ABSTRACT
Background: There is dearth of studies in India on the management of paediatric septic shock. So it is prudent to do a study on paediatric septic shock management. The objective of the study is to determine the correlation between Paediatric Assessment Triangle and serum lactate levels., to determine the role Paediatric Assessment Triangle in predicting mortality in septic shock and to the determine the role of elevated lactate levels in predicting mortality in septic shock.Methods: Descriptive study of 100 children from 31 days to 12 years of age who are admitted with septic shock in a tertiary care hospital are assessed with paediatric assessment triangle and clinical score and serum lactate was tested along with other standard tests and the children are managed as per the standard protocols. Outcome is analysed.Results: In this study, septic shock children with total clinical score >22 are having statistically significant low levels of diastolic blood pressure and low mean arterial pressure. There was a significant difference in median serum lactate levels between the survivors (28.08 mg/dl) and non-survivors (40.92 mg/dl).Conclusions: Paediatric assessment triangle and clinical scoring based on it more than 22 and serum lactate levels of more than 2mmol/L or 18mg/dl predict the mortality.
ABSTRACT
Effect of respirable fly ash particles inhalation on lungs of rats was investigated by exposing them to respirable aerosols of size classified power plant fly ash at average concentrations of up to 14.4 +/- 1.77 mg/m3 for 4 hr/day for 28 consecutive days. A remarkable increase was found in blood eosinophil counts of fly ash exposed animals. Biochemical indicators of pulmonary damage viz. lactate dehydrogenase (cytoplasmic enzyme used as a measure of cell injury), gamma-glutamyl transferase (Clara cell damage) and alkaline phosphatase (potential measure of Type 11 cell secretions) in broncho alveolar lavage fluid (BALF) of fly ash exposed group showed significant elevation. Clumping of fly ash particles in the lungs was observed as evidenced by fly ash ladened macrophage accumulation in the alveolar region. The results suggest a damage, local inflammation and remodelling of lung as indicated by hypertrophy and hyperplasia. These changes reflect the toxic effects of the fly ash inhalation.