RESUMO
Agricultural revolution and increasing pesticidal use have brought its share of downsides in the form of pesticidal poisoning. Every year approximately 300,000 deaths happen worldwide due to pesticide poisoning. Organophosphates, chlorates, and aluminum phosphide are the commonly used pesticides. Alkaline phosphatase (ALP) is the most lethal among the available pesticides and no antidote is available and aptly called as suicide poison. The common use and easy availability of ALP is causing acute and chronic health effects which have reached major proportions in Asian and Middle Eastern countries such as India, Bangladesh, Iran, Jordan, and Sri Lanka. Toxicity of ALP is related to prompt release of lethal phosphine gas as ALP tablet absorbs moisture. Phosphine gas mainly affects cardiovascular system gastrointestinal tracts, lungs, and kidneys. The clinical features of poisoning include nausea, vomiting, abdominal pain, pulmonary edema, cyanosis shock arrhythmias, and alter sensorium. Diagnosis of ALP poisoning largely depends on history and clinical setting and treatment is usually initiated without waiting for silver nitrate paper test or gastric aspirate analysis. Treatment includes early gastric lavage symptomatic supportive therapy and palliative care. There has been greater understanding about the mechanism and pathophysiology of ALP toxicity over the years, although that cannot be commented about the treatment modalities. Government efforts to restrict sale have been offset by the lack of strict enforcement by regulatory agencies. Case fatality rates from ALP poisoning have shown some decline over the years due to early supportive management. Different treatment modalities and protocols have been tried at various centers with variable success; however, further research for an antidote is the need of the hour.
RESUMO
Background: Malnutrition generally implies under-nutrition and refers to all deviations from adequate and optimal nutritional status in infants, children and in adults. In children, under-nutrition manifests as underweight and stunting (short stature), while severely undernourished children present with the symptoms and signs that characterize conditions known as kwashiorkor, marasmus or marasmic-kwashiorkor. Materials and methods: The present study was carried out in the department of pediatrics and microbiology at UP Rural Institute of Medical Sciences and Research, Saifai, Etawah (U.P) during April 2014 to March 2015. Total 85 children were included in study. Results: Although under reported UTI is common in children with SAM as came out in our study. Prevalence of UTI is common (22.4%) in children with SAM in our study. In our study, Urinary tract infection was more common in females than males in SAM children with maximum prevalence among 37-59 months of age .but there is no significant difference between sex. Sharma IK, Garg KK, Saxena D, Sharma N. Study to determine the prevalence of urinary tract infection and to identify the causative organism and their antibiotic sensitivity pattern in severe acute malnourished children. IAIM, 2017; 4(7): 89-104. Page 90 Conclusion: Most sensitive first line oral Antibiotic was Nitrofurantoin and parentral antibiotic was Amikacin for UTI in children with SAM, in our study.