ABSTRACT
Background: Enteric fever is a common public health problem with variable clinical presentation. The aim of study was to study the clinical spectrum of enteric fever in children.Methods: This was a prospective study conducted over period of one year from January 2019 to January 2020 in the Department of Paediatrics at Govt Medical College Srinagar. It included all patients in the age group of 1-18 years who were clinically suspected to have enteric fever and had either a positive blood culture for Salmonella or a positive Widal test.Results: This study included total of 76 patients out of which 36 were males and 40 were females. The most common presenting symptoms were fever anorexia, vomiting, diarrohea, abdominal pain, headache and constipation. The most common signs were coated tongue, toxic look, hepatomegaly, splenomeagly, pallor, jaundice and abdominal distension. Complications were seen in in 8 (10.5%) patients. Myocarditis was seen in 3 patients. Encephalopathy and hepatitis was seen in 2 patients each. Pneumonia was seen in 1 patient. Majority of patients had normal white blood cell count (4000-11000/cumm). Leukopenia (<4000/cumm) was seen in 10% patients and leukocytosis (>11000/cumm) was seen in 15% patients. Thrombocytopenia was seen in 9% patients. Blood culture was positive in 36 (47.36%) patients. Salmonella typhi was seen in 33 patients whereas Salmonella paratyphi A was seen in 3 patients. All culture positive cases were sensitive to ceftriaxone, cefixime and azithromycin. Ciprofloxacin resistance was seen in 11 (14.4%) patients.Conclusions: Enteric fever is a common public health problem with fever as most common presenting symptom. Culture yield can be increased in enteric fever by drawing blood culture prior to administration of antibiotics. Ceftriaxone is highly efficacious as monotherapy in enteric fever.
ABSTRACT
Background: Severe Acute Malnutrituon (SAM) is a form of malnutrition where there is an imminent threat of death to the child. The chances of complications are very high and in most case child requires hospitalization for stabilization and rehabiliatation. Objective of study the clinicoepidemiological and laboratory profile of children with severe acute malnutrition (SAM) admitted to a Nutritional Rehabilitation Centre (NRC) of our hospital.Methods: A retrospective chart review of admitted patients. Nutritional Rehabilitation centre (NRC) at GB Pant Hospital Government Medical College Srinagar over a one year period between June 2017 and June 2018.Results: Total of 187 patients of SAM was admitted in NRC during the study period. One hundred and eight (57.7%) were males and 79(42.3%) were females .Patients were equally among various districts. Infants (<12months) constituted the majority of admissions (54.5%). Marasmus was by far the commonest phenotype presenting as SAM (85.5%).Respiratory comorbidity was the commonest present in about' 41 (26.3%) followed by daiarrhea in' 32(20.5%). Delayed initiation of complimentary feeding was found in 75(40.1%) while early weaning was found in another 55 children (29.4%). Birth order more than three was present in 92 children (49%). Mother's literacy status had a direct bearing on the prevalence of SAM. Most of the children were from rural background (75%).Most belonged to low economic and income class as around 65.2% had a very meager' family income.Conclusions: SAM is more common in Infants and in children from rural background. It is highly associated with faulty feeding practices including lack of breast feeding and presence of mixed and faulty feeding. It is also associated with increasing birth order, low maternal education and low family income Pneumonia and diarrhea are leading comorbidities. Hypoglycemia and hypothermia are leading complications.' Marasmus is the commonest phenotype.