Early hematological parameters as predictors for outcomes in children with dengue in northern India: A retrospective analysis

Abstract INTRODUCTION: Dengue presents with a variable clinical course, ranging from mild illness to potentially fatal hemorrhage and shock. We aimed to evaluate the capabilities of various hematological parameters observed early in the course of illness for predicting the clinical outcomes of illness. METHODS: We retrospectively analyzed the records of children admitted in the pediatric inpatient services of the institute with dengue between 2017 and 2019. We determined the relationships between the hematological parameters observed during the first evaluation and the various clinical outcomes. RESULTS: We evaluated data from 613 patients (age range, 26 days to 17 years). Of these, 29.85% exhibited fever with warning signs, and 8.97% had severe dengue. Lower values of hemoglobin, platelet count, mean corpuscular volume, mean corpuscular hemoglobin concentration, and mean platelet volume, and higher values of total leukocyte count (TLC), hematocrit, and red cell distribution width variably correlated with numerous clinical outcomes-duration of hospital stay, development of complications, requirement of blood component transfusion, inotropic support, and mortality. Among the parameters, TLC ≥20,000/mL and initial platelet count ≤20,000/mL significantly associated with mortality, with odds ratios (95% confidence interval) of 11.81 (4.21-33.80) and 5.53 (1.90-16.09), respectively. CONCLUSIONS: Hematological parameters observed early during dengue infection may predict its clinical outcomes in infected children. Initial high TLC and low platelet count are potential predictors of fatal outcomes in the course of disease.

Oral Candida Carriage Including Speciation, Biofilm Production And Correlation With Occurrence Of Dental Caries In Student Population

The study was done to establish oral carriage of Candida, speciation, assay biofilm production and correlate the oral Candida carriage with occurrence of dental caries in students. Swab samples from oral cavity were collected from 206 students and were cultured for yeasts. Isolated yeasts were identified and detected for Biofilm production. Results:Overall Candida carriage was found in 90 of the 206 students (75 with caries). The rate of Candida carriage in students with caries (64%) was significantly higher as compared to overall carriage in students (43.7%). Atotal of 123 Candida strains were isolated including C albicans (63%), C tropicalis (23 %), C. parapsilosis (6 %), C. glabrata (4 %) and C. krusei (4 %). Biofilm production by C albicans was less frequent (42. 85%) than that by non-C albicans (63.33 %). and was significantly higher in students with caries than from without caries. Conclusion:We found a significant risk of dental caries with oral Candida carriage rates in student population. Candida albicans was the most common species isolated. Biofilm production was implicated in Candida virulence and was more important for non- C.albicans than C.albicans strains to establish infections.

Study of Biomedical waste management practices in a private hospital and evaluation of the benefits after implementing remedial measures for the same.

A study has been carried out to ascertain, whether biomedical Waste generated in private hospitals being segregated and managed properly? The study was carried out in a private tertiary care 620 bedded hospital located in an urban area in Delhi, India to assess the awareness and attitude of the hospital staff, to document the ongoing practices, enlisting the deficiencies, to identify the root causes and to suggest remedial measures for proper biomedical waste management and assess the benefits of implementing them. A process flow chart was made of the existing waste system of the hospital. An anonymous questionnaire survey was conducted to determine the awareness about the policies and practices. A training programme was organised and a manual for waste management was made and distributed in the hospital. The quantum of waste generated per day in the hospital was 610 kg with 150 kg being biomedical waste. It was observed that although the waste generated was being disinfected properly before disposal the hospital staff was not segregating the waste properly, with delays in lifting of waste compounded with improper disposal. The hospital has its own incinerator but it was underutilized. After the remedial measures including training and distribution of manuals, an improvement was found in the segregation process resulting in decrease in amount of infectious waste load to 50%. The survey shows that no appropriate strategy exists and there is an urgent need to increase awareness about rules, regulations and procedures regarding this vital issue.