uttar Pradesh which is a low performing state, during the period of 2018 to 2019. A total of 5134 obstetric patients including 1032 low general condition patients were included over duration of 20 months since January 2018 to august 2019. This observational study collected information regarding number of deliveries in different years in this tertiary care hospital, effect on availability of health facilities and antenatal care to the antenatal women after introduction of JSY, ASHA and ambulance services. CONCLUSIONS: After JSY there is major difference in OPD admission and institutional delivery rate. Ambulance services had major contributory role in reducing maternal mortality and morbidity. There is need to improve performance of ASHA by proper supervision and monitoring.

scholarly journals Transport characteristics and predictors of mortality among neonates referred to a tertiary care centre in North India: a prospective observational study

BMJ Open ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. e044625
Author(s):  
Jasbir Singh ◽  
Poonam Dalal ◽  
Geeta Gathwala ◽  
Ravi Rohilla
Keyword(s):  
Observational Study ◽  
Prospective Observational Study ◽  
Tertiary Care ◽  
Birth Asphyxia ◽  
North India ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Predictors Of Mortality ◽  
Transport Services ◽  
Interhospital Transport

ObjectiveThe paucity of specialised care in the peripheral areas of developing countries necessitates the referral of sick neonates to higher centres. Organised interhospital transport services provided by a skilled and well-equipped team can significantly improve the outcome. The present study evaluated the transport characteristics and predictors of mortality among neonates referred to a tertiary care centre in North India.DesignProspective observational study.SettingsTertiary care teaching hospital in North India.Patients1013 neonates referred from peripheral health units.Main outcome measuresMortality among referred neonates on admission to our centre.ResultsOf the 1013 enrolled neonates, 83% were transferred through national ambulance services, 13.7% through private hospital ambulances and 3.3% through personal vehicles. Major transfer indications were prematurity (35%), requirement for ventilation (32%), birth asphyxia (28%) and hyperbilirubinaemia (19%). Hypothermia (32.5%, 330 of 1013), shock (19%, 192 of 1013) and requirement for immediate cardiorespiratory support (ICRS) (10.4%, 106 of 1013) on arrival were the major complications observed during transfer. A total of 305 (30.1%, N=1013) deaths occurred. Of these, 52% (n=160) died within 24 hours of arrival. On multivariate logistic analysis, unsupervised pregnancy (<4 antenatal visits; p=0.037), antenatal complications (p<0.001), prematurity ≤30 weeks (p=0.005), shock (p=0.001), hypothermia (p<0.001), requirement for ICRS on arrival (p<0.001), birth asphyxia (p=0.004), travel time >2 hours (p=0.005) and absence of trained staff during transfer (p<0.001) were found to be significant predictors of mortality.ConclusionThe present study depicts high mortality among infants referred to our centre. Adequate training of peripheral health personnel and availability of pre-referral stabilisation and dedicated interhospital transport teams for sick neonate transfers may prove valuable interventions for improved outcomes.

scholarly journals Correlation of Vitamin D Deficiency with Predictors of Mortality in Critically Ill Children at a Tertiary Care Centre in North India—A Prospective, Observational Study

2020 ◽  
Author(s):  
Shilpa Bansal ◽  
Amarpreet Kaur ◽  
Seema Rai ◽  
Gurmeet Kaur ◽  
Gitanjali Goyal ◽  
...  
Keyword(s):  
Vitamin D ◽  
Mechanical Ventilation ◽  
Multivariate Analysis ◽  
Observational Study ◽  
Prospective Observational Study ◽  
Tertiary Care ◽  
North India ◽  
Factors Associated ◽  
Predictors Of Mortality ◽  
The Relationship

AbstractThis study was conducted to assess the relationship of vitamin D deficiency (VDD) with various demographic characteristics, laboratory parameters, and predictors of mortality. This prospective observational study was performed at pediatric intensive care unit (PICU) of a tertiary care hospital situated in north India. A total of 125 children admitted in PICU with age from 2 months to 14 years were analyzed. The subjects were classified as Vitamin D deficient (≤20 ng/mL) and nondeficient (>20 ng/mL). The relationship between VDD and predictors of mortality were analyzed using correlation and multivariate analysis. Respiratory system (40%) was most commonly involved. VDD was seen in 72% of the patients. There was statistically significant correlation of VDD with age (p = 0.019), season (p = 0.018), height (p = 0.005), and weight (p = 0.003). On multivariate analysis factors associated with VDD were age (odds ratio [OR] = 1.01, 95% confidence interval [CI] 1.00–1.03, p = 0.006), season (OR = 3.98, 95% CI 1.09–14.50, p = 0.036). VDD was also correlated to bacteriuria (p = 0.033), cardiovascular sequential sepsis-related organ failure assessment score (CV-SOFA score) (p = 0.001), and mechanical ventilation (p = 0.043). On multivariate analysis, factors associated with VDD were bacteriuria (OR = 4.88, 95% CI 1.04–22.89, p = 0.04), mechanical ventilation requirement (OR = 2.95, 95% CI 1.12–7.85, p = 0.029), and CV-SOFA score (OR = 2.33, 95% CI 1.14–4.76, p = 0.021). Median (interquartile range) duration of PICU stay in VDD patients was (3–7) days while in nondeficient patients it was (2–6) days (p = 0.107). VDD was a significant risk factor for the need of mechanical ventilation, bacteriuria, and mortality among patients in our cohort.

scholarly journals Etiological factors of severe acute malnutrition and impact of nutrition rehabilitation centre: a prospective observational study from Bhavnagar

2021 ◽  
Vol 8 (4) ◽  
pp. 652
Author(s):  
Vibhuti D. Gamit ◽  
Jayendra R. Gohil ◽  
Adithya Nikhileshwar B. ◽  
Tanmay P. Vagh
Keyword(s):  
Weight Gain ◽  
Observational Study ◽  
Prospective Observational Study ◽  
Severe Acute Malnutrition ◽  
Birth Spacing ◽  
Acute Malnutrition ◽  
Rehabilitation Centre ◽  
Etiological Factors ◽  
Nutrition Rehabilitation

Background: Severe acute malnutrition (SAM) causes almost half of childhood deaths in children <5 years in developing countries. In India, as National Family Health Survey (NFHS), prevalence of SAM has increased from 6.4 in NFHS-3 (2005-2006) to 7.5% in NFHS-4 (2015-1016); [5.8 to 9.5% Gujarat]. The aim of study was to determine the etiological factors and outcome of SAM and the benefit of nutrition rehabilitation centre (NRC) among 6 months to 5 years children at the Pediatrics, NRC ward, Sir T. General Hospital.Methods: A prospective observational study of 151 SAM children over nine months. Etiological factors were determined by history and relevant investigations, exclude other systemic disorders. Therapeutic nutrition was provided for 14 days. Cases were followed up two weekly for 2 months by monitoring weight after NRC admission.Results: Association was found between Small for gestational age (64.9%), joint family (59.6%) and low birth spacing (59.6%) as etiological factors leading to SAM. 81.5% children gained weight during 14 days NRC stay. Weight gain was noted at follow-up. Defaulter rate increased from 9.9% at discharge to 28.5% at 2 months follow-up. Weight was static for 9% children. 34.4% children were from rural area and 65.6% from urban area. 23.8% children had received pre lacteal feed. Timing of complementary feeding was incorrect in 29%. There were no deaths.Conclusions: Small for gestational age, joint family, low birth spacing, and incorrect feeding practices and urban residence were etiological factors. NRC stay (defaulter rate 26%), produced weight gain in SAM children. 

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