Clinical and aetiological profile of Pneumonia in age group between 1 month to 1 year: a hospital based prospective study

Background: Pneumonia is one of the leading causes of morbidity and mortality in children under five years of age across the world. The present study was designed to clinically evaluate the children of age 1 month to 1 year with pneumonia, correlate it with bacteriological, radiological findings and to study the risk factors.Methods: Clinical, bacteriological, radiological features and risk factors of community acquired pneumonia in children of age group 1 month to 1 year were noted and analysed.Results: As per WHO ARI control programme, 72% had pneumonia, 25.3 % had severe pneumonia and 2.6% had very severe pneumonia. Bacterial pneumonia was detected radiologically in 4.6% and viral pneumonia in 88.6% of cases. Chest X-ray was normal in 6.6% of cases. Tachypnoea, chest retractions, crepitations alone and crepitations with rhonchi correlated well with positive radiological findings. Inappropriate immunization for age, lack of breast feeding, preterm birth, smoking in family were significant risk factors for severe Pneumonia. 39.3% had leucocytosis and 24% had positive CRP. Culture was positive in 23 cases (15.3% culture positivity).Conclusions: Radiologically confirmed Pneumonia should be treated with antibiotics because, in clinical practice, it is virtually impossible to distinguish exclusively between viral pneumonia and bacterial pneumonia. As the viruses are most common causative agents of Pneumonia in 1 month to 1 year, PCR kits should be used to identify viral etiological agents. Early and exclusive breast feeding should be promoted to decrease the risk of pneumonia.

A Study of Lipid Profile Changes in Diabetes Mellitus.

Background: In the recent years, increase in the incidence of Diabetes Mellitus in developing countries has been associated with complications resulting in mortality and morbidity. This research determined the Lipid profile abnormalities in diabetes mellitus which is one of the leading cause of complications of diabetes mellitus. The incidence of type 2 diabetes mellitus (Type 2 DM) with altered lipid profile in one of the main causes of cardiovascular disease. Methods: 100 diabetic and 100 non diabetic patients enrolled in our hospital were included in the study. Biochemical tests for blood sugar levels, glycated hemoglobin, Total cholesterol, triglycerides, LDL, VLDL and HDL were performed. Results: The high levels of Total cholesterol, TGL and LDL were seen more among females than in males. Elevated levels of lipids were seen more among the diabetics than normal controls. Conclusion: Since high lipids with diabetes is a very dangerous combination, people should be educated properly towards the risk of this so that proper action can be taken maintain normal lipid levels.

Incidence of Hookworm Infection Related Anemia in Children in a Teaching Hospital in Telangana.

Background: Ancylostoma duodenale and Necator americanus are the blood sucking nematodes commonly called hookworms. They cause mild to severe anemia in patients especially children. The most common cause for hookworm infection is unhygienic conditions of the surroundings. Methods: 780 stool samples were collected from the children in wards, ICUs and schools. All the stool samples were subjected to wet mount by iodine and saline. They were also subjected to concentration technique by formalin ethyl acetate solution. Complete Blood Picture, estimation of Hemoglobin was done for all children for anemia and eosinophil testing. Results: 10.1% of the stool samples were positive for hookworms with 43 boys and 36 girls. 79.1% of the males and 88.3% of females were anemic with overall percentage being. Most of the children were from poor background with unhygienic conditions. Conclusion: Since most children belonged to poor background with unhygienic conditions, health education, improvement in sanitation, and mass treatment in affected areas can be tried.

Role of Induced Sputum, Bronchial Aspirate and Post Bronchoscopic Sputum in the Diagnosis of Sputum Smear Negative Pulmonary Tuberculosis.

Background: The diagnosis of Pulmonary Tuberculosis is largely dependent of the positive result of the sputum smear by ZN staining. But in many cases, although active tuberculosis is present, due to many reasons, sputum smear may yield a negative result. With a late culture result, no reliable serological test available to enable an early diagnosis, role of induced sputum and bronchoscopy has been tried with excellent results. Methods: 50 fresh smear negative cases between the ages of 16-65 years, clinically and radiologically suspected of Pulmonary Tuberculosis were subjected to induced sputum and bronchoscopy after detailed history and thorough clinical examination as done. Clinical symptoms were noted, 2 sputum smears (spot and early morning) and chest x-rays were taken for all patients. Results: Males between 24 – 44 years were seen to be predominant patients. The most common symptom appeared to be cough in 80% followed by fever in 60% of the cases. 76% of patients had unilateral lesions and 24% with bilateral lesions. 84% of the sputum negative patents were identified as active tuberculosis cases. Conclusion: Induced sputum and fiber optic bronchoscopy with bronchial aspirate and post bronchoscopic sputum can provide excellent material for diagnosis of suspected cases of Pulmonary Tuberculosis in whom smears of expectorated sputum do not reveal mycobacteria. There is minimum patient discomfort, reduced complications and relatively good yield which makes these procedures justifiable in the diagnosis of fresh smear negative pulmonary tuberculosis.

In vitro antimicrobial activity of cefsulodin and kanamycin in combinations.

Background: Infectious diseases are the greatest challenge of the world. The main failure in the treatment of infectious diseases is development of antibiotic resistance by the infective agents. Combination drug therapy is proposed to be more successful to contain diseases. But before the selection of combination of antibiotics, it is important to determine interaction of such antibiotics. Two antibiotics may have either synergistic or antagonistic action. In this study it was designed to find out the Minimum Inhibitory Concentration (MIC), and Minimum Bactericidal Concentration (MBC), which is usually used for the quantitative assessment of bacterial sensitivity to antibiotics. Methods: Checkerboard titration in microtitre trays used for this assay, and Fractional Inhibitory Concentration (FIC) and Fractional Bactericidal Concentration (FBC) measured to identify the type of interaction between the two antibiotics. Cefsulodin (Cef) and Kanamycin (Kan) were used against Escherechia coli (Esch. coli) and Staphylococcus aureus (Staph. aureus) to determine the efficacy of these antibiotics in combination. Results: MIC of cefsulodin and kanamycin against Staph. aureus was 3.125 and 3.125 respectively. MIC of Cef for Esch. coli was 6.25 and for Kan 50. FIC for Staph. aureus was 1. FIC for Esch. coli was different in different antibiotic concentrations and the least value was 0.37. There was no bactericidal effect of these antibiotics in combination against these organisms. Conclusion: Combination of two drugs cefsulodin and kanamycin showed synergistic action against Esch. coli and additive against Staph. aureus. So combined drug therapy can be used for better treatment with low toxicity, broad spectrum activity, and prevent emergence of drug resistance organism.