Visceral leishmaniasis among children presenting with pancytopenia

Background: Pancytopenia can result from either a failure of production of hematopoietic progenitors or peripheral destruction of a cellular element either due to infection, immune-mediated damage or hypersplenism. Visceral leishmaniasis (VL), one of the chronic parasitic diseases in the world that affects millions of people recently, leishmaniasis has been seen with increasing frequency in patients with Pancytopenia.Objective: To determine the frequency of visceral leishmaniasis among children presenting with pancytopenia at Pediatric Department, Azzd Jammu and Kashmir Medical College MuzaffarabadMethodology This cross sectional study was conducted at the Department of paeds SKBZ/ CMH, Muzaffarabad. The study duration was 6 months from June 2018 to December 2018. All children with pancytopenia either of gender were enrolled. After taking informed demographic information, all the cases underwent bone marrow sampling to assess the Visceral Leishmaniasis. All the data was collected by self-made proforma.Results: Total 75 patients were studied; their mean age of patients was 6.74±3.14 years. Males were in majority 67.69% and 32.31% were females. Leishmaniasis was found 15.38% of the cases. Leishmaniasis was statistically insignificant according to age and gender; p-values were quite insignificant.Conclusion: It is concluded that the visceral leishmaniasis in children with pancytopenia was 15.38%

Bacteria Causing Early Onset Sepsis in Neonates Admitted in Neonatal Intensive Care Unit of a Military Hospital in Muzaffarabad, Azad Kashmir Pakistan

Objective: To determine the burden of early onset of sepsis (EOS) in suspected neonates and to assess the most common causative agents of EOS in these neonates. Methods: This prospective cross-sectional study was conducted at H.H. Sheikh Khalifa Bin Zayed Al Nahyan Hospital/Combined Military Hospital, Muzaffarabad, Pakistan from January 2020 to June 2021. All neonates admitted in Neonatal Intensive Care Unit (NICU) during first 3 days of life with suspicion of sepsis, based on maternal history or neonatal clinical examination were enrolled. EOS was defined based on the presence of clinical sepsis developed within 72 hours of life or if positive blood/cerebrospinal fluid (CSF) cultures were detected . This information along with the bacteria causing EOS was noted. Results: Of 109 suspected neonates for EOS, positive blood culture for EOS was observed in 26 (23.9%) neonates. Risk of EOS was 7 times higher among neonates with total leucocyte count (TLC) ≥30,000 per mm as compared to neonates with < 30,000 per mm of TLC (aOR 7.19, 95% CI 2.12 to 24.31, p-value 0.002). Gram positive was the most common bacterial isolates, i.e., 15 (57.69%) whereas gram negative was observed in 11 (42.31%) neonates. Of 15 neonates with gram positive bacteria, all had staphylococcus aureus, i.e., 15 (100%) whereas of 11 neonates with gram negative bacteria, Escherichia coli was observed in majority of the neonates, i.e., 7 (63.64%). Conclusion: In our study cohort, a significant occurrence of EOS we observed. Specifically, gram-positive organism (staphylococcus aureus) was the predominant cause of sepsis

A UWB-Driven Self-Actuated Projector Platform for Interactive Augmented Reality Applications

With the rapid development of interactive technology, creating systems that allow users to define their interactive envelope freely and provide multi-interactive modalities is important to build up an intuitive interactive space. We present an indoor interactive system where a human can customize and interact through a projected screen utilizing the surrounding surfaces. An ultra-wideband (UWB) wireless sensor network was used to assist human-centered interaction design and navigate the self-actuated projector platform. We developed a UWB-based calibration algorithm to facilitate the interaction with the customized projected screens, where a hand-held input device was designed to perform mid-air interactive functions. Sixteen participants were recruited to evaluate the system performance. A prototype level implementation was tested inside a simulated museum environment, where a self-actuated projector provides interactive explanatory content for the on-display artifacts under the user’s command. Our results depict the applicability to designate the interactive screen efficiently indoors and interact with the augmented content with reasonable accuracy and relatively low workload. Our findings also provide valuable user experience information regarding the design of mobile and projection-based augmented reality systems, with the ability to overcome the limitations of other conventional techniques

A UWB-Based Lighter-Than-Air Indoor Robot for User-Centered Interactive Applications

Features such as safety and longer flight times render lighter-than-air robots strong candidates for indoor navigation applications involving people. However, the existing interactive mobility solutions using such robots lack the capability to follow a long-distance user in a relatively larger indoor space. At the same time, the tracking data delivered to these robots are sensitive to uncertainties in indoor environments such as varying intensities of light and electromagnetic field disturbances. Regarding the above shortcomings, we proposed an ultra-wideband (UWB)-based lighter-than-air indoor robot for user-centered interactive applications. We developed the data processing scheme over a robot operating system (ROS) framework to accommodate the robot&rsquo;s integration needs for a user-centered interactive application. In order to explore the user interaction with the robot at a long-distance, the dual interactions (i.e., user footprint following and user intention recognition) were proposed by equipping the user with a hand-held UWB sensor. Finally, experiments were conducted inside a professional arena to validate the robot&rsquo;s pose tracking in which 3D positioning was compared with the 3D laser sensor, and to reveal the applicability of the user-centered autonomous following of the robot according to the dual interactions

Clinical Efficacy of Use of Probiotics in Children with Acute Watery Diarrhea

watery diarrhea in children aged 6 months to 5 years, at H.H Sheikh Khalifa Bin Zayed Al-Nahyan Hospital/Combined Military Hospital, Muzaffarabad. Methodology: The Randomized Controlled Trial was done at Pediatric department, H.H Sheikh Khalifa Bin Zayed Al-Nahyan Hospital/CMH, Muzaffarabad from January 2020 to December 2021. All patients aged 6 months to 5 years with acute watery diarrhea who present with severe, minimal, or no dehydration within the first five days of illness were included. Children meeting the inclusion criteria were consecutively enrolled and randomly assigned to either the study group (ORS plus oral administration of Saccharomyces Boulardii) or the control group (ORS alone). From day 1 to day 5, the quantity and consistency of feces were counted. On day 5, clinical effectiveness was indicated by 3 stools or fewer per day. SPSS version 26 was used for data analysis. Results: Of 252 patients, a significant mean difference of number of stools and consistency was observed on day 3, day 4, and day 5 (p:&lt;0.005). A significant association of efficacy was observed with probiotic group (p: 0.021). After adjustment for other covariates, efficacy was 2.37 times higher among children who were in probiotic group as compared to control group (OR 2.37, 95% CI 1.07-5.24, p: 0.033). The efficacy was 3.23 times higher among children with age ?3 years than children with age &gt;3 years (aOR 3.23, 95% CI 1.32-7.91, p: 0.010). The efficacy was 94% lower among children without dehydration (aOR 0.06, 95% CI 0.01-0.52, p: 0.011) and 91% lower among children with some dehydration (aOR: 0.09, 95% CI 0.01-0.77, p: 0.028). Conclusion: The efficacy of probiotics was observed to be higher in treatment of acute watery diarrhea in hospitalized children. Probiotics, when used as an adjunct to standard therapy, may be beneficial in reducing the severity and duration of diarrhea, potentially leading to improved clinical outcomes