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Background: The objective of this study is to find out the proportion of children with thrombocytopenia in acute encephalitis syndrome (AES); second, to compare the aetiology of AES in thrombocytopenic cases with non-thrombocytopenic cases; and finally, to find out clinical and laboratory predictors of thrombocytopenia in AES, as well as to study platelet aggregation and compare it in both scrub positive and scrub negative AES cases.Methods: This prospective observational study was conducted on 176 children with presumed viral aetiology were investigated to find out the cause of AES.Results: The majority of patients presented with thrombocytopenia. The most common aetiologies are Japanese encephalitis (JE). No significant difference was observed in the aetiology of AES between the thrombocytopenic and non-thrombocytopenic groups. Rash, bleeding, swelling, hepatomegaly, and splenomegaly were significantly more common in thrombocytopenic AES cases. Among the laboratory parameters, haemoglobin, PCV, and serum protein were found to be significantly low in the thrombocytopenic group. Liver enzymes, serum AST, and serum ALT were significantly high in the thrombocytopenic group. Platelet aggregation percentage was found to be significantly high in AES children who were positive for scrub typhus in comparison to other AES cases. Eighty-seven patients were discharged from the hospital. The mortality rate was 18%. There was no significant difference in the outcome of AES cases in relation to thrombocytopenia.Conclusions: This approach may help clinicians in the diagnosis of AES due to the scrub along with other tests available. There was no significant difference in the short-term outcome of AES cases in relation to thrombocytopenia.
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Background: This study aimed to identify the distribution of pathogens and their antimicrobial resistance patterns in the neonates admitted to the NICU of a tertiary care hospital in northern India.Methods: After obtaining written informed consent, neonates with confirmed or suspected cases of neonatal sepsis (n=167) aged 0-28 days were included. As soon as the baby arrived, all the clothes were removed and kept in a pre-heated warmer. Before administering I/V antibiotics, all the routine and culture samples were taken. The clinical data were collected and analysed using SPSS.Results: Most of the neonates were from lower middle class, out-born, LSCS, early preterm, and low birth weight (LBW). 167 neonates had culture-confirmed infections [blood culture positive (13.8%) and sepsis screen positive (86.2%)]. Gastric aspirate cytology was positive in 61.7% of patients. Maximum cytology-positive cases were seen in neonates with EOS. The most common risk factors were birth asphyxia. 142 individuals were discharged, with 72.5% diagnosed with EOS and 89% with LOS. There was a significant difference in gastric aspirate cytology when associated with expiry and discharge. Out of 167 neonates, 13.77% were culture-positive for neonatal sepsis. Out of 23 organisms, 82.6% were resistant, while, 17.4% were not. Staph aureus was the major causative organisms. Among the Gram Positive and Negative bacteria, the highest sensitivity was observed for imipenum. All gram-positive bacteria were resistant to cotrimazole, tobramycin, and erythromycin.Conclusions: Implementation of effective preventive strategies to combat the emergence of antibiotic resistance is urgently needed.
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Recurrent tummy (abdominal) pain (RAP) is among the most prevalent symptoms where children experience frequent stomach pain over an extended period. RAP is prevalent in children, affecting 10-20% of school aged children. There is no consensus regarding this widespread issue's genesis, investigation, and management. This review touches on a few concerns about children's recurrent abdominal pain.
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Background: The study's objective was to evaluate and compare total serum protein, serum albumin, and thyroid hormones in children with PEM (protein-energy malnutrition) and healthy controls.Methods: In this cross-sectional study, 100 children with PEM served as cases, while an equal number of age and gender-matched healthy children served as controls. 4 ml of venous blood were taken (3 ml in a plain vial and 1 ml in an EDTA vial) and immediately submitted for further investigation. SPSS software (version 25) was used to analyze the data. A p value of ?0.05 was considered statistically significant.Results: PEM children have lower serum total protein, albumin level, total T3 (TT3), and total T4 (TT4) levels compared to healthy controls (p<0.0001). Mean TSH levels in cases and controls were nearly similar. There was no significant difference between serum TSH concentrations in PEM children and the controls. Grade I PEM had the highest mean total protein, serum albumin, T3, and T4 levels, followed by grades II, III, and IV. When mean total protein, serum albumin, T3, and T4 levels of each grade of PEM were compared to controls, mean total protein, serum albumin, T3, and T4 levels were substantially lower in each grade of PEM (p<0.0001).Conclusions: PEM children have low serum total protein and albumin levels. This is probably due to decreased oral intake of proteins and reduced biosynthesis. Serum TT3 and TT4 levels are lower in children with PEM than in healthy controls, which is most likely due to reduction in circulating plasma proteins.