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Background: Atypical organisms are a common causative agent of pneumonia in children more than 3 years of age, causing around 10-30% of the cases. Though atypical pathogens are said to cause relatively milder form of pneumonia as compared to other bacterial and viral pathogens, severe manifestations can also occur. Early identification of these pathogens can help in starting treatment with macrolides, which can reduce the length of hospital stay and mortality. Hence in this study the prevalence of atypical organisms was identified by using serum Polymerase chain reaction (PCR).Methods: This was a prospective observational study conducted in children between 3 years to 18 years of age with clinical diagnosis of pneumonia admitted in wards and PICU in KIMS hospital. Authors excluded Immunocompromised children. Detailed history and clinical examination was done. Investigations - complete hemogram, Chest Xray, blood Culture and sensitivity and serum PCR was done for a sample size of 100 children.Results: In this study among the three atypical organisms, Legionella pneumoniae was identified in 2% of the cases by serum PCR.Conclusions: In this study among the three atypical pathogens authors could only identify Legionella pneumoniae. Prevalence of Legionella pneumoniae was 2%. While treating children aged 3 years to 18 years with pneumonia, a high degree of suspicion of atypical pathogens is required, especially in Legionella because of its high mortality rate. In such circumstances adding macrolides along with other antibiotics will be beneficial to the patients outcome and duration of hospital stay.
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Background: Pneumonia accounts for 15% all deaths in children under 5 years of age, being the single largest infectious cause of deaths in children worldwide according to WHO. Establishing the exact etiological factor is a difficult task, as there are no definite clinical, radiological markers to differentiate between causative organisms. Hence by detecting the genetic material of causative organism by serum PCR (polymerase chain reaction) and correlating it with the clinical and radiological features can help in appropriate use with antibiotics.Methods: It is a observational study conducted in department of paediatrics KIMS hospital Bangalore, India which included inpatients admitted with clinical and radiological features of pneumonia over a study period from February 2018-April2019 .In this study we excluded immunocompromised children . After obtaining informed written consent, detailed history and clinical examination was done. Investigations including complete hemogram, CXR were done. Under sterile precautions, blood samples for serum PCR and blood culture and sensitivity were obtained. Serum PCR was done for a panel of 33 respiratory pathogens.Results: Etiological agents were identified in 63% of cases. Streptococcus pneumoniae was the most common causartive agent being detected in 50.6% of the cases. Staphylococcus aureus has been detected to be the second common organism 16%.Conclusions: In our study Pneumococci was identified in 50.6% of cases. Multiplex serum PCR could be a useful rapid diagnostic tool to identify the etiological agents. Introduction of pneumococcal vaccine worldwide in government immunization schedule, nationwide will help to reduce the disease burden caused by Streptococcus pneumoniae.
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Background: Neonatal encephalopathy, following severe birth asphyxia or perinatal hypoxia is referred to as hypoxic ischemic encephalopathy (HIE). Cerebral ischemia occurs as a consequence of cerebral oedema and reduced cerebral perfusion due to myocardial dysfunction as a result of hypoxic cardiomyopathy. Sarnat stage I -100% recovery, HIE stage II - 80% normal and 20% mortality and HIE stage III - 50% mortality and 50% morbidity. Relatively few studies have been made on outcome in HIE affected preterm infants. The aims and objectives of this study was to find out the neurodevelopmental outcome in preterm infants with HIE.Methods: This study is an observational clinical study, undertaken in Kempegowda Institute of Medical sciences and research centre, Bangalore, India. Study was performed between November 2016 to September 2018. 31 preterm infants with HIE were included in the study. Regular follow-up was done at 3, 6, 9, 12.15, 18 months by using Trivandrum development screening chart (TDSC) to stage II HIE infants.Results: The incidence of abnormal neurological outcome was 12.9%. Out of 31 preterm babies, stage I were 24, stage II was 4 (100% morbidity) and stage III were 3 (100% mortality).Conclusions: In present study, stage II HIE had 100% morbidity and moderate disability, stage III 100% mortality. Thus at 3-5 months of age during follow-up, when authors identify developmental delay, it is an ideal time to start interventional therapy to improve long term outcome.
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Background: Post graduate residents in tertiary care teaching hospitals in metropolitan cities bear the overwhelming burden due to heavy workload, they are at high risk of developing burnout syndrome, which in turn may affect hospital outcomes such as the quality and safety of the provided care.' This study was conducted to assess their perceived stress, stress induced somatic symptoms and coping strategies by postgraduates in Bangalore, India.Methods: This cross-sectional study was conducted on all postgraduates willing to participate in the study, pursuing their post-graduation in various specialties in Six medical colleges in Bangalore, India. Stress was assessed by Perceived stress scale (PSS-10), Stress induced physical symptoms using selected items from self-reporting questionnaire (SRQ-20), coping strategies using selected items from BRIEF COPE. Descriptive and inferential statistical analysis has been carried out in the present study.Results: The mean PSS score in present study was found to be 22.92 (moderate stress). Stress was associated with clinical specialty, higher workload, poor sleep quality due to more working hours, marital status, harmful ideations. In present study Post graduates of OBG, pediatrics, radiology demonstrated higher perceived stress score with a mean PSS Score of 25.57, 24.25, 24.22 respectively. Dermatology postgraduates reported lowest stress levels with a mean PSS score of 16.86.Conclusions: In present study post graduates are facing moderate stress, affecting their physical and mental health resulting in dysfunctional coping strategies and harmful ideations like quitting, which has an impact on quality and safety of provided care.