Factors impacting referral of JIA patients to a tertiary level pediatric rheumatology center in North India: a retrospective cohort study

Objective: The objective of this study was to investigate the impact of anti-platelet drug/s on duration of continuous renal replacement therapy (CRRT) in those patients where anti-coagulants were not used due to certain contraindications and in cases where patients were on anti-platelet drugs and were given anti-coagulant during CRRT. Method: This single-center, retrospective cohort study was conducted using the medical records patients treated with CRRT in the cardiac ICU of the inpatient urban facility, located in North India. Data was collected from only those patients who received CRRT for the duration of at least 12 h. Patient’s in NAC group were not on any anti-platelet/s and did not receive anti-coagulant during CRRT. AC and AP group patients received anti-coagulant alone or were already on anti-platelet/s and did not receive anti-coagulant respectively while ACAP group patients were on anti-platelet drug/s and also received anti-coagulant during CRRT. Result: Patients in AC, AP, or ACAP group showed significantly ( p < 0.001) higher CRRT filter life compared to NAC group. The median CRRT filter life was significantly higher in the ACAP group compared to AC ( p < 0.05) and AP ( p < 0.001) groups. Conclusion: This study indicates that systemic anti-platelet therapy can provide additional support in critical patients undergoing CRRT even with or without anti-coagulant therapy. However, the increase in CRRT filter life was more profound in patients who were on anti-platelet/s and also received anti-coagulant drug/s during CRRT.

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Fever under 3 months and the full septic screen: Time to think again? A retrospective cohort study at a tertiary-level paediatric hospital

Journal of Paediatrics and Child Health ◽

10.1111/jpc.13743 ◽

2017 ◽

Vol 54 (3) ◽

pp. 272-278

Author(s):

Patrick Aldridge ◽

Arjun Rao ◽

Rebecca Sethumadavan ◽

Nancy Briggs

Keyword(s):

Cohort Study ◽

Retrospective Cohort Study ◽

Screen Time ◽

Retrospective Cohort ◽

Tertiary Level ◽

Paediatric Hospital

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Bacterial sepsis in dengue fever – A paediatric perspective

Tropical Doctor ◽

10.1177/0049475521993608 ◽

2021 ◽

pp. 004947552199360

Author(s):

Taneja Sunil ◽

Bansal Alexandra ◽

Midha Tanu ◽

Mansuri M Ali ◽

Agarwal Neha ◽

...

Keyword(s):

Cohort Study ◽

Hospital Stay ◽

Dengue Fever ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Bacterial Contamination ◽

Blood Cultures ◽

North India ◽

Bacterial Sepsis ◽

Private Hospitals

Dengue fever is the most common arthropod borne infection worldwide. Bacterial sepsis in dengue fever is not widely recognised. This is a retrospective cohort study of children who had sepsis coexisting along with Dengue fever. One hundred and twenty-four patients aged between three months and eighteen years admitted in two private hospitals in North India were studied. Thirteen children had concurrent sepsis (13/124, 10.4%). Children between 0 and five years (7/13, 53.8%, p = 0.019), having longer hospital stay (7/13, 53.8%, p = 0.00029), shock (10/13, 76.9%, p = 0.00001), and increased PCT (13/13, 100%, p < 0.001) were some indicators of sepsis in these patients. Blood cultures were positive in five children. It is a matter of speculation as to why these patients of dengue are more susceptible to sepsis. Increased vascular permeability may increase the chances of bacterial contamination. Antibiotics should not be used routinely in dengue fever. However, young children presenting with severe symptoms especially shock should be screened for sepsis, and appropriate antibiotics should be started early.

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