scholarly journals ASSOCIATION OF IRON DEFICIENCY ANEMIA WITH ACUTE LOWER RESPIRATORY TRACT INFECTIONS IN CHILDREN

2021 ◽  
Vol 71 (4) ◽  
pp. 1322-26
Author(s):  
Raazia Nawaz ◽  
Shabbir Hussain ◽  
Arshad Khushdil ◽  
Sidra Tanveer ◽  
Maria Javed ◽  
...  

Objective: To establish association between acute lower respiratory tract infection and iron deficiency anemia. Study Design: Case-control study. Place and Duration of Study: Pediatrics Department, Pak Emirates Military Hospital, Rawalpindi, from Dec 2017 to May 2018. Methodology: A total of 100 children with age ranging from 6-60 months were selected for this study with 50 being in each group. Study group constituted of children presenting with acute lower respiratory tract infection and healthy children presenting to outpatient were taken as controls. Hemoglobin levels (<11g/dl), mean corpuscular volume (<70fl), Serum Ferritin (<30ng/ml) and red blood cell Morphology were used to determine iron deficiency anemia. Patients meeting the WHO criteria were labeled to have acute lower respiratory tract infection. Results: The frequency of iron deficiency was found to be 40 (80%) in cases and only 34 (17%) in healthy controls. A significant association was found between iron deficiency anemia and acute lower respiratory tract Infection with an odds ratio of 7.76 and a significant p-value of <0.01. Conclusions: Iron deficiency anemia has an increased association of up to seven times in children with acute lower respiratory tract infections as compared to healthy children thus highlighting it as a significant risk factor.

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


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.


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


Author(s):  
Lise Beier Havdal ◽  
Britt Nakstad ◽  
Hans Olav Fjærli ◽  
Christian Ness ◽  
Christopher Inchley

AbstractViral lower respiratory tract infection (VLRTI) is the most common cause of hospital admission among small children in high-income countries. Guidelines to identify children in need of admission are lacking in the literature. In December 2012, our hospital introduced strict guidelines for admission. This study aims to retrospectively evaluate the safety and efficacy of the guidelines. We performed a single-center retrospective administrative database search and medical record review. ICD-10 codes identified children < 24 months assessed at the emergency department for VLRTI for a 10-year period. To identify adverse events related to admission guidelines implementation, we reviewed patient records for all those discharged on primary contact followed by readmission within 14 days. During the study period, 3227 children younger than 24 months old were assessed in the ED for VLRTI. The proportion of severe adverse events among children who were discharged on their initial emergency department contact was low both before (0.3%) and after the intervention (0.5%) (p=1.0). Admission rates before vs. after the intervention were for previously healthy children > 90 days 65.3% vs. 53.3% (p<0.001); for healthy children ≤ 90 days 85% vs. 68% (p<0.001); and for high-risk comorbidities 74% vs. 71% (p=0.5).Conclusion: After implementation of admission guidelines for VLRTI, there were few adverse events and a significant reduction in admissions to the hospital from the emergency department. Our admission guidelines may be a safe and helpful tool in the assessment of children with VLRTI. What is Known:• Viral lower respiratory tract infection, including bronchiolitis, is the most common cause of hospitalization for young children in the developed world. Treatment is mainly supportive, and hospitalization should be limited to the cases in need of therapeutic intervention.• Many countries have guidelines for the management of the disease, but the decision on whom to admit for inpatient treatment is often subjective and may vary even between physicians in the same hospital. What is New:• Implementation of admission criteria for viral lower respiratory tract infection may reduce the rate of hospital admissions without increasing adverse events.


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.


2019 ◽  
Vol 36 (1) ◽  
pp. 27-37 ◽  
Author(s):  
Vahid Rahmanian ◽  
Masihollah Shakeri ◽  
Heshmatollah Shakeri ◽  
Abdolreza Sotoodeh Jahromi ◽  
Alireza Bahonar ◽  
...  

Summary Influenza is of particular importance because of the pace of epidemics, the extent and number of infected people, and the severity of the side effects. The aim of this study was to investigate the epidemiological and clinical aspects of this disease during the last epidemic in southern Iran. The present cross-sectional study was performed on the basis of secondary data analysis and information in medical records of patients with acute lower respiratory system infection in hospitals affiliated to Jahrom University of Medical Sciences. Data were analyzed by SPSS 18 using descriptive statistics, Chi-square test and logistic regression at 0.05 significance level. From 1st September 2015 to 20th March 2016, 108 patients with acute lower respiratory tract infection with a mean age of 42.92 ± 19.65 years were admitted to Jahrom hospitals, of which 43 were diagnosed with definite influenza, all of which (100%) had H1N1 type A influenza. There were eight deaths in all, of which five were positive for H1N1, and of these five cases, three cases had delayed diagnosis and treatment, and four cases had underlying diseases. The results of multivariate logistic regression analysis showed a significant relationship between positive H1N1 cases and history of contact with definite influenza, traveling abroad, and clinical symptoms of chills (p < 0.05). The results of this study showed that 39.81% of the patients with acute lower respiratory tract infections suffered from influenza. Furthermore, the delayed treatment and the underlying diseases were the most important cause of death.


Author(s):  
Jefri Naldi ◽  
Rosidah Rosidah ◽  
Ricke Loesnihari

Objective: The aim of this study was to establish cases of bacteria associated with lower respiratory tract infections (LRTIs) in General Hospital Dr. Pirngadi Medan with the view to identify the bacteria well as to assess their antibiotics susceptibility.Methods: An observation and prospective study were analyzed to patients with lower respiratory tract infection in respiratory and internal wards Dr. Pirngadi Hospital Medan. For the identification method of bacteria was using optochin test, catalase test, Mannitol salt agar, coagulase, indole, methyl red, Voges–Proskauer test, citrate, urease, and Triple Sugar Iron test.Results: The bacteria that cause lower respiratory tract infection were Pseudomonas aeruginosa (25.53%), Klebsiella pneumoniae (17.02%), Proteus sp. (14.89%), Staphylococcus aureus (12.77%), Escherichia coli (10.64%), Streptococcus pneumoniae (10.64%), and Haemophilus influenzae (8.51%). The result of sensitivity testing showed that gentamicin is more sensitive and the resistant antibiotic is chloramphenicol among all the tested antibiotics.Conclusion: P. aeruginosa was the most common isolated from LRTIs patients with gentamicin is the most sensitive antibiotics while chloramphenicol is the most resistant antibiotics among all the tested antibiotics.


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