A study on screen time use in children between 24 to 60 months of age in Tamil Nadu, India

Background: This study was done with the objective of finding the average daily duration and pattern of screen time use in children in the age group of 24 to 60 months in the state of Tamilnadu, India and to find the correlation between screen time and demographic parameters.Methods: This cross-sectional observational study was conducted at the state of Tamilnadu, India from June 2019 to August 2019 among 148 children in play school and kindergarten classes in the age group of 24 to 60 months fulfilling the inclusion and exclusion criteria. Details regarding screen time use were collected from the parents using a predesigned questionnaire and analyzed using suitable statistical methods.Results: A total of 148 children (77(52.0%) male and 71(48.0%) female) were studied. The average daily screen time in the study group was 139.4 minutes (SD: 1.6). Majority of the children had a screen time duration between 61 to 120 minutes (48.6%). Only 14.2% had a screen time of ?60 minutes as per AAP and WHO recommendations. Majority of the screen time was used to watch children's entertainment programs and play games (67.6%). 83.1% of the children were using 2 or more screen types. Television and smart phones were the commonest screen types used by children in this age group. The percentage of children with average daily screen time ? 60 minutes was found to be more in joint families (16.3%) compared to nuclear families (10%). But this difference was not statistically significant. No statistically significant correlation was found between screen time duration in children and age, gender, parent's socioeconomic status, education and occupation.Conclusions: Increasing screen time activity in early childhood is an emerging problem of the digital age which requires interventions at family, social and healthcare levels.

A Randomized Controlled Trial Comparing the Duration of Phototherapy Following NICE and AAP Guidelines in Neonatal Hyperbilirubinemia

Aims and Objectives: To compare duration of phototherapy between AAP and NICE guidelines in neonatal hyperbilirubinemia. Methods: In an open labelled study 130 babies with non-haemolytic hyperbilirubinemia were randomised to receive phototherapy following one guidelines between AAP and NICE. In this study we compared AAP 2004 and NICE 2010 guidelines to see whether following any of these two guidelines leads to phototherapy for longer duration. The primary outcome variable was duration of phototherapy and the secondary outcome variable was failure of phototherapy, defined as inability to reduce the TSB level of 2-3 mg/dl from baseline within 6 hours of phototherapy or inability to reduce TSB below exchange level. Results: Median age at onset of phototherapy was 77.55(19.43)hours in AAP group and 73.57(12.93) hours in NICE group, median gestational age was 37weeks in AAP group and 38weeks in NICE group, mean birth weight 2377.92gm in AAP group and 2457.10 gm. in NICE group, mean serum bilirubin at the onset of phototherapy was 18.77(1.570) mg/dl in AAP group and 18.24(1.89)g/dl in the NICE group. Average spectral irradiance was 55.8(µw/cm2/nm) in the study. Median duration of phototherapy in NICE as well as AAP group was 18 hours. There was no treatment failure in either group. Neurological examination was done at 40 weeks and 3 moths of corrected age. No abnormal neurological examination or BERA finding was reported in any of the babies. Conclusion: There is no difference in duration of phototherapy in any of the guidelines.

The comparison between management recommendations of the Neonatal Early Onset Sepsis Calculator and CDC/AAP guidelines among culture-proven early onset sepsis admitted at University of East Ramon Magsaysay Memorial Medical Center from January 2013 to December 2017 / The Health Sciences Journal

INTRODUCTION Early onset sepsis is difficult to diagnose due to nonspecific symptoms and a lack ofreliable tests. It can progress quickly, and lead to neurodevelopmental consequences or be fatal if nottreated. However, approximately 10-fold more newborns are treated with antibiotics empirically and oftenunnecessarily. This study aimed to compare the management recommendations of the Neonatal EarlyOnset Sepsis Calculator with those of the Centers for Disease Control/American Academy of Pediatricsguidelines.METHODS Neonatal Early Onset Sepsis Calculator was applied to the data set to examine how an alternativemodel would perform compared to current guidelines published by the CDC and compared to currentpractice within the institution. Chi square and kappa value agreement was used to determine the differencebetween treatment recommendations of NEOS calculator and AAP guideline.RESULTS Of the 330 patients who received therapy, only 14.2% were recommended empiric antibiotics bythe EOS calculator, compared to the 39% recommended by the CDC guidelines (p Eleven patients were identified to have culture-positive sepsis.CONCLUSION The number of infants suspected with EOS and subsequently require antibiotic use at birthmay be dramatically reduced with the use of the neonatal EOS calculator.

Reconstrucción perineal con colgajo miocutáneo vertical de recto anterior del abdomen luego de amputación abdomino perineal extraelevador. Una alternativa factible para el cirujano colorrectal / Perineal reconstruction with vertical myocutaneous flap of the anterior rectus abdominis after extra-elevating perineal abdominal amputation. A feasible alternative for the colorectal surgeon

Las complicaciones perienales luego de la amputación abdominoperineal son frecuentes y clínicamente relevantes en términos de estadía hospitalaria, costos, calidad de vida y los resultados oncológicos. La utilización creciente de radioterapia pre operatoria y la incorporación gradual a la técnica extra-elevador, ha llevado a un aumento en la morbilidad perineal. Es por elloque la búsqueda de una técnica confiable y con buenos resultados para el cierre perineal se hace necesaria. Se han publicado muchas series que describen diferentes técnicas de cierre del defecto perineal, pero faltan estudios clínicos de alta calidad que indiquen cuál es la mejor opción. Cuando la proctectomía resulta en un amplio defecto perineal, el colgajo vertical del recto del abdomen parece ser la mejor opción. Presentamos dos casos de tumores anorectales localmente avanzados en los que se realizó una amputación abdominoperineal extraelevador con posterior reconstrucción perineal con colgajo de recto anterior y, a su vez, describimos la técnica quirúrgica. (AU)

Perineal complications after abdominoperineal amputation are frequent and clinically relevant in terms of hospital stay, costs, quality of life and oncological results. The growing utilization of pre-operative radiotherapy and the gradual incorporation to the extra-elevator technique, has leaded to an increase in perineal morbidity. That is why the search for a reliable technique with good postoerative outcomes for the perineal closure is necessary. Many series describing different closure techniques of the perineal defect have been published, but high quality clinical studies have to indicate which the best option is. When the proctectomy results in a wide perineal defect, the vertical rectus abdominis flap seems to be the best option. We presented two cases of locally advanced anorectal tumors in which an extraelevatory abdominoperineal amputation was carried out with posterior perineal reconstruction with vertical rectus abdomins flap and we described the surgical technique. (AU)

Asthma Action Plan for Adults

@#Asthma action plan (AAP) is an essential component of asthma education and self-management. AAPs provide patients with instructions on how to recognise loss of asthma control and the appropriate treatment steps. The use of AAP improves asthma-related quality of life and reduces the risk of asthma exacerbation. Despite its benefits, utilisation of AAP is disappointingly low both locally and worldwide. This review highlights the importance of AAP as part of an asthma care plan and provides practical information on the prescription of AAPs. We conclude by identifying possible barriers to AAP implementation and how these may be overcome.

Detection of aap, aggR, and astA in strains off enteroaggregative E.Coli

Background: Aap, aggR, astA have been found to play important roles in diarrheal pathogenecity of enteroaggregative (EAEC). Objective: (1) To determine the distribution of aap, aggR, astA in EAEC. (2) To compare the distribution of aap, aggR, astA in EAEC isolated from healthy children and children with diarrhea. Subject and methods: \r\n', u'86 strains of EAEC isolated from children under 5 living in Hanoi, have been screened by PCR with specific primers. Results: Aap was found at the highest prevalence of 96.5%, aggR (79.1 %) and astA (60.5%). 37.2% of strains had all of aap, aggR and astA. None of strains was shown negative with these genes. Distributive rate of aap, aggR, astA in EAEC strains isolated from children with diarrhea was higher than EAEC strains isolated from healthy children. However, this difference was not statistically significant. Nearly 100% of the EAEC strains isolated from children with diarrhea had aap gene. The rate of aggR and astA was lower. Among children aged 0-24 months and children aged 25-60 months, distribution of these three genes was not different with statistical significance Conclusion: This finding has contributed to understanding the distribution of aap, aggR and astA of EAEC\r\n', u'\r\n', u'

Detection of aaP, aggR, and astA in strains of ETEC, EPEC, EIEC and non-diarrheagenic E.coli

Background: aaP, aggR, and astA have been found to play important roles in diarrheal pathogenecity of EAEC. They may be exist in other diarrheagenic E.coli (DEC). Objectives: To determine the distribution of aaP, aggR, and astA in ETEC, EPEC, EIEC and non-diarrheagenic E.coli. Subjects and method: 75 strains of ETEC, EPEC, EIEC and 100 non-DEC have been screen by PCR with primers specific toaaP, aggR, and astA. Results: aaP, aggR, and astA have been seen in DEC with the prevence from 7 to 72,7%. The highest prevence was in EIEC, 72,7% for aap; 45,5% in EIEC for aggR; and 50% in ETEC for astA. 14% of non-DEC harbored aggR and more than 30% harbored aap and astA. Conclusion: This finding has contributed to understanding the distribution of aap, aggR and astA in ETEC, EPEC, EIEC and non-DEC as well.

Produção de biofilme, detecção dos genes icaAD. atlE e aap e resistência aos antimicrobianos em cepas de Staphylococcus epidermidis resitentes à meticilina (MRSE) / Biofilm production, detection of genes icaAD. Atle and aap and antimicrobial resistance in strains of Staphylococcus epidermidis quite resistant to methicillin (MRSE)

O biofilme tem sido considerado o principal fator de virulência dos Staphylococcus epidermidis. A presença do operon ica e de outros genes incluindo atlE e aap, tem sido sugerida como importante para a sua formação. Nosso trabalho teve como objetivo estudar a expressão de biofilme, detectar a presença dos genes icaAD, atlE e aap e determinar a susceptibilidade a antimicrobianos em cepas de S epidermidis resistentes à meticilina (MRSE) obtidas de pacietnes hospitalizados no Hospital Antonio Pedro (HUAP...Nossos dados demonstraram ainda uma correlação entre a característica de forte produçao de biofilme e a presença concomitante dos genes icaAD, atlE e aap. Finalmente, cepas de MRSE multirresistentes estavam mais associadas ao padrão aderente, sugerindo que o ambiente do biofilme possa favorecer as transferências de genes de resistência aos antimicrobianos.

Effect of Auricularia auriculajudae polysaccharide on cell immunity of tumor-bearing mice / 中成药

AIM: To study the influence of Auricularia auriculajudae polysaccharide (APP) on celular immunity of mice bearing tumor. METHODS: Influence of AAP on lymphocyte proliferaton and IL-2 production of H_(22) mice and was observed by cell cultivation. And the influence of AAP on free Ca~(2+) concentration in lymphocytes of H_(22) mice through laser sacanning confocal microscope (LSCM). RESULTS: AAP can lengthen the average survival time of H_(22) tumor-bearing mice. The research of immune function indicated that AAP can improve the tumor-bearing mice's celular immunity the increase in lymphocytes, and the product of IL-2 and Ca~(2+) concentration inside lymphocytes. CONCLUSION:AAP has a function of anti-tumor. The mechanism has a relation to raising the celular immunity.