Acute Illness Observation Scale in community acquired pneumonia in children aged 2 months to 59 months

Background: Pediatric respiratory disease remains an important cause of morbidity in both the developing and the developed world. Aim of the study is to validate Acute Illness Observation Scale (AIOS) in predicting illness severity and clinical outcome of community acquired pneumonia.Methods: This was a descriptive study done in a cohort of 248 children at the Department of Paediatrics, at a tertiary care hospital in Chennai. Children between 2 months - 59 months coming to outpatient department with suspected pneumonia, if satisfying the inclusion criteria were enrolled into the study. AIOS scoring is done on each subject on day 1, day 2, day 5 by two persons simultaneously in a reasonably quite state. Respiratory parameters, vital signs and pulseoximeter reading of each patient as in data collection form are documented.Results: Children scoring abnormally on AIOS (>10) had significantly higher frequency of severe tachypnea (p=0.001), marked chest retraction (p=0.001), grunting, cyanosis (p=0.01), lethargy, inability to drink and so on except incidence of convulsion and wheeze which didn't have any statistical significance. Severe hypoxemia associated with cyanosis (SpO2<85) was observed in 14 children of which 92.9% (13) scored a high value on AIOS (AIOS>15). Complications were absent in those who scored <10, while maximum complications were seen in those who scored >15.Conclusions: AIOS can be used as a tool to decide on therapeutic modalities and prognosticating a child with pneumonia admitted to the hospital by a physician.

Surgical correction of urethral diverticulum in a female pseudo-hermaphrodite crossbred calf

A 40 kg crossbred calf of one month age was presented to the Institute Referral Polyclinic, with a history of dysuria, stranguria along with a fluctuant swelling in the mid-perineal region. On physical examination, a diverticulum was observed which on aspiration revealed urine. It was reported that urine outflow was from a tiny orifice at the proposed natural site of the vulva. Dissection of the skin over the diverticulum revealed hypoplastic penis with adhesion of the preputeal sheath along with penile hypospadia. Permanent perineal urethrostomy and diverticulectomy was performed in the region of the defect. The urethral layer was sutured along with the skin using 1-0 Polyamide sutures in a simple interrupted pattern. No postoperative complication was reported till one year of surgery and animal was urinating properly