ABSTRACT
Background: Majority of the children in India who live below the poverty line in an environment of deprivation and starvation have physical and developmental retardation. The Objective of this study to study the impact and comparison of protein energy malnutrition on the development with normal children.Methods: This was a hospital based cross sectional study in which total 128 cases of protein energy malnutrition and 30 normal children were enrolled from nutritional rehabilitation center and in patients wards. The study population comprised of children less than 5 years of age, having weight for height/length ?3 SD, with visible wasting, or bipedal oedema, with mid arm circumference <11.5 cm were assessed for their development in all four domains using Denver II developmental Screening Test (DDST-II).Results: The gross motor milestones are affected in 62.5% with grade4 PEM & 42.85% with grade 3, the fine motor component is affected more in grade 4 with other domains less affected, no significant relation of language delay with PEM was observed in this study, 40% of children with grade 4 PEM shows delay in social domain while 18.18% of the patients with grade 3 PEM show delay in social domain. No patients with grade 1 or grade 2 PEM showed delay in social domain. All four domains are affected in PEM with a maximum effect in gross motor, but the difference does not seem to be significant as the p value is 0.3 i.e.' >0.05 which is insignificant.Conclusions: My study on the effect of protein energy malnutrition on development proves that there in increasing delay in all the domains of development with increasing grade of malnutrition. Early detection of malnutrition in community can cause early intervention and increase the productivity of nation.
ABSTRACT
Background: Carbapenem resistance in Gram Negative Bacilli is an emerging threat in tertiary care centers which is mediated by Metallo-β-lactamase (MBL) enzyme. As per the National committee for Clinical Laboratory Standards (NCCLS), still does not have documented standard procedure from there several screening methods to detect their enzyme. Some subcontinents of India still awaiting to see prevalence and screening methods to detect enzyme which is responsible for Carbapenem Resistance. Aim: The present study was undertaken to early detection of MBL by screening methods in Gram Negative Bacilli isolated from hospital and the prevalence MBL production in carbapenem resistant bacterial isolates. Materials and methods: 176 consecutive different Gram Negative Bacilli (GNB) isolated from hospitalized patients which were tested antimicrobial susceptibility for different antibiotics including Carbapenem drugs as Imipenem by Kirby Bauer Disc Diffusion (CLSI 2010) and screening of Metallo-β-lactamase production by method as Imipenem- EDTA combined disc synergy test (ICDST) and Imipenem-Double Disc Synergy Test (I-DDST) which determine the MBL by zone size enhancement with EDTA Impregnated Imipenem. Munesh Kumar Sharma, Dakshina Bisht, Shekhar Pal. Detection of Metallo-β-lactamase producing Gram Negative Bacteria in clinical isolates in Tertiary care Hospital - A prospective study. IAIM, 2019; 6(4): 107-111. Page 108 Results: Out of 176 Gram Negative Bacilli, 20.45% (n=36) of isolates were resistance to Imipenem by disc diffusion method and 94.44% (n=34) by DDST EDTA impregnated Imipenem and 88.89% (n=32) showed enhancement of zone size ≥7 mm with EDTA impregnated Imipenem CDST. Imipenem susceptible bacteria strains did not show any enhancement with EDTA impregnated antibiotic disc. Conclusion: Critically ill patient’s therapy is cause of concern for MBL mediated imipenem resistance gram Negative Bacilli. Two methods used for supplementary support in treatment of patients. In both methods of detection DDST is more effective.
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Summary Objective: According to data from the World Health Organization (WHO), anemia is a prevalent health problem that leads to increased morbidity and mortality, especially in preschool children. Anemia is recognized as a major health problem due to its negative effects on the mental and physical development during childhood. The aim of our study was to determine the levels of anemia of children in a kindergarten affiliated to the Directorate of National Education using a non-invasive method, and to investigate the effects of anemia on the physical, mental and neuromotor development of children. Method: The levels of anemia was evaluated by using a non-invasive measurement device. Data collection was performed by means of a questionnaire to evaluate the children's physical development and set Denver Developmental Screening Test II scores. Results: Our findings show that 21% of non-anemic and 15% of anemic children are in the suspected abnormal group according to their DDST II total score. Furthermore, it has been identified that mild anemia has a positive effect on neuromotor development, while overweight and obesity affect neuromotor development in a negative way. Conclusion: According to the results obtained from the study, mild anemia may have a positive effect on the children's neuromotor development, while malnutrition could have a negative impact.
Subject(s)
Humans , Male , Female , Psychomotor Performance/physiology , Body Mass Index , Child Development/physiology , Anemia/complications , Obesity/etiology , Severity of Illness Index , Developmental Disabilities/diagnosis , Anemia/physiopathology , Obesity/physiopathologyABSTRACT
Extended spectrum beta- lactamases (ESBLs) continue to be a major problem in clinical setup worldwide. An attempt is made to detect ESBL production among Enterobacteriaceae members by phenotypic methods, which is easier to perform in all laboratories. A total of 138 multi-drug resistant strains from pyogenic infection were tested for ESBL production by Double disc synergy test (DDST) and Phenotypic confirmatory disc diffusion test (PCDDT). Of the 84 ESBL producer identified, PCDDT detects 71 (84.5%) whereas DDST detects 52 (61.9%) as ESBL producers. Continued detection of ESBL is essential for proper disease management. PCDDT is better and easy test for screening than DDST. Confirmation has to be done by molecular methods.
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Objectives: Resistance to third generation cephalosporins in E. coli and K. pneumoniae are due to various factors. The present study was undertaken to detect resistance mediated by ESBL’s. Multidrug resistance in isolates producing ESBL was also studied. Methods: The study included a total of 200 clinical specimens which include 95 urine, 45 pus, 32 sputum, 11 blood, 9 throat swabs, 6 suction tips and 2 vaginal swabs. The E. coli and K. pneumoniae isolates which were screen positive were studied for ESBL production by DDST method. Results: Culture of 200 samples yielded 200 isolates (117 E. coli and 83 K. pneumoniae). Out of these, 98 (49%) were screen positive for ESBL. Among them 79 (53 E. coli and 26 K. pneumoniae) were found to produce ESBL. Among them, 4 (7.6%) isolates of E. coli and 4 (15.3%) isolates of K. pneumoniae were positive by DDST method. The prevalence of 39.5% of ESBL production was noted in the present study. Among ESBL positive isolates, 98.1% were resistant to cefoxitin, however all of them were susceptible to imipenem. Conclusion: The prevalence of ESBL producing E. coli and K. pneumoniae was found to be high and routine screening of ESBL should be preformed on all isolates showing decreased susceptibility to one or more of third generation cephalosporins.
ABSTRACT
This descriptive exploratory study was conducted to analyze the results of developmental screening test using DDST and the follow-up diagnostic evaluation in one public health center, and to evaluate the feasibility of developmental screening in nursing. Samples were 373 children under 6 years who visited the public health center. Mothers' satisfaction on the developmental clinic was also determined. Summaries of the results were as follows: 1.0.5% of children in height and 1.9% of children in weight were included in below 3 percentile of Korean children's growth chart, but none of them showed developmental delay. 2.The results of DDST showed 92.1% of subjects were classified as normal, 3.7% as abnormal, and 4.2% as questionable among 354 children. 3. Most of children who showed the abnormal development at the first DDST were confirmed having the developmental delay at the follow-up diagnostic evaluation. On the other hand, most of children who showed the questionable development at the first DDST revealed having the normal development in follow-up screening test. 4. The result of the DDST was influenced by the birth order of the subject and delivery type. 5.The mean satisfaction score by mothers on developmental clinic was 4.35 in 5 Likert scale. In conclusion, we could certain the feasibility and usefulness of developmental screening in community and child care nursing. To fulfil the increasing needs of mothers with infants on the child development, nurses have to provide anticipatory guidance and parent education in addition to the developmental screening test. We hope to expand the developmental screening in nursing field not only of clinical setting but also of community.