ABSTRACT
Background: Vitamin D plays important role in immunity and its deficiency might be associated with increased risk of lower respiratory tract infection. This study aimed to determine whether vitamin D deficiency is commoner in infants with acute lower respiratory tract infection as compared to normal infants and to correlate the severity of vitamin D deficiency with severity of ALRTI.Methods: A hospital based prospective case-control study was conducted in a tertiary care hospital. A total of 208 infants (109 cases and 99 controls) older than 7 days to 12 months of age, were enrolled. Cases were selected according to the definition of ALRTI given by WHO (2). Controls were chosen from children attending paediatric outpatients department for immunization or minor short duration aliments. Primary outcome measured as serum 25-hydroxy vitamin D3 (25OHD3) levels and severity of ALRTI was independent variable.Results: Among 109 cases suffering from ALRTI, vitamin D deficiency was present in 65.11%, 92.3%, 88.9% children of ‘pneumonia, severe pneumonia and very severe pneumonia group respectively. It was found that vitamin D deficiency was commoner in cases as compared to controls (80.70 % vs 25.50% ) with OR of 12.40 (95 % CI was 6.13 - 25.38). There was inverse relationship between the severity of ALRTI and Vitamin D levels (p value <0.001 and Pearson correlation coefficient -0.32).Conclusions: Vitamin D levels were significantly lower in ALRI cases as compared to controls and had negative correlation between vitamin D levels and severity of pneumonia.
ABSTRACT
Background: Pediatric intensive care units (PICU) have brought about dramatic increase in the survival of critically ill children. The aim of pediatric intensive care is not just to save lives but also to maximise the quality of those lives. Evaluation of the outcome of an intensive care unit is necessary as a measure of quality improvement in patient care.Methods: A retrospective observational study was done in a PICU of a teaching hospital between February 2017 to August 2018. Records of all admissions, transfer outs, discharges and deaths were collected along with age, sex, diagnosis, length of stay, and outcome.Results: Mean age of the 601 patients admitted over a period of nineteen months was 4 years. 36% patients were between 1-5 year and 32% were infants. Major indication for admission to the PICU was respiratory (30%) followed by neurological illnesses (25%) and infections (22%). Increased length of stay (LOS) (>5 days) was seen in respiratory, neurological diseases and infections. A significant relation (p value <0.05) was found between outcome and patients admitted with sepsis and the group classified as others. Patients admitted with involvement of nephrology system had a significant relation with LOS (p value <0.05). The mortality rate was 2%.Conclusion: The outcome analysis of our newly setup PICU is comparable with other studies in the Indian subcontinent. Active surveillance or audit of PICU admissions help capture lapses in management and bring a better outcome with available resources.