A prospective study of ALRI in childrenaged2months to 5 years conducted at Department of Paediatrics, Sri Muthu Kumaran Medical College. Totally 100 Children admitted to our hospital with a clinical diagnosis of ALRI as per WHO criteria from January 2016 TO December 2016.Inclusion Criteria-Children with ALRI from 2months to 60 months. Exclusion Criteria-Children less than 2months and more than 60 months. Children with any underlying chronic respiratory or cardiac illness. Children in the age group of 2months to 5 years admit- ted with ALRI during the study period were enrolled in the study as cases. A detailed history and physical
This is to certify that the dissertation titled “PREVALENCE OF RAISED IgE LEVELS AND ABSOLUTE EOSINOPHIL COUNT IN BRONCHIOLITIS IN CHILDRENAGED2MONTHS TO 2 YEARS IN TERTIARY CARE CENTRE” is submitted by Dr.SINDHU BHARATHI S , post graduate student in department of paediatrics to The Tamilnadu Dr.M.G.R Medical University, Chennai in partial fulfilment of the requirement of the award for the degree of M.D BRANCH VII (PEDIATRICS) and is a bonafide work done by her under our direct supervision and guidance, for MD degree examination to be conducted on April 2016
All the three components of care envisaged in IMCI strategy can be upgraded by the use of AIOS. Firstly, the evidence based syndromic approach lays significant emphasis on evaluating the severity of child’s condition by primary care workers who usually misclassify symptoms with overlapping causes or for which a single diagnosis using earlier vertical disease WHO algorithm, AIOS seems to fulfill this role in simple and objective manner. In a series of articles beginning in 1980 McCarthy et al ad already demonstrated the utility of AIO children who have the most toxic illness and those who have serious illness (e.g. pneumonia, UTI, meningitis, severe gastroenteritis, a focal complication etc.). AIOS offers an explicit, objective, and actionable easily implemented in real world practice.
Results: Out of 120 children involved in the study, majority 56 (46.66%) children were <6 months age. Male preponderance was observed in the study (M:F-1.4:1). Higher proportion of moderate to severe cases was from rural area (61 cases). More severe cases were seen in lower socioeconomic class people and who had history of second hand smoking (21.67%). Clinically better improvement was seen in children that received nebulized hypertonic saline along with supportive management with mean length of hospital stay of 2.5 days when compared to only supportive management with mean length of hospital stay of 3.25 days. The mean length of hospital stays with nebulized salbutamol along with supportive management is 3.05 days which is not clinically significant. Of the 120 children studied, 118 (98.33%) survived and were discharged, while 2children who presented critically succumbed to death (1.67%).
The most common cause of CNS vasculitis is bacterial meningitis. Cerebral infarction is found in 12 to 27% of children with bacterial meningitis. These children are more prone to seizures, and their outcomes are poor. Risk factors include high CSF white cell count, hypoglycorrhachia, age below 12 months, and delayed treatment. Antibiotic treatment should be started as early as possible. Steroids before the first dose of antibiotics may reduce the risk of neurologic and audiologic impairment. CNS vasculitis is seen in most children with tuberculous meningitis, and cerebral infarction in the basal ganglia area is common. Septic embolism caused by bacterial endocarditis can cause CNS vasculitis and stroke.
could be that, in our setting, we follow only the immunization guidelines listed under the National immunization schedule where optional vaccines are not listed. Besides, the economically disadvantaged group do not afford the optional vaccines. It was observed that mud (kutcha) house have a very significant impact of wheezing among the children. 58.7% of the cases were residents of kuccha house as compared to 41.3% who reside in pukka houses. This result can be compared with study by Savitha MR et al, where they found 61.54% of cases had either mud/cowdung flooring in their house. 8
During their management 8.5% (21/248) of children were so severely affected that they needed normal saline boluses to correct the shock and 7.7% (19/248) needed ionotropic support with dopamine or dobutamine. Airway intubation was needed in 2.8% (7/248) of cases either for respiratory failure or shock management. Oxygen was administered for 32.3% (80/248) of cases in view of severe respiratory distress or cyanosis. 28.6 % (71/248) of children required maintenance intravenous fluids because of severe respiratory distress and/or dehydration. Parenteral antibiotics were administered to 50.4% (125/248) patients while remaining were treated with oral antimicrobials. Presence of wheeze necessitated salbutamol nebulization in 25.4% (63/248) of cases. During the hospital stay 9.7% (24/248) developed complications either in the form of shock, empyema or pyopneumothorax. 5 children (2%) expired even after intensive care management. The mean duration of hospital stays (±SD) was 4.58 (±4.94) days.
Besides, the research includes a theoretical analysis of works of a number of the most leading Russian researchers, particularly A.V. Zaporozhets. He came to the definition of the “internal picture” or internal form of movement (Zaporozhets 1986). According to the researcher, this picture contains the course of the situation and those actions that can be made within this situation. A.V. Zaporozhets was the first researcher in the world who included the course of the situation and the course of action, i.e., a sort of sensuous tissue in biodynamic tissue of movement, motion experience. Mastering new actions (not acquiring objects by actions or activity) is real enrichment of a human being. It means the development of not only operative and technical peculiarities but also his/her personality, really human life style. Simultaneously with the analysis of fundamental resources, childrenaged2months–7 years were observed (512 children participated in the research) in order to study the hand movements made in everyday life and in the process of various types of art activity.
Of the 7.6 million children who died in the first five years of life in 2010, 4.9 million (64%) died of infectious conditions. Pneumonia caused 1.4 million deaths (18.3%) of all mortalities in children under five, and 4% of 18.3% mortalities were in the neonatal period. In India an estimated 4 lakh pneumonia deaths occurs annually, which is highest among all the countries in the world. 5 The aim was to study the clinical profile of ALRTI in childrenaged2months to 5 years, to study the risk factors associated with ALRI in these children, to study the outcome and its predictors.
The aims of the study were to estimate the incidence of reactive thrombocytosis (RT) among febrile childrenaged2months to 12 years and to identify any differences in age group and gender in mounting thrombocytosis as a response to infection, to identify if thrombocytosis occurred preferentially in any particular group of serious bacterial infections (SBI), to compare thrombocytosis with other parameters like total white cell count, C- reactive protein (CRP), cultures etc. and to assess the utility of platelet count as a potential predictor of serious bacterial infection.
Zinc supplementation also decreased the severity of acute respiratory exacerbations in children with cystic fibrosis. The present study included all cases which had respiratory symptoms. This may have led to inclusion of bacterial pneumonia, viral bronchiolitis, chronic infections like tuberculosis and also non-infectious respiratory conditions like asthma and respiratory complications of sickle cell disease. 28 The varied clinical
To investigate the impact of vaccination timing and timeliness on effective cov- erage among young children, we cal- culated the proportion of susceptible children for a hypothetic group of in- fants and toddlers aged 6 months to 2 years. The chosen age range is rep- resentative of a substantial propor- tion of children in day care groups in Switzerland and elsewhere, an envi- ronment where measles transmissions could easily occur during an outbreak. The relative age distribution and mea- sles vaccination levels in this group re ﬂ ected that in our cohort. In such a group and under the same assump- tions as detailed previously, on average 48.6% of children are susceptible to measles at current levels of vaccina- tion. The recommended timing of MCV1 and the resulting 6 months that chil- dren may spend susceptible to mea- sles even when up-to-date with respect to the immunization schedule had the largest impact on effective coverage. Inclusion of older children in this hy- pothetical group shows the additional effects of timeliness. Among childrenaged 6 months to 3 years, effective vaccine coverage would be 61.3%, the higher coverage largely re ﬂ ecting on- going immunization activity after the recommended ages for MCV1 and MCV2 vaccination.
inclusion criteria were recruited until the calculated sample size of one hundred and forty-four (144) was achieved. Study subjects involved childrenaged2-59 months with pneumonia defined by presence of cough and/ or difficulty with breathing plus tachypnoea and/ or lower chest in-drawing in addition to lobar consolidation, patchy infiltrate or pleural effusion on chest radiograph whose parents or guardians gave informed consent were recruited while children presenting with wheeze or rhonchi, stridor, a history of foreign body or chemical aspiration precipitating the presenting clinical features, pre-existing lung or heart disease or features of shock were excluded. This was to reduce the chances of recruiting children with bronchial asthma, bronchiolitis, upper airway obstruction or aspiration pneumonitis; exclude other disease conditions that can cause hypoxaemia and reduce the chances of obtaining false pulse oximetry values.
children, 123 (61.2%) were anemic and among 126 female children, 78 (38.8%) were anemic; the difference between gender was not statistically significant (Table-I). The mean (±SD) hemoglobin levels were 9.2± 1.2 g/dl in children with anemia, and 11.9±1.0 g/dl in children without anemia. Hemoglobin levels was significantly low in anemic children (P =0.001) than children without anemia (Table-II). The study patients were divided into three age groups. Maximum number was found in 12-23 months in both anemic and non anemic children which was 83(41.21%) in children with anemia and 62(47.69%) in children without anemia. The mean (±SD) age was 15.2±8.8 month for children with anemia and 18.6 ± 9.3 month for children without anemia. The mean age difference was statistically significant (p<0.001). The most affected
urban areas. 4 Based on NFHS-3 report, among under three years children in rural area-stunted 47.2%, underweight 43%, wasting 24.1%. 5 There is steep increase in prevalence of underweight from 27% at 6 months of age to 45% at 24 months of age. This mainly due to faulty infant and young child feeding practices in the community. 6 The proportion of underweight for the first 20 months of age is 47% after that fluctuates. 3 It has an adverse effects on economic growth of the country with an adult productivity loss of 1.4% of gross domestic product (GDP). 7 Wasted children have 5-20 times higher risk of dying from common diseases like diarrhoea or pneumonia than normally nourished children. 8 World health organization reported that malnutrition causes double burden. Across the world among under 5 years children, 156 million were stunted, 50 million wasted, 42 million have a problem of overweight. 9 Hence this study was conducted to assess the nutritional status of 6 months to 2 years agedchildren in terms of acute and chronic malnutrition and to estimate the association of feeding practices on acute and chronic malnutrition among mothers.
strips were placed in a holder and labeled (one blank well, one negative control, two calibrators, one positive control, and 91 wells for sample specimens). About 3 µ L of the test samples, negative control, positive control, and calibrators, was added to 240 µ L of the serum diluent and mixed well to make 1:80 dilutions. Next, 100 µ L each of the diluted samples was dispensed into appropriate wells, ensuring that there were no air bubbles. Air bubbles present in the liquid were removed by tapping the holder, and 100 µ L of the serum diluent was then added into the reagent blank well. The wells were incubated at room temperature (21 ° C–25 ° C) for 30 minutes. After incubation, the liquid from all wells was removed by washing three times with 300 µ L of wash buffer. Next, 100 µ L of enzyme conjugate was added into each well and incubated at room temperature for 30 minutes. Excess enzyme conjugate was removed by washing three times with the buffer; 100 µ L of chromogen/substrate solu- tion was then dispensed into each well and incubated at room temperature for 15 minutes. The reaction was stopped by addition of 100 µ L of stop solution (1 M H 2 SO 4 ) and the plate was tapped gently to mix the contents of the wells. The reading was done using an enzyme-linked immunosorbent assay microplate reader at 450 nm.
ARIs are the most common cause of both illness and mortality in children under five, who average three to six episodes of ARIs annually regardless of where they live or what their economic situation is. However the proportion of mild to severe disease varies between high and low income countries resulting in higher case fatality rate. Although medical care can to some extent mitigate both severity and fatality, estimates indicate that in 2000, 1-9 million of them died because of ARIs, 70 percent of them in Africa and South East Asia (Williams and Other 2002). The World health organization with estimates that 2 million children under five die of pneumonia in each year (Bryce and others 2005) 16
Acute respiratory infections, malaria, and diarrhoeal diseases remain among the leading causes of child morbidity and mortality in Mauritania [5,6]. At the time of the most recent multi-cluster indicator survey (MCIS3), conducted in 2007, 7% of children under- five reportedly had rapid and difficult breathing two weeks prior to the survey . Likewise, 18% of children under-five were reported to have had a fever at least once in the two weeks preceding the survey; 57% of households owned a mosquito net; and 12% of households were in possession of an insecticide treated net (ITN) . Diarrhoea affected approximately one-fifth (22%) of children under-five, and a more recent study conducted in Nouakchott reported a 52% diarrhoea risk due to poor basic hygiene . Only 35.8% of childrenaged 12-23 had received all recommended vaccines as part of the Ministry of Health’s Programme Élargi de Vaccination (Expanded Programme on Immunisation) and one in five children (20%) between the ages of 6-59 months had never received a Vitamin A supplement . In 2007, just over half of children (56%) had had their birth registered .
Childrenaged2 through 23 months presenting to a study hospital with a history of cough with a duration of less than 14 days and/or difficulty breathing are recruited by good clinical practice (GCP)-trained hospital staff during routine intake and screening procedures in the hospitals’ outpatient and/or emergency departments and referred to trained study staff for study screening. To avoid poten- tial selection bias, referred children are screened for enrolment in a sequential manner as much as possible. Referred children are considered for enrolment as cases if they present with chest indrawing or for enrolment as controls if they present with no chest indrawing, fast breathing or fever. Trained study staff assess the child for all inclusion and exclusion criteria (table 1). Final eligibility determination depends on the results of the medical history, clinical examination including WHO IMCI assessment, appropriate understanding of the study and completion of the written informed consent process. Cases and controls may be inpatient or outpatient at the discretion of the study site.
Place of residence implies the place where the respondent was interviewed and is described as either urban or rural based on whether the cluster or sample point was defined as rural or urban. However, the coding of this variable is not well defined in the DHS description for Kenya and thus difficult to differentiate between urban and rural residence from the available data. In the data it was coded 1 or 2 and it is not clear which one indicated urban and rural. We then referred to other studies and found rural was coded as 2 and urban as 1. Further we found that of 2979 subjects, 2701 were categorised as rural and only 278 are from the urban areas. This gives a poor representation of the urban community where obesity is expected to be more prevalent, despite the fact that the DHS survey is claimed to be nationally representative.