ABSTRACT
Background: Iron deficiency is the most common cause of anemia and studies have shown poor cognition, psychomotor and social/emotional development in children who are deficient in iron, even with normal hemoglobin levels, the so-called Latent phase of Iron deficiency. It is therefore crucial to identify LID, as well as IDA at the earliest stage, in order to initiate treatment.' Many tests like serum ferritin and soluble transferring receptor(sTfR) have been described collectively as a panel to detect iron deficiency; however no single test is specific enough to be used independently. Also during treatment it takes weeks to observe changes in Hb, hematocrit or RBC indices, hence the need for a more sensitive and reliable test. Objective was to evaluate effectiveness of CHr in diagnosing LID and IDA.Methods: Samples were collected from 180 children, clinically suspected to be anemic. Complete hemogram and Iron profile were measured. Three groups were defined, LID (Tfsat <20%, Hb >11g/dL; n=52), IDA (Tfsat <20%, Hb <11g/dL; (n=84) and controls (Tfsat >20%, Hb >11g/dL; n=44). The mean values of RBC indices, Iron profile and CHr was compared across the groups. A cut off value of <26 pg CHr was taken to represent Iron deficiency state.Results: Comparison between anemic group and control found that all RBC indices were found to be significantly lower including Reticulocyte hemoglobin. All of the variables in anemic group were lower compared to latent iron deficient group except MCHC and reticulocyte count. CHr was found to be statistically lower in LID and IDA group in comparison to control group.Conclusions: CHr can be used as a valuable indicator in diagnosis as well as follow-up of LID and IDA, which is easily available and inexpensive.
ABSTRACT
Background: Hypomagnesemia is a common finding in current medical practice, especially in critically ill patients. Magnesium ion plays a vital role in various metabolic processes in body and its deficiency leading to serious clinical consequences. Since hypomagnesemia is most often asymptomatic, it goes unsuspected and therefore undiagnosed. Hence, early detection of hypomagnesemia has prognostic and therapeutic implications. It is imperative to understand the various risk factors and their clinical outcome that is associated with hypomagnesemia.Methods: This is an observational study done in a tertiary centre in Bangalore, India where-in 100 children who met the inclusion criteria, admitted to the PICU were recruited and prospectively studied. Serum Magnesium along with various clinical and biochemical parameters were correlated to enumerate the various risk factors associated with hypomagnesemia.Results: In this study authors found the incidence of hypomagnesemia to be around 53%. Authors found higher incidence in age group of 1-5 yrs (40%) and least were in the age groups of <1 year and more than 10 years (19%) and there was no gender preponderance. Authors also evaluated the various risk factors associated with hypomagnesemia. There was significant association of hypocalcemia (60%) and hypokalemia (45.2%) with hypomagnesemia. Infections (33.9%) and neurological disorders (26.41%) seemed to collectively comprise around 60% of the hypomagnesemic group. All patients admitted secondary to sepsis and Traumatic Brain Injury (TBI) had hypomagnesemia proving to be a significant risk factor. Authors also found increased mortality among hypomagnesemic group. However, found no association between low serum magnesium and PICU stay.Conclusions: There is high prevalence of hypomagnesemia in critically ill patients and is associated with a higher mortality. It is also commonly associated with infections, CNS disorders, respiratory diseases and metabolic derangements like hypokalaemia and hypocalcaemia. There is no association of Hypomagnesemia with duration of PICU stay.
ABSTRACT
Background: In India acute respiratory infections are an important public health problem accounting for 15-30 % of under-five mortality. Early detection, timely intervention, standard management and a proper early referral service can reduce the mortality rate. The objective of this study was to study the sociodemographic and clinical profile of children admitted with pneumonia, to study its relation to the duration of stay at the hospital.Methods: The study was conducted in KIMS hospital, Bangalore from September 2016 to August 2017. Sociodemographic and clinical features of children aged from 2 months to 18 years of age were studied. A total of 92 children who fulfilled the inclusion criteria for community-acquired pneumonia were studied. The patient population comprises mainly of the low-income group from rural areas, urban slums, referred patients from surrounding rural areas, and other centres.Results: A total of 92 children were studied, 52 boys and 40 girls. 45% children were breastfed for <6 months, and 28% were incompletely immunized. Majority of children belonged to lower socioeconomic group. Passive smoking was present in 38 % of the patients and overcrowding was seen in 50% of children studied. There is a significant association between passive smoking, delayed hospital care, and length of stay.Conclusions: Present study concluded that ARI was more common in LES children and incompletely immunised children. And children who got early medical attention i.e. <4 days had a lesser duration of hospital stay i.e. <7 days.