ABSTRACT
BACKGROUND : There is a paucity of reports on Highly Active Antiretroviral therapy (HAART) in children. We studied feasibility and effectiveness fixed dose combination (FDC) of lamivudine, nevirapine and stavudine in HIV infected children. DESIGN: Interventional study. SETTING: A Tertiary care center. SUBJECTS: Twenty five consecutive HIV positive antiretroviral naive children older than 18 months. METHODS: The study subjects were started on weight-appropriate doses of the FDC and followed up for 6 months. Weight, CD4 counts, absolute lymphocyte count (ALC) and number of episodes of illness were assessed before and after HAART. Adherence and barriers to adherence were studied. RESULTS: Mean weight increased from 15.2 to 16.8 kg (P < 0.001) while mean CD4 counts increased from 488/cmm to 765/cmm (P < 0.001). Only 2 cases of drug associated adverse event were encountered. Improvement in Center for Disease Control (CDC) immunological classification of the subjects was significant while that in World Health Organization (WHO) clinical staging was not statistically significant. Follow up visits were 95% of the expected 175 visits. The average distance traveled by the patient for every visit was 72 km (one way). CONCLUSIONS: Use of FDC in weight specific dosages is feasible and effective for treatment of Pediatric HIV in resource scarce setting. These preliminary results need to be tested in a different setting.
Subject(s)
Anti-Retroviral Agents/administration & dosage , Antiretroviral Therapy, Highly Active , Child , Child, Preschool , Drug Therapy, Combination , Feasibility Studies , Female , Guideline Adherence , HIV Infections/drug therapy , Humans , India , Infant , Lamivudine/administration & dosage , Male , Nevirapine/administration & dosage , Patient Compliance , Pilot Projects , Stavudine/administration & dosageABSTRACT
The association between Hodgkins Lymphoma (HL) with HIV is common in adults but rare in children. A 5 year old boy, known case of HIV on antiretroviral therapy, presented with prolonged fever, multiple enlarged lymph nodes along with hepatosplenomegaly. A diagnosis of Hodgkins lymphoma was entertained on histopathological examination; further subtyping was done by immunohistochemistry.
Subject(s)
Child, Preschool , Fatal Outcome , Hodgkin Disease/diagnosis , Humans , Lymphoma, AIDS-Related , MaleABSTRACT
Leptospirosis has a broad spectrum of clinical manifestations varying, from inapparent influenza like illness to fulminant fatal disease with hepato-renal dysfunction and hemorrhagic phenomena. Our cases had fever, puffiness, respiratory distress and bleeding diathesis as leading manifestations. Leptospirosis was suspected in view of epidemic situation prevailing in the city. We report four cases here, three of which survived and one died.
Subject(s)
Anti-Bacterial Agents , Child , Drug Therapy, Combination/administration & dosage , Female , Humans , India , Infant , Leptospirosis/diagnosis , Male , Risk Assessment , Sampling Studies , Severity of Illness Index , Survival Rate , Treatment OutcomeABSTRACT
A prospective controlled blind study was carried out in the Special Care Unit for Newborns to assess the effect of commercially available sweetener on pain relief in newborns. Response to intramuscular injection and the pain stimulus was studied in twenty-five sick newborns, 13 preterm and 12 term, in a blinded fashion. Pain score, duration of cry, heart rate and oxygen saturations were studied. Basal response, responses with sterile water or sweetener were recorded in each baby. Responses to sweetener versus no solution and sweetener versus sterile water were compared by applying paired t-test. The reduction in pain score with sweetener was significant when compared with no solution. The difference was not significant when compared with sterile water. Similarly, duration of cry and heart rate with sweetener were significantly less when compared to sterile water or to no solution. However, the difference in oxygen saturation was not significantly different. Sweetener has an analgesic effect in sick babies. This can minimise adverse effects associated with painful procedures.
Subject(s)
Analgesics , Humans , Infant, Newborn , Infant, Premature , Pain/therapy , Prospective Studies , Sweetening Agents/therapeutic useSubject(s)
Air Conditioning/methods , Humans , India , Infant, Newborn , Nurseries, Hospital , Solar EnergySubject(s)
Child , Child, Preschool , Female , HIV Infections/diagnosis , Humans , India/epidemiology , Infant , Male , Risk FactorsSubject(s)
Apgar Score , Asphyxia Neonatorum/mortality , Chi-Square Distribution , Female , Humans , Infant, Newborn , Male , Prognosis , Resuscitation/methods , Risk Factors , Survival RateSubject(s)
Developing Countries , Female , Home Childbirth/trends , Humans , India , Infant Care/methods , Infant, Newborn , Midwifery/education , Pregnancy , Program EvaluationABSTRACT
OBJECTIVE: Solar energy could be used as an alternate energy source for keeping neonates warm especially in tropical countries. The present study investigated the efficacy of solar powered room heating system. SETTING: Referral center for neonatal care. INTERVENTION: A fluid system heated by solar panels and circulated into a room was used to maintain room temperature. A servocontrolled heating device was used to regulate and maintain desired room temperature. MAIN OUTCOME MEASURES: Neonatal rectal temperature and room temperature. RESULT: Infants between 1750-2250 g were observed to require a mean room temperature of 32.5 degrees C to maintain normothermia. In 85 infants less than 1500 g, of the 5050 infant temperature records, only 3% showed a record less than 36 degrees C. CONCLUSIONS: Solar powered room heating is effective in maintaining infant temperature and is cost-effective as compared to the existing warming devices.
Subject(s)
Humans , Incubators, Infant , Infant, Newborn , Infant, Very Low Birth Weight , Solar EnergyABSTRACT
Anganwadi worker was involved in rural newborn care as a link between a dai and a health worker. She was trained to ensure that, (i) borderline LBW/preterm baby was kept warm at home and (ii) a very small baby was referred to hospital. The training was conducted during routine monthly meetings and cost of equipping each anganwadi worked out to be Rs 110. Newborn survival, infant survivals and overall MCH performance improved. Thus, newborn care formed an ideal entry point into MCH activities.