scholarly journals Oral Zinc supplementation in the treatment of sepsis in Nepalese children: A double-blind randomised placebo-controlled trial

2021 ◽  
Vol 10 (2) ◽  
pp. 84-91
Author(s):  
Shyam Prasad Kafle ◽  
Lalan Prasad Rauniyar ◽  
Eqtedar Ahmad ◽  
Namu Koirala ◽  
Maya Rouniyar

Background: Sepsis is one of the most common causes of morbidity and mortality in young children. Zinc supplementation has a preventive effect against diarrhoeal diseases and respiratory infections, but little is known about its effect on the treatment of sepsis.  Objectives: To evaluate the benefit of oral Zinc supplementation along with standard antimicrobial therapy in childhood sepsis.  Methods: A randomised, double-blind controlled trial was conducted on 164 septic children between 1-15 years of age from 15th April 2017 to 14th April 2018 in a eastern Nepal tertiary care centre. Block randomisation was done with four participants in each block. There were 21 and 20 blocks in the intervention and in the placebo group respectively. Each child received oral zinc (20 mg elemental zinc/day) or a placebo once a day for 14 days.  Percentage was calculated for descriptive statistics and Chi-square for inferential statistics with 95% CI and p <0.05 for data analysis using SPSS v.16. Results: Of the participants, 84 (51.21%) received Zinc and 80 (48.79%) received a placebo in adjunct to the standard antimicrobial therapy. Most of the children 76 (46.34%) were under five years and were male 98 (59.75%), and 69 (42.07%) were underweight. Those receiving zinc and placebo had similar improvements at discharge; there was no reduction in the need for higher-order antibiotics or in the length of PICU/ hospital stay. Zinc supplementation in childhood sepsis had no benefit on decreasing mortality or decreasing severity (p >0.05). Conclusion: Zinc supplementation during childhood sepsis does not help in short-term clinical recovery.

2011 ◽  
Vol 51 (3) ◽  
pp. 128
Author(s):  
Rustam Siregar ◽  
Lilisianawati Lilisianawati ◽  
Endang Dewi Lestari ◽  
Harsono Salimo

Background The Indonesian Health Ministry reported that 35 .6% of Indonesian children and up to 50% in certain regions have stunted growth. They are at high risk of chronic zinc deficiency. Inadequate zinc intake may result in an impaired immune sy stem and high incidence of morbidity. Zinc supplementation is knO\Vll to improve immune status thus reducing the incidence of morbidity among stunted children.Objective To evaluate the effects of zinc supplementation on morbidity incidence among stunted Indonesian school children. Methods We evaluated the effects of daily zinc supplementation (2.38 mg of zinc􀁇supplemented milk) on the incidence of diarrhea, respiratory infections, and fever in a double􀁇blind, randomized, controlled trial in 169 stunted children (zinc􀁇supplemented n=84; placebo n=85) aged 7 to 9 years in Jakarta and Solo. Zincsupplementation and morbidity surveillance were perfonned for 6 months.Results Compared to the first 3 months of intervention, zinc supplementation resulted in a reduction in the incidence of diarrhea, respiratory infections, and fever during the second three months (by 67%, 42%, and 30%, respectively). Children from the zinc􀁇supplemented group tended to have a lower episodic incidence of diarrhea and fever than those from the placebo group, although neither of these differences was statistically significant (P< 0.45,95% CI 0.63 to 0.89).Conclusion Zinc supplementation has no significant effect in reducing the incidence of diarrhea, respiratory infections, and fever in stunted children although tended to have a lower episodic incidence. 


2013 ◽  
Vol 32 (2) ◽  
pp. 193-199 ◽  
Author(s):  
Ubaid H. Shah ◽  
Amani K. Abu-Shaheen ◽  
Mohammad A. Malik ◽  
Seema Alam ◽  
Muhammad Riaz ◽  
...  

2019 ◽  
Vol 11 (2) ◽  
Author(s):  
Sanguansak Rerksuppaphol ◽  
Lakkana Rerksuppaphol

Acute Lower Respiratory Tract Infections (ALRI) are one of the most common causes of morbidity and mortality in young children. Zinc supplementation has been shown to have a preventive effect against respiratory infections, but little evidence is available on its effect on the treatment of ALRI. This study examined the effect of zinc supplementation on the treatment outcome in children that were hospitalized with ALRI. A randomized, doubleblinded, placebo-controlled trial was conducted on 64 hospitalized children with ALRI, who were aged between 2 and 60 months. Children were randomly allocated to receive zinc (30 mg elemental zinc/day) or placebo. The primary outcome was the time to the cessation of ALRI, while the secondary outcomes were the length of the stay in hospital and the individual features of the disease. The study found that ALRI cessation was faster in children who received zinc supplementation (median (IQR): 3 (2-4) days and 4 (3-5) days, respectively; P=0.008), and that their hospital stay was shorter (mean (SD): 3.8 (1.3) days and 6.1 (3.2) days, respectively; P<0.001) than the placebo group. Zinc supplementation was well-tolerated, and no adverse events were reported. In conclusion, zinc supplementation reduced the number of days of ALRI in Thai children, as well as their stay in hospital.


2021 ◽  
pp. 153857442110225
Author(s):  
Joel Mathew John ◽  
Vimalin Samuel ◽  
Dheepak Selvaraj ◽  
Prabhu Premkumar ◽  
Albert A Kota ◽  
...  

Objective: The use of drug coated balloon (DCB) for angioplasty has shown superior efficacy against plain balloons for treating complex infrainguinal arterial disease. We report and compare the clinical outcomes following application of DCB(Paclitaxel) and plain angioplasty (POBA) in our tertiary care centre. Methods: A retrospective, single centre analysis of 301 patients with chronic limb-threatening ischemia involving the infrainguinal segment was conducted between September 2014 and September 2018, after approval from the Institutional review board. We analyzed clinical outcomes by measuring postoperative ABI improvement, restenosis requiring reintervention procedure, minor and major amputations at the end of 18 months. . To find the association between the group variables (POBA and DCB) and other risk variables, Chi-square test/Fisher’s exact test was used. Multivariable logistic regression analysis was used. Results: Patients who underwent treatment with plain balloon (POBA) and DCB(Paclitaxel) angioplasty were 246(81.7%) and 55(18.3%) respectively. Our study group was predominantly male (Male: Female = 6.7:1), most patients were more than 50 years of age (n = 251, 83.4%). Smoking (n = 199, 66.1%) and diabetes (n = 210, 69.8%) were the most common atherosclerotic risk factors. Postoperative Ankle Brachial Pressure Index (ABI) improvement were similar in both groups (POBA = 57.7%; DCB = 69.8%; p = 0.103). Minor and major amputations following POBA were 26% and 22%; and DCB were 12.7% and 16.4% respectively. Re-stenosis requiring a re-interventional procedure within 18 months was 15%, (n = 37) following POBA; and 12.7% (n = 7) following DCB (p = 0.661). Conclusions: This retrospective study shows similar clinical limb related outcomes following POBA and DCB at 18 months. However, our comparative analysis between the POBA and DCB groups was totally unadjusted and not adjusted for common confounders such as age and sex. Hence, for one to draw definitive conclusions leading to changes in clinical practice; a randomized, prospective study with a larger patient cohort is needed.


2008 ◽  
Vol 61 (10) ◽  
pp. 1104-1107 ◽  
Author(s):  
M Hoffmann ◽  
A E Zemlin ◽  
W P Meyer ◽  
R T Erasmus

Aim:The aim of this study was to determine the most common causes of hypophosphataemia (⩽0.5 mmol/l) in a hospital population in order to identify patient groups at risk of developing the condition.Methods:The study was conducted at Tygerberg Hospital, a tertiary care centre in the Western Cape, South Africa. All patients identified with a phosphate level ⩽0.5 mmol/l during an 18-month period were included in the study. Medical records of these patients were reviewed.Results:Of all the requests received for serum phosphate determination by the laboratory, 2% (861 out of 45 394 requests) were ⩽0.5 mmol/l. Thirty per cent (30%; n = 189) of the patients in the study population died during their hospital stay. Most (45%; n = 278) of the patients with low phosphate levels occurred in an intensive care setting, whereas 10% (n = 63) were most likely due to refeeding, and 6% (n = 35) had neoplastic disease. Sepsis was implicated as a contributing factor in 26% (n = 162).Conclusion:Severe hypophosphataemia is associated with a very high mortality (30%, n = 189). Patients with a high risk of developing hypophosphataemia include those in an intensive care unit (ICU), patients suffering from neoplastic diseases, possible refeeding syndrome and septic patients. Regular phosphate determination is recommended in these patients to facilitate early diagnosis of hypophosphataemia.


2021 ◽  
pp. 19-21
Author(s):  
Naik Viraj R ◽  
Manjusha Jindal ◽  
Siddhi D. Naik

Introduction: (1) The female genital tract is constituted by the ovaries, fallopian tubes, uterus (body/corpus and cervix), vagina, and vulva. Female genital tract lesions can be benign or malignant. Our study was carried out to nd out the frequency of various histopathological lesions including neoplasms of female genital tract. Materials and Methods: Our study is retrospective conducted over 2 years period. Data was collected from case records of patients presenting to Goa Medical College and histopathology reports obtained from Dept of pathology. Data was represented in form of charts and tables. The analysis of statistical data of variables was done using SPSS software version 22. Signicance was calculated using chi square test. Value of p <0.05 was considered signicant. Results: Out of total 270 subjects studied, 229 were having benign lesions and 41 had malignant lesions.The mean age was 49.5 years. Leiomyoma was diagnosed in (40.58%) cases. In abnormalities of endometrium proliferative endometrium was seen in 37.6%. Chronic cervicitis was seen 78.74% cases. Among the ovarian lesions, 67.74% cases were simple follicular cysts. Cervical cancer was found in 73.17% cases followed by ovarian malignancies in 19.51 % cases, endometrial carcinoma in 4.87% cases and vulvar cancer in 2.44% cases. Among the malignant tumors (58.54%) cases were postmenopausal women. Conclusion: Microscopic assessment and clinico-pathological correlation of lesions is necessary as grossly identiable benign lesion may harbour a focus of malignancy. It aids to appropriate management in the postoperative period. A concerted effort should be done towards prevention of cancers, by creating awareness through health education in addition to implementation of screening methods.


2016 ◽  
Vol 54 (201) ◽  
pp. 24-28 ◽  
Author(s):  
Sita Ghimire

Introduction: Eclampsia is a preventable and treatable cause of maternal morbidity and mortality with poor feto-maternal outcome in developing countries. Despite development in the level of health education expertise in human resources and institutional obstetric care in our country, the delay in early recognition of the problem, transportation to proper health facility and getting proper expert care are major hurdles to reduce complications. Therefore we decided to study feto-maternal outcomes in our setting.Methods: A retrospective cross-sectional hospital based study carried out in Nobel Medical College, Biratnagar, from 17th June 2014 to 16th June 2015. Details and data obtained from Medical Record Section were analysed. All patients with eclampsia were included and fetomaternal outcomes measured in terms of complications. Simple descriptive statistical method was applied for analysis.Results: Among 8,066 deliveries, 112 had eclampsia with incidence of 13.8/1000 deliveries. Majority (41%) were of <19 years of age. Above 90% were unbooked. Aoubt 63.4% were primiparas and 83% had antepartum eclampsia. Eclamptic fits were more common (41.6%) in 37-40 weeks period of gestation. Fits to delivery interval was more than six hours in 89.1% women and 69.3% women underwent caesarean delivery. About 18.9% women developed eclampsia related complications. Common causes of maternal deaths (5.36%) were pulmonary edema, aspiration pneumonia, cerebrovascular accidents and HELLP syndrome. Perinatal death was nine percent.Conclusions: Although the obstetric care facilities are improving with time, the feto-maternal outcomes are still poor in our country. Therefore early recognition and proper management are vital to tackle this challenge. Keywords: eclampsia; fetomaternal outcomes; retrospective analysis. | PubMed


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