scholarly journals Efficacy of prednisolone for children with acute bronchiolitis having family history of atopy: A randomized placebo-controlled trial

2015 ◽  
Vol 6 (1) ◽  
pp. 9-11
Author(s):  
Md Abid Hossain Mollah ◽  
Khondokar Jahirul Hasan ◽  
M Ekhlasur Rahman ◽  
Shegufta Rahman
Keyword(s):  
Placebo Group ◽  
Family History ◽  
Hospital Stay ◽  
Oxygen Therapy ◽  
Controlled Trial ◽  
Length Of Hospital Stay ◽  
Oral Prednisolone ◽  
Acute Bronchiolitis ◽  
Medical College ◽  
History Of

Objective : To determine the efficacy of oral prednisolone among children with acute bronchiolitis who have associated family history of atopy.Materials and Methods : This randomized double blind placebo controlled trial was carried out in Dhaka Medical College Hospital during July’08 to June’10. A total of sixty patients (1-24 months) of acute bronchiolitis who had family history of atopy (e.g. allergic rhinitis, allergic conjunctivitis, asthma, eczema) were enrolled. After enrollment, allocation of either prednisolone or placebo to the study subjects were done randomly by lottery method and the researcher remained blind about the allocation. Finally 30 cases received prednisoloneorally at a dose of 2mg/kg/day 8 hourly for 3 consecutive days and 30 cases received placebo (made of flour). In addition, both the groups got same supportive measures. During intervention, study subjects were monitored by Modified Respiratory Distress Assessment Instrument (MRDAI) score twice daily for consecutive 3 days. Duration of oxygen therapy as well as length of hospital stay was also determined. Data were analyzed using appropriate statistical tests and a p value of <0.05 was considered significant.Results : The respiratory rate, accessory muscle use and auscultatory finding scores were significantly declined in Prednisolone group than the placebo group (p<.05). However, cyanosis score though declined in both groups, the difference was not significant (p>.05). Mean duration of oxygen therapy needed in Prednisolone group was significantly lesser than the placebo group (13.7 vs 24.1 hours; P<.01). Similarly, the length of hospital stay was shorter in prednisolone group than in placebo group (3.3 vs 4.6days; p<.01).Conclusions : Three days of oral prednisolone therapy along with supportive measures was found to be significantly useful among children with acute bronchiolitis having family history of atopy in terms of clinical recovery, oxygen requirement and duration of hospital stayNorthern International Medical College Journal Vol.6(1) 2014: 9-11

scholarly journals Comparative Efficacy of Nebulized 7% Hypertonic Saline versus 3% Hypertonic Saline in Children with Acute Bronchiolitis

2018 ◽  
Vol 26 (2) ◽  
pp. 153-156
Author(s):  
Md Saiful Islam ◽  
Md Abid Hossain Mollah ◽  
Tafazzal Hossain Khan ◽  
Chandan Kumar Shaha ◽  
Md Zahir Uddin ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Hypertonic Saline ◽  
Severity Score ◽  
Oxygen Therapy ◽  
Length Of Hospital Stay ◽  
Saline Group ◽  
Clinical Severity ◽  
Acute Bronchiolitis ◽  
Medical College ◽  
Group I

Background: Acute bronchiolitis is an acute viral lower respiratory tract infection in early childhood and is the leading cause of hospitalization in infants below 2 years of age. Being a viral disease, there is no effective treatment of this problem other than supportive care. To provide this care, both 3% hypertonic saline and 7% hypertonic saline has been used and found effective. However, which option is more effective to reduce clinical severity and length of hospital stay, still remain unsettled.Objective: To determined the efficacy of 7% hypertonic saline in children with acute bronchiolitis.Methodology: The study was a randomized controlled trial and carried out in the Department of Paediatrics, Dhaka Medical College Hospital (DMCH), Dhaka between January 2015 to December 2016. A total of 135 children from 1 month to 2 years of age irrespective of sex with clinical presentation of acute bronchiolitis admitted in the paediatrics ward of DMCH were included in the study and were randomly assigned to either 7% nebulized hypertonic saline (Group-I = 45) or to 3% nebulized hypertonic saline (Group-II = 90) in ratio (1:2). The main outcome variables were clinical severity score and length of hospital stay. The outcome was evaluated at 12 hourly and 24 hourly intervals till discharge (up to 120 hours)Result: In this study both groups were almost similar with respect to their demographic characteristics like age and sex and baseline clinical characteristics. The study demonstrated that respiratory rate score, wheezing score, retraction score, general condition score and clinical severity score of both treatment modalities were reduced. Children of group-I(7% HS) 40(88.9%) recovered at the end of 72 hours where as 67(74.4%) of the children of group-II(3% HS) recovered from the disease during the same period. Length of hospital stay was shorter in 7% hypertonic saline group compared to 3% hypertonic saline group (56.36±16.33 hours vs63.07±21.48 hours, p=.067). The patients of 7% hypertonic saline group required a shorter duration of oxygen therapy compared to 3% hypertonic saline group (16.53±3.98) hours vs (20.25± 4.15) hours, (p=0.109) respectively.Conclusion: Nebulized 7% hypertonic saline as well as 3% hypertonic saline both were effective in acute bronchiolitis and found no significant difference in efficacy between these options in terms of reducing clinical severity, length of hospital stay and duration of oxygen therapy. No side effect were observed in either group.J Dhaka Medical College, Vol. 26, No.2, October, 2017, Page 153-156

scholarly journals Lung Ultrasound and Clinical Progression of Acute Bronchiolitis: A Prospective Observational Single-Center Study

Medicina ◽  
2020 ◽  
Vol 56 (6) ◽  
pp. 314
Author(s):  
Antonio Di Mauro ◽  
Anna Rita Cappiello ◽  
Angela Ammirabile ◽  
Nicla Abbondanza ◽  
Francesco Paolo Bianchi ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Oxygen Therapy ◽  
Lung Ultrasound ◽  
Length Of Hospital Stay ◽  
Supplemental Oxygen ◽  
Acute Bronchiolitis ◽  
Clinical Progression ◽  
Single Center Study ◽  
Ultrasound Score ◽  
Center Study

Background and Objectives: Recent literature suggests that lung ultrasound might have a role in the diagnosis and management of bronchiolitis. The aim of the study is to evaluate the relationship between an ultrasound score and the clinical progression of bronchiolitis: need for supplemental oxygen, duration of oxygen therapy and hospital stay. Materials and Methods: This was a prospective observational single-center study, conducted in a pediatric unit during the 2017–2018 epidemic periods. All consecutive patients admitted with clinical signs of acute bronchiolitis, but without the need for supplemental oxygen, underwent a lung ultrasound in the first 24 h of hospital care. The lung involvement was graded based on the ultrasound score. During clinical progression, need for supplemental oxygen, duration of oxygen therapy and duration of hospital stay were recorded. Results: The final analysis included 83 patients, with a mean age of 4.5 ± 4.1 months. The lung ultrasound score in patients that required supplemental oxygen during hospitalization was 4.5 ± 1.7 (range: 2.0–8.0), different from the one of the not supplemented infants (2.5 ± 1.8; range: 0.0–6.0; p < 0.001). Ultrasound score was associated with the need for supplemental oxygen (OR = 2.2; 95% CI = 1.5–3.3; p < 0.0001). Duration of oxygen therapy was not associated with LUS score (p > 0.05). Length of hospital stay (coef. = 0.5; 95% CI = 0.2–0.7; p < 0.0001) correlates with LUS score. Conclusion: Lung ultrasound score correlates with the need of supplemental oxygen and length of hospital stay in infants with acute bronchiolitis.

scholarly journals Comparative Efficacy of Nebulized 3% Hypertonic Saline versus 0.9% Normal Saline in Children with Acute Bronchiolitis

2018 ◽  
Vol 42 (3) ◽  
pp. 130-137 ◽  
Author(s):  
Khandaker Tarequl Islam ◽  
Abid Hossan Mollah ◽  
Abdul Matin ◽  
Mahmuda Begum
Keyword(s):  
Hospital Stay ◽  
Hypertonic Saline ◽  
Normal Saline ◽  
Severity Score ◽  
Oxygen Therapy ◽  
Length Of Hospital Stay ◽  
Clinical Severity ◽  
Acute Bronchiolitis ◽  
Group I ◽  
Group Ii

Background: Acute bronchiolitis is leading cause of hospitalization in infants below 2 years of age. Bronchiolitis being a viral disease, there is no effective treatment. 3% nebulized hypertonic saline and 0.9% nebulized normal saline are often used, although there is disagreement over their efficacy. The aim of this study was to evaluate the efficacy of 3% hypertonic saline in children with acute bronchiolitis in reducing clinical severity and length of hospital stay. Methodology: A randomized control trial carried out in the Department of Pediatrics, Dhaka Medical College Hospital from January 2013 to December 2013.Ninty children from 1 month to 2 years of age hospitalized with clinical bronchiolitis were randomized to receive 3% nebulized hypertonic saline(Group-I) or 0.9% nebulized normal saline (Group-II). Nebulization was done 8 hourly until discharge. Outcome variable were clinical severity score, duration of oxygen therapy and length of hospital stay. Results: Baseline clinical severity score and O2 saturation were in group-I 9.0±1.0 and 94.9±1.7 and in group- II 9.3±1.8 and 94.6±2.6 respectively (p>0.05). At 72 hours, the mean severity score for the group-I was 1.64±0.99 and that for the group-II was 3.0 ± 1.48 (95% CI -2.17 to - 0.53, p=0.002). The cases of group-I required a shorter duration of oxygen therapy compared to those of group-II (15.0±6.0 hours vs 26.4±5.37 hours, 95% CI -20.35 to -2.44, p<0.05). Forty two (93.3%) of the group-I children recovered by the end of72 hours and discharged whereas 26 (57.8%) of the group-II children recovered during the same period (p<0.05). Length of hospital stay was shorter in group-I compared to group-II (58.1±22.0 hours vs 74.7±27.2 hours, 95% CI -26.89 to- 6.17, p=0.002). None of the cases encountered any side-effects. Conclusion: Nebulization with 3% hypertonic saline significantly reduced clinical severity, length of hospital stay and duration of oxygen therapy in case of acute bronchiolitis in comparison to 0.9% normal saline and was safe. Bangladesh J Child Health 2018; VOL 42 (3) :130-137

scholarly journals Prediction of Length of Hospital Stay and Immediate Outcome of Children Suffering From Bronchiolitis on the Bases of Associated Risk Factors

2021 ◽  
Vol 7 (2) ◽  
pp. 67-71
Author(s):  
Bithi Debnath ◽  
Sajani Islam ◽  
Nazmul Haque
Keyword(s):  
Risk Factors ◽  
Family History ◽  
Hospital Stay ◽  
Previous History ◽  
Length Of Hospital Stay ◽  
Wood Burning ◽  
History Of ◽  
Male Sex ◽  
Associated Risk Factors ◽  
Length Of Hospitalization

Background: Bronchiolitis is the most common reason for hospitalization among children younger than 2 years. Objective: The aim of the study was to assess the possibility that the associated risk factors in children suffering from bronchiolitis could predict the length of hospital stay and also to observe the immediate outcome. Methodology: This prospective study was conducted in a district hospital of Bangladesh in a period of two years from January 2011 to December 2012. Patients aged 2 years or less fulfilling inclusion criteria for bronchiolitis and required admission were enrolled in this study. Patients having comorbidities and who were discharged before fulfilling the study criteria for discharge were excluded from the study. Treatment was given according to National Guidelines for the Management of Bronchiolitis. All demographic, clinical and laboratory data were recorded in a prefixed questionnaire and analyzed. Results: Among 100 patients, 60% cases were hospitalized for 4 days or more. Mean duration of hospital stay was 4.37±1.93 days. Patients of male sex (67%), younger than 6 months of age (71%), preterm birth (21%), weight-for-age was either ≥2SD (60%) or ≤3SD (23%) were hospitalized for longer duration. Length of hospitalization was also increased in patients with family history of asthma (37%), smoking (75%), using wood-burning stoves for cooking (89%) and no previous history of respiratory distress (81%). Exclusively breastfed infants (41%) stayed hospital for shorter duration than those who fed partially (53%) or not at all (6%). All patients were improved in this case series (100%). Conclusion: Bronchiolitis patients having male sex, age less than 6 months, preterm born, partially breast fed , family history of asthma, exposure to smoking and wood-burning stoves were deduced to be significant risk factors for prolongation of length of hospitalization. Further research is needed to determine how these risk factors contribute to the development of the disease and prolong the length of hospital stay. Bangladesh Journal of Infectious Diseases 2020;7(2):67-71

scholarly journals Efficacy of oral erythromycin to enhance feeding tolerance in preterm infants

2017 ◽  
Vol 57 (3) ◽  
pp. 154
Author(s):  
Made Sukmawati ◽  
Rinawati Rohsiswatmo ◽  
Rulina Suradi ◽  
Pramita Gayatri
Keyword(s):  
Placebo Group ◽  
Hospital Stay ◽  
Preterm Infants ◽  
Enteral Feeding ◽  
Controlled Trial ◽  
Length Of Hospital Stay ◽  
Feeding Intolerance ◽  
Body Weights ◽  
Full Enteral Feeding ◽  
Feeding Tolerance

Background Feeding intolerance is a common condition that affects preterm infants. Erythromycin is a prokinetic agent used to treat feeding intolerance, but its efficacy remains inconclusive.Objective To evaluate the effectiveness of oral erythromycin to enhance feeding tolerance in preterm infants.Methods This prospective, randomized controlled trial in preterm infants was conducted at Sanglah Hospital, Denpasar, Bali, from June 2015 to January 2016. Eligible infants were randomized to receive either 12.5 mg/kg/dose oral erythromycin or a placebo, every 8 hours. The primary outcome was the time to establish full enteral feeding. The secondary outcomes were body weight at full enteral feeding and length of hospital stay.Results Of 62 initial subjects, 3 infants dropped out of the study. Thirty infants were given erythromycin and 29 infants were given placebo. The baseline characteristics of the two groups were similar, with mean of gestational ages of 31.4 (SD 1.7) weeks in the erythromycin group and 32.4 (SD 2.2) weeks in the placebo group. The median times to reach full enteral feeding did not significantly differ between the two groups, with 10 (SD 5.3) days in the erythromycin group vs. 8 (SD 6.5) days in the placebo group (P=0.345). Also, median body weights at full enteral feeding and lengths of hospital stay were not significantly different between the two groups.Conclusion Erythromycin of 12.5 mg/kg/dose every 8 hours as prophylactic treatment does not significantly enhance feeding tolerance in preterm infants. Median body weights at full enteral feeding and length of hospital stay are not significantly different between the erythromycin and placebo groups.

scholarly journals Implementation of enhanced recovery after surgery in gynecological operations: a randomized controlled trial

2020 ◽  
Vol 12 (1) ◽  
Author(s):  
Amr Nady Abdelrazik ◽  
Ahmad Sameer Sanad
Keyword(s):  
Hospital Stay ◽  
Enhanced Recovery ◽  
Enhanced Recovery After Surgery ◽  
Controlled Trial ◽  
Length Of Hospital Stay ◽  
Gynecologic Surgery ◽  
Complication Rates ◽  
Control Groups ◽  
Analog Scale ◽  
Randomized Controlled

Abstract Background To investigate the effects of enhanced recovery after surgery (ERAS) in patients undergoing gynecologic surgery on length of hospital stay, pain management, and complication rate. Results The length of hospital stay was reduced in ERAS groups when compared with the control groups (3.46 days vs 2.28 days; P < 0.0001; CI − 1.5767 to − 0.7833 for laparotomy groups and 2.18 vs 1.76 days; P = 0.0115; CI − 0.7439 to − 0.0961 for laparoscopy groups respectively). Intraoperative fluid use was reduced in both ERAS groups compared to the two control groups (934 ± 245 ml and 832 ± 197 ml vs 1747 ± 257 ml and 1459 ± 304 respectively; P < 0.0001) and postoperative fluid use was also less in the ERAS groups compared to the control groups (1606 ± 607 ml and 1210 ± 324 ml vs 2682 ± 396 ml and 1469 ± 315 ml respectively; P < 0.0001). Pain score using visual analog scale (VAS) on postoperative day 0 was 4.8 ± 1.4 and 4.1 ± 1.2 (P = 0.0066) for both laparotomy control and ERAS groups respectively, while in the laparoscopy groups, VAS was 3.8 ± 1.1 and 3.2 ± 0.9 (P = 0.0024) in control and ERAS groups respectively. Conclusion Implementation of ERAS protocols in gynecologic surgery was associated with significant reduction in length of hospital stay, associated with decrease intravenous fluids used and comparable pain control without increase in complication rates.

scholarly journals The role of bovine colostrum on recovery time and length of hospital stay of acute diarrhea in infants and children: a double-blind randomized controlled trial

2016 ◽  
Vol 46 (3) ◽  
pp. 127
Author(s):  
IGN Suwarba ◽  
Sudaryat S ◽  
Hendra S ◽  
IKG Suandi ◽  
Raka Widiana
Keyword(s):  
Hospital Stay ◽  
Acute Diarrhea ◽  
Recovery Time ◽  
Controlled Trial ◽  
Length Of Hospital Stay ◽  
Bovine Colostrum ◽  
Mean Difference ◽  
Infants And Children ◽  
Double Blind ◽  
Defecation Frequency

Background WHO standard treatment for acute diarrhea remainsunsatisfying to the parents of acute diarrhea patients, particularlythe need of medical treatment. Bovine colostrum contains immuneand growth factors that is thought able to neutralize some agentscausing acute diarrhea in infants and children.Objective To evaluate the efficacy of bovine colostrum as adju-vant therapy on recovery time and length of hospital stay for acutediarrhea in infants and children.Methods A double-blind randomized controlled trial was conductedon infants and children with acute diarrhea admitted to SanglahHospital. Treatment group received standard therapy with bovinecolostrums and control group received standard therapy plus pla-cebo. The primary outcomes were achievement of recovery timeand length of hospital stay. Recovery time was determined by thenumber of days needed to achieve defecation frequency <3 times/day and needed to achieve normal stool consistency.Results Seventy infants and children were enrolled. The treatmentgroup significantly achieved recovery time earlier than the control groupin regard to the time of achieving defecation frequency to <3 times/day [2.31 (0.76) vs 3.34 (1.45); mean difference of -1.03; P= 0.001; CI95% -1.58;-0.48] and normal stool consistency [2.40 (0.77) vs 3.43(1.48); mean difference of -1.03; P = 0.001; CI 95% -1.59;-0.46]. Lengthof hospital stay was shorter in the treatment group than the controlgroup [2.89 (0.78) vs 3.94 (1.53); mean difference of -1.05; P= 0.001;CI 95% (-1.3;-0.7)]. No significant difference was found in mean ofbody weight recovery in two groups [0.47 (0.16) vs 0.49 (0.20); meandifference of -0.03; P=0.556; CI 95%: -0.11;0.06]. Age, nutritionalstatus, breastfeeding, and diarrhea before admission did not influ-ence the study outcome.Conclusion Bovine colostrums as an adjuvant in standard therapyfor acute diarrhea in infants and children is effective in regard toachieve earlier recovery time and shorter length of hospital stay

scholarly journals Study of risk factors and its correlation with constraint induced movement therapy for atherosclerosis in patients of coronary artery disease and their offspring

2020 ◽  
Vol 7 (3) ◽  
pp. 446
Author(s):  
Venugopal Margekar ◽  
Shweta Thakur ◽  
O. P. Jatav ◽  
Pankaj Yadav
Keyword(s):  
Risk Factors ◽  
Family History ◽  
Positive Family History ◽  
Surrogate Marker ◽  
Control Group ◽  
Medical College ◽  
Constraint Induced Movement Therapy ◽  
Group Data ◽  
History Of ◽  
Artery Disease

Background: A significant percent of cardiovascular event occurs without well-known modifiable risk. A new tool for early identification for atherosclerosis is required for early intervention. Aims and objectives of the study was to study the risk factors for CAD and its correlation with CIMT.Methods: One hundred and forty subjects were studied for the risk factors of CAD in Department of Medicine of G.R. Medical College, Gwalior from 2012 to 2013. Out of 140 subjects, 100 were patients having CAD and 40 age matched subjects were included as control group. Data was also recorded from their offspring. High resolution B mode ultrasonography was performed to assess CIMT of carotid arteries. The maximum CIMT of any one side of carotid artery was taken for study.Results: CAD was more prevalent among males (78%). Majority of the offspring of cases had age between 28-42 years and majority were male (73%). Most common risk factors for CAD was dyslipidemia (48%), hypertension (24%), diabetes (12%) and smoking (21%), whereas in offspring’s of CAD patients, dyslipidemia was seen in 28%, hypertension in 3%, diabetes and tobacco smoking in 12% and 24% respectively. The CIMT of CAD patients was significantly increased with increasing the number of risk factors and the same pattern was also seen in controls.  The CIMT of asymptomatic offspring’s having positive family history was significantly more than the asymptomatic offspring without positive family history of CAD.Conclusions: CIMT measurements can be used as a surrogate marker of atherosclerosis as it has showed a direct link with number of risk factors of CAD. 

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