scholarly journals Trend of Breastfeeding and its Impact on Morbidity in Children in a Tertiary Care Hospital in Kathmandu

2019 ◽  
Vol 7 (1) ◽  
Author(s):  
Anwesh Bhatta ◽  
Rydam Basnet
Keyword(s):  
Exclusive Breastfeeding ◽  
Respiratory Infections ◽  
Tertiary Care ◽  
Current Trend ◽  
Acute Otitis Media ◽  
College Teaching ◽  
Care Hospital ◽  
Prospective Longitudinal Study ◽  
Significant Difference ◽  
Prospective Longitudinal

Introduction: WHO advocates for exclusive breastfeeding in infants till six months of age. Exclusive breastfeeding has been estimated to reduce 70% of infection related mortality in children. This study aims to elaborate the current trend of breastfeeding and its impact on common infectious morbidities in children. Methods: This study was a prospective longitudinal study done at Kathmandu Medical College Teaching Hospital with a sample size of 103 infants. Detailed proforma including sociodemographic data, breastfeeding related data and morbidities were collected at one and half months of life. The patients were followed up at 6 months of age again and the same proforma was again filled up. Statistical analysis was done with SPSS 20.0 and  various associations were elucidated.  Results: A total of 103 infants were analyzed. Males were 58 in numbers with mean birth weight of the infants being 3048±537 grams. Breast feeding was initiated within an hour in around 37%. At one and half months of age, 63% reported of exclusive breastfeeding which decreased to 23% at 6 months of age. Breastfeeding for at least 45 days decreased the incidence of Acute Respiratory Infections(ARI), Acute Otitis Media(AOM) and diarrheal diseases although statistically significant difference was found with only ARIs.     Conclusion: Prevalence of exclusive breastfeeding is low in the study. The study has also shown that breastfeeding significantly reduces incidence of common infectious morbidities in infants. 

scholarly journals Radiological Analysis of Frontal Cells and its Association with Frontal Sinus Mucosal Disease: A Tertiary Care Hospital Based Study

2019 ◽  
Vol 27 (1) ◽  
pp. 1-7
Author(s):  
Bikash Lal Shrestha ◽  
Sameer Karmacharya
Keyword(s):  
Frontal Sinus ◽  
Small Sample Size ◽  
Statistical Significance ◽  
Tertiary Care ◽  
Small Sample ◽  
Care Hospital ◽  
Prospective Longitudinal Study ◽  
Mucosal Disease ◽  
Complex Anatomy ◽  
Prospective Longitudinal

Introduction The frontal sinus and frontal recess both have complex anatomy causing difficulty during endoscopic sinus surgeries. The term frontal cells is currently used to describe a group of anterior ethmoidal cells classified by Kuhn et al into 4 types. Though there are precise descriptions, the frequency of frontal sinus cells (FSCs) varies widely in the literature. The presence of FSCs is responsible for a narrowing of the frontal sinus outflow tract which subsequently causes a partial obstruction of drainage and aeration of the frontal sinus. Our main aim is to the see the distribution of different frontal cells in Nepali population and relation with frontal sinus mucosal disease.   Materials and Methods This prospective, longitudinal study performed in 110 consecutive patients who underwent CT scan of nose and paranasal sinuses. The frontal cells and agger nasi cells were identified and association between the frontal cells and agger nasi cells with frontal sinus mucosal disease was analyzed with chi square test.   Results The agger nasi was present in 83.63% CT scans whereas frontal cells were distributed in 61.82% CT (computed tomogram) scans. There was not statistical significance and any association between the frontal cells and agger nasi cells with frontal sinus mucosal disease.   Conclusion The frontal cells and agger nasi cells distribution in Nepalese population, even though in small sample size, is similar with other studies in the literature. There is also non association of either frontal cells or agger nasi cells with frontal sinus mucosal disease.

scholarly journals Bacteriological profile and antimicrobial susceptibility pattern of endotracheal tube secretion of patients in ICUs of a tertiary care hospital in Punjab

2021 ◽  
Vol 8 (3) ◽  
pp. 224-229
Author(s):  
Kiranjeet Kaur ◽  
Shavetika Jindal
Keyword(s):  
Antimicrobial Susceptibility ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Multidrug Resistant ◽  
Diffusion Method ◽  
Care Hospital ◽  
Susceptibility Pattern ◽  
Prospective Longitudinal Study ◽  
Antimicrobial Susceptibility Pattern ◽  
Prospective Longitudinal

Healthcare associated pneumonia (HAP)is second most common HCAIs that occur in 27% critically ill patients. Eighty-six percent of HAP are associated with mechanical ventilation and termed as ventilator associated pneumonia (VAP). VAP due to multidrug resistant has also increased in recent past. To isolate and identify the bacterial pathogens in endotracheal tubes aspirates of ICUs patients and study their antimicrobial susceptibility pattern.A prospective longitudinal study was conducted in the Microbiology laboratory of a tertiary care hospital over a period of six months after clearance from institutional Research Committee and Ethical Committee. All the samples of ETT secretions received in Clinical Microbiology lab from ICU patients and fulfilling the criteria for VAP were included in this study. Samples were processed as per standard protocol and organisms were identified on the basis of gram staining, colony characters and biochemical tests. Antibiotic sensitivity was performed by Kirby Bauer disc diffusion method as per CLSI guidelines. : A total of 100 samples of ET secretions were collected and proceeded for culture. Out of 100 samples, 76 (76.0%) were positive for bacterial growth. Among 76 positive cultures, a total 80 bacterial isolates were obtained as some cultures were showing polymicrobial growth. Five (6.26%) isolates were Gram Positive bacteria and 75(93.7%) were Gram negative. The most frequent isolates were 35(43.7%) followed by , isolates were sensitive to colistin while resistant to ampicillin and amoxiclav. isolates were sensitive to colistin and resistant to ampicillin, amoxiclav, ciprofloxacin, cefixime, piperacillin tazobactam. isolates were sensitive to colistin while resistant to ampicillin, amoxiclav, ceftizidime and piperacillin tazobactam. In our study antimicrobial pattern of isolated bacteria shows multidrug resistant pathogens which are associated with VAP and limit therapeutic options.

scholarly journals Comparison of efficiency of 1% permethrin lotion vs. 0.5% ivermectin shampoo in the treatment of pediculosis capitis

2018 ◽  
Vol 4 (3) ◽  
pp. 357
Author(s):  
B. M. Monisha ◽  
M. Madhumitha ◽  
S. Thilagavathi
Keyword(s):  
Head Louse ◽  
Treatment Options ◽  
Tertiary Care ◽  
Care Hospital ◽  
Louse Infestation ◽  
Pediculosis Capitis ◽  
Prospective Longitudinal Study ◽  
Number Of Patients ◽  
Head Lice Infestation ◽  
Prospective Longitudinal

<p class="abstract"><strong>Background:</strong> Pediculosis or head louse infestation is a common condition and an issue of concern in developing countries. Various treatment options are available for the management of this condition but still needs further research due to drug resistance. This study seeks to compare the efficacy of 1% permethrin lotion and 0.5% ivermectin shampoo in the management of pediculosis capitis.</p><p class="abstract"><strong>Methods:</strong> A prospective longitudinal study was conducted in a tertiary care hospital from September 2013 to June 2015. Patients presenting with pediculosis capitis infestation were divided into two groups of 50 each. They were treated with either topical 1% permethrin lotion or 0.5% ivermectin shampoo. Follow up was done once in 4 weeks on the extent of head lice infestation.<strong></strong></p><p class="abstract"><strong>Results:</strong> After being treated with either topical 1% permethrin or 0.5% ivermectin shampoo, the presence of nits decreased significantly in the ivermectin group. Number of patients either had no nits or less than 5 dead nits in the permethrin group than in the ivermectin group.</p><p class="abstract"><strong>Conclusions:</strong> It is concluded that both 1% permethrin and 0.5% ivermectin have comparable efficacies in managing pediculosis capitis infestation, but permethrin was found to be more effective in treatment. In addition, none of the participants in both the treatment groups experienced any side effects.  This is one of the very few studies exploring the treatment efficacy of topical ivermectin and the potential scope for future studies on the treatment options for pediculosis capitis.</p>

scholarly journals The relationship between breastfeeding and reported respiratory and gastrointestinal infection rates in young children

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Nicole M. Frank ◽  
◽  
Kristian F. Lynch ◽  
Ulla Uusitalo ◽  
Jimin Yang ◽  
...  
Keyword(s):  
Otitis Media ◽  
Exclusive Breastfeeding ◽  
Respiratory Infections ◽  
Estimating Equation ◽  
Breastfeeding Duration ◽  
Inverse Association ◽  
Gastrointestinal Infection ◽  
Prospective Longitudinal Study ◽  
Logistic Regression Models ◽  
Prospective Longitudinal

Abstract Background Although breastfeeding is touted as providing many health benefits to infants, some aspects of this relationship remain poorly understood. Methods The Environmental Determinants of Diabetes in the Young (TEDDY) is a prospective longitudinal study that follows children from birth through childhood, and collects data on illness events, breastfeeding duration, and time to introduction of formula or foods at 3 month intervals up until 4 years of age and at 6 months intervals thereafter. Exclusive and non-exclusive breastfeeding is examined in relation to the 3-month odds of a respiratory or gastrointestinal infection for 6861 children between the ages of 3–18 months, and 5666 children up to the age of 4 years. Analysis was performed using logistic regression models with generalized estimating equation methodology. All models were adjusted for potential confounding variables. Results At 3–6 months of age, breastfeeding was found to be inversely associated with the odds of respiratory infections with fever (OR = 0.82, 95% CI = 0.70–0.95), otitis media (OR = 0.76, 95% CI = 0.62–0.94), and infective gastroenteritis (OR = 0.55, 95% CI = 0.46–0.70), although the inverse association with respiratory illnesses was observed only for girls during the winter months. Between 6 and 18 months of age, breastfeeding within any 3 month period continued to be inversely associated with the odds of ear infection and infective gastroenteritis, and additionally with the odds of conjunctivitis, and laryngitis and tracheitis, over the same 3 month period within this age range. However, breastfeeding in this group was associated with increased reports of common cold. Duration of exclusive breastfeeding was inversely associated with the odds of otitis media up to 48 months of age (OR = 0.97, 95% CI = 0.95–0.99) after breastfeeding had stopped. Conclusions This study demonstrates that breastfeeding can be protective against multiple respiratory and gastrointestinal acute illnesses in some children up to at least 6 months of age, with duration of exclusive breastfeeding being somewhat protective of otitis media even after breastfeeding has stopped. Trial registration ClinicalTrials.gov Identifier: NCT00279318. Date of registration: January 17, 2006 (proactively registered). First Posted: January 19, 2006.

scholarly journals Prevalence of carriage of community-acquired Methicillin-resistant Staphylococcus aureus among children attending the pediatric OPD at a tertiary care hospital

2018 ◽  
Vol 5 (5) ◽  
pp. 1956 ◽  
Author(s):  
Vishnurajan Radhakrishnan ◽  
Saranya Ravichandran ◽  
Senthamarai Murugaiyan Vadivelu ◽  
Shankar Radhakrishnan
Keyword(s):  
Staphylococcus Aureus ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Tertiary Care ◽  
Control Measures ◽  
Care Hospital ◽  
Prospective Longitudinal Study ◽  
Entire Study ◽  
Methicillin Resistant ◽  
Sensitivity Pattern ◽  
Prospective Longitudinal

Background: Community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) infections are commonly recognized in persons without traditional risk factors. Nasal carriage of MRSA is an important risk factor for subsequent MRSA infection and transmission of this pathogen. The aim of this study was to estimate the prevalence of carriage of community acquired MRSA and to describe its antibiotic susceptibility pattern among the pediatric population.Methods: A prospective longitudinal study was conducted in our hospital for a period of 6 months. All pediatric patients age less than 15 years attending the pediatric OPD were included in the study. A total of 325 children were included in the study based on our inclusion and exclusion criteria. Nasal smear was collected by tilting back the child’s head and gently inserting a sterile cotton swabs pre-wetted with sterile saline and slowly rotating against the turbinate of both anterior nares. The following antibiotics were tested for sensitivity pattern: penicillin, pipercillin, erythromycin, clindamycin, cotrimoxazole, vancomycin, linezolid, rifampin, ciprofloxacin and daptomycin. Any S. aureus that is resistant to Cefoxitin was defined as MRSA.Results: The prevalence of Staphylococcus aureus was found to be 26.7% of the entire microorganism detected and 6.4% (n = 21) of the entire study subjects had methicillin resisitant Staphylococcus aureus. Of testing the susceptibility of the various antibiotics vancomycin was the only drug found to be 100% sensitive followed by linezolid and pipericillin (90%). 50% sensitivity was seen with erythromycin and very poor sensitivity was seen in cefuroxime and ciprofloxacin (<50%).Conclusions: CA-MRSA strains tend to replace HA-MRSA in health-care settings, making infection control measures less effective. Hospital based antibiotic policy has to be created and strictly followed to minimize the burden of antibiotic resistance. 

scholarly journals A PROSPECTIVE STUDY OF DRUG UTILIZATION PATTERN OF ANTI-EPILEPTIC DRUGS AND THEIR ADVERSE EFFECTS IN A TERTIARY CARE HOSPITAL

2017 ◽  
Vol 9 (6) ◽  
pp. 42 ◽  
Author(s):  
Henry Daniel Raj T ◽  
Sylvia A. ◽  
Chidambaranathan S. ◽  
Nirmala P.
Keyword(s):  
Sodium Valproate ◽  
Tertiary Care ◽  
Diet Therapy ◽  
Care Hospital ◽  
Age Group ◽  
Utilization Pattern ◽  
Prospective Longitudinal Study ◽  
Pediatric Age Group ◽  
A Prospective Study ◽  
Prospective Longitudinal

Objective: Epilepsy or seizure disorder is a common neurologic disorder in the pediatric age group and occurs with a frequency of 4-6 cases per thousand children. Epilepsy, particularly childhood epilepsy, remains a challenge to treat. The management of epilepsy is primarily based on theuse of anti-epileptic drugs. Surgery and diet therapy are the other modes of treating childhood seizures. To get an insight into the utilization pattern of anti-epileptic drugs (AEDs) used in pediatric seizures.Methods: This prospective, longitudinal study was conducted for a period of 8months in Paediatric Neurology Department of a tertiary care teaching hospital. The data collected from 50 children at the end of the study, were compiled in a specially designed data form and were analyzed.Results: The distribution of paediatric seizures was found to be high in male children (62%) and in the age group of 2 to 5 y (46%). The majority of the children (70%) were diagnosed with Generalized Tonic-clonic seizures. Sodium valproate was the commonly prescribed AED in all forms of seizures followed by Carbamazepine (18%), Phenobarbitone (4%) and Phenytoin Sodium (4%). AEDs were mostly prescribed as monotherapy (82%). Adverse reactions noted during this study was minimal (12%).Conclusion: Sodium valproate, a conventional AED still remains the commonly prescribed AED for all types of seizures in children aged 2 to 16 y and also was found to be effective and safe.

scholarly journals Knowledge, Attitude and Practice Regarding Exclusive Breastfeeding Among Mothers Attending Tertiary Care Hospital

2022 ◽  
Vol 9 (1) ◽  
pp. 44-48
Author(s):  
Jahanzeb khan Afridi ◽  
Rashida Karim ◽  
Adnan Khan ◽  
Bilal Khan ◽  
Anwar Ullah ◽  
...  
Keyword(s):  
Exclusive Breastfeeding ◽  
Economic Status ◽  
Tertiary Care ◽  
Age Groups ◽  
Educational Status ◽  
Care Hospital ◽  
Cross Sectional ◽  
Attitude And Practice ◽  
Significant Difference ◽  
Knowledge Attitude And Practice

OBJECTIVES: To determine knowledge, attitude, and practice regarding exclusive breastfeeding among mothers attending tertiary care hospitals.  METHODOLOGY: A descriptive cross-sectional study was conducted at the Department of Pediatrics in Hayatabad Medical Complex, Peshawar. A total of 162 mothers were selected who were practicing breastfeeding of ages between 20 to 35 years, having a full-term baby of age up to 6 months old. The data is collected through a pre-planned questionnaire and then was analyzed using statistics version 24.0. The duration of the study was from 1st June 2020 to 30th October 2020. RESULTS: The results showed that no significant association was found between age groups, socio-economic status regarding knowledge, attitude, and practice (p>0.05). However, there was a significant difference between knowledge, attitude, and practice with respect to educational status (p<0.05). 123 (73.21%) mothers had unsatisfactory; whereas 39 (24.07%) mothers had excellent knowledge regarding breastfeeding. 39 (27.07%) of breast-feeding mothers had a positive attitude towards breastfeeding. 123 (73.21%) women showed a negative response regarding the practice of breastfeeding. CONCLUSION: Most of the mothers didn’t have adequate knowledge of exclusive breastfeeding (EBF) practice. As a result, it is suggested that media can be used as a medium to educate women about the benefits of exclusive breastfeeding (EBF).

scholarly journals Study of risk factors leading to poor outcomes in severe pneumonia age 2M-60M in a tertiary care hospital

2019 ◽  
Vol 6 (3) ◽  
pp. 1270
Author(s):  
Mohammed Abdul Rahman ◽  
Sowjanya Bhanu Veera ◽  
Venkata Priyanka Dandugula
Keyword(s):  
Risk Factors ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Tertiary Care ◽  
Total Duration ◽  
Severe Pneumonia ◽  
Care Hospital ◽  
Prospective Longitudinal Study ◽  
Poor Outcomes ◽  
Prospective Longitudinal

Background: Childhood pneumonia is the single leading cause of mortality in children aged less than 5 years. Most cases occur in India (43 million); pneumonia is responsible for about 19% of all deaths in children aged less than 5 years. According to Child Health and Epidemiology Reference Group (CHERG) latest estimates, Pneumonia was responsible for 0.397 million of a total estimated 1.682 million under-five deaths in India.Methods: A hospital based prospective longitudinal study. In the present study 200 cases belong to age group 2 months to 5 years  fulfilling WHO criteria for pneumonia who were  attended to the department of paediatrics, Siddhartha medical college  from January 2017 to January 2018 were evaluated the risk factors in relation to their outcomes after obtaining consentResults: Out of 200 children with severe pneumonia  11 risk factors are studied for significance against outcomes like Death of the patient, mechanical ventilation oxygen supplementation, hospital stay of patient and total duration of illness, Risk factors found to be significant are maternal literacy (p =0.0002617), malnutrition (p <0.00001), exclusive  breastfeeding (p <0.05), low birth weight (p <0.05), immunisation (p=0.01).Conclusions: Severe malnutrition, maternal illiteracy, exclusive breast feeding, improper immunization and low birth weight are having a significant association with poor outcomes in children with severe pneumonia. Proper preventive strategies to decrease the incidence of these risk factors can help in increasing the survival rate of children with severe pneumonia.

scholarly journals Respiratory Tract Viral Infections and Coinfections Identified by Anyplex™ II RV16 Detection Kit in Pediatric Patients at a Riyadh Tertiary Care Hospital

2017 ◽  
Vol 2017 ◽  
pp. 1-10 ◽  
Author(s):  
Saleh A. Eifan ◽  
Atif Hanif ◽  
Sameera Mohammed AlJohani ◽  
Muhammad Atif
Keyword(s):  
Respiratory Tract ◽  
Pediatric Patients ◽  
Viral Infections ◽  
Respiratory Infections ◽  
National Guard ◽  
Burden Of Illness ◽  
Tertiary Care ◽  
Care Hospital ◽  
Significant Difference ◽  
Tract Infections

Respiratory infections are caused by an array of viruses, and limited information is available about viral coexistence, comparative symptoms, and the burden of illness. This retrospective cohort study aimed to determine the etiological agents responsible for respiratory tract infections by Anyplex II RV16 detection kit (RV16, Seegene), involving 2266 pediatric patients with respiratory infections admitted to the Department of Pediatrics at King Abdul-Aziz Medical City, Ministry of National Guard, Riyadh, from July 2014 to June 2015. The most frequent respiratory infections were recorded in the 1 to 5 year age group (44.7%). Rhinovirus (32.5%), Adenovirus (16.9%), and Respiratory syncytial virus (RSV) B (10.4%) were most common. In single viral infections, Rhinovirus (41.2%), Metapneumovirus (15.3%), and Bocavirus (13.7%) were most frequent. In multiple viral infections, Rhinovirus (36.7%), Adenovirus (35.2%), Bocavirus (11.2), RSV B (7.8%), and RSV A (6.7%) were most frequent. No significant difference was observed in clinical presentations; however, rhinorrhea and hypodynamia were significantly associated with viral respiratory infections. Most respiratory viral pathogens peaked during December, January, March, and April. Rhinovirus, Adenovirus, and Bocavirus circulations were detected throughout the year. Winter peaks were recorded for Rhinovirus, RSV B, Adenovirus, and RSV A, whereas the Metapneumovirus, and the Bocavirus peaked in March and April. These findings enhance understanding of viral etiology and distribution to improve respiratory infection management and treatment.

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