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Introduction: Bubble CPAP is an important, simple, noninvasive, and cost effective treatment modality for respiratorydistress in neonates. The aim of our study was to know theoutcome of Bubble CPAP in preterm and term neonatesrequiring respiratory support and to study its failure factors.Material and methods: A retrospective observational studywith Bubble CPAP was done on 100 babies both term andpreterm with respiratory distress requiring for respiratorysupport admitted in NICU of Government General Hospital,Guntur. Monitoring was done clinically, with pulse oximeter,radiologically and with blood gases. Neonates with respiratorydistress secondary to sepsis, necrotizing entero colitis,congenital anomalies like Tetrology of Fallot, cleft lip withcleft palate, congenital diaphragmatic hernia, choanal atresia,who had severe respiratory distress with cardio vascularinstability were excluded in our study.Results: The mean gestational age was 32-34 weeks, birthweight was 1.4 kgs.52% were very low birth weight<1.5kgs. CPAP failure rate was higher in preterm and very lowbirth weight. The most common disease for starting BubbleCPAP was Respiratory Distress Syndrome 56 cases followedby Meconium Aspiration Syndrome 16 cases, congenitalpneumonia, Transient Tachypnea of New Born and BirthAsphyxia. The common complications on CPAP were shock,apnea and nasal damage. Overall failure rate was 36% (36cases). All babies who failed on CPAP were put on mechanicalventilation. Failure among Respiratory Distress Syndromewas about 42%, in Meconium Aspiration Syndrome 31%,congenital pneumonia 35.7%. Higher cases of sepsis andpulmonary hemorrhage were seen in failure group. Overallsurvival rate of the study was 64%(64cases).Conclusion: Bubble Continuous Positive Airway Pressure issafe, effective and easy to use in preterm and term neonateswith mild to moderate Respiratory Distress. The major failurefactors in our study were sepsis, recurrent apnea. The successrate was 64%
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Introduction: Seizure is a common problem evaluated inpediatric emergency department. The different causes ofseizures are febrile seizures, CNS infections, metabolic,developmental defects, traumatic brain injury, vascularaccidents, brain tumors and idiopathic or epilepsy. Currentresearch aimed to study the etiology of convulsions in childrenbetween 1 month to 5 years of age admitted in pediatricward, Government General Hospital, Guntur. To assess thecommon incidence of convulsions in children of age 1 to 5years admitted to pediatric ward, Department of Pediatrics,Government General Hospital, Guntur.Material and methods: Our study was retrospective,descriptive study. 100 cases admitted to pediatric ward,Government General Hospital, Guntur with convulsions in theage group of 1 month to 5 years during the period of July 2018and April 2019. Study was done by detailed history, throughphysical examination and relevant investigations includingcomplete blood counts, serum electrolytes, serum glucose,serum calcium, CSF analysis, EEG and neuroimaging (CT/MRI brain) studies. Variables recorded were demographics,clinical presentation, laboratory investigations, EEG andneuroimaging.Results: The most common cause of seizures in our study wasfebrile seizures (32%). About 24% cases were due to epilepsy(idiopathic or unprovoked) and 33% cases were symptomaticseizures of various causes like CNS infection, metabolic,traumatic, vascular etc.Remaining 11% were due to othermiscellaneous causes.Conclusion: This was the hospital based retrospective,descriptive study to know the etiology of convulsions inchildren between 1 month to 5 years. Convulsions in childrencan be due to various underlying pathology. In our study mostcommon cause of convulsions was febrile seizures, followedby epilepsy and symptomatic seizures of infective etiology ofCNS, viral encephalitis being the most common.
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Introduction: Influenza A (H1N1) virus infection was first seen in Mexico and later spread quickly to United States and worldwide as a pandemic including India. During the H1N1 pandemic of 2009-2010, the number of hospital admissions and mortality rates were high in India as well as globally. The goal of this study was to analyse the clinical and epidemiological profile of Influenza A positive cases which were reported in the flu isolation unit in the hospital during the year 2015 and to examine the epidemiological trends of this disease. Material and Methods: This was a hospital based study conducted in Government general hospital,Guntur Medical College which was a officially designated as swine flu nodal centre since 2009. Children with influenza like illness of category B and C were hospitalised and samples sent for confirmation. Results: Males were more frequently affected (61%) than females (39%). Majority of the children affected with swine flu belonged to the under-five age group (84.5%) and 6-15 years children accounted for only 15.5% of the swine flu cases. Fever, cough and cold (100%) were the most common clinical manifestations followed by S.O.B (25.55%), diarrhoea (11.11%), sore throat (3.33%) and convulsions (2.22%). Majority of the patients belonged to category C (55.56%) followed by category B (44.44%). Peak admissions were in the month of February (36.84%). The mortality rate was very low. Conclusion: This study has shown that the prevalence of Influenza A (H1N1) is high in the under-five children. Fever, cough and cold are the most common presenting symptoms. Though the study was mainly from a nodal hospital, the information collected was for only a limited period. A longer time study is required to understand the seasonal variation of the Influenza virus
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The purpose of this study was to investigate the efficacy and safety of 0.1% tacrolimus powder in Oraguard-B for the treatment of patients with symptomatic oral lichen planus [OLP]. This was a nonrandomized, nonblinded study conducted in the outpatient department. The 20 patients with symptomatic OLP oral lichen planus who were asked to participate in the study were provided with 20-g containers of the study medication. Patients were asked to use the medication over the symptomatic areas three times a day until resolution of the lesion. Patients were recalled to assess the drug response every 15 days. The duration of treatment ranged from 30 to 183 days, with a mean of 81.8 +/- 44.4 days; all 20 patients reported a favourable response to the topical tacrolimus therapy. Eleven patients had complete resolution of their lesions. In 16 of 20 patients, there was marked resolution in symptoms as recorded by visual analogue scale. Out of 10 patients followed up for a period of 3 months, 5 had recurrence of their lesions but with less intensity, and the patients were symptom-less. No serious side effects were associated with the study medication. Topical tacrolimus 0.1% in Oraguard-B was effective and safe in treating patients with OLP. However, there is still a need to undertake more detailed and objective clinical studies to determine the exact benefit of tacrolimus compared with conventional therapies and examine the influence of different dose regimes and formulations and assess the incidence of recurrence