Background and Aims:Noninvasive ventilation (NIV) is an emerging popular concept, which includes bi-level positive airway pressure or continuous positive airway pressure (CPAP). In settings with scarce resources for NIV machines, CPAP can be provided through various indigenous means and one such mode is flow inflating device - Jackson-Rees circuit (JR)/Bain circuit. The study analyses the epidemiology, various clinical indications, predictors of CPAP failure, and stresses the usefulness of flow inflating device as an indigenous way of providing CPAP.Methods:A prospective observational study was undertaken in the critical care unit of a Government Tertiary Care Hospital, from November 2013 to September 2014. All children who required CPAP in the age group 1 month to 12 years of both sexes were included in this study. They were started on indigenous CPAP through flow inflating device on clinical grounds based on the pediatric assessment triangle, and the duration and outcome were analyzed.Results:This study population included 214 children. CPAP through flow inflating device was successful in 89.7% of cases, of which bronchiolitis accounted for 98.3%. A prolonged duration of CPAP support of >96 h was required in pneumonia. CPAP failure was noted in 10.3% of cases, the major risk factors being children <1 year and pneumonia with septic shock.Conclusion:We conclude that flow inflating devices - JR/Bain circuit are effective as an indigenous CPAP in limited resource settings. Despite its benefits, CPAP is not a substitute for invasive ventilation, as when the need for intubation arises timely intervention is needed.
Children decide the future of a country and hence a lot of importance is given to childhood nutrition. School age is the vital period during which body's nutritional status is built. Adolescence is a critical phase in the life cycle of human beings. Rapid rate of growth occurs in this phase and it is a transition from childhood to adulthood. 1 Hence adequate nutrition is essential for this spurt of growth. 2 Adolescence is also considered as a second chance for growth or catch up growth for those children who had undergone deficits in nutrition in their early life. 3 Adolescents contribute to approximately 21.4% of Indian population (National Youth Policy 2002). 4 A lot of studies have been done on the nutritional status of children in the under-five age group. Hence we had proposed a study to focus on the adolescent nutritional status based on anthropometry. METHODS This cross-sectional study was done in a semi urban area of Southern part of India during November 2012-November 2013, after obtaining clearance from the ABSTRACT Background: Adolescent nutrition is generally given less importance when compared to the under-five nutrition in developing countries like India. Studies throwing light on the nutritional status of adolescent children are needed. Aims and objectives of the study were to know the prevalence of obesity, overweight, thinness, severe thinness and stunting in adolescent schoolchildren based on anthropometry and its association with various factors. Methods: A cross sectional study was done in six schools in a semi urban area of Southern part of India during November 2012-November 2013.Obesity,overweight,thinness, severe thinness and stunting were determined in the children of the age group of 9-17 years based on WHO Z scores. A predesigned questionnaire and clinical examination were used to find out the factors associated with malnutrition and their implications. Results: Out of the 2100 children studied, the prevalence of obesity was 6%; overweight 10.9%, thinness 13%; severe thinness 5% and stunting 19.8%. Mother's education, occupation and socioeconomic status have significant associations with both over nutrition and under nutrition. Skipping breakfast is associated with thinness. Conclusions: Even though obesity and overweight are increasing in recent times; under nutrition is still prevalent in adolescent school children. Routine school health visits, improving female literacy, dietary modifications, imparting health as well as physical education are the need of the hour to avoid malnutrition in adolescent school children.
Introduction: Dengue is a viral infection with different presentations, hence predicting the disease severity at admission is essential to triage patients needing meticulous monitoring. In severe dengue there is increase of urinary protein clearance due to the increase in systemic vascular permeability. Simple urine protein excretion screening test could guide the triage and monitor the patients with suspected dengue infection. Aim: To evaluate the urine spot Protein Creatinine Ratio (PCR) as a tool in predicting the disease severity and adverse outcome in children with dengue. Materials and Methods: The present cross-sectional study was conducted in Institute of Child Health, Egmore, Tamil Nadu, India, from October 2021 to December 2021. All children aged 1 month to 12 years presenting with symptoms of fever, thrombocytopenia (less than 1, 50, 000 /µL) with or without dengue non structural protein component (NS1)/ Immunoglobulin M Enzyme Linked Immunosorbent Assay (ELISA) positivity were recruited for the study. Study parameters included were demographic factors, severity of dengue classification based on National Vector Borne Disease Control Programme (NVBDCP) guidelines, urine spot PCR. The UPCR (urine protein creatinine ratio) was compared between dengue and non dengue cases and within the different categories of dengue cases. Chi-square was used for comparing proportions. Results: Among 150 children enrolled in present study, 134 (89.3%) were dengue positive, 16 (10.7%) were non dengue. Most predominant age group involved was 6-9 years followed by 3 to 6 years. Among 134 children with dengue, 98 (73.1%) had high UPCR and among 16 non dengue children, 2 (12.5%) had high UPCR which was statistically significant (p<0.0001). Mean spot UPCR was 0.32±0.12 in mild dengue, 0.77±0.40 in moderate dengue and 1.68±1.67 in severe dengue which was statistically significant (p<0.0001). Children with severe dengue had higher PCR values in comparison to mild and moderate dengue. Conclusion: There was a statistically significant association of urine spot PCR with severity of dengue and this simple test can be used for triaging and monitoring children with suspected dengue.
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