ABSTRACT
Background: The normal intestinal microbiota of critically ill patients is altered and replaced by pathogens. Any significant insult to the gut or alteration to its microbiota plays a role in promoting systemic inflammation and infection in the critically ill population. Probiotics may affect other body sites in addition to the GI tract , and they can have applications in a variety of populations, including healthy individuals, children, elderly, immunocompromised and genetically predisposed individuals. These studies the effect of probiotics in pediatric population on mechanical ventilation in a tertiary care hospital.Methods: Present study was conducted in a PICU of a tertiary care teaching hospital in children aged 12 years or less admitted to PICU and who were likely to need mechanical ventilation for more than 48 h were recruited.Results: In present study 25 patients were recruited in each group i.e. case (probiotics) group and control group. Most common age group among case group was 6-8 years (44 %), while 9-12 years (36 %) was most common age group in control group. Mean age was comparable in both groups (7.6'3.5 years in case group and 7.9'4.1 years in control group). In both groups septic shock and pneumonia were most common diagnosis followed by admission due to miscellaneous cause. In both groups mechanical ventilation was used due to respiratory failure and shock. Outcome was compared in both groups. Authors noted a statistically significant difference in duration of ICU stay, duration of hospital stay and duration of mechanical ventilation, between case 7 control group (p<0.05). In terms of overall mortality, authors did not noted any significant difference among groups.Conclusions: Authors noted a statistically significant difference in duration of ICU stay, duration of hospital stay and duration of mechanical ventilation, between case and control group (p<0.05).
ABSTRACT
Background: When the body is stressed in diverse pathological conditions, it responds by mounting an inflammatory response. Predictive biomarkers reflecting the response may serve as guide to management. Neutrophil to Lymphocyte Ratio and Platelet to Lymphocyte Ratio has been frequently used in adult patients as an indicator for mortality. However, no study has looked into their use within pediatric population. The objective of the study is to assess the prognostic value of rise in NLR and PLR in pediatric intensive care as markers of mortality.Methods: A retrospective study based on 3 year data from HIMS and G-HEALTH data systems of AJ Institute of Medical Science, of all patients admitted to PICU after excluding those in whom all the study parameters were not retrievable, were postoperative patients and/or stay was less than 5 days. NLR and PLR ratios were determined and compared to PELOD 2 using SPSS version 17.0.Results: The demographic data was matched. PELOD 2 (>20) predicted mortality in 72.2% of the patients, while NLR increase predicted in 61.1% and PLR increase in 77.8%. A decreasing trend in NLR and PLR were both closely related to better survival. Among the 3, Rise in PLR had higher sensitivity, specificity, PPV, NPV, and overall accuracy of 72.73% (p <0.001) to predict mortality.Conclusions: The study gives an insight into the fact that simple and inexpensive markers such as rise in NLR and PLR helps in predicting the mortality in the pediatric intensive care which is comparable to PELOD 2 score.
ABSTRACT
Background: Venipuncture is one of the most common cause of iatrogenic pain in neonates which is equally stressful to the parents as well as to the personnel performing the procedure. Despite an abundance of data that demonstrate the efficacy of local anesthetics for reducing venipuncture pain in neonates their use in day to day practice is not used widely used. Our objective was to evaluate the efficacy of EMLA cream and 5% Lignocaine cream versus placebo for pain relief in newborns undergoing venipuncture.Methods: Present study was a hospital based, double blind randomised, case control study. A 240 eligible new-borns were randomised into EMLA, 5%lignocaine and placebo groups after randomization. The respective creams were applied 1 hour before the procedure and pain scores were assessed using NIPS scoring during venepunture. Data was analysed using SPSS ver. 20.0 statistical package. Student's unpaired t-test and paired t tests was used to compare continuous data, and to compare pain scores one-way ANOVA was used to compare categorical data. A p-value <0.05 was considered statistically significant.Results: Paired t-tests revealed significant lower NIPS scores in EMLA and 5% lignocaine group than the placebo group (p value=0.001).Conclusions: From present study it can be concluded that both EMLA and 5% lignocaine are equally efficacious and cost effective in reducing the pain of venepuncture in neonates.
ABSTRACT
In vitro assessment of antimalarial drug susceptibility of Plasmodium has been a major research success, which has paved the way for the understanding of parasite and rapid screening of antimalarial drugs for their effectiveness. In the present study a preliminary screening to check the antiplasmodial activity of mother tincture (ϕ) and various potencies (6C, 30C, 200C) of homeopathic medicines Cinchona officinalis/china (Chin.), Chelidonium majus (Chel.) and Arsenicum album (Ars.) were done by assessing the in vitro schizont maturation inhibition assay. A significant reduction in the growth of intraerythrocytic stages of P. berghei was observed with decreasing dilution of ϕ and various potencies of Chin., Chel. and Ars. exhibiting a dose dependent effect. Maximum schizont maturation inhibition was observed by Chin. ϕ (1:1), Chin. 30 (1:1, 1:2) and Chel. 30 (1:1) i.e. 80%. The standard drug CQ at 10 µM concentration exhibited 95.4±1.6% inhibition of schizont maturation. Ars. 30 (1:1) also have been found to possess strong antiplasmodial efficacy with 75.5±2.6% schizont inhibition. The presence of free merozoites in Ars. 200 with weak schizonticidal inhibition activity (40-45%) also pointed towards the ability of parasite to survive in the given drug pressure.
O estudo in vitro da susceptibilidade de Plasmodium a drogras antimaláricas representa um grande avanço nas pesquisas, abrindo novas rotas para o entendimento do parasite e da efetividade de drogas antiomaláricas. Nesse trabalho, realizamos um estudo preliminar da atividade antiplasmódica da tintura mãe (ϕ) e várias potências (6 cH, 30 cH, 200 cH) dos medicamentos homeopáticos China officinalis (Chin), Chelidonium majus (Chel) e Arsenicum album (Ars), através do estudo in vitro da inibição da maturação de esquizontes. Observamos uma redução significativa do crescimento do estágio intra-eritrócito do P. berghei conforme a tintura mãe e demais potências de Chin, Chel e Ars foram diluídas, observando-se um efeito dependente da dose. O máximo de inibição na maturação dos esquizontes (80%) foi observado com Chin ϕ (1:1), Chin 30 cH (1:1, 1:2) and Chel 30 cH (1:1). A droga Cloroquina (CQ), usada como controle, em uma concentração de 10µM, exibiu (95.4 ± 1.6) % de inibição. Ars 30cH (1:1) também apresentou uma forte eficácia antiplasmódica com (75.5 ± 2.6) % de inibição de esquizontes. A presence de merozoites livres com Ars 200 cH e uma fraca atividade inibidora (40-45%) indicam a habilidade do parasita em sobreviver na presença dessa droga.