Clinical Characteristics and Immediate-Outcome of Children Mechanically Ventilated in PICU of Pakistan

Back ground and Objective: Mechanical Ventilation (MV) is frequently used as one of the most frequent life-supportive technology in Pediatric Intensive Care Units (PICUs). Very little data is available from Asian countries like Pakistan regarding use of MV in PICUs. Our objective was to assess the frequency, indications and immediate-outcomes in mechanically ventilated pediatric patients in tertiary-care center of developing country.Methods: Retrospective cohort study of critically ill pediatric patients admitted in PICU of Aga Khan University Hospital, who required MV for more than 24-hour over two-year period.Results: A total of 605 patients were admitted to PICU, 307 (50.7%) patients required MV support for \u3e24hr. The median age was 3 years (IQR 6 month to 6 yr 2 months), and male was 59.6% (183/307). Common indications for MV was neurological illness 35.8%, followed by respiratory diseases in 20.8% patients and cardiac diseases in 13%; and 30.3 % patients were ventilated for other reasons. The median length of MV was 2.1 days. 9.4% developed complications and atelectasis (4.6%) was the most common. The mortality rate of children mechanically ventilated was 30.3% as compared to the overall mortality rate of in PICU was 16.3%. The long duration (\u3e 10 days) and cardiogenic shock were identified as independent risk factor associated with increased mortality.CONCLUSION: About half of PICU admission required mechanical ventilation for more than 24 hours. The neurological illness was the most common reason for ventilation. The low incidence of complication rate and relatively high mortality in cardiac cases and long duration of mechanical ventilation were noted in our cohort

Ex Vivo Antiplatelet and Thrombolytic Activity of Bioactive Fractions from the New-Fangled Stem Buds of <i>Ficus religiosa</i> L. with Simultaneous GC-MS Examination

Different parts of Ficus religiosa are the common components of various traditional formulations for the treatment of several blood disorders. The new-fangled stem buds’ powder was extracted with 80% ethanol and successively fractionated by chloroform and methanol. Chloroform and methanol fractions of Ficus religiosa (CFFR and MFFR) were tested for antiplatelet, antithrombotic, thrombolytic, and antioxidant activity in ex vivo mode. The MFFR was particularly investigated for GC-MS and toxicity. The antiplatelet activity of the CFFR, MFFR, and standard drug aspirin at 50 μg/mL was 54.32%, 86.61%, and 87.57%, and a significant delay in clot formation was noted. CFFR at different concentrations did not show a significant effect on the delay of clot formation, antiplatelet, and free radical scavenging activity. The most possible marker compounds for antiplatelet and antioxidant activity identified by GC-MS in the MFFR are salicylate derivatives aromatic compounds such as benzeneacetaldehyde (7), phenylmalonic acid (13), and Salicylic acid (14), as well as Benzamides derivatives such as carbobenzyloxy-dl-norvaline (17), 3-acetoxy-2(1H)-pyridone (16), and 3-benzylhexahydropyrrolo [1,2-a] pyrazine-1,4-dione (35). A toxicity study of MFFR did not show any physical indications of toxicity and mortality up to 1500 mg/kg body weight and nontoxic up to 1000 mg/kg, which is promising for the treatment of atherothrombotic diseases