Approach to childhood interstitial lung disease in resource limited setting

Childhood interstitial lung disease (ChILD) is a rare disease and sensitization is needed in the recognition, diagnosis and treatment approaches. There is no formal approach to diagnosis or therapy in resource limited regions. We present a case of a 4-month infant who presented with all the criteria for diagnosis of ChILD. Lung biopsy being the gold standard is a challenge in our setting and diagnosis was based on clinical signs and imaging after ruling out of other similar respiratory conditions by way of individual trials of therapy. Monotherapy with prednisone showed clinical improvement within days of initiation

RANDOMISED DOUBLE BLIND STUDY TO COMPARE EFFECTIVENESS OF HONEY, SALBUTAMOL AND PLACEBO IN TREATMENT OF COUGH IN CHILDREN WITH COMMON COLD

Background: Acute upper respiratory infection is the most common childhood illness and presents with cough, coryza and fever. Available evidence suggests that cough medicines may be no more effective than honey-based cough remedies. Objective: To compare effectiveness of honey, salbutamol and placebo in the treatment of cough in children with acute onset cough. Design: Randomised control trial Setting: Aga Khan University Hospital Paediatric Casualty Subjects: Children between ages one to twelve years presenting with a common cold between December 2010 and February 2012 were enrolled. Outcome measures: Frequency, severity and extent to which cough bothered and disturbed child and parental sleep were assessed at baseline and over the subsequent five days through telephone interview using a validated scoring tool. Results: One hundred and forty five children were enrolled in the study (45- placebo, 57 –honey, 43 –salbutamol). Of the 145 children 51% were male. Honey significantly reduced the total mean symptom score by day three (p\u3c 0.001). Total mean difference in scores between day zero to five demonstrated a significant difference of honey’s efficacy over placebo (p\u3c 0.002) however no difference was noted when compared to salbutamol (p\u3c0.478). Significant differences in both total as well as each individual symptom score was detected with honey consistently scoring the best whilst placebo and salbutamol scored the worst. In paired comparisons honey was superior to placebo but not salbutamol, whilst salbutamol was not superior to placebo. Conclusion: Honey was most effective in symptomatic relief of symptoms associated with the common cold whilst salbutamol or placebo offered no benefit

Opportunistic health promotion among family practice patients at a teaching hospital in Karachi

Background: Consultations in primary health care are considered ideal for opportunistic health promotion. A need exists to study opportunistic health promotion practiced in our setting. Objectives: To study opportunistic health promotion among family practice patients visiting a teaching hospital for treatment. Methods: A Questionnaire-based cross-sectional survey was conducted at the Family Practice Center, Aga Khan University Hospital, Karachi, Pakistan, in July and August, 2005. It included demographic profile of the patients and questions based on study objective. Written informed consent was taken and confidentiality was ensured. SPSS computer software was used for data management. Results: 274 patients were interviewed. The mean age of the respondents was 37 years, a majority being married housewives, with above grade X education, and in private service, student or self-employed. Reasons for visit during which opportunistic care was explored were regular check-up, chest pain, palpitations, and heart problem, antenatal care, orthopedic and eye problems and hypertension/ diabetes mellitus in 139 (50.8%), 43 (15.7%), 26 (9.5%) 20 (7.4%) and 9 (3.3%) cases, respectively. 259 (94.5%) patients want a doctor to provide opportunistic health promotion, while it was provided to 160 (58.4%) patients. Tobacco use was asked, and advice provided on diet, physical exercise, immunization and weight control in 109 (39.8%), 182 (66.4%), 165 (60.2%), 72 (26.3%) and 207 (75.5%) cases, respectively. Advice to check serum cholesterol was provided in 140 (51.1%) cases. Patients were screened for heart disease, cancers, and depression in 111 (40.5%), 82 (29.9%) and 120 (43.8%) cases, respectively. Blood pressure was checked in 234 (85.4%) cases. Conclusions: We have documented opportunistic health promotion in our setting. Research and interventional strategies are recommended to further promote it and also to look at its advantages and disadvantages in our settings

A Low-Cost Device for Measurement of Exhaled Breath for the Detection of Obstructive Lung Disease

Breath sensor technology can be used in medical diagnostics. This study aimed to build a device to measure the level of hydrogen sulfide, ammonia, acetone and alcohol in exhaled breath of patients as well as healthy individuals. The purpose was to determine the efficacy of these gases for detection of obstructive lung disease. This study was conducted on a total of 105 subjects, where 60 subjects were patients of obstructive lung disease and 45 subjects were healthy individuals. Patients were screened by means of the Pulmonary Function Test (PFT) by a pulmonologist. The gases present in the exhaled breath of all subjects were measured. The level of ammonia (32.29 ± 20.83 ppb), (68.83 ± 35.25 ppb), hydrogen sulfide (0.50 ± 0.26 ppm), (62.71 ± 22.20 ppb), and acetone (103.49 ± 35.01 ppb), (0.66 ± 0.31 ppm) in exhaled breath were significantly different (p < 0.05) between obstructive lung disease patients and healthy individuals, except alcohol, with a p-value greater than 0.05. Positive correlation was found between ammonia w.r.t Forced Expiratory Volume in 1 s (FEV1) (r = 0.74), Forced Vital Capacity (FVC) (r = 0.61) and Forced Expiratory Flow (FEF) (r = 0.63) and hydrogen sulfide w.r.t FEV1 (r = 0.54), FVC (r = 0.41) and FEF (r = 0.37). Whereas, weak correlation was found for acetone and alcohol w.r.t FEV1, FVC and PEF. Therefore, the level of ammonia and hydrogen sulfide are useful breath markers for detection of obstructive lung disease

Proficiency in Informatics and Communication Technology Application to Improve Agricultural Counseling Performance in Luwu Regency, Indonesia

Informatics and Communication Technology (ICT) provides relevant agricultural information, which is essential in agricultural development attempts, in timely fashion. Aiming to find out if it is able to improve the efficiency of agricultural counseling agents, this study examined agricultural counseling agents in Luwu Regency, South Sulawesi, Indonesia. As explanatory quantitative research, simple random sampling was applied to respondents of google form questionnaire and the data were analyzed as per Structural Equation Model (SEM) and supported by smart PLS application. The result came out with R2 value of 0.868, representing the agricultural counseling agent’s proficiency and ICT application signified agricultural counseling agent’s efficiency at 86.8 %. It is therefore conclusive that agricultural counseling agent’s efficiency in extension activities relies on both their proficiency and ICT application