Risk factors in predicting mortality among children admitted for PCAP C and D at Philippine Children’s Medical Center

OBJECTIVE@#The study aimed to identify risk factors associated with mortality among patients admitted for PCAP C and D.@*METHODOLOGY@#The study was a cross-sectional study involving children admitted for PCAP C and D at PCMC from January 2017 to December 2019. Univariate and multivariate analyses through binomial logistic regression were used to determine significant predictors of mortality.@*RESULTS@#A total of 472 patients were included in the study, of whom 77% had PCAP C and 23% had PCAP D. More than half in each patient group were infants; male; and of normal nutritional status. Most common comorbidities in both groups were neurologic and cardiovascular in nature. Leukocytosis, thrombocytosis, and anemia were the most common hematologic findings. Overall mortality rate among patients was 5.08%. On univariate analysis, being severely underweight (cOR 8.28 [95% CI 2.52–27.23]), with history of antibiotic use (cOR 3.01 [95% CI 1.18–7.62], neurologic comorbidities (cOR 4.04 [95% CI 1.42–11.43]), cardiac comorbidities (cOR 5.33 [95% CI 1.31–21.75]), Down syndrome (cOR 22.11 [95% CI 2.44- 200.30]), and thrombocytopenia (cOR 22.11 [95% CI 2.44-200.30]) were associated with greater odds of mortality among PCAP-D patients. On multivariate analysis, the odds of mortality were 5.02 (95% CI 1.05-23.96) for severely underweight patients, 4.51 (95% CI 1.13-17.95) in patients with neurologic disease, and 73.62 (95% CI 3.63–1491.10) in patients with Down syndrome.@*CONCLUSION@#Patients with PCAP D who have severe malnutrition, Down syndrome, cardiac and neurologic abnormalities, and thrombocytopenia should be managed more aggressively to decrease mortality in these patients.

A randomized double blind controlled study on the efficacy of spirulina as an adjunct therapy in the management of pediatric community acquired pneumonia-c in patients 6 months to 5 years old admitted in a tertiary government hospital

OBJECTIVE@#To determine the effect of Spirulina among patients with community acquired Pneumonia-C (PCAP-C) based on the resolution of the following symptoms; fever, respiratory rate, chest indrawings, rales, oxygen saturation and compare their length of hospital stay.@*DESIGN@#A randomized-double blind, placebo controlled clinical trial.@*SETTING@#The study was done at a tertiary government hospital@*PATIENTS/PARTICIPANTS@#Children 6 months to 5 years old with PCAP-C were randomized to either treatment group A or B. The two groups received the standard treatment for pneumonia and adjunct treatment of Spirulina for group A and placebo for group B.@*RESULTS@#A total of 14 7 patients participated in the study. Seventy four patients were randomized to group A and 73 patients to group B. Respiratory rate showed greater improvement with Spirulina supplementation starting day 3, 4 and 5. Resolution of chest in-drawing was significant in Spirulina group on day 2 (p- value < 0.05), day 3 (p - value < 0.05) and day 4 (p - value <0.05). There were more patients in Spirulina group with decreased to absent rales on day 2 (p-value 0.02), day 3 (p-value 0.039), day 4 (p-value 0.01) and day 5 (p-value 0.01). Temperature and oxygen saturation on both groups had almost similar trends. The mean hospital stay in Spirulina group (3.09 days) is shorter as compared to the placebo group (p-value 0.02).@*CONCLUSION@#Spirulina supplementation showed positive effects in PCAP-C. Its immunemodulating effect played a positive role in the treatment outcome of pneumonia.