scholarly journals Children, comorbidities and COVID-19 - What tilts the balance?

2021 ◽  
Vol 12 (3) ◽  
pp. 10-13
Author(s):  
Umesh Shukla ◽  
Nita Radhakrishnan ◽  
Bhanu Kiran Bhakhri ◽  
Ravi Shankar ◽  
Sohini Ghosh ◽  
...  
Keyword(s):  
Respiratory Distress ◽  
Care Center ◽  
Tertiary Care ◽  
Thalassemia Major ◽  
Clinical Severity ◽  
National Capital Region ◽  
Severe Respiratory Distress ◽  
Multiple Rib Fractures ◽  
High Flow Oxygen ◽  
National Capital

Background: Data on the outcome of children with SARS-COV-2 infection (COVID-19) is still evolving as the pandemic unfolds. Aims and Objective: The present study aims at describing the clinical severity, course and outcome of COVID-19 in children who had underlying illnesses or co-infections. Materials and Methods: Retrospective, single center, observational study, conducted in a pediatric tertiary care center at Noida (National Capital Region, India). Results: We analyzed the data of 15 children with co-morbidities associated with COVID-19. Cancer (n=4, 26.6%), co-infections (n=5, 33.3%), Thalassemia major (n=2, 13.3%) and one child each with celiac disease, cholelithiasis, Duchenne muscular dystrophy and multiple rib fractures were diagnosed with COVID-19. None were asymptomatic. 9 children (60%) had mild symptoms and 4 had moderate symptoms (26.6%) with respiratory distress. 2 children had severe respiratory distress requiring high flow oxygen. Convalescent plasma, IVIG, Oseltamivir, Azithromycin, Hydroxychloroquine were given as treatment in varying combinations. All children recovered from COVID-19. Conclusion: Active malignancy, hypogammaglobinemia, underlying lung disease were associated with moderate to severe symptoms in this series of patients. Convalescent plasma helped in both children with severe hypoxia.

scholarly journals Evaluation of Hypothermia in Sick Neonates as Predictor of Fatality at a Tertiary Care Center of Eastern Nepal

2018 ◽  
Vol 14 (2) ◽  
pp. 8-11
Author(s):  
Piush Kanodia ◽  
R Bhandari ◽  
N Bhatta ◽  
S Yadav
Keyword(s):  
Respiratory Distress ◽  
Neonatal Sepsis ◽  
Prospective Observational Study ◽  
Mild Hypothermia ◽  
Care Center ◽  
Tertiary Care ◽  
Birth Asphyxia ◽  
Moderate Hypothermia ◽  
Time Of Admission ◽  
Frequent Problem

Introduction: Hypothermia is a common and frequent problem in newborns. It has larger impact in outcome related to management of sick infants.Objective: To correlate the severity of hypothermia in sick extramural neonates with fatality and physiological derangements.Materials and Methods: This prospective observational study was carried out at Neonatology unit of Pediatric department of B. P. Koirala Institute of Health Sciences (BPKIHS) Dharan. Total 200 extramural hypothermic neonates were transferred to BPKIHS from June 2015 to June 2016. Neonates weighing more than 1000 g, with abdominal skin temperature less than 36.5°C at admission were included in the study.. Clinical features and associated features were recorded at the time of admission. Oxygen saturation was recorded by a pulse oximeter.Results: Fatality was observed to be 39.3% in mildly hypothermic babies, 51.6% in moderately hypothermic babies and 80% in severely hypothermic babies. However, the presence of associated illness (birth asphyxia, neonatal sepsis and respiratory distress), physiological derangements (hypoxia, hypoglycemia and shock) and weight less than 2000 g were associated with more than 50% fatality even in mildly hypothermic babies. When moderate hypothermia was associated with hypoxia or shock, the fatality was 83.3% and 90.9%, respectively. Similarly, mild hypothermia with hypoglycemia was associated with 71.4% fatality.Conclusion: The presence of associated illness (birth asphyxia, neonatal sepsis and respiratory distress), physiological derangements (hypoxia, hypoglycemia and shock) and weight less than 2000 g should be considered adverse factors in hypothermic neonates. Their presence should classify hypothermia in the next higher category of severity in WHO classification. JNGMC Vol. 14 No. 2 December 2016,   page: 8-11  

scholarly journals Quality of life in children with thalassemia major following up at a tertiary care center in India (GOTQoL)

2018 ◽  
Vol 6 (1) ◽  
pp. 168
Author(s):  
Ankush Ankush ◽  
Amit Dias ◽  
M. P. Silveira ◽  
Yash Talwadker ◽  
Joachim Piedade Souza
Keyword(s):  
Quality Of Life ◽  
Blood Transfusion ◽  
Care Center ◽  
Tertiary Care ◽  
Thalassemia Major ◽  
Summary Score ◽  
Healthy Children ◽  
Tertiary Care Center ◽  
Government School

Background: This study aims to measure the quality of life (QoL) scores in children with thalassemia major following up at a tertiary care center for routine blood transfusion in comparison to healthy children.Methods: A case control study design was adopted, wherein on the QoL of 36 children with thalassemia in the age group 5 to 18 following up for blood transfusion at Goa Medical College, was measured using PedsQL™ 4.0. This was compared to the QoL in age and gender matched healthy children from a government school. A higher score on a subscale indicates better quality of life on this instrument.Results: The children with thalassemia had lower mean scores on physical (67.85 vs 84.24; P <0.001), social (78.34 vs 87.95; P=0.002) and school (62.64 vs 79.48; P <0.001) functioning subscales compared to the healthy children. They also had lower mean psychosocial summary score (73.32 vs 82.01; P=0.003) and total health summary score (71.95 vs 82.57; P <0.001). The physical functioning subscale had significantly higher score among the children who were on chelation and also among the ones whose parents reported as being informed about the condition.Conclusions: The children with thalassemia have poor QoL in physical, social and school functioning domains. Improvement in QoL requires consolidated efforts on part of doctors, parents, school authorities and policy makers. These patients should be provided with low cost-effective chelation therapy. The parents need to be counselled about this disease by the treating team.

scholarly journals Short-term complication rate following orthopedic surgery in a tertiary care center in Argentina

SICOT-J ◽  
2018 ◽  
Vol 4 ◽  
pp. 26 ◽  
Author(s):  
Gaston Camino Willhuber ◽  
Joaquin Stagnaro ◽  
Matias Petracchi ◽  
Agustin Donndorff ◽  
Daniel Godoy Monzon ◽  
...  
Keyword(s):  
Orthopedic Surgery ◽  
Complication Rate ◽  
Care Center ◽  
Critical Role ◽  
Tertiary Care ◽  
Additional Treatment ◽  
Clinical Severity ◽  
Type I ◽  
Short Term ◽  
Start Time

Introduction: Registration of adverse events following orthopedic surgery has a critical role in patient safety and has received increasing attention. The purpose of this study was to determine the prevalence and severity of postoperative complications in the department of orthopedic unit in a tertiary hospital. Methods: A retrospective review from the postoperative complication registry of a cohort of consecutive patients operated in the department of orthopedic surgery from May 2015 to June 2016 was performed. Short-term complications (3 months after surgery), age gender, types of surgery (elective, scheduled urgency, non-scheduled urgency, and emergency), operative time, surgical start time (morning, afternoon or evening), American Society of Anesthesiologists score and surgeon's experience were assessed. Complications were classified based on their severity according to Dindo-Clavien system: Grade I complications do not require alterations in the postoperative course or additional treatment; Grade II complications require pharmacological treatment; Grade III require surgical, endoscopic, or radiological interventions without (IIIa) or with (IIIb) general anesthesia; Grade IV are life-threatening with single (IVa) or multi-organ (IVb) dysfunction(s), and require ICU management; and Grade V result in death of the patient. Complications were further classified in minor (Dindo I, II, IIIa) and major (Dindo IIIb, IVa, IVb and V), according to clinical severity. Results: 1960 surgeries were performed. The overall 90-day complication rate was 12.7% (249/1960). Twenty-three complications (9.2 %) were type I, 159 (63.8%) type II, 9 (3.6%) type IIIa, 42 (16.8%) type IIIb, 7 (2.8%) type IVa and 9 (3.6%) were grade V according to Dindo-Clavien classification (DCC). The most frequent complication was anemia that required blood transfusion (27%) followed by wound infection (15.6%) and urinary tract infection (6%). Discussion: The overall complication rate after orthopedic surgery in our department was 12.7%. The implementation of the DCC following orthopedic surgery was an important tool to measure the standard of care.

scholarly journals Acute Respiratory Distress and Its Risk Factors among Neonates Admitted in a Tertiary Care Center of Western Nepal

2017 ◽  
Vol 15 (1) ◽  
pp. 5-8
Author(s):  
Jyoti Adhikari ◽  
Sajju Aryal ◽  
Veena Gupta
Keyword(s):  
Respiratory Distress ◽  
Rural Areas ◽  
Teenage Pregnancy ◽  
Care Center ◽  
Tertiary Care ◽  
Birth Asphyxia ◽  
Early Marriage ◽  
Respiratory Pattern ◽  
Control Group ◽  
Female Ratio

Background: Neonatal period is defined as a period from birth to under 4 weeks (<28 days) of age. It is a highly vulnerable time for an infant, who is completing many of the physiologic adjustments required for extra uterine existence. The term Respiratory distress (RD) is used to indicate signs & symptoms of abnormal respiratory pattern. Methods: All neonates admitted in neonatal intensive care unit of Nepalgunj Medical College, Kohalpur with respiratory distress were included. Same number of age and sex matched controls without RD were selected. Results: The NICU based hospital incidence of RD was 9.1% with  male: female ratio 1.4:1 The Most Common etiology was neonatal sepsis (51.6%), followed by hyaline membrane disease (17.8%), TTN (12.7%), meconium aspiration syndrome (6%), birth asphyxia (5.08%), tracheoesophageal fistula (2%) and pneumothorax (2%). Newborns with poor APGAR score requiring resuscitation were more likely to develop RD (p=0.025). Newborns with birth weight <2.5 kg and >4 kg were 2 times likely to develop RD as compared to control group (p<0.012). There was 7 times higher risk of developing MAS when a baby was born through thick MSL as compared to control group (P<0.022). Inadequate ANC visit significantly increased RD in newborns (p<0.001). Babies born to mother with PROM for more than 18 hours were 5.5 times likely to develop RD (p<0.001) whereas those born to mother who had any source of infection were about 6 times at risk of developing respiratory distress than control group (p=0.007). Conclusion: Certain measures that could be taken to reduce the number of RD are: 1. discouraging early marriage and teenage pregnancy. 2. Increasing awareness regarding temporary and permanent contraceptive measures. 3. Promoting education of girls. 4. Increasing coverage of ANC visit in rural areas and 5. formulating integrated plan and policies from the Government level.

scholarly journals METABOLIC SYNDROME IN URBAN AND RURAL POPULATION OF GREATER NOIDA NATIONAL CAPITAL REGION OF INDIA

2018 ◽  
Vol 11 (9) ◽  
pp. 110
Author(s):  
Manoj Kumar Sharma ◽  
Sonali Pandey ◽  
Suryakant Nagtilak
Keyword(s):  
Metabolic Syndrome ◽  
Rural Areas ◽  
Patient Population ◽  
Health Care Policy ◽  
Tertiary Care ◽  
National Capital Region ◽  
Rapid Urbanization ◽  
Male And Female ◽  
Urban Patient ◽  
National Capital

Objective: The objective of this study was to evaluate the prevalence of metabolic syndrome (MetS) and to define its predictors in urban and rural patients presenting to tertiary care hospitals located in Greater Noida district Gautam Budh Nagar, India.Methods: A total of 367 participants recruited in the study, aged 20–55 years, comprising, 290 patients (149 rural and 141 urban) and 77 healthy age, sex-matched controls from the study area. Anthropometric, clinical and laboratory examination information was obtained. MetS was defined as per the National Cholesterol Education Program, Adult Treatment Panel III (NCEP, ATP III) report.Results: There were significant differences in biochemical and anthropometric measurements between control and patient population (p<0.05). There was a substantial difference in the prevalence of MetS among male and female patient population of urban as well as rural areas. As per NCEP, ATP III criteria, the prevalence of MetS in urban patient population was 21.7% in male and 27.8% in female whereas rural male and female exhibited 13.8% and 18.8% of MetS, respectively. Waist circumference was found as the strongest predictor of MetS among the patient population.Conclusion: Rapid urbanization of the cities is affecting the village life and indicating toward a major burden of diseases associated with MetS. A higher prevalence of MetS in female irrespective of the area of residence needs major health-care policy change. There is an urgent need to address this issue by adopting healthy eating, physical exercise, and weight reduction.

scholarly journals Prevalence of MRSA and Antimicrobial Susceptibility Staphylococcus aureus in Clinical Samples in National Capital Region, India

2021 ◽  
pp. 209-215
Author(s):  
Pradeep Kumar ◽  
Geeta Gupta ◽  
Gajendra Kumar Gupta ◽  
Vashishth Mishra ◽  
Gaurav Gupta
Keyword(s):  
Staphylococcus Aureus ◽  
Methicillin Resistance ◽  
Tertiary Care ◽  
Clinical Samples ◽  
National Capital Region ◽  
Medical College ◽  
Diffusion Technique ◽  
National Capital ◽  
Mrsa Strains ◽  
Transmission Capability

Background: Infections caused by Staphylococci are frequently linked to indwelling medical equipment. These are extremely difficult to treat with antibiotics. In India, the prevalence of Methicillin-Resistant Staphylococcus aureus (MRSA) varies from 30 to 70%, resulting in high mortality, increased economic burden, and high treatment failure in tertiary care hospitals. Rapid and reliable identification of MRSA is critical for infection management and avoiding the needless use of antibiotics. Materials and Methods: This prospective study was carried out in the Department of Microbiology, Santosh Medical College, Ghaziabad, from the 1st of August 2020 to the 31st of January 2021. MRSA isolates were screened and confirmed using standard methods recommended by the Clinical and Laboratory Standards Institute (CLSI). Methicillin resistance, in Staphylococcus aureus strains, was evaluated using oxacillin/cefoxitin. The Kirby-Bauer disc diffusion technique was used to assess the antibiotic susceptibility pattern of all MRSA strains. Results: In this investigation, MRSA was identified in 29.4% of the 384 Staphylococcus aureus strains. When compared to females, men outnumbered females. Cefoxitin detects a greater amount of MRSA than oxacillin. In this investigation, the majority of MRSA was found in pus samples. Conclusion: MRSA prevalence is known to vary depending on geographical region, hospital type, investigated population, and technique of detection used. Given the clinical implications of MRSA infection and its fast transmission capability, MRSA strains must be monitored on a regular basis.

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