ABSTRACT
Objective: To determine the profile and outcome of children admitted in paediatric intensive care unit of a public hospital in Karachi
Study Design: Descriptive / Observational study
Place and Duration of Study: This study was conducted at PIGU of Civil Hospital Karachi from July 2013 to June 2014
Materials and Methods: Data of the admitted patients was collected from the file records. It included demographic profile, admitting diagnosis, length of stay and outcome. Descriptive statistics were applied to describe the results
Results: Overall 243 children were admitted in PICU during the study period. Among which 133 were admitted in 1[st] half and 110 during the later half of the year. 126 [51.85%] were male, whereas 117 were female. According to the age group, 91 [37.44%] were under 1 year where as 152 [62%] were more than 1 year among which 92 were between 1-5 years of age. Majority, 160 [67%] were admitted through emergency. Duration of stay in the hospital was varied, and 176 [72.42%] patients stayed for more than 24 hours, of these, 60 stayed for 3- 5 days. Upon admission, 83 [34.15%] needed ventilatory support. 16 [6.58%] children needed fluid boluses for resuscitation, whereas inotropic support was required by 49 [20.16%] children. Most of the cases i.e. 68 [27.98%] had respiratory illness as reason for admission. CNS diseases were present in 44 [18%] patients followed by sepsis/infection in 35 [14.40%] cases and Cardiovascular diseases in 22 [9%] cases. Out of total admission, 174 [1.60%] were shifted to the ward. Mortality was recorded in 59 [4%] cases, among which 40 occurred during 1[st] half of year and 19 during later half of the year, resulting in mortality of 30% in 1[st] half and 17% in 2[nd] half, respectively. Out of 59 expiries, 24 [40%] died within 1[st] 24 hours due to poor status at admission. Sepsis was the most common cause seen in 42 [71%] of non survivors. 7 cases were referred to other specialized centers for further management after initial stabilization, whereas 3 cases left against medical advice
Conclusion: Respiratory system, central nervous system and infectious disease/sepsis were the commonest reasons for admission. PICU showed improved working in later half of year after its beginning
ABSTRACT
Objective: To study the demographic and clinical features, outcome, complications and treatment cost of tetanus patients admitted in Paediatirc Intensive Care Unit [PICU] of Civil Hospital Karachi [CHK]
Methods: It is a descriptive observational study conducted at Civil Hospital Karachi from July 2013 to June 2015. Patients of tetanus admitted in PICU during the study period were enrolled. Data was collected from the file records of patients and included the demographic profile, clinical presentation, grade of severity, length of stay, complications and outcome. It also included the cost of treatment. Descriptive statistics were applied to describe the results
Results: During the study period, 23 cases of tetanus were admitted in P.I.C.U. twelve were male and 11 female. Majority of cases [13] belonged to age group 2-6 years. Seventeen cases were unvaccinated and 6 had received only BCG and OPV. None was appropriately vaccinated for age.There were 9 cases of post injury tetanus, 6 of them were males, 5 cases of otogenic tetanus and 9 cases had no clinically identifiable portal of entry. Eleven cases belonged to grade III severity of Ablett classification and 6 had grade IV severity. Mortality in our case series was 26%. Autonomic instability was seen in 17 patients and all of them needed ionotropic support. The estimated cost of per day treatment of a tetanus patient with mechanical ventilation was approximatly 31, 979/Pak Rs and without mechanical ventilation was 20,000/Pak Rs
Conclusion: Tetanus is an entirely preventable disease with a high mortality. Treatment is very costly as compared to vaccination which is free of cost. Complete vaccination and proper wound care is the only option to reduce the ongoing burden of tetanus