Journal of Tropical Pediatrics最新文献_第6页

Tumor necrosis factor alpha gene polymorphism affects the pattern of idiopathic nephrotic syndrome in Kuwaiti Arab children. 肿瘤坏死因子α基因多态性影响科威特阿拉伯儿童特发性肾病综合征的模式。

IF 2 4区医学

Journal of Tropical Pediatrics Pub Date : 2023-12-06 DOI: 10.1093/tropej/fmad047

Amal A Al-Eisa, Maysoun Al Rushood, Sumedha Kashyap, Mohammad Z Haider

{"title":"Tumor necrosis factor alpha gene polymorphism affects the pattern of idiopathic nephrotic syndrome in Kuwaiti Arab children.","authors":"Amal A Al-Eisa, Maysoun Al Rushood, Sumedha Kashyap, Mohammad Z Haider","doi":"10.1093/tropej/fmad047","DOIUrl":"10.1093/tropej/fmad047","url":null,"abstract":"Objectives: TNF-α is a pro-inflammatory cytokine that has been implicated in many inflammatory diseases, but its association with idiopathic nephrotic syndrome (INS) is poorly understood. This study looked for an association of TNF-α gene polymorphisms with INS, as well as its effect on steroid responsiveness among Kuwaiti Arab children.Methods: Genotypes of the TNF-a gene polymorphisms were analyzed using polymerase chain reaction-restriction fragment length polymorphism in 151 INS Kuwaiti Arab patients and 64 age and sex-matched controls. Clinical data of all subjects were reviewed.Results: The heterozygous AG genotype was detected in 8.6% of INS patients compared 23.4% of the controls (p < 0.01). Comparing steroid responsiveness, AA genotype was significantly more common in steroid-sensitive nephrotic syndrome (SSNS) cases than steroid-resistant nephrotic syndrome (SRNS) patients (p = 0.001). However, AG genotype was significantly more common in SRNS patients compared to the SSNS cases (p = 0.001). No difference was found between these two subgroups in the GG genotype frequency.Conclusion: AG genotype of TNF-a gene polymorphisms may be considered a suitable marker for INS disease among Kuwaiti children. Both AA and AG genotypes may be useful in predicting steroid responsiveness among these cases of Arab ethnicity. The findings might open the era for the use of genetic markers in the early treatment of NS.","PeriodicalId":17521,"journal":{"name":"Journal of Tropical Pediatrics","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2023-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138805881","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Ten- vs. 14-day antibiotic therapy for culture-positive neonatal sepsis. 10天和14天抗生素治疗培养阳性新生儿败血症。

IF 2 4区医学

Journal of Tropical Pediatrics Pub Date : 2023-10-05 DOI: 10.1093/tropej/fmad036

Kamirul Islam, Nazima Khatun, Kuntalkanti Das, Sudipto Paul, Taraknath Ghosh, Kaustav Nayek

{"title":"Ten- vs. 14-day antibiotic therapy for culture-positive neonatal sepsis.","authors":"Kamirul Islam, Nazima Khatun, Kuntalkanti Das, Sudipto Paul, Taraknath Ghosh, Kaustav Nayek","doi":"10.1093/tropej/fmad036","DOIUrl":"10.1093/tropej/fmad036","url":null,"abstract":"Background: Neonatal sepsis is a major determinant of neonatal mortality. There is a scarcity of evidence-based guidelines for the duration of antibiotics in culture-positive sepsis.Objectives: The aim of this study was to compare the efficacy of 10- and 14-day antibiotic therapies in the management of culture-positive neonatal sepsis.Methods: This randomized controlled trial was conducted in the neonatal intensive care unit of a tertiary care center among the neonates suffering from culture-positive sepsis (with signs of clinical remission on day 9 of antibiotic) between January 2023 and May 2023. Newborns with major congenital anomaly, deep-seated infections, multi-organ dysfunction, associated fungal infections/infection by multiple organisms and severe birth asphyxia were excluded. Two hundred and thirty-four newborns were randomized into two groups-study (received 10 days of antibiotics) and control (received 14 days of antibiotics). Treatment failure, hospital stay and adverse effects were compared between the two groups. p < 0.05 was taken as the limit of statistical significance.Results: Median [interquartile range (IQR)] birth weight and gestational age of the study population (53.8% boys) were 2.424 kg (IQR: 2.183-2.695) and 37.3 weeks (IQR: 35.5-38.1), respectively. Acinetobacter was the most commonly isolated species (56, 23.9%). The baseline characteristics of both groups were almost similar. Treatment failure was similar in the study and control groups (3.8% vs. 1.7%, p = 0.40), with a shorter hospital stay [median (IQR): 14 (13-16) vs. 18 (17-19) days, p < 0.001].Conclusion: Ten-day antibiotic therapy was comparable with 14-day antibiotic therapy in efficacy, with a shorter duration of hospital stay and without any significant increase in adverse effects.","PeriodicalId":17521,"journal":{"name":"Journal of Tropical Pediatrics","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2023-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138176548","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Assessment of interleukin 1 receptor antagonist (IL-1RA) levels in children with and without community acquired pneumonia: a hospital based case-control study. 有和没有社区获得性肺炎的儿童白细胞介素1受体拮抗剂(IL-1RA)水平评估:一项基于医院的病例对照研究

IF 2 4区医学

Journal of Tropical Pediatrics Pub Date : 2023-10-05 DOI: 10.1093/tropej/fmad040

Neha Verma, Shally Awasthi, Anuj K Pandey, Prashant Gupta

{"title":"Assessment of interleukin 1 receptor antagonist (IL-1RA) levels in children with and without community acquired pneumonia: a hospital based case-control study.","authors":"Neha Verma, Shally Awasthi, Anuj K Pandey, Prashant Gupta","doi":"10.1093/tropej/fmad040","DOIUrl":"10.1093/tropej/fmad040","url":null,"abstract":"The primary objective was to compare serum interleukin-1 receptor antagonist (IL-1RA) levels in cases of community acquired pneumonia (CAP) and healthy age-gender-matched controls. The secondary objective was to compare serum IL-1RA levels in cases which were positive or negative for Streptococcus pneumoniae in the blood by real-time-polymerase chain reaction (RT-PCR). Hospitalized children with World Health Organization defined CAP, aged 2-59 months, were included as cases. Healthy controls were recruited from the immunization clinic of the hospital. Enzyme-linked immunosorbent assay (ELISA) test was used to detect serum IL-1RA levels. Identification of S.pneumoniae in blood was done by RT-PCR. From October 2019 to October 2021, 330 cases (123, 37.27% female) and 330 controls (151, 45.75% females) were recruited. Mean serum IL-1RA levels (ng/ml) were 1.36 ± 0.95 in cases and 0.25 ± 0.25 in controls (p < 0.001). Within cases, serum IL-1RA levels were significantly higher in those whose RT-PCR was positive for S.pneumoniae. Thus serum IL-1RA levels may be evaluated as a surrogate marker of S.pneumoniae in future studies.","PeriodicalId":17521,"journal":{"name":"Journal of Tropical Pediatrics","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2023-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138295423","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Anthropometric measurements and body composition of preterm infants born ≤34 weeks at 12-13 months corrected age as compared to term infants. 在12-13个月龄时出生≤34周的早产儿与足月儿的人体测量测量和身体组成。

IF 2 4区医学

Journal of Tropical Pediatrics Pub Date : 2023-10-05 DOI: 10.1093/tropej/fmad038

Apoorva Kutar, Padmasani Venkat Ramanan, Kandathil Eapen Elizabeth, A J Hemamalini

{"title":"Anthropometric measurements and body composition of preterm infants born ≤34 weeks at 12-13 months corrected age as compared to term infants.","authors":"Apoorva Kutar, Padmasani Venkat Ramanan, Kandathil Eapen Elizabeth, A J Hemamalini","doi":"10.1093/tropej/fmad038","DOIUrl":"10.1093/tropej/fmad038","url":null,"abstract":"Background: Growth in the first year of life depends primarily on nutrition. Currently, the infant feeding practices of term babies are being extrapolated for preterms. While extrapolating, it is not clear if corrected age (CA) or chronological age should be used. In preterm infants, born ≤34 week gestation age, this difference may be more than 6 weeks. We studied the growth parameters and body composition of preterm infants born ≤34 week gestation age as compared to that of term infants at 12-13 months CA.Methods: The growth of 99 term infants and 170 preterm infants born ≤34 weeks was evaluated at 12-13 months CA. The anthropometric measurements, body mass index (BMI) and skin fold thickness (SFT) at four sites (biceps, triceps, subscapular and suprailiac) were compared in the two groups. The sum of the SFT was taken as a marker of fat mass.Result: At 12-13 months CA, preterm infants had significantly less weight, length and BMI as compared to term babies. The weight and BMI for age Z-scores, weight for length Z-scores and fat mass were also significantly less in preterm babies.Conclusion: The anthropometry measures in preterms (<34 weeks) at 12-13 months CA were significantly lower than that of term infants. In our study population, preterms did not catch up in growth in the first year even when the CA is used for comparison. The causes could be multifactorial and need to be studied further.","PeriodicalId":17521,"journal":{"name":"Journal of Tropical Pediatrics","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2023-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138299334","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Prevalence of sleep disorders in children with Congenital Zika Syndrome. 先天性寨卡综合征患儿睡眠障碍的患病率。

IF 2 4区医学

Journal of Tropical Pediatrics Pub Date : 2023-10-05 DOI: 10.1093/tropej/fmad033

Carolina Santos Souza Tavares, Raquel Souza Marques, Victor Santana Santos, Hudson P Santos, Monique Carla da Silva Reis, Paulo Ricardo Martins-Filho

{"title":"Prevalence of sleep disorders in children with Congenital Zika Syndrome.","authors":"Carolina Santos Souza Tavares, Raquel Souza Marques, Victor Santana Santos, Hudson P Santos, Monique Carla da Silva Reis, Paulo Ricardo Martins-Filho","doi":"10.1093/tropej/fmad033","DOIUrl":"10.1093/tropej/fmad033","url":null,"abstract":"Studies have reported that children with Congenital Zika Syndrome (CZS) experience changes in their sleep patterns, which can result in mood disturbances, behavioral issues and delays in growth and development. This systematic review synthesized the available evidence on the prevalence of sleep disorders in children with CZS. Eligible studies were those with an observational design that reported sleep disorders in children with CZS using validated questionnaires, polysomnography/electroencephalographic recording or parent/caregiver reports. Searches were conducted in PubMed, Web of Science, SCOPUS and Embase, as well as a gray literature search using Google Scholar. The Freeman-Tukey double-arcsine transformation with a random-effects model was used to estimate the pooled prevalence of sleep disorders with a 95% confidence interval (CI). Five studies were included and data from 340 Brazilian children with CZS were analyzed. The overall prevalence of sleep disorders was 27.4% (95% CI 16.7-39.4), without differences among studies using validated questionnaires (29.4%, 95% CI 21.4-37.8) or report from parents and caregivers (27.4%, 95% CI 11.5-47.0). Sleep disorders are prevalent in children with CZS, impacting their development and quality of life. It is critical to examine the quality of sleep in these children to develop appropriate interventions that can mitigate these issues.","PeriodicalId":17521,"journal":{"name":"Journal of Tropical Pediatrics","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2023-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41131945","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

COVID-19 lockdown effect on healthcare utilization and in-hospital mortality in children under 5 years in Cape Town, South Africa: a cross-sectional study. 新冠肺炎封锁对南非开普敦5岁以下儿童医疗保健利用和住院死亡率的影响：一项横断面研究。

IF 2 4区医学

Journal of Tropical Pediatrics Pub Date : 2023-10-05 DOI: 10.1093/tropej/fmad035

Noradin Elmi, Liezl Smit, Thandi Wessels, Moleen Zunza, Helena Rabie

{"title":"COVID-19 lockdown effect on healthcare utilization and in-hospital mortality in children under 5 years in Cape Town, South Africa: a cross-sectional study.","authors":"Noradin Elmi, Liezl Smit, Thandi Wessels, Moleen Zunza, Helena Rabie","doi":"10.1093/tropej/fmad035","DOIUrl":"10.1093/tropej/fmad035","url":null,"abstract":"Background: COVID-19 pandemic measures resulted in the de-escalation of non-COVID-19 healthcare provision.Methods: A retrospective cross-sectional study of routinely collected data was done to investigate the effect of COVID-19 policies on the healthcare utilization and mortality of children younger than 5 years in Eastern Cape Town, South Africa. We compared visits to primary and urgent care facilities, hospitalization, in-hospital deaths, and vaccine uptake from 1 January to 31 December 2020 to similar periods in 2018 and 2019.Results: During April and May 2020, the most restricted period, visits to primary care facilities declined from 126 049 in 2019 to 77 000 (1.8-fold; p < 0.05). This corresponded with a 1.2-fold reduction in the provision of the first dose of measles vaccine at 6 months compared to 2019. Throughout 2020 there was a 4-fold decline in the number of fully immunized children at 1 year of age (p = 0.84). Emergency room visits fell by 35.7% in 2020 (16 368) compared to 2019 (25 446). Hospital admissions decreased significantly (p < 0.01) in 2020 (9810) compared to 2018 (11 698) and 2019 (10 247). The in-hospital mortality rate increased from 2.3% (96/4163) in 2019 to 3.8% (95/2498) (p < 0.01) in Tygerberg Hospital, where 80% (95/119) of deaths were recorded. Twelve of the 119 (10%) deaths occurred in HIV-positive children (p = <0.01).Conclusion: Measures instituted during the COVID-19 pandemic disrupted access to healthcare services for children. This resulted in an immediate, and potential future, indirect effect on child morbidity and mortality in Cape Town.","PeriodicalId":17521,"journal":{"name":"Journal of Tropical Pediatrics","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2023-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/1e/20/fmad035.PMC10570990.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41204208","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Trends in clinical features and severity of Plasmodium vivax malaria among children at tertiary care center in North India. 北印度三级护理中心儿童间日疟原虫疟疾的临床特征和严重程度趋势。

IF 2 4区医学

Journal of Tropical Pediatrics Pub Date : 2023-10-05 DOI: 10.1093/tropej/fmad034

Aditi Arya, Shyam Sundar Meena, Monika Matlani, Shewta Chaudhry, Vineeta Singh

{"title":"Trends in clinical features and severity of Plasmodium vivax malaria among children at tertiary care center in North India.","authors":"Aditi Arya, Shyam Sundar Meena, Monika Matlani, Shewta Chaudhry, Vineeta Singh","doi":"10.1093/tropej/fmad034","DOIUrl":"10.1093/tropej/fmad034","url":null,"abstract":"Background: Malaria is a significant cause of morbidity and mortality in adults and children. Plasmodium falciparum is the primary cause of severe malaria, but recently Plasmodium vivax is also recognized to cause severe malaria-associated morbidity and mortality. The study focuses on determining the mortality related to severity parameters in individuals under 12 years and their critical presentation in P.vivax malaria-infected children.Methods: A prospective cross-sectional hospital-based study was conducted at Safdarjung Hospital, New Delhi, and ICMR-NIMR, New Delhi. All clinically suspected cases were admitted for screening. Exclusion criteria (rapid malaria antigen test, microscopy and medication history) were applied to all the admitted patients (n = 221) to obtain P.vivax patients only. Patients aged ≤ 12 years were included in the study. DNA was extracted from dried blood spots and amplified by nested PCR, followed by visualization on gel electrophoresis.Result: A total of 221 clinically suspected cases of malaria were screened for P.vivax. After implementing various exclusion criteria, 45/221 cases were enrolled for the study, among which 44.4% (20/45) of children had the symptoms of severe malaria in terms of cerebral malaria, thrombocytopenia, anemia, pancytopenia, acute respiratory distress syndrome and hemophagocytic lymphohistiocytosis.Conclusion: Plasmodium vivax mono-infection can cause severe manifestation and must be treated as P.falciparum without any delay because it may lead to increased morbidity and mortality. A changing trend in clinical symptoms has shown in P.vivax which was an earlier phenomenon of P.falciparum.","PeriodicalId":17521,"journal":{"name":"Journal of Tropical Pediatrics","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2023-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49679028","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Seroprevalence of SARS-CoV-2 antibodies in pediatric hospital surgical unit: a lower-middle-income country perspective. 儿科医院外科病房SARS-CoV-2抗体血清阳性率:中低收入国家视角

IF 2 4区医学

Journal of Tropical Pediatrics Pub Date : 2023-10-05 DOI: 10.1093/tropej/fmad039

Murad Habib, Noshela Javed, Sadia Asmat Burki, Mansoor Ahmed, Muhammad Amjad Chaudhary

{"title":"Seroprevalence of SARS-CoV-2 antibodies in pediatric hospital surgical unit: a lower-middle-income country perspective.","authors":"Murad Habib, Noshela Javed, Sadia Asmat Burki, Mansoor Ahmed, Muhammad Amjad Chaudhary","doi":"10.1093/tropej/fmad039","DOIUrl":"10.1093/tropej/fmad039","url":null,"abstract":"Background: The objective of our study was to measure and give insight into the seropositivity of anti-SARS-CoV-2 antibodies in the patients in our pediatric hospital surgical unit in Pakistan.Methods: A prospective cohort study was conducted at a tertiary care pediatric hospital surgical unit in Pakistan between 1 January 2021 and 1 June 2021 on the enrolled neonates and children aged 1 day to 13 years. All patients from three different pediatric strata [neonates (<1 month), infants (1 to 12 months) and children (>1 year)] were enrolled in the study.Results: Six-hundred patients were enrolled, and 426 patients were included in the study. Among 426 patients, 234 (54.9%) were male, and 192 (45.1%) were female. Overall only 118 (27.7%) patients developed symptoms. The other 308 (72.3%) were asymptomatic of which 28 (9.1%) had fever, 28 (9.1%) had cough, 38 (12.33%) had body aches, 292 (94.8%) had vomiting/diarrhea, and only 28 (9.1%) developed loss of smell and taste. Our results showed seropositivity of 27.7% (n = 118), while 72.3% (n = 308) had negative antibody titers.Conclusion: A much higher pediatric SARS-CoV-2 burden of 27.7% was found in our pediatric surgical unit than has previously been reported in the literature of 6.8% for children in pediatric hospitals or pediatric surgical units. Contrary to reporting early in the COVID-19 pandemic, this study determined that children experience a significant burden of COVID-19 infection. Thus, children appear very important in SARS-CoV-2 pandemic, from harboring the virus and further studies need to be done to find if they are transmitting the disease silently.","PeriodicalId":17521,"journal":{"name":"Journal of Tropical Pediatrics","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2023-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138440905","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Cerebrospinal fluid tumor necrosis factor-alpha (TNF-α) levels in children with cerebral malaria. 脑型疟疾患儿脑脊液肿瘤坏死因子-α（TNF-α）水平。

IF 2 4区医学

Journal of Tropical Pediatrics Pub Date : 2023-10-05 DOI: 10.1093/tropej/fmad032

Rajniti Prasad, Raghvendra Singh Patel, S P Mishra, Ankur Singh, Abhishek Abhinay, Tej Bali Singh

{"title":"Cerebrospinal fluid tumor necrosis factor-alpha (TNF-α) levels in children with cerebral malaria.","authors":"Rajniti Prasad, Raghvendra Singh Patel, S P Mishra, Ankur Singh, Abhishek Abhinay, Tej Bali Singh","doi":"10.1093/tropej/fmad032","DOIUrl":"10.1093/tropej/fmad032","url":null,"abstract":"This prospective cross-sectional study evaluated the diagnostic and prognostic role of cerebrospinal fluid (CSF) tumor necrosis factor-alpha (TNF-α) in children with cerebral malaria (CM) and its role in the differentiation of CM from non-cerebral severe malaria. CSF TNF-α was measured using a human TNF-α enzyme-linked immunosorbent assay kit of 39 cases of CM and 19 cases of non-cerebral severe malaria. CSF TNF-α levels were significantly higher in CM (p < 0.001). Based on the receiver operating characteristics curve, a cutoff value of CSF TNF-α was 5.7 pg/ml for diagnosis of CM with sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of 87.2%, 94.7%, 97.1% and 78.3% respectively. The cutoff value of CSF TNF-α was 13.7 pg/ml for predicting adverse outcomes in CM with sensitivity, specificity, PPV and NPV of 100%, 96.8%, 88.9% and 100%, respectively. However, the cutoff value of CSF TNF-α was 4.96 pg/ml for predicting adverse outcomes in non-cerebral severe malaria with a sensitivity, specificity, PPV and NPV of 100%, 94.1%, 88.9% and 100% respectively. So, CSF TNF-α is an excellent biomarker and can be used as a diagnostic and prognostic tool. More studies are needed to establish CSF TNF-α as a predictor of neurological sequelae.","PeriodicalId":17521,"journal":{"name":"Journal of Tropical Pediatrics","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2023-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41166545","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Kangaroo mother care utilization at stepdown ward of a tertiary care teaching hospital: a quality improvement study. 袋鼠妈妈护理在三级护理教学医院下坡病房的应用:质量改进研究。

IF 2 4区医学

Journal of Tropical Pediatrics Pub Date : 2023-10-05 DOI: 10.1093/tropej/fmad041

Dipen V Patel, K Sameer, Reshma K Pujara, Somashekhar M Nimbalkar, Paresha Y Patel, Jayshreeben B Makwana, Smita N Patel

{"title":"Kangaroo mother care utilization at stepdown ward of a tertiary care teaching hospital: a quality improvement study.","authors":"Dipen V Patel, K Sameer, Reshma K Pujara, Somashekhar M Nimbalkar, Paresha Y Patel, Jayshreeben B Makwana, Smita N Patel","doi":"10.1093/tropej/fmad041","DOIUrl":"10.1093/tropej/fmad041","url":null,"abstract":"Purpose: India has the highest burden of preterm/low birth weight newborns. To tackle this, Kangaroo Mother Care (KMC) needs to be scaled up. We did a quality improvement (QI) study to increase KMC coverage to 80% and its utilization to at least 4 h/infant/day.Methods: This study was conducted at a stepdown ward (KMC ward) of a tertiary care teaching institute over a period of four months. All babies with birth weight <2.5 kg were eligible. The QI team included faculty in-charge, one senior resident and three senior staff nurses. Potential barriers were listed using fish-bone analysis. Four possible interventions were identified (daily documentation of total KMC hours by doctor, providing KMC during all the nursing duty shifts, counseling and education to mothers and family members), introduced, and then subsequently tested by four Plan-Do-Study-Act (PDSA) cycles and sustenance was assessed over three months.Results: A total of 93 infants were included in this QI study. During baseline phase, the KMC coverage was 50% which increased to 100% by the end of fourth PDSA cycle and remained 100% during the sustenance phase. During baseline period, KMC was given for ≥ 4 h in 18.8% (28 of 149) patient days which increased to 88.96% (137 of 154) during the sustenance phase. The mean KMC utilization increased from 1.97 (1.57) h/infant/day to 5.65 (1.20) h/infant/day in the sustenance phase.Conclusion: QI study incorporating PDSA cycles helped improve coverage and utilization of KMC.","PeriodicalId":17521,"journal":{"name":"Journal of Tropical Pediatrics","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2023-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138440903","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0