Background: Candidial infections are a serious problem in neonatal intensive care units (NICU) which increases the mortality and morbidity in addition to increasing health care costs. Confirming the diagnosis by laboratory tests is difficult and a high index of suspicion is required. The objective of this study was to identify the clinical spectrum and epidemiology of neonatal candidiasis in a tertiary care NICU.Methods: The present study was carried out in the NICU of SDM medical college and hospital, Dharwad. All babies who were admitted to NICU and who had positive blood culture for Candida were included in the study. One year Data (1st December 2015 to 31st November 2016) was collected retrospectively from NICU case records. Statistical test used was chi square test.Results: Total admissions to the NICU during the study period were 2591. Blood cultures were positive in 132 babies. Among these, Candidial sepsis was noted in 39.39% (52) babies. Out of the 52 positive fungal cultures, 15 were Candida albicans, 35 were Candida non albicans and 2 were mixed cultures (Candida albicans and non albicans) showing an increasing incidence of non-albicans Candida infections. Among the non albicans Candida, Candida tropicalis and Candida guilliermondii were the predominant species (11 each) followed by Candida famata (6), Candida krusei (6) and Candida parapsilosis (3). Candidial sepsis was seen to be more common among preterm and low birth weight babies. Usage of antibiotics, Total parenteral nutrition (TPN) and mechanical ventilation were common risk factors noted in our study.Conclusions: Systemic Candidiasis is a disease of modern neonatal intensive care. It deserves urgent attention for its prevention as well as effective treatment in order to minimize neonatal morbidity and mortality.
INTRODUCTIONDengue ranks among the most important mosquito-borne viral disease in the world. Dengue fever is an acute infectious disease caused by an arbovirus in the Flavivirus genus. It has four serotypes, and the mosquito Aedes aegypti is the vector. While dengue is a global concern, currently close to 75% of the global population exposed to dengue are in the Asia-Pacific region.Dengue virus was isolated in India for the first time in 1945. Over the last few years, atypical manifestations of ABSTRACT Background: Although dengue virus is a non hepatotropic virus, liver injury due to dengue infection is not uncommon. Atypical manifestations with liver involvement have frequently been reported, ranging from mild elevations of aminotransferase levels to fulminant hepatitis. The aim of the present study is to study the serum transaminases level in various forms of dengue infection and correlate with severity. Methods: An analysis of 151 serologically confirmed cases (0-14 yrs) of dengue from June 2017 to July 2017 at a tertiary care hospital, Dharwad was made to assess the frequency and degree of hepatic dysfunction in children with dengue infection by analyzing serum transaminase levels. Patients were classified according to WHO as dengue without warning signs, with warning signs and severe dengue. Patients were divided into primary and secondary dengue based on serology and serum transaminases levels were assessed in each of the above groups. Patients with normal aminotransferase levels were categorized into Grade A, those with atleast one of the enzymes raised to less than 3 times the reference range as Grade B, those with atleast one of the enzymes elevated more than 3 times but less than 10 times as Grade C and those with elevations more than 10 times as Grade D. χ2 test was applied to check statistical significance. Results: During the study period, the total number of serologically confirmed cases of dengue were 151 among which dengue fever without warning signs were 38, with warning signs were 91 and severe dengue were 22. Serum transaminase levels were significantly raised in severe dengue (χ2=14.228, df=6, p=0.027).It was also found that transaminases were significantly higher in secondary dengue infection than primary dengue ( χ2=10.155, df=3, p=0.017). Transaminases were significantly elevated in non-survivors (χ2=16.958, df=3, p<0.001). Conclusions: Hepatic dysfunction was common in all forms of dengue infection, with AST rising significantly more than ALT. Transaminases were significantly elevated in severe dengue and secondary dengue infections. Patients with significantly high transaminases had a poor outcome.
The present study is conducted with the objective of assessing the awareness level of the investors. The success of ETF depends upon the awareness and confidence level of the investors. The investment pattern varies with age, education, gender, occupation. The study was conducted in Karnataka the study is based on primary data with a sample size of 87 respondents the study observed that awareness about ETF among the investors. It also observed no significant difference in the awareness level the investors belonging to different education background and gender. There is no significant difference in the awareness level about ETF Investment with respect to age, gender, qualification & occupation.
Background: Hypoglycemia and hypocalcemia are common metabolic problems occurring in the newborn and have direct consequences in the early neonatal period, prompt identification and treatment prevents severe neurodevelopmental outcomes. The primary objective was to compare blood glucose and serum calcium levels in term Intrauterine growth restriction (IUGR) babies with term appropriate for age (AGA) babies and secondarily to compute number of term IUGR babies with hypoglycemia and hypocalcemia.Methods: Fifty term IUGR and 50 term AGA babies delivered at SDMCMSH, Dharwad during the study period of one year were included as cases and controls respectively after considering the inclusion and exclusion criteria. Two ml of peripheral venous blood was analyzed at 3 hours and 24 hours of life. Serum calcium was measured by calorimetric test method and blood glucose by auto analyzer. Statistical analysis was done using SPSS-17.Results: At 3 hours of birth, 24% of term IUGR and 4% of AGA neonates had hypoglycemia. The mean RBS of cases at 3rd hour was 61.36±23.56 mg/dl, significantly lower than control group (75.90±22.57mg/dl). The mean RBS among cases at 24 hours of life was 70.42±16.14 mg/dl compared to 78.84±15.90 mg/dl among controls. Both correlations were statistically significant. 8% cases had hypocalcemia at 3 hours and 6% had at 24 hours. The mean serum calcium level was lower in cases (8.50±1.40 mg/dl) than controls (8.63±1.14 mg/dl) at the 3rd hour of life and 24 hours of life [cases (8.42±1.07 mg/dl) versus controls (8.64±0.91 mg/dl)].Conclusions: Significantly lower blood glucose levels were identified in term IUGR neonates. This association was apparent at 3 hours of life. The measurement of serum calcium & glucose in IUGR babies could predict a poorer outcome in these patients. Identifying and treating these biochemical abnormalities can avoid short term as well as long term sequelae.
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