bluuebunny/crossref_metadata_2025_split huggingface dataset:
Utility of Blood Culture Among Children Hospitalized With Community-Acquired Pneumonia
Authors: Neuman Mark I. , Hall Matthew , Lipsett Susan C. , Hersh Adam L. , Williams Derek J. , Gerber Jeffrey S. , Brogan Thomas V. , Blaschke Anne J. , Grijalva Carlos G. , Parikh Kavita , Ambroggio Lilliam , Shah Samir S. ,   for the Pediatric Research in Inpatient Settings Network
Published: August 2017

BACKGROUND AND OBJECTIVES:
National guidelines recommend blood cultures for children hospitalized with presumed bacterial community-acquired pneumonia (CAP) that is moderate or severe. We sought to determine the prevalence of bacteremia and characterize the microbiology and penicillin-susceptibility patterns of positive blood culture results among children hospitalized with CAP.

METHODS:
We conducted a cross-sectional study of children hospitalized with CAP in 6 children’s hospitals from 2007 to 2011. We included children 3 months to 18 years of age with discharge diagnosis codes for CAP using a previously validated algorithm. We excluded children with complex chronic conditions. We reviewed microbiologic data and classified positive blood culture detections as pathogens or contaminants. Antibiotic-susceptibility patterns were assessed for all pathogens.

RESULTS:
A total of 7509 children hospitalized with CAP were included over the 5-year study period. Overall, 34% of the children hospitalized with CAP had a blood culture performed; 65 (2.5% of patients with blood cultures; 95% confidence interval [CI]: 2.0%–3.2%) grew a pathogen. Streptococcus pneumoniae accounted for 78% of all detected pathogens. Among detected pathogens, 50 (82%) were susceptible to penicillin. Eleven children demonstrated growth of an organism nonsusceptible to penicillin, representing 0.43% (95% CI: 0.23%–0.77%) of children with blood cultures obtained and 0.15% (95% CI: 0.08%–0.26%) of all children hospitalized with CAP.

CONCLUSIONS:
Among children without comorbidities hospitalized with CAP in a non-ICU setting, the rate of bacteremia was low, and isolated pathogens were usually susceptible to penicillin. Blood cultures may not be needed for most children hospitalized with CAP.
Prevalencia de <i>Cystoisospora suis</i> en granjas porcinas intensivas de la región central de Venezuela
Authors: Pinilla Juan Carlos , Da Silva Borges Natalia 
Published: August 2017

It was carried out an investigation at the central region of Venezuela from January to June 2014 with the aim to determine the prevalence of coccidian Cystoisospora suis in intensive swine herds. For parasitic determination 572 litters were selected with signsof diarrhea. Likewise, 1.712 fecal samples were also collected in mature pigs. Stoolsamples were cultured in a 2.5% potassium dichromate solution and later processedby coprological technique. The results of this investigation indicated that C. suis was observed in 55 herds (82.1%) and 210 litters (36.7%) with the highest prevalence values in first two weeks of age (P < 0.05). Regarding to mature pigs, there was a significant correlation (rho = 0.35; P < 0.05) among oocysts excretion in piglets and sows, suggesting that sows may act as infection sources. Sows parity was statistically correlated with the prevalence values in litters as in lactating sows (P < 0.05). This might indicate that as parity increase, prevalence decreases in these groups. Probably these findings are associated with unknown immunologic mechanisms. It is concluding that C. suis is broadly distributed in Venezuela and it could be controlled by improving conditions sanitary herd, however, non elucidated immunologic mechanisms might be involved in the protozoa transmission cycle.
Risk factors for severe acute malnutrition in under-five children attending nutritional rehabilitation centre of tertiary teaching hospital in Karnataka: a case control study
Authors: Prashanth M. R. , M. R. Savitha , B. Prashantha 
Published: August 2017

Background: To determine and analyse the risk factors leading to severe acute malnutrition (SAM) in children under 5 years of age attending nutritional rehabilitation centre of our hospital.Methods: This questionnaire based case control study was conducted from January 2016 to December 2016 on SAM children. For comparison children attending outpatient department without any evidence of malnutrition were included. These SAM children were admitted to the nutritional rehabilitation centre of Cheluvamba Hospital attached to Mysore Medical College and Research Institute, Mysore, Karnataka.Results: A total of 103 SAM cases were compared with 100 controls. The sociodemographic risk factors were age less than 2 yrs, more family members (55.3% had 5 to 8 members), Birth spacing less than 2 years (39.8%), open air defecation (37.9%) and living in kucha house (32%). The dietary risk factors which were statistically significant were poor appetite (33%), prelacteal feed (19.4%), lack of exclusive breast feeding (42.7%), discontinuing breast feed before 2 years (74.8%), receiving complementary feed before 6 months (67%), bottle feeding (32%), calorie deficit (79.6%), protein deficit (66%) and feeding difficulty (17.5%).Conclusions: The social risk factors identified in this study were large family size, low income, more number of siblings and living standards like type of house, open air defecation. The nutritional risk factors were giving prelacteal feed, not giving exclusive breast feeding until 6 months, starting complementary feed before 6 months and giving food low in calories and protein.
Role of zinc supplementation in acute respiratory tract infections in children aged 2 to 60 months
Authors: Nair Bindu T. , Bhunia Rabindra , Sharma Kuldeep Kumar 
Published: August 2017

Background: Zinc has a major role in improving immune function and decreasing morbidity in various infectious diseases like acute respiratory tract infections, diarrhoeal diseases etc. The objective of the study was to study the effect of zinc supplementation on clinical manifestations, progress of illness and duration of acute respiratory infections.Methods: A randomized double blind controlled study was conducted in the Paediatric ward of a tertiary care hospital in New Delhi in 50 children aged 2 to 60 months. Children with previous episodes of wheezing, severe malnutrition, congenital heart diseases, pneumonia, history of taking multiple micronutrient formulations or zinc for any intercurrent illnesses like diarrhoea in the previous month prior to admission and history of any known immuno-deficiency disease or on any immunosuppressive medications(steroids) or anti malignancy treatment were excluded. Both placebo (syrup base) and zinc syrup (20 mg/5 mL elemental zinc as zinc sulfate) were given orally for a period of 14 days to the respective groups. Statistical analysis used: Statistical Package for the Social Sciences (IBM SPSS Statistics for Windows, Version 22.0. Armonk, NY: IBM Corp.). Chi-square test was done for qualitative variables and t-test was used for quantitative variables. P<0.05 was considered as statistically significant.Results: The mean age of zinc group was 22.77 months (SD - 5.74) and that of placebo group was 22.86 months (SD - 5.88) with a p value of 0.98 which was not statistically significant. There were no significant differences in the clinical features in the two groups before starting therapy or after treatment at 24, 48 and 72 hours (P>0.05).Conclusions: Zinc supplementation during episode of ARI did not show any substantial benefit in reducing duration or morbidity in children aged 2-60 months.
Clinical study of neonatal septicemia with reference to early indicators of sepsis
Authors: Kishore E. , S. V. S. Sreedhar 
Published: August 2017

Background: The use of CRP (C-reactive protein) in early diagnosis of neonatal septicemia. The usefulness of CRP in early detection of neonatal septicemia/meningitis and urinary tract infection was studied in a neonatal unit using a semi-quantitative latex-agglutination as a rapid screening method and electroimmuno assay as reference method for CRP determination.Methods: The present study was conducted among 150 patients 218 samples were taken for serum globulin determinations. Additionally, all infants born at the hospital throughout August 2016 to February 2017 with a designation of blood disease, infectious disease or tract infection (UTI) were retrospectively studied. Depending on the clinical course and therefore the results of the culture the 110 infants were divided into four groups.Results: The 110 infants in 92% of non-infected infants CRP was 16 mg/l and 80% had CRP <10 mg/l up to 3 days of age. After 3 days of age 93% had CRP <12 mg/l. The initial CRP level was increased in 9 out of 11 patients (82%) with bacterial septicemia. Low CRP was seen in one patient with total agranulocytosis and septicemia from Streptococcus type B and in one patient with Staphylococcus albus sepsis. A rise in CRP was also seen in very pre-term infants with septicemia. Increased initial CRP was uncommon in neonatal urinary tract infection (2 of 9) but a rise was seen in 3 additional patients.Conclusions: A comparison between CRP, total neutrophil blood cell count and hand neutrophil count as diagnostic parameters was in favor of CRP at this early stage of infection. CRP is of definite value as an aid in early diagnosis of neonatal septicemia and bacterial meningitis.
To study the role of probiotics in the prevention of necrotizing enterocolitis in preterm neonates
Authors: Arora Sunita , Khurana Mandeep Singh , Saini Ritish 
Published: August 2017

Background: Necrotizing enterocolitis is defined as an inflammatory bowel necrosis in premature infants and is major cause of morbidity and mortality in neonatal intensive care units throughout the world. We aim to study the role of probiotics in reducing incidence and severity of necrotizing enterocolitis in preterm neonates ≤34 weeks and its role on secondary outcomes like mortality, time to reach full feeds, daily weight gain, days of hospitalization and effect on nosocomial infections.Methods: This study was a prospective randomized controlled interventional trial conducted in SGRDIMSAR, Amritsar. A sample size of 150 was selected. 75 were randomized to test group and 75 to control group by simple random sampling.Results: The incidence of NEC was significantly lower in the test group compared with the control group (1 of 75 neonates vs 12 of 75 neonates; p=0.001). The severity of NEC, nosocomial sepsis and mean duration of hospital stay was significantly lower in the test group. Daily weight gain was significantly higher in the test group. There was no significant difference in mean age of onset of NEC, mortality and mean age to reach full feeds in two groups.Conclusions: Incidence and severity of NEC was less in the probiotic group. Daily weight gain was better, nosocomial sepsis and mean duration of hospital stay were less in the probiotic group.
Efficacy of urine screening and culture methods in childhood urinary tract infections and analysis of the causative pathogens
Authors: J. Kavitha , D. Anuradha , M. A. Aravind , J. Ganesh 
Published: August 2017

Background: Urinary tract infection (UIT) is common in infants and children causing significant morbidity and long- term complications. In infants and young children symptoms and signs of UTI tend to be non-specific A presumptive diagnosis can be supported with a microscopic examination of a urine specimen. Definitive diagnosis requires a semi-quantitative culture of urine. There has been growing interest in developing efficient technology, that can rapidly and accurately diagnose UTIs and guide the clinician on antibiotic preference for maximum therapeutic benefit.Methods: This prospective hospital-based study was conducted in patients from 2-12 years in a tertiary care hospital. Screening and confirmation of urinary tract infections by urine microscopy and urine culture and comparison, with an analysis of the bacterial strains and antibiotic sensitivity patterns was also done.Results: Among the 214 culture positive patients analysed in the study 64 were 2-5years of age and 150 belonged to 5 -12 years. 128 (59.5%) were boys and 86 (40.2%) were girls. Proteinuria was observed in 68 children (31.8%). Significant pus cells of >5/hpf was present in 77 (36%). E. coli was the commonest organism in 98 children (45.8%) with 100% of organisms were sensitive to amikacin.Conclusions: Over the years, the causative organisms of UTI in India have remained fairly constant but drug sensitivity has changed according to antibiotic usage. In the present era, the emergence of resistant strains poses a significant threat that can be ameliorated by rational and judicious antibiotic use.
Impact of mode of transport on the outcome of extramural newborns in a tertiary care centre
Authors: Thenmozhi M. , Sathya J. 
Published: August 2017

Background: Neonatal transport system in our country is a major gap in holistic newborn care and acute neonatal physiology deranged during neonatal transport which adversely affects the mortality and morbidity of sick newborns. To determine the effect of mode of transport on outcome of extramural newborns. To determine the effect of mode of transport on extramural newborns outcome at the level of tertiary care center.Methods: This is a prospective cohort study carried out in chengalpattu medical college and hospital, NICU over a period of 6 months. Inclusion criteria were all admitted extramural babies, readmitted intramural babies and those babies died while transport. Exclusion criteria were those babies born in the institution of study. A predesigned and tested proforma was used to record the required information for the study at the time of admission. Data was analysed and tabulated, for analysis of data software STATISTIX was used.Results: Out of 490 newborns 11% were died, 84% were discharged and 2.45% were gone against medical advice. About the mode of transport was 60% by Ambulances, 10.6% by Auto, 22% by Bus and 6.8% by Car.Conclusions: The study concludes that even though the mode of transport accompanied by a health personnel no difference in the outcome of babies. So, we suggest well trained and equipped transport system to improve the outcome.
Association of gastro esophageal reflex with chronic asthma and its significance: a prospective study
Authors: Daruru Rangnath , Mahadevan Shanker , Kokiwar Prashant R. 
Published: August 2017

Background: Many studies have reported that gastro esophageal reflux is significantly more common in asthmatics than in control populations and this appears to apply particularly in childhood. To study the incidence of gastro esophageal refluxes in children which chronic asthma. To identity the clinical characteristic in children with chronic asthma and GER, which would predict reflux, related asthma?Methods: It is a prospective study of association of GER and chronic asthma using Radio nuclide scintigraphy carried at General pediatric in-patient wards of Niloufer hospital, Hyderabad. A Total of 50 patients with chronic asthma and 15 healthy children were evaluated.Results: Our study showed an incidence of Gastro Esophageal Reflux (GER) in 42% of chronic asthmatic children. High incidence of reflux (47.6%) under 4 years of age. No significance difference in the incidence of GER in children with seasonal verus Non-Seasonal asthma. About 50% of children with GER had no symptoms i.e. they had silent reflux. Nocturnal symptoms were significantly higher in asthmatic children with Ger (54.8%) than asthmatic children without GER (21%). Children with reflux related asthma suffered more morbidity in terms of recurrence of attacks, severity of chronic asthma (moderate persistent) and sleep disturbance as compared to children with no reflux. Presence of atopic signs was significantly higher in patients with asthma without GER.Conclusions: GER should be considered as a potentially important contributing factor in any patient with poorly controlled asthma. The asthmatic patient most likely to experience measurable benefit from anti-reflux therapy is the patients with significant nocturnal asthma and who have symptoms of both asthma and of reflux.
A study on validity of C-reactive protein in deciding the duration of antibiotic therapy in suspected neonatal bacterial infection
Authors: Siddaiah Prashanth , Shetty Pradeep Nanjappa , N. W. Krishna , Jagadeeshwara Sowmya 
Published: August 2017

Background: Neonatal septicemia is defined as generalized bacterial infection of newborns documented by positive blood culture in first four weeks of life. Objective of present study was to determine whether C-Reactive protein can be used as a parameter to identify the time point when antibiotic treatment can safely be discontinued in a defined major subgroup of neonates treated for suspected bacterial infection.Methods: A total of 50 neonates with birth weight more than 1500gms with suspected septicemia were enrolled in the prospective study. Serum CRP were determined 24-48 hours after the first dose of antibiotics. If CRP was less than 6mg/l, infants were considered unlikely to be infected and the antibiotic treatment was stopped. If CRP was more than 6mg/l, antibiotics were continued and CRP measured on alternative days in one subgroup (2a) and on seventh day in another subgroup (2b). CRP was the single decision criterion to stop the antibiotic therapy. Negative predictive value with respect to further treatment was determined.Results: Duration of antibiotic therapy could be reduced to less than seven days in 54% cases and < 72 hours in 48% cases.Conclusions: Negative predictive value of serial CRP is 100% in deciding the duration of antibiotic therapy in suspected neonatal septicemia.
Comparison of morbidity and mortality between serologically positive and serologically negative dengue cases
Authors: Matti Mahantesh , Maralihalli Mahesh B. , Dinesh Shilpa 
Published: August 2017

Background: Dengue is most common arboviral disease caused by 4 types of dengue viruses. In most of the hospitals laboratory diagnosis is made by dengue serology using Rapid Immunochromatographic Test for NS1Ag, IgM and IgG antibodies. We found more morbidity and mortality in suspected dengue cases whose serology was negative for dengue.Methods: Children with clinical features suggestive for case definition for dengue, who belonged to group C of World Health organisation (WHO) guidelines for dengue fever (severe dengue), were included. They were categorised into dengue positive and dengue negative groups. The clinical features and complications of the disease between the two groups were compared.Results: 98 cases (77.8%) were serologically positive for dengue and 28 (22.2%) were negative. 39% of the patients with dengue negative serology developed hypotensive shock in comparison to 18% of dengue positive cases, mortality in serology negative cases (21%) was significantly higher than positive cases (8%).Conclusions: We could not find the reasons for more morbidity and mortality in seronegative dengue group, we stress up on improving the sensitivity and specificity of rapid diagnostic tests. More caution need to be taken for serology negative dengue cases. Epidemiological studies directed to find circulation of other viruses which causes dengue like symptoms should be made.
Study of iron deficiency as a risk factor for first episode of simple febrile siezure
Authors: Kumawat Rakesh , Garg Pukhraj , Karnawat B. S. , P. Verma Ishwari , Arora Akansha , Sonkaria Mukesh 
Published: August 2017

Background: Febrile seizure are seizure that occur between the age of 6 month to 60 months with a temperature of 100.4f or higher, that are not the result of central nervous system infection or any metabolic imbalance and that occur in the absence of a history of prior afebrile seizure. Febrile seizures are the commonest cause of seizures in children, occuring in 2-5% of children. The maximum age of febrile convulsion occurrence is 14-18 months, which overlap with the maximum prevalence of iron deficiency anaemia which is 1-2 year old. 7 So far, the dilemma of cause of febrile seizure could not be solved. Standard text book still mention iron deficiency is associated with an increased risk of febrile seizure, thus screening for that problem and treating it appears appropriate.Methods: This case control study was done from June 2015 to December 2016. 60 cases of first episode of simple febrile seizure in age group of 6 month to 5 years were included in the study. A control group was selected from age and sex matched children admitted with febrile illness but without seizure. In all cases detailed clinical history, anthropometry, clinical sign of iron deficiency, CNS examination, CBC, PBF, Red cell indices, serum iron, serum ferritin and serum TIBC level was done. These were analysed in three groups mild, moderate, severe deficiency of anemia. A clinical correlation is tried to establish between overt and subtle iron deficiency with seizure.Results: Majority of subjects with first episode of simple febrile seizure were males (63.3%). Majority of cases of febrile seizure occur in the 6-24 months age group (83.3%). Incidence of anemia among case group subjects was 90.0% whereas the same in control group was 30 %. Mean RDW and TIBC levels in cases were significantly higher as compared to that in controls. MCV, Mean Serum ferritin and Serum Iron levels in cases were significantly lower as compared to that in controls.Conclusions: The findings in present study established an association between iron deficiency anemia and first episode of simple febrile seizures.
Study of maternal profile in children admitted to nutritional rehabilitation centre at a tertiary hospital
Authors: B. M. Nagabhushan , J. Poornima , R. Premalatha 
Published: August 2017

Background: Study of maternal profile in children affected with severe acute malnutrition is very essential. Maternal nutritional status, social and educational status and her medical conditions have direct impact on malnutrition of children. Small efforts to study the maternal profile for one year in our nutritional rehabilitation centre.Methods: A one-year prospective study was carried out in a nutritional rehabilitation centre, Department of paediatrics, Bangalore Medical College and Research Institute, Bangalore, Karnataka, India, from September 2015 to August 2016. All maternal details were recorded. All mothers were examined for height weight BMI, checked for vitals and underlying medical conditions. Anaemia is confirmed by laboratory test.Results: Out of 302 mothers enrolled for study, majority were 23 plus or minus 5 years aged mothers. More than 33.7% mothers were under weight. Around 8% mothers were pre-obese and obese. Nearly 88% mothers were found to have anemia, 39% mothers had mild anemia, 30% had moderate anemia, 30% had severe anemia. Hypertension, hypothyroidism, tuberculosis and gynecological problems were other major medical illness seen in these mothers. Majority of the mothers were primigravida (42.38%), around 22% mothers were having birth order more than 3 children. Nearly 78% mothers were not practicing any family planning, only 21% mothers were aware and practicing family planning. Nearly 45% mothers were educated less than high school education. Only few mothers (18%) have studied till post-graduation.Conclusions: In the study majority of the mothers were found to be under weight, nearly 88% mother had anaemia, several underlying medical conditions were detected in mothers, most of the mothers were not practicing family planning, majority of the mothers were studied below high school education.