ABSTRACT
Background: Diarrhoea still continues to be a major cause of hospitalization and death in under fives. Electrolyte disturbances play an important role in the associated morbidity and mortality. Acute renal failure is one of the important complications of acute gastroenteritis (AGE) in children. Early intervention and proper fluid replacement may lessen this risk. This study was designed to find out the incidence of acute gastroenteritis and the status of associated electrolyte derangements and renal involvement.Methods: This was a cross sectional study conducted at KIMS, Bengaluru in which 117 children from the age of 1 month to 5 years with acute diarrhea were included based on a predefined inclusion and exclusion criteria. Demographic profile of the patients, details of diarrhea, clinical examination and accompanying degree of dehydration (defined as per WHO criteria) were recorded. Serum electrolytes along with renal parameters were investigated.Results: Total 117 children with acute gastroenteritis were enrolled in the study as per the inclusion criteria which constituted 5% of total paediatric admissions. Children aged 1-12 months had the highest incidence of diarrhea (50%). Male to female ratio is 1.3:1. 65% had some dehydration, 19% no dehydration and 16% had severe dehydration. Isonatremia was seen in 58% followed by hyponatremia in 35% and hypernatremia in only 7%. 83% had isokalemia, hypokalemia in 12%, hyperkalemia in 5%. Levels of serum sodium and potassium decreased with the severity of dehydration. Serum urea and creatinine were significantly high in severe dehydration (p value 0.001). Out of 28 children who were given diluted ORS before admission, majority had hyponatremia (39%) and all of them who received concentrated ORS had hypernatremia.Conclusions: Hyponatremic dehydration is the second most common type of dehydration next to isonatremic dehydration, but it is more common in children who took diluted ORS. Increased awareness regarding ORS preparation may help in preventing electrolyte imbalance in AGE. The levels of serum sodium and potassium decreased and urea and creatinine increased with severity of dehydration. Measurements of serum electrolytes and renal parameters early can help to predict the complications due to AGE and may help in the prevention of diarrhea related complications in children.
ABSTRACT
Background: Neonatal death is one of the major contributors (50%) of Under-five child mortality and 70% of the infant mortality. The main causes of neonatal deaths are prematurity and low birth weight (LBW). This study was undertaken to assess newborn foot length and determine its usefulness in identifying LBW/Preterm Babies.Methods: This is a cross sectional hospital based study of 173 newborn babies, done in KIMS Hospital, Bengaluru. All live newborn infants were included in the study. Newborn babies with lower limb congenital anomalies were excluded from the study.Results: Out of 173 newborn, 99 babies were male (57%) and 74 were female (43%). 122 (70.5%) were term and 51(29.5%) were preterm. 48 (38%) were SGA, 120 (69%) were AGA and 5 (3%) were LGA. Their gestational age ranged from 28 to 40 weeks. In this study positive Correlation between foot length and gestational age was found with the “r” value of 0.823. The study also showed a positive correlation between foot length and weight with the “r” value of 0.831.Conclusions: This study has a good correlation of Foot length with gestational maturity and birth weight. Foot length of 7.45cm can be used as a cut- off point for differentiating between term and preterm babies. Derived equation from this study can be used by ASHAs and Anganwadi workers for the estimation of gestational age in resource poor situations and refer the preterm newborns to higher centres for further management as early as possible to prevent long and short term complications of prematurity.
ABSTRACT
Background: The changing pattern of antimicrobial susceptibility of bacterial pathogens causing acute UTI is a growing problem. Hence, the knowledge of the local pattern of urinary pathogens and their susceptibility to various antimicrobials is of atmost importance for selection of the appropriate empiric therapy for children with acute UTI.Methods: This retrospective cross-sectional study was conducted in 208 children of 1-18 years age group with suspected UTI infection who were admitted in KIMS hospital, Bangalore from January to December 2018. The data of all samples were collected from medical record.Results: Overall 208 children between 1-18 years with suspected UTI were screened. Out of which 48 were culture positive, with a prevalence of 23%. Culture positive UTI was predominantly found in males in 1-5 years age group as against female predominance in 6-18 years age group. E. coli (45.83%) was the commonest organism isolated in our study, followed by Enterococcus (31.25%), Klebsiella (16.67%), Proteus (4.17%) and Acinetobacter (4.17%). Antibiotics with highest sensitivity to E-coli are Amikacin (91%) and Gentamicin (77%). Klebsiella is most sensitive to Gentamicin (87.5%) and piperacillin (75%). Enterococcus has highest sensitivity to Vancomycin (67%) and Linezolid (60%).Conclusions: It requires regular monitoring to determine the current status of resistance against antimicrobial agents. The use of antimicrobials must be restricted in order to decline the resistance and we suggest that empirical antibiotic selection should be based on the knowledge of local pattern of bacterial organisms and their susceptibility to various antimicrobials rather than on universal guidelines.