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Background: Children bear a substantial proportion of the enteric fever disease burden in endemic areas. Controversy persists regarding which age groups are most affected, leading to uncertainty about optimal intervention strategies. We performed a systematic review and meta-analysis of studies in Asia and Africa to compare the relative proportion of children with enteric fever in the age groups. Materials and methods: This prospective research was conducted at Tertiary Care Teaching Hospital over a Period of 1 year. A total of 90 pediatric cases of EF were included in this study who were either culture positive or had significantly raised Widal test titer for Salmonella with suggestive clinical features. A total of 200 children aged one to 15 years who were either blood culture positive for the Fastidious Antibiotic Neutralization (FAN) or had significant Widal test titer (at least four-fold rises or 1:160 dilutions of both O and H antibodies) were included in the study. Those who had enteric fever with comorbidities (malignancy, nephrotic syndrome, chronic kidney disease, chronic liver disease, etc.) or complications (multiorgan failure, encephalopathy, etc.) were excluded from the study. Result: The clinical features of the study population, where all patients suffered from both fever and anorexia. 60% of patients had vomiting, 54.4% had diarrhea, half had abdominal pain, 43.3% had constipation, and only 3(3.3%) patients had myalgia. According to the Widal test report, 56 (62.2%) patients were reported positive, and 34 (37.8%) patients were reported negative. In the Blood C/S test report, 56 (62.2%) reported negative and 34 (37.8%) patients reported positive. The study population by the total leucocyte count, 45% of patients had >11000 count/mm3, 32.81% of patients had <4000 count/mm3, and 21.88% of patients had 4000-11000 count/mm3. Conclusion: Our findings indicate variability in disease presentation in adults compared to children, in different regions and in resistant vs sensitive cases. Majority of studies are from hospitalized cases, and are not disaggregated by age. Despite higher complications in MDR enteric fever, case fatality rate are comparable to sensitive cases, with an overall hospital based CFR of 2%, which is similar to recent global estimates. [ABSTRACT FROM AUTHOR]

Introduction: Intrathecal fentanyl and dexmedetomidine are adjuvants that can be used along with bupivacaine in spinal anesthesia to enhance the quality and duration of analgesia. Fentanyl is a potent opioid that acts on the muopioid receptors in the spinal cord, which inhibits the transmission of pain signals. Dexmedetomidine is a selective alpha-2 adrenergic agonist that acts on the spinal cord to reduce sympathetic outflow and modulate pain transmission. Material and Methods: 100 ASA I and II patients scheduled for major surgeries under spinal anaesthesia were chosen for the study. Under strict asepsis, using 25 G Quincke spinal needle, lumbar puncture was performed at L 3 - L 4 space. Group F received 3ml, 0.5 % hyperbaric bupivacaine + 25 μg Fentanyl (vol 0.5ml). Group D received 3ml, 0.5 % hyperbaric bupivacaine + 5 μg Dexmedetomidine (vol 0.5 ml). Intra-operatively pulse rate, non-invasive blood pressure, electrocardiogram, SpO2 was recorded. 50 patients in Group F (Fentanyl) and 50 patients in Group D (Dexmedetomidine) were taken to study the changes in haemodynamics and side effects. Chi-square test, Anova test and student' 't' test was done to analyse the data and p value was determined. Results: Dexmedetomidine performed better than Fentanyl as an adjuvant based on the various parameters. Conclusions: Dexmedetomidine is a safe and effective adjuvant for intrathecal administration in the management of postoperative pain as compared to Fentanyl. [ABSTRACT FROM AUTHOR]