Acute lower respiratory tract infection; therapeutic role of zinc in patients

ABSTRACT: Zinc is an essential rnicronutrient with catalytic role in over a hundred specific metabolic enzymes in human metabolism regulates the expression of the metallothionein gene, apoptosis and synaptic signaling and needed for many aspects of immune system. Thus the zinc 'supplementation in patients with acute lower respiratory tract infections might have potential benefits

Objectives: To evaluate the efficacy of zinc supplementation in patients with acute lower respiratory tract infections. Study design: Quasi experimental study. Setting: Study was conducted in the pediatrics department Independent hospital Faisalabad; the indoor patients meeting the inclusion criteria from 26[th] January to 25[th] July 2013 were included in study

Material and methods: 100 children meeting the inclusion criteria were included in the study which were divided into two groups with random allocation i.e. Group A [Odd number] and Group B [Even number]. Group A was given zinc supplementation 20mg of elemental zinc for 14 days. Along with antimicrobials, oxygen and antipyretics for fever while 50 children in Group B were given with antimicrobials. Oxygen and antipyretics for fever without zinc

Results: Baseline clinical parameters were comparable in both groups at admission. Outcome measures considered were duration of fever, tachypneoa, chest indrawings and total duration of hospital admission. Effect of zinc supplementation is significant with p-value of less than 0.05 for duration of tachypnoea and chest indrawings and total duration of hospital admission while result showed p-value equal to 0.05 that is just significant for duration of fever

Phototherapy; frequency of hypocalcemia in neonates undergoing in Tertiary Care Hospital in Faisalabad

Hyperbilirubinemia is the most common abnormal physical finding in first few weeks of lif and its most common management is phototherapy. Amongst other common complications a less known complication of phototherapy is hypocalcemia

Objectives: to study the incidence of phototherapy induced hypocalcemia in neonates and to have a comparison between preterm and term neonates

Study design: descriptive cross-sectional study

Setting: paediatric Unit II DHQ Hospital Faisalabad, which is a tertiary care centre for all kind of patients

Duration of study with dates: six months from 1-11-2012 to 30-04-2013

Methods: 196 neonates with hyperbilirubinemia full term / preterm neonates admitted in pediatric DHQ hospital faislabad were selected. Inclusion criteria. 1] Hyperbilirubinemia. 2] No hypocalcemia on admission. 3] Received phototherapy for hyperbilirubinemia. Serum Calcium levels were measured in all neonates before and 48 hours after receiving phototherapy. Incidence of hypocalcemia among all neonates was calculated as an absolute percentage and the sample population was also divided into preterm / full term neonates to evaluate the incidence of hypocalcemia in these two groups individually

RESULTS: mean serum calcium in neonates was 7.5+- 1.5 mg / dl .16.84% of neonates were found to have calcium level below the cut off value. 33 out of 196 developed hypocalcemia after phototherapy and out of these 54% were preterm and 45% were term neonates < P-value [0.01]>

Conclusion: phototherapy induces hypocalcemia in neonates more so in preterm neonates

Impact: consideration for additional calcium supplementation should be undertaken in all neonates undergoing phototherapy and further randomized trials need to be done with these concerns