Fontan patients with a higher MELD-XI score have shorter freedom from sudden cardiac death, death from congestive heart failure and cardiac transplantation.

Background and objective Bacterial infectioins in particular meningitis, pneumonia and septicemia are still some of the most causes of mortalities in children. The aim of present study was to identify the most common bacterial agents causing infectionis in children under 14 and detection of antibiotic resistance paterns. Material and methods During two years,1897 samples were obtained from the patients suspected bacterial infectioins. They were investigated for bacterial cultures, age, sex and antibiogram patterns. The species were identified by biochemical and serological methods.Results Of 1897 samples, 563 (29.6%) had positve bacterial culture. Of these 74.7% were gram negative and 25.3% gram positive. The most common species were Escherichia coli (34.1%), Staphylococcus aureus (17.1%), Psuedomonas aeroginosa (12.4%), Kelebsiella (11%) and Staphylococcus epidermidis (5.7%). The most effective antibiotics against both gram positive and gram negative bacteria were ceftriaoxne, nitrofurantoin, nalidixic acid, amikacin and gentamycin. Conclusion The gram negative bacteria in particular Escherichia coli, Psuedomonas aeroginosa and Kelebsiella are the predominant causes of bacterial infections in children under 14 in these regions. Most species showed a high relative resisitance to routine antibiotics such as ampicillin, trimethoprim and chloramphenicol.

Background: Malnutrition is one of the most serious complications of chronic kidney disease due to its devastating consequences in terms of quality of life, morbidity, hospitalization and mortality. This study aims to evaluate the prevalence of malnutrition among chronic kidney disease patients globally and its contrast with India. Methods: Articles reporting the prevalence of malnutrition associated with CKD patients were retrieved from PubMed/Medline, ScienceDirect, Cochrane library & Google scholar. The quality assessment of studies was performed by using Newcastle-Ottawa scale. The pooled prevalence was reported with effect size considering the random effect model using comprehensive meta-analysis version 2.0. Results: The results from 61 observational studies containing 21119 patients are presented. The global prevalence of malnutrition associated with CKD was found to be 42.7%. The prevalence of malnutrition in peritoneal dialysis group was found to be (45.3%, 95%CI; 29.5-62.1) higher as compared to hemodialysis group (43.1%, 95% CI; 32.2-54.7) followed by non-dialysis group (38.5%, 95% CI; 24.0-55.3). The prevalence of malnutrition in India was found to be 56.7% (95% CI: 42.4-70.0%). Males were predominantly affected with malnutrition as compared to females. The prevalence in India was reported to be higher as compared to all the included countries, except Mexico and Jordan. Conclusions: Globally, India occupies the highest share of prevalence studies followed by Brazil. The geographical stratification of results revealed that the highest prevalence of malnutrition was observed in India except Mexico and Jordan. Given the high prevalence of malnutrition among CKD patients, evaluation of interventions for malnutrition with patient centered outcomes are warranted.

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