scholarly journals Epidemiology of Hyponatraemia among Elderly Patients with Lower Respiratory Tract Infection

2019 ◽  
Vol 31 (1) ◽  
pp. 13-17
Author(s):  
B Raju ◽  
A Rishab ◽  
K Vikram ◽  
T Vaibhav ◽  
T Sharat ◽  
...  

Background: Decrease in serum sodium concentration is frequent observation among hospitalised elderly patients. The common causes for hyponatremia are degenerative physiology, dehydration, medications and infections. Hence the present study was undertaken to know the extent of hyponatremia among elderly with Lower Respiratory Tract Infections. Objectives: The present study was undertaken to assess the prevalence of hyponatremia in lower respiratory tract infection among geriatric age group and to determine the association between severity of hyponatraemia and LRTI. Methods: This was hospital based cross sectional study carried out in the Department of General Medicine of a tertiary care teaching hospital situated in north Karnataka, India during November 2016 to May 2018. 100 elderly patients (age e” 60 years) with history of cough for more than four to five days, clinical findings and X-ray findings suggestive of LRTI, were selected for the study. Results: In the present study 59% comprised of male whereas females constituted 41%. The prevalence of hyponatraemia among elderly patients with LRTI was 45%. The most common cause of hyponatraemia was GI loss (vomiting) 53.33%, Euvolemic hyponatramia 51.11%. The mean age was 69.99±8.44 years. Most of the patients were aged between 61 to 70 years. .Hyponatraemia was not associated with sex, age and type of LRTI. Duration of hospital stay was significantly longer in patients with hyponatraemia compared to those who did not develop hyponatraemia. Conclusion: Hyponatraemia among elderly individuals with LRTI is higher as compared to other age group hence leading to prolonged duration of hospitalisation. Bangladesh J Medicine Jan 2020; 31(1) : 13-17

2020 ◽  
Vol 7 (11) ◽  
pp. 2219
Author(s):  
Tabrez Altaf Noorani ◽  
Jaini S. Kothari ◽  
Bhavesh Kanabar

Background: Acute lower respiratory tract infection (ALRI) is leading cause of hospitalization and mortality among children under 5 years age in developing societies. Risk factors such as socioeconomic status, overcrowding, parental education, passive smoking, exposure to biomass fuels, kerosene lamps etc should also be considered in possible etiology of ALRI. Knowledge of risk factors would help prevention through proper health education efforts and other interventional community development initiatives. The objective of the study was to study various socio-demographic and nutritional risk factors associated with acute lower respiratory tract infection among 6 to 60 months aged childrenMethods: This cross-sectional study was conducted in a tertiary care institute Gujarat state of India. All the children in the age group of 6 months to 60 months admitted in paediatrics ward with ALRI were included in study. Data collection was done using a pretested questionnaire including socio-demographic factors. Data was analyzed using Statistical package for social sciences (SPSS) and excel and p<0.05 was considered as statistically significant.Results: Higher percentage (32%) of malnutrition was observed in age group of 13 months to 36 months (p<0.05). Lack of maternal education is significantly associated with malnutrition in patients of acute lower respiratory tract infection (LRTI) (p<0.05). Passive smoking was found among 38.1% of ALRI patients in urban area while it was among 25.6% of patients in rural patients (p<0.05). Difference in exposure to biomass fuel among rural and urban patients is statistically significant (p<0.05). Giving pre-lacteal feeding (63.9%), incomplete immunization (56.8%), no birth spacing (50.2%), no predominant breast feeding (47.7%) are some of the leading causes of acute LRTI.Conclusion: Socio-demographic factors and malnutrition impact ALRI among 6 to 60 months age group of children according to place of residence.


Author(s):  
Basel Habra ◽  
Atqah AbdulWahab

Bird Fancier&rsquo;s Syndrome is a rare, non-atopic immunologic response to repeated or intense inhalation of avian (bird) proteins/antigens found in the feathers or droppings of many species of birds, which leads to an immune mediated inflammatory reaction in the respiratory system. Although this is the most common type of hypersensitivity pneumonitis reported in adults, it is one of the classification of a rare subtype of interstitial lung disease that occurs in the pediatric age group of which few case reports are available in the literature. The pathophysiology of hypersensitivity pneumonitis is complex; numerous organic and inorganic antigens can cause immune dysregulation, leading to an immune related antigen-antibody response (immunoglobulin G&ndash;IgG- against the offending antigen). Diagnosing Bird Fancier&rsquo;s disease in the pediatric age group is challenging, history of exposure is usually missed by health care providers, symptoms and clinical findings in such cases are nonspecific and often misdiagnosed during the acute illness with other common diseases such asthma, or acute viral lower respiratory tract infection, and the lack of standardization of criteria for diagnosing such condition, or sensitive radiological or laboratory test. Treatment, on the other hand, is also controversial. Avoidance of the offending antigen could be the sole or most important part of treatment, particularly in acute mild and moderate cases. Untreated cases can result in irreversible lung fibrosis. In this case report, we highlight how children presenting with an acute viral lower respiratory tract infection can overlap with hypersensitivity pneumonitis. Early intervention with pulse steroids markedly improves the patient&rsquo;s clinical course.


2018 ◽  
Vol 1 (1) ◽  
pp. 5-8
Author(s):  
Henish Shakya ◽  
Saurav Singh ◽  
Ashish Lakhey

Introduction: Lower respiratory tract infection is a major cause of death in children in a developing country and anemia is found to be one of the commonest associated cofactors. This study was aimed to determine association of anemia in children with lower respiratory tract infections.Materials and Methods: The retrospective study was done over a one-year period for children under 5 years of age, admitted in Pediatric Ward of a tertiary Hospital in Lalitpur. The study included 100 diagnosed cases of lower respiratory tract infections as per WHO criteria and 100 age and sex matched patients who did not have respiratory complaints as controls, excluding prematurity, chronic diseases, malnutrition and severe systemic illness. Appropriate clinical history, examination routine investigations like hemoglobin, peripheral smear, and Chest X-ray were included.Results: The age distribution maximum children were in the age group of 3 months to 23 months with significant association with prevalence of both pneumonia (p value 0.005) and anemia (p value 0.002). Anemia was found to be a significant risk factor for LRTI (p value < 0.001) with odds ratio of 2.68 and 95% CI (1.51 – 4.75).Conclusions: Anemia was significantly found to be associated with lower respiratory tract infections and these children were found to be 2.68 times more susceptible to lower respiratory tract infections. Early diagnosis and prevention of anemia is thus important to reduce the incidence of lower respiratory tract infections in children.Nepalese Medical Journal. vol.1, No. 1, 2018, page: 5-8


2021 ◽  
Vol 8 (10) ◽  
pp. 1658
Author(s):  
Chandrakala P. ◽  
Vinutha Patil ◽  
Kavya V. N. ◽  
Sushmitha .

Background: Community acquired pneumonia remains a significant cause of morbidity and mortality due to infection all over the world. Thrombocytes are known to be an essential part of immune response to various infectious agents. Platelet count elevated more than normal is often sign of severe pneumonia according to various studies.Methods: This is a retrospective study conducted in Kempegowda Institute of Medical Science, a tertiary care hospital in Bangalore with a study duration of 1 year. All children were classified into two groups based on platelet count that is with thrombocytosis and without thrombocytosis. Respiratory distress was defined as presence of tachypnoea, chest retractions, oxygen saturation <94% in room air. Children with respiratory distress were classified as severe pneumonia and those with no respiratory distress as non-severe pneumonia.Results: A total of 213 children were admitted with lower respiratory tract infection of which 35 children were excluded based on exclusion criteria. Of these 178 children 142 (80%) belonged to non-severe pneumonia group and 36 (20%) belonged to severe pneumonia group. Thrombocytosis is found in 31 (17%) children, 147 (82%) children had platelet count less than 4.5 lakhs/cu mm. Of these children with thrombocytosis 13 (42%) had non severe pneumonia and 18 (58%) had severe pneumonia. The p<0.0000001 which showed statistical significance, that is thrombocytosis was significantly associated with severity of pneumonia.Conclusions: Thrombocytosis can be considered as a marker of severity of pneumonia in day-to-day practice.


1999 ◽  
Vol 67 (6) ◽  
pp. 3051-3054 ◽  
Author(s):  
Rihab ElKarim ◽  
Carl Granert ◽  
Lars Lindquist ◽  
Hans Link ◽  
Moiz Bakhiet

ABSTRACT To study the involvement of cytokines and their corresponding autoantibodies (Aabs) in inflammatory mechanisms in patients with lower respiratory tract infections, blood samples were taken from patients at the time of admission to the hospital and before treatment. Cell-released capturing enzyme-linked immunosorbent assay was used to measure the levels of gamma interferon (IFN-γ) and interleukin-4 (IL-4) produced spontaneously by peripheral mononuclear cells (PMNC). ELISA was used to measure Aabs to these cytokines in sera. The levels of both cytokines were inversely related to the levels of their corresponding Aabs. While a high level of IFN-γ was observed together with a low level of anti-IFN-γ Aab, decreased IL-4 levels were observed with increased levels of Aabs to IL-4. Immunoglobulins were purified, digested to obtain Fab fragments, and tested for specificity and cross-reactivity. The Aabs and their Fab fragments were tested in cytokine biological assays and showed neutralizing effects. Our data demonstrated increased levels of the proinflammatory cytokine IFN-γ and decreased release of the anti-inflammatory cytokine IL-4 during early presentation of lower respiratory tract infection. The levels of these cytokines were inversely related to the levels of their corresponding Aabs that exhibited regulatory effects on the cytokine biological function in vitro.


Author(s):  
Chandrakala Sharma ◽  
Arkojit Endow ◽  
Sudip Dutta

Background: Prescription audit is an important tool to analyse rational use of drug at different health sectors. The aim of the study was to evaluate the prescribing pattern using World Health Organization prescribing indicators for lower respiratory tract infection in children below five years of age.Methods: A cross-sectional study was conducted in the outpatient department of Paediatrics at Central Referral Hospital, Gangtok, Sikkim, India for a period of 18 months. Study involved children between 1-5 years of age with fever/cough with or without respiratory distress. The data were collected from the out patient department prescription slips as well as interviewing the parents/guardians after finishing the physician consultation. The data were processed using statistical software SPSS 20.Results: The study was conducted with 57 prescriptions comprising 210 drugs from both male (54.38%) and female (45.61%) patients. The average number of drugs per prescription was found to be 3.68. negligible (0.013%) prescription containing generic name of drug was found, 96.66% of medicines were prescribed from National Essential List of Medicine (NELM). No prescriptions were found to have injectables, 8.57% of the prescriptions were found to contain fixed dose combination. Amongst the drug categories, salbutamol accounted for 23.33% in total prescription followed by paracetamol (22.85%) and amoxicillin (7.14%). While accounting for the formulations used, the maximum prescriptions were containing syrup followed by nebulization.Conclusions: The use of generic names was minimal, only few of the prescriptions had vitamins and tonics with no use of injectable preparations. Maximum numbers of drugs were prescribed from NELM.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Timothy L. Wiemken ◽  
Stephen P. Furmanek ◽  
Ruth M. Carrico ◽  
Paula Peyrani ◽  
Daniel Hoft ◽  
...  

Abstract Background Influenza is associated with excess morbidity and mortality of individuals each year. Few therapies exist for treatment of influenza infection, and each require initiation as early as possible in the course of infection, making efficacy difficult to estimate in the hospitalized patient with lower respiratory tract infection. Using causal machine learning methods, we re-analyze data from a randomized trial of oseltamivir versus standard of care aimed at reducing clinical failure in hospitalized patients with lower respiratory tract infection during the influenza season. Methods This was a secondary analysis of the Rapid Empiric Treatment with Oseltamivir Study (RETOS). Conditional average treatment effects (CATE) and 95% confidence intervals were computed from causal forest including 85 clinical and demographic variables. RETOS was a multicenter, randomized, unblinded, trial of adult patients hospitalized with lower respiratory tract infections in Kentucky from 2009 through 2012. Adult hospitalized patients with lower respiratory tract infection were randomized to standard of care or standard of care plus oseltamivir as early as possible after hospital admission but within 24 h of enrollment. After randomization, oseltamivir was initiated in the treatment arm per package insert. The primary outcome was clinical failure, a composite measure including failure to reach clinical improvement within 7 days, transfer to intensive care 24 h after admission, or rehospitalization or death within 30 days. Results A total of 691 hospitalized patients with lower respiratory tract infections were included in the study. The only subgroup of patients with a statistically significant CATE was those with laboratory-confirmed influenza infection with a 26% lower risk of clinical failure when treated with oseltamivir (95% CI 3.2–48.0%). Conclusions This study suggests that addition of oseltamivir to standard of care may decrease clinical failure in hospitalized patients with influenza-associated lower respiratory tract infection versus standard of care alone. These results are supportive of current recommendations to initiate antiviral treatment in hospitalized patients with confirmed or suspected influenza as soon as possible after admission. Trial registration Original trial: Clinical Trials.Gov; Rapid Empiric Treatment With Oseltamivir Study (RETOS) (RETOS); ClinicalTrials.gov Identifier: NCT01248715 https://clinicaltrials.gov/ct2/show/NCT01248715


2020 ◽  
Vol 7 (9) ◽  
pp. 1876
Author(s):  
Bhagat Ram Thakur ◽  
Pancham Kumar

Background: Frequency of nutritional rickets, its clinicobiochemical profile and its relationship to the lower respiratory tract infections in indoor patients from 2 to 60 months of age.Methods: Children aged 2 to 60 months admitted for the first time were included in the study and divided into two groups i.e. with and without clinical signs of rickets. Disease profile was studied in both groups. Incidence of lower respiratory tract infection was compared between two groups.  Children with clinicoradiological signs of rickets were also investigated for biochemical abnormalities.Results: During the one year study period a total of 393 children were admitted, 65 were found to have rickets constituted as study group and 328 were without rickets were included the controls. Rickets incidence was 16.5% of which majority (74.6%) were males and most rachitic children (64.6%) were below six months of age. Acute lower respiratory tract infection (64.6%) was commonest in study group and acute gastroenteritis (24.4%) in the controls. The rate of ALRTI was nearly three times in study group.  Frontal bossing (67.7%) was most common sign of rickets and increased alkaline phosphatase (93.8%) was the commonest biochemical abnormality.Conclusions: Nutritional rickets, a multifactorial disease, is easily preventable. The present study has revealed the high incidence of rickets i. e., 16.5% and also show the strong statistically significant association of nutritional rickets with acute lower respiratory tract infections.


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