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Research Article
Expert Perspectives on the Diagnosis and Management of Infections in the Pediatric Intensive Care Unit:
A Cross-sectional Survey of Indian Clinicians
Manjula Suresh*
,
Krishna Kumar Manjunath
Issue:
Volume 14, Issue 4, August 2026
Pages:
57-64
Received:
27 July 2026
Accepted:
7 August 2026
Published:
24 August 2026
Abstract: Objective: To assess clinicians perspectives on the diagnosis and management of infections in the pediatric intensive care unit (PICU) in India, with a focus on common pathogens, diagnostic and therapeutic approaches, meropenem usage, antimicrobial stewardship, and clinicians' perceptions of the efficacy, safety, and clinical outcomes of meropenem therapy. Methods: Clinicians across India participated in a cross-sectional survey using a structured 23-item questionnaire that assessed pathogen profile, diagnostic and therapeutic practices, meropenem usage, antimicrobial stewardship, and clinicians' perceptions of efficacy, safety, and clinical outcomes. Data were analyzed using descriptive statistics. Results: Among the 205 clinicians who participated in the survey, more than three-quarters (76.59%) identified bacterial infections as the most common cause of pediatric infections in the PICU. Nearly two-thirds (63.90%) reported that newborns and infants were the age group at the highest risk of developing severe infections in the PICU. Most clinicians (78.05%) recognized sepsis as the most common complication associated with ventilator-associated pneumonia in pediatric patients. Additionally, 74% preferred antibiotics as the initial treatment for critically ill pediatric patients with confirmed septic shock. Meropenem was the preferred antimicrobial agent for both empirical and targeted therapy, depending on the clinical scenario, as reported by 80% of respondents. Approximately three-quarters (75.61%) identified inadequate awareness of antibiotic stewardship as the primary factor contributing to the misuse or overuse of meropenem. Furthermore, 87% considered meropenem's broad-spectrum activity against both Gram-positive and Gram-negative organisms to be its greatest therapeutic advantage. Based on the 5-point Global Improvement Scale, 69% reported marked improvement in clinical outcomes following meropenem therapy. Conclusion: The survey emphasizes the importance of early antibiotic therapy, appropriate meropenem use, and antimicrobial stewardship. Meropenem is perceived as an effective broad-spectrum agent, with favorable clinical outcomes reported by most clinicians, supporting its role in the management of severe pediatric infections.
Abstract: Objective: To assess clinicians perspectives on the diagnosis and management of infections in the pediatric intensive care unit (PICU) in India, with a focus on common pathogens, diagnostic and therapeutic approaches, meropenem usage, antimicrobial stewardship, and clinicians' perceptions of the efficacy, safety, and clinical outcomes of meropenem ...
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Research Article
The Kidney Transplant Mission: Breaking Ground, Saving Lives
Obiatuegwu Kenenna*,
Aniede Ernest
Issue:
Volume 14, Issue 4, August 2026
Pages:
65-74
Received:
29 July 2026
Accepted:
8 August 2026
Published:
24 August 2026
Abstract: Introduction: The success of kidney transplantation depends on key factors including appropriate patient selection, satisfactory donor compatibility test, early commencement of immunosuppressant and premedication, good surgical technique with experienced transplant team, intensive post-surgery care, serial daily monitoring of renal function, early renal Doppler study as well as continuous immunosuppression and prompt follow up. We report our initial experience at BeWell Kidney Transplant Mission with emphasis on common contemporary indices that influence outcome of kidney transplantation including etiology, patient selection as well as serial outcome amongst donors and recipients following a successful kidney transplant camp. Methodology: This is a prospective observational study involving patients who had kidney transplantation secondary to varying degree of chronic kidney disease over an 8-month period. Structured questionnaire was designed to obtain relevant information. Data analysis was via python 3.x and results represented in tables and charts. Results: A total of 30 kidney transplantation were carried out within the study period. 80% of the recipients were males. All the donors were males. The youngest recipient was 22 years and the oldest was 80 years with a mean age of 61.53 +/- 3.04. Hypertension coexisting diabetes mellitus was the leading cause of kidney failure. Left donor nephrectomy dominated in 83.3% of cases while right donor nephrectomy was performed in only 17.7%. Donor stay ranges from 5 to 6 days while recipients were discharged between 8 to 10 days. The 6 months and one year prognosis was excellent. 96.7% of recipient had improved QoL with return to normal life. Conclusion: Our impressive outcome was probably due to strictly adherence to our local protocol which includes good patient selection, complete HLA typing, cross matching and DSA quantitative analysis, legal documentation, early commencement of immunosuppression, experience transplant team, good surgical techniques, high dependency unit monitoring until discharge. Improving understanding of how to best address these indices can empower transplant centers with appreciable progress toward a worthwhile experience.
Abstract: Introduction: The success of kidney transplantation depends on key factors including appropriate patient selection, satisfactory donor compatibility test, early commencement of immunosuppressant and premedication, good surgical technique with experienced transplant team, intensive post-surgery care, serial daily monitoring of renal function, early ...
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Research Article
Lifestyle Intervention for the Management of Hypercholesterolemia in a Low-Risk Middle-Aged Female: A Case Report
Janislene Santos Ferreira*
Issue:
Volume 14, Issue 4, August 2026
Pages:
75-79
Received:
22 June 2026
Accepted:
24 July 2026
Published:
26 August 2026
DOI:
10.11648/j.ajim.20261404.13
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Abstract: Background: Intensive lifestyle modification is central to dyslipidemia management, although pharmacologic therapy is often prioritized when lipid levels are moderately elevated. Similar to quality improvement efforts addressing pre-analytical variables in laboratory medicine—where outcomes depend on structured interventions and patient adherence—the management of hypercholesterolemia likewise requires sustained engagement in non-intuitive but beneficial health behaviors. Case Presentation: A 53-year-old woman with a 2–3-year history of hypercholesterolemia presented with total cholesterol 6.4 mmol/L (247.5 mg/dL), LDL-C 4.0 mmol/L (154.7 mg/dL), HDL-C 1.65 mmol/L (63.8 mg/dL), triglycerides 1.12 mmol/L (99.2 mg/dL), BMI 26.6 kg/m2, and blood pressure 95/60 mmHg. She had a family history of diabetes (grandmother), no smoking history, and no premature atherosclerotic cardiovascular disease. Statin therapy was initially recommended. Instead, she implemented a fat-restricted diet emphasizing fruits, vegetables, fish, chicken, and oatmeal, along with 1 hour of exercise 6 days per week. After 2 months, total cholesterol decreased to 5.3 mmol/L (205.0 mg/dL), LDL-C to 3.2 mmol/L (123.7 mg/dL), HDL-C remained stable at 1.63 mmol/L (63.0 mg/dL), triglycerides 0.81 mmol/L (71.69 mg/dL), BMI decreased to 24.7 kg/m2, and blood pressure remained stable. Carotid ultrasound showed normal morphology, vessel wall thickness, lumen diameter, and Doppler flow. Statin therapy was no longer recommended. Conclusion: Intensive lifestyle interventions are associated with significant improvements in lipid profiles among carefully selected low-risk patients and may reduce or obviate the need for pharmacologic therapy. Behavioral factors remain integral to the management of dyslipidemia, highlighting the importance of patient-driven modification of cardiovascular risk. Further large-scale, methodologically rigorous studies are warranted to validate the reproducibility and generalizability of these findings.
Abstract: Background: Intensive lifestyle modification is central to dyslipidemia management, although pharmacologic therapy is often prioritized when lipid levels are moderately elevated. Similar to quality improvement efforts addressing pre-analytical variables in laboratory medicine—where outcomes depend on structured interventions and patient adherence—t...
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