Impact of Diarrhea on the Clinical Presentation and Outcome of Severe Pneumonia in Bangladeshi Children

Impacts of lipopolysaccharide on fetal lung developmental maturity and surfactant protein B and surfactant protein C protein expression in gestational diabetes mellitus rats

The rise of bioinformatics based on computer medicine provides a new method to reveal the complex biological data. This experiment is to explore the impacts of lipopolysaccharide on fetal lung developmental maturity and expressions of lung surfactant protein B (SP-B) and lung surfactant protein C (SP-C) in rats with gestational diabetes mellitus (GDM), thereby discussing the mechanism of developmental disorders in rats. Forty-eight conceived female rats were experimental subjects. Twenty-eight rats were randomly selected to construct the GDM models. All conceived rats underwent section on the 21st day of pregnancy. The ultrastructure of alveolar type II epithelial cells and the morphology of lung tissue were observed under a microscope. The protein localization and expression of SP-B and SP-C were determined by immunohistochemistry; the protein levels of SP-B and SP-C were determined by Western blot. Blood glucose and body weight of the GDM group were higher than those of the control group; the number of alveoli and alveolar area in the GDM group was lower than those in the control group; the alveolar interval in the GDM group was significantly higher than that in the control group (P < 0.05). The average absorbance of SP-B and SP-C in fetal lung tissue was significantly lower in the GDM group than that in the control group (P < 0.01). Changes in fetal lung tissue structure of rats were related to SP-B and SP-C, which was one of the main factors that affected the maturation of fetal lung tissue.

Vitamin D supplementation among Bangladeshi children under-five years of age hospitalised for severe pneumonia: A randomised placebo controlled trial

INTRODUCTION

Vitamin D is important for its immunomodulatory role and there is an independent association between vitamin D deficiency and pneumonia. We assessed the effect of vitamin D supplementation on the outcome in children hospitalized for severe pneumonia.

METHODS

This was a randomised, double blinded, placebo-controlled clinical trial in children aged >2-59 months with severe pneumonia attending Dhaka Hospital, icddr,b. Children received age-specific megadose of vitamin D3 (20,000IU: <6 months, 50,000 IU: 6-12 months, 100,000 IU:13-59 months) or placebo on first day and 10,000 IU as maintenance dose for next 4 days or until discharge (if discharged earlier) along with standard therapy. This trial is registered at ClinicalTrials.gov, number NCT02185196.

FINDINGS

We enrolled 100 children in placebo group and 97 in vitamin D group. On admission, 50 (52%) and 49 (49%) of children in vitamin D and placebo groups, respectively were vitamin D deficient. Among children with a sufficient serum vitamin D level on admission, a lower trend for duration of resolution of severe pneumonia in hours [72(IQR:44-96)vs. 88(IQR:48-132);p = 0.07] and duration of hospital stay in days [4(IQR:3-5)vs.5(IQR:4-7);P = 0.09] was observed in vitamin D group compared to placebo. No beneficial effect was observed in vitamin D deficient group or irrespective of vitamin D status.

CONCLUSION

Age-specific mega dose of vitamin D followed by a maintenance dose shown to have no statistical difference between the two intervention groups, however there was a trend of reduction of time to recovery from pneumonia and overall duration of hospital stay in under-five children with a sufficient serum vitamin D level on hospital admission.

Therapeutic effect of live combined Bifidobacterium and Lactobacillus tablets for children with diarrhea secondary to pneumonia: Influencing factors

AIM

To observe the clinical effects of combined Bifidob-acterium and Lactobacillus tablets in the treatment of children with diarrhea secondary to pneumonia, and to analyze the related influencing factors.

METHODS

Two hundred and thirty children with secondary diarrhea were selected from 722 children with pneumonia admitted to our hospital between June 2016 and June 2017 and randomly divided into a study group and a control group (n = 115, each). In the control group, only antibiotics were given, and the study group was treated with antibiotics and combined Bifidobacterium and Lactobacillus tablets. The efficacy of the two groups was observed and compared, and the related influencing factors were analyzed.

RESULTS

The total effective rate in the study group was 94.78%, which was significantly higher than that in the control group (71.30%; P < 0.05). The number of bowel movements in the study group was significantly less than that of the control group, and the time to disappearance of diarrhea symptoms was significantly shorter than that of the control group (P < 0.05). Logistics multivariate analysis showed that age, length of hospital stay, use of hormones, use of probiotics, and severity of illness were independent risk factors for secondary diarrhea in children with pneumonia (P < 0.05).

CONCLUSION

Live combined Bifidobacterium and Lactobacillus tablets are effective in the treatment of children with diarrhea secondary to pneumonia and can promote the disappearance of diarrhea symptoms and reduce the number of stools. There are many clinical factors that can affect the development of secondary diarrhea, and early intervention should be targeted at such risk factors to reduce the risk of secondary diarrhea in children with pneumonia.