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Mishra P, Panda SS, Tripathy M, Panda M, Das RR. Infantile cortical hyperostosis: two cases with varied presentations. J Clin Diagn Res 2014; 8:PJ01-2. [PMID: 25478424 DOI: 10.7860/jcdr/2014/9077.4945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2014] [Accepted: 07/01/2014] [Indexed: 11/24/2022] [Imported: 09/18/2023]
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Panda SS, Das RR, Arora K. Benign skin lesion in a neonate. J Paediatr Child Health 2014; 50:1029. [PMID: 25440166 DOI: 10.1111/jpc.12564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] [Imported: 09/18/2023]
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Prevalence and outcome of diastolic dysfunction in children with fluid refractory septic shock--a prospective observational study. Pediatr Crit Care Med 2014; 15:e370-8. [PMID: 25230313 DOI: 10.1097/pcc.0000000000000249] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] [Imported: 09/18/2023]
Abstract
OBJECTIVES Our primary objective was to determine the prevalence and outcome of diastolic dysfunction in children with fluid refractory septic shock. The secondary objective was to determine possible early predictors of diastolic dysfunction. DESIGN Prospective observational study. SETTING PICU of a tertiary care teaching hospital. PATIENTS Consecutive children 17 years old or younger with fluid refractory septic shock and not on mechanical ventilation admitted to our ICU from June 2011 to August 2012 were included. Survivors were followed up till 1 year of discharge (July 2013). INTERVENTIONS Children were subjected to 2D echocardiography and qualitative cardiac troponin-T test within the first 6 hours of admission. MEASUREMENTS AND MAIN RESULTS A total of 56 children were included. Median age was 7 years (interquartile range, 1.5, 14) and majority (52%) were males. Most common underlying diagnoses were meningitis and pneumonia. The prevalence of diastolic dysfunction was 41.1% (95% CI, 27.8-54.4), and mortality rate was 43% in those with diastolic dysfunction. At 1-year follow-up, residual dysfunction was present in only one of 11 of the survivors (11%). On univariable analysis of possible early predictors of diastolic dysfunction, we observed that these children tended to have higher mean central venous pressure (13 vs 6; p < 0.0001) and greater positivity for cardiac troponin-T (70% vs 36%; p = 0.01) compared with others. Although factors such as duration of illness and diastolic blood pressure were also lower in children with diastolic dysfunction compared with others, the difference was not statistically significant. On multivariable analysis, only the variable central venous pressure remained significant (adjusted odds ratio, 1.6; 95% CI, 1.12-2.14; p = 0.008). CONCLUSIONS Diastolic dysfunction is common in children with fluid refractory septic shock, and immediate outcomes may be poorer in such patients. Increased central venous pressure after initial fluid resuscitation may be an early indicator of diastolic dysfunction and warrant urgent bedside echocardiography to guide further management.
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Panda SS, Panda M, Das RR, Mohanty PK. Radiological versus clinical evidence of malrotation: Role of laparoscopy/laparotomy in Indian scenario. J Minim Access Surg 2014; 10:225. [PMID: 25336829 PMCID: PMC4204272 DOI: 10.4103/0972-9941.141536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] [Imported: 09/18/2023] Open
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Jaiswal N, Singh M, Das RR, Jindal I, Agarwal A, Thumburu KK, Kumar A, Chauhan A. Distribution of serotypes, vaccine coverage, and antimicrobial susceptibility pattern of Streptococcus pneumoniae in children living in SAARC countries: a systematic review. PLoS One 2014; 9:e108617. [PMID: 25268974 DOI: 10.1371/journal.pone.108617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2014] [Accepted: 08/22/2014] [Indexed: 09/18/2023] [Imported: 09/18/2023] Open
Abstract
INTRODUCTION Each SAARC nation falls in the zone of high incidence of pneumococcal disease but there is a paucity of literature estimating the burden of pneumococcal disease in this region. OBJECTIVE To identify the prevalent serotypes causing invasive pneumococcal disease in children of SAARC countries, to determine the coverage of these serotypes by the available vaccines, and to determine the antibiotic resistance pattern of Streptococcus pneumoniae. METHODS We searched major electronic databases using a comprehensive search strategy, and additionally searched the bibliography of the included studies and retrieved articles till July 2014. Both community and hospital based observational studies which included children aged ≤12 years as/or part of the studied population in SAARC countries were included. RESULTS A total of 17 studies were included in the final analysis. The period of surveillance varied from 12-96 months (median, 24 months). The most common serotypes country-wise were as follows: serotype 1 in Nepal; serotype 14 in Bangladesh and India; serotype 19F in Sri Lanka and Pakistan. PCV-10 was found to be suitable for countries like India, Nepal, Bangladesh, and Sri Lanka, whereas PCV-13 may be more suitable for Pakistan. An increasing trend of non-susceptibility to antibiotics was noted for co-trimoxazole, erythromycin and chloramphenicol, whereas an increasing trend of susceptibility was noted for penicillin. CONCLUSION Due to paucity of recent data in majority of the SAARC countries, urgent large size prospective studies are needed to formulate recommendations for specific pneumococcal vaccine introduction and usage of antimicrobial agents in these regions.
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MESH Headings
- Anti-Bacterial Agents/therapeutic use
- Asia, Western/epidemiology
- Child
- Child, Preschool
- Chloramphenicol/therapeutic use
- Drug Resistance, Bacterial
- Erythromycin/therapeutic use
- Female
- Humans
- Infant
- Infant, Newborn
- Male
- Pneumococcal Vaccines/administration & dosage
- Pneumococcal Vaccines/immunology
- Pneumonia, Pneumococcal/drug therapy
- Pneumonia, Pneumococcal/epidemiology
- Pneumonia, Pneumococcal/microbiology
- Pneumonia, Pneumococcal/prevention & control
- Serogroup
- Serotyping
- Streptococcus pneumoniae/drug effects
- Streptococcus pneumoniae/genetics
- Streptococcus pneumoniae/immunology
- Streptococcus pneumoniae/isolation & purification
- Trimethoprim, Sulfamethoxazole Drug Combination/therapeutic use
- Vaccination/statistics & numerical data
- Vaccines, Conjugate
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Jaiswal N, Singh M, Das RR, Jindal I, Agarwal A, Thumburu KK, Kumar A, Chauhan A. Distribution of serotypes, vaccine coverage, and antimicrobial susceptibility pattern of Streptococcus pneumoniae in children living in SAARC countries: a systematic review. PLoS One 2014; 9:e108617. [PMID: 25268974 PMCID: PMC4182530 DOI: 10.1371/journal.pone.0108617] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2014] [Accepted: 08/22/2014] [Indexed: 11/18/2022] [Imported: 09/18/2023] Open
Abstract
INTRODUCTION Each SAARC nation falls in the zone of high incidence of pneumococcal disease but there is a paucity of literature estimating the burden of pneumococcal disease in this region. OBJECTIVE To identify the prevalent serotypes causing invasive pneumococcal disease in children of SAARC countries, to determine the coverage of these serotypes by the available vaccines, and to determine the antibiotic resistance pattern of Streptococcus pneumoniae. METHODS We searched major electronic databases using a comprehensive search strategy, and additionally searched the bibliography of the included studies and retrieved articles till July 2014. Both community and hospital based observational studies which included children aged ≤12 years as/or part of the studied population in SAARC countries were included. RESULTS A total of 17 studies were included in the final analysis. The period of surveillance varied from 12-96 months (median, 24 months). The most common serotypes country-wise were as follows: serotype 1 in Nepal; serotype 14 in Bangladesh and India; serotype 19F in Sri Lanka and Pakistan. PCV-10 was found to be suitable for countries like India, Nepal, Bangladesh, and Sri Lanka, whereas PCV-13 may be more suitable for Pakistan. An increasing trend of non-susceptibility to antibiotics was noted for co-trimoxazole, erythromycin and chloramphenicol, whereas an increasing trend of susceptibility was noted for penicillin. CONCLUSION Due to paucity of recent data in majority of the SAARC countries, urgent large size prospective studies are needed to formulate recommendations for specific pneumococcal vaccine introduction and usage of antimicrobial agents in these regions.
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MESH Headings
- Anti-Bacterial Agents/therapeutic use
- Asia, Western/epidemiology
- Child
- Child, Preschool
- Chloramphenicol/therapeutic use
- Drug Resistance, Bacterial
- Erythromycin/therapeutic use
- Female
- Humans
- Infant
- Infant, Newborn
- Male
- Pneumococcal Vaccines/administration & dosage
- Pneumococcal Vaccines/immunology
- Pneumonia, Pneumococcal/drug therapy
- Pneumonia, Pneumococcal/epidemiology
- Pneumonia, Pneumococcal/microbiology
- Pneumonia, Pneumococcal/prevention & control
- Serogroup
- Serotyping
- Streptococcus pneumoniae/drug effects
- Streptococcus pneumoniae/genetics
- Streptococcus pneumoniae/immunology
- Streptococcus pneumoniae/isolation & purification
- Trimethoprim, Sulfamethoxazole Drug Combination/therapeutic use
- Vaccination/statistics & numerical data
- Vaccines, Conjugate
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Mishra P, Das RR. Unilateral Caffey disease (infantile cortical hyperostosis). Assoc Med J 2014. [DOI: 10.1136/bmj.g5289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] [Imported: 09/18/2023]
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Das RR, Panigrahi I, Naik SS. The effect of prophylactic antipyretic administration on post-vaccination adverse reactions and antibody response in children: a systematic review. PLoS One 2014; 9:e106629. [PMID: 25180516 PMCID: PMC4152293 DOI: 10.1371/journal.pone.0106629] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2014] [Accepted: 08/08/2014] [Indexed: 11/24/2022] [Imported: 09/18/2023] Open
Abstract
Background Prophylactic antipyretic administration decreases the post-vaccination adverse reactions. Recent study finds that they may also decrease the antibody responses to several vaccine antigens. This systematic review aimed to assess the evidence for a relationship between prophylactic antipyretic administration, post-vaccination adverse events, and antibody response in children. Methods A systematic search of major databases including MEDLINE and EMBASE was carried out till March 2014. Randomized controlled trials (RCTs) comparing prophylactic antipyretic treatment versus placebo post-vaccination in children ≤6 years of age were included. Two reviewers independently applied eligibility criteria, assessed the studies for methodological quality, and extracted data [PROSPERO registration: CRD42014009717]. Results Of 2579 citations retrieved, a total of 13 RCTs including 5077 children were included in the review. Prophylactic antipyretic administration significantly reduced the febrile reactions (≥38.0°C) after primary and booster vaccinations. Though there were statistically significant differences in the antibody responses between the two groups, the prophylactic PCM group had what would be considered protective levels of antibodies to all of the antigens given after the primary and booster vaccinations. No significant difference in the nasopharyngeal carriage rates (short-term and long-term) of H. influenzae or S. pneumoniae serotypes was found between the prophylactic and no prophylactic PCM group. There was a significant reduction in the local and systemic symptoms after primary, but not booster vaccinations. Conclusions Though prophylactic antipyretic administration leads to relief of the local and systemic symptoms after primary vaccinations, there is a reduction in antibody responses to some vaccine antigens without any effect on the nasopharyngeal carriage rates of S. pneumoniae & H. influenza serotypes. Future trials and surveillance programs should also aim at assessing the effectiveness of programs where prophylactic administration of PCM is given. The timing of administration of antipyretics should be discussed with the parents after explaining the benefits & risks.
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Role of 99mTc-ECD SPECT in the management of children with craniosynostosis. BIOMED RESEARCH INTERNATIONAL 2014; 2014:172646. [PMID: 24987670 DOI: 10.1155/2014/172646] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/09/2014] [Revised: 03/31/2014] [Accepted: 03/31/2014] [Indexed: 11/17/2022] [Imported: 09/18/2023]
Abstract
PURPOSE OF THE REPORT There is a paucity of data on correlation of various imaging modalities with clinical findings in craniosynostosis. Moreover, no study has specifically reported the role of (99m)Tc-ECD SPECT in a large number of subjects with craniosynostosis. MATERIALS AND METHODS We prospectively analyzed a cohort of 85 patients with craniosynostosis from year 2007 to 2012. All patients underwent evaluation with (99m)Tc-ECD SPECT and the results were correlated with radiological and surgical findings. RESULTS (99m)Tc-ECD SPECT revealed regional perfusion abnormalities in the cerebral hemisphere corresponding to the fused sutures preoperatively that disappeared postoperatively in all the cases. Corresponding to this, the mean mental performance quotient (MPQ) increased significantly (P < 0.05) postoperatively only in those children with absent perfusion defect postoperatively. CONCLUSIONS Our study suggests that early surgery and release of craniosynostosis in patients with preoperative perfusion defects (absent on (99m)Tc-ECD SPECT study) are beneficial, as they lead to improved MPQ after surgery.
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Arora K, Thukral A, Das RR, Gupta N, Kabra M, Agarwal R. Fryns syndrome: a lethal birth defect with variable phenotypic expressions in siblings. Indian J Pediatr 2014; 81:614-6. [PMID: 23604607 DOI: 10.1007/s12098-013-1011-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2012] [Accepted: 03/13/2013] [Indexed: 11/24/2022] [Imported: 09/18/2023]
Abstract
Fryns syndrome (FS) is a multiple congenital anomaly syndrome, inherited as an autosomal recessive defect with variable expression. The authors report a newborn with FS, whose mother had two previous affected pregnancies with the infants having variable phenotypic expression. FS is characterized by craniofacial dysmorphism, diaphragmatic hernia and distal limb hypoplasia. This is the first published report from India describing a case of FS with familial recurrence, which would serve further to illustrate the clinical variability of this disorder.
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Gajendra S, Das RR, Chopra A, Singh A, Seth R. Accelerated phase at initial presentation in Chédiak-Higashi syndrome: is it really uncommon ? Pediatr Hematol Oncol 2014; 31:382-5. [PMID: 24274591 DOI: 10.3109/08880018.2013.848386] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] [Imported: 09/18/2023]
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Abstract
CLINICAL QUESTION Is oral zinc associated with a shorter duration, decreased severity, and reduced incidence of the common cold compared with placebo? BOTTOM LINE When initiated within 24 hours of symptom onset, oral zinc is associated with a shorter duration of the common cold in healthy people. However, there is no association between oral zinc and symptom severity, and the prevalence of adverse effects with zinc lozenges is high. Given the high heterogeneity of data, these results should be interpreted with caution. Used prophylactically, oral zinc is associated with a reduced cold incidence in children. Prophylactic use has not been studied in adults.
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Das RR, Sami A, Seth R, Nandan D, Kabra SK, Suri V. Thoracic neuroblastoma presenting as recurrent empyema. THE NATIONAL MEDICAL JOURNAL OF INDIA 2014; 27:84-85. [PMID: 25471760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023] [Imported: 09/18/2023]
Abstract
Neuroblastoma is the most common intra-abdominal and extracranial solid tumour in children, accounting for 7%-8% of all childhood cancers. It is a malignant tumour of the autonomic nervous system derived from the neural crest. Most children with neuroblastoma have distant metastatic disease at the time of diagnosis. Pulmonary metastasis at the time of diagnosis is rare, and rarer is the presence of associated pleural effusion. We present the case of a child with recurrent empyema, who was diagnosed to have a thoracic neuroblastoma.
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Overlapping phenotypes in OFD type II and OFD type VI: report of two cases. Clin Dysmorphol 2014; 22:109-114. [PMID: 23459408 DOI: 10.1097/mcd.0b013e32835fe161] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] [Imported: 09/18/2023]
Abstract
Mohr syndrome [orofaciodigital (OFD) syndrome type II] is an autosomal recessive condition that presents with short stature, broad or a bifid nasal tip, orofacial clefts, hypertrophied oral frenulae, tongue nodules or lobulated tongue, and digital anomalies. The features of OFD type II overlap with those of OFD type VI, Joubert syndrome, and short rib polydactyly (Majewski syndrome). Patients with OFD seen in our genetics in the last 4 years were reviewed. Of the five patients with OFD seen, two had Y-shaped metacarpals and other abnormalities consistent with the phenotypic spectrum of Mohr syndrome. They also had the additional radiological features of hypoplastic middle phalanges of index fingers and a hypertrophied or enlarged metatarsal with multiple phalanges arising from it. We hypothesize that type II and type VI OFD syndromes represent a continuum of the same phenotypic spectrum with severe central nervous system abnormalities at the more severe end of the spectrum.
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Arora P, Ganesh S, Arora K, Das RR. Bilateral geographical ulcer in a neonate. Braz J Infect Dis 2014. [PMCID: PMC9425265 DOI: 10.1016/j.bjid.2013.07.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] [Imported: 09/18/2023] Open
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Singh M, Das RR, Kumar L, Kumar R. Bacille Calmette-Guérin vaccination is associated with lower prevalence of allergic diseases in Indian children. Am J Rhinol Allergy 2013; 27:e107-12. [PMID: 23883802 DOI: 10.2500/ajra.2013.27.3940] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] [Imported: 09/18/2023]
Abstract
BACKGROUND Immunization with bacille Calmette-Guérin (BCG) has been shown to augment T helper (Th) 1 biased response and hence gives protection against developing allergies. However, results across the studies have been inconclusive and there is no Indian study verifying this association. We explored the link between BCG vaccination and prevalence of allergic diseases among school children of Chandigarh, North India. METHODS In a large cross-sectional study, children aged 7-14 years, with and without documentation and/or scar consistent with BCG vaccination, were examined over a period of 2 years and 5 months with the help of a questionnaire-based survey followed by skin-prick test (SPT). RESULTS A total of 10,028 children were included. The mean age was 11.04 ± 2.8 years and M/F ratio was 1.1:1. Among them, 77.7% had documentation of BCG vaccination, 17% had a BCG-like scar but no documentation and 5.3% had no scar/documentation. SPT was performed on 1614 (16%) children. In the BCG group (vaccination and/or scar) 16.7% were atopic (positive SPT) compared with 21.3% in no BCG (no vaccination/scar). The prevalence of allergic diseases among BCG(+) subjects was 10.1%. Among these, asthma was the commonest one (6.1%), followed by rhinitis (3.5%) and eczema (0.5%). There was significant negative correlation between BCG positivity, atopy (p = 0.037), and allergic diseases as a whole (p = 0.028), but on independent analysis the negative correlation was strongest with allergic rhinitis (p = 0.011). CONCLUSION BCG vaccination is associated with lower prevalence of allergic disorders in Indian children.
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Das RR, Kabra SK, Singh M. Treatment of pseudomonas and Staphylococcus bronchopulmonary infection in patients with cystic fibrosis. ScientificWorldJournal 2013; 2013:645653. [PMID: 24489509 PMCID: PMC3893016 DOI: 10.1155/2013/645653] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2013] [Accepted: 10/02/2013] [Indexed: 12/24/2022] [Imported: 09/18/2023] Open
Abstract
The optimal antibiotic regimen is unclear in management of pulmonary infections due to pseudomonas and staphylococcus in cystic fibrosis (CF). We systematically searched all the published literature that has considered the evidence for antimicrobial therapies in CF till June 2013. The key findings were as follows: inhaled antipseudomonal antibiotic improves lung function, and probably the safest/most effective therapy; antistaphylococcal antibiotic prophylaxis increases the risk of acquiring P. aeruginosa; azithromycin significantly improves respiratory function after 6 months of treatment; a 28-day treatment with aztreonam or tobramycin significantly improves respiratory symptoms and pulmonary function; aztreonam lysine might be superior to tobramycin inhaled solution in chronic P. aeruginosa infection; oral ciprofloxacin does not produce additional benefit in those with chronic persistent pseudomonas infection but may have a role in early or first infection. As it is difficult to establish a firm recommendation based on the available evidence, the following factors must be considered for the choice of treatment for each patient: antibiotic related (e.g., safety and efficacy and ease of administration/delivery) and patient related (e.g., age, clinical status, prior use of antibiotics, coinfection by other organisms, and associated comorbidities ones).
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Vitamin d supplementation for the treatment of acute childhood pneumonia: a systematic review. ISRN PEDIATRICS 2013; 2013:459160. [PMID: 24455293 PMCID: PMC3880753 DOI: 10.1155/2013/459160] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/25/2013] [Accepted: 12/04/2013] [Indexed: 11/19/2022] [Imported: 08/29/2023]
Abstract
Background. Studies have found an increased incidence of vitamin D deficiency in children with pneumonia; however, there is no conclusive data regarding the direct effect of vitamin D supplementation in acute pneumonia. Methods. A comprehensive search was performed of the major electronic databases till September 2013. Randomized controlled trials (RCTs) comparing treatment with vitamin D3 versus placebo in children ≤5 years old with pneumonia were included. Results. Out of 32 full text articles, 2 RCTs including 653 children were eligible for inclusion. One trial used a single 100,000 unit of oral vitamin D3 at the onset of pneumonia. There was no significant difference in the mean (±SD) number of days to recovery between the vitamin D3 and placebo arms (P = 0.17). Another trial used oral vitamin D3 (1000 IU for <1 year and 2000 IU for >1 year) for 5 days in children with severe pneumonia. Median duration of resolution of severe pneumonia was similar in the two groups (intervention, 72 hours; placebo, 64 hours). Duration of hospitalization and time to resolution of tachypnea, chest retractions, and inability to feed were also comparable between the two groups. Conclusions. Oral vitamin D supplementation does not help children under-five with acute pneumonia.
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Congenital portosystemic venous shunt in a preterm Rh-isoimmunized infant. Indian J Pediatr 2013; 80:1053-5. [PMID: 23389350 DOI: 10.1007/s12098-013-0972-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2012] [Accepted: 01/14/2013] [Indexed: 10/27/2022] [Imported: 09/18/2023]
Abstract
The authors report a preterm infant with Rh-isoimmunization, who had persistent hepato-splenomegaly with conjugated hyperbilirubinemia, transaminitis, and hyperammonemia. Ultrasound abdomen revealed an intrahepatic portosystemic venous shunt (PSVS). The child was managed conservatively. On follow up at 2.4 y of age, the child is having normal growth and development, but with persisting shunt. Severe Rh-isoimmunisation in a neonate can sometimes share some of the features of congenital PSVS and delay the diagnosis of the latter. The index case had shunt ratio >80 % during the neonatal period but did not require any intervention.
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Das RR, Gajendra S, Bakshi S, Seth R, Kumar R. Spontaneous Tumor Lysis Syndrome in Childhood T cell Acute Lymphoblastic Leukemia. Oman Med J 2013; 28:e063. [PMID: 31011405 DOI: 10.5001/omj.2013.132] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] [Imported: 09/18/2023] Open
Abstract
We report two cases that presented with unexplained acute renal failure and hyperuricemia and were subsequently diagnosed with T-cell acute lymphoblastic leukemia. The patients improved with conservative therapy without the need for dialysis. Case 1 is the youngest case of acute lymphoblastic leukemia with spontaneous tumor lysis syndrome reported to date, and Case 2 presented with spontaneous tumor lysis syndrome without hyperleukocytosis.
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Barik M, Bajpai M, Das RR, Panda SS. Study of environmental and genetic factors in children with craniosynostosis: A case-control study. J Pediatr Neurosci 2013; 8:89-92. [PMID: 24082921 PMCID: PMC3783739 DOI: 10.4103/1817-1745.117833] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] [Imported: 09/18/2023] Open
Abstract
Background: Craniosynostosis is a congenital defect that causes one or more sutures on an infant's skull to close earlier than normal. Though both genetic and environmental factors play a role in its pathogenesis, there is no published Indian data to verify this. Materials and Methods: In this case-control study, we investigated the association of craniosynostosis with parental age in 50 children with craniosynostosis attending the surgical outpatient department of a tertiary care institution in North India. Results: There was a significant association of craniosynostosis with advanced parental [OR 2.17 (95% CI 1.08 to 4.36)] but not maternal age. Education status of parents also revealed that those having a higher education had an increased risk of having a child with craniosynostosis [maternal education, OR 2.32 (95% CI 1.2 to 4.76); paternal education, OR 2.51 (95% CI 1.21 to 5.0)]. Molecular analysis by sequencing confirmed following amino-acid substitution in different Exons of the FGFR2 gene. Besides these, we found other novel identical mutations in FGFR2 gene in both syndromic and non-syndromic craniosynostoses. Conclusion: This is the first epidemiological study in India that provides evidence that, advanced paternal age and higher parental education level might be associated with an increased risk of craniosynostosis. New mutations were identified in cases of both syndromic and non-syndromic craniosynostosis.
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Chinnakkannan S, Das RR, Rughmini K, Ahmed S. A case of bilateral tibial hemimelia type VIIa. INDIAN JOURNAL OF HUMAN GENETICS 2013; 19:108-10. [PMID: 23901205 PMCID: PMC3722620 DOI: 10.4103/0971-6866.112924] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] [Imported: 09/18/2023]
Abstract
Congenital absence of tibia is a rare anomaly, and may be total or partial, unilateral or bilateral. Total absence is more frequent than partial, unilateral absence occurs more often than bilateral, with right limb more commonly affected than the left. In partial defect, almost always the distal end of the bone is affected, and of the bilateral cases, there may be total absence on both sides, or total on one side and partial on the other. Males are slightly more commonly affected than the females. Though, the family history is usually negative for congenital abnormalities and other diseases, there is a considerable chance of occurrence of congenital defect of the tibia or of other abnormalities, in near or remote relatives. We report a case of newborn having bilateral tibial hemimelia type VIIa.
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Gupta AK, Das RR, Panda SS, Panda M. A neonate with facial asymmetry. BMJ Case Rep 2013; 2013:bcr-2013-200096. [PMID: 23897388 DOI: 10.1136/bcr-2013-200096] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] [Imported: 09/18/2023] Open
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Das RR, Naik SS, Singh M. Probiotics as additives on therapy in allergic airway diseases: a systematic review of benefits and risks. BIOMED RESEARCH INTERNATIONAL 2013; 2013:231979. [PMID: 23956972 PMCID: PMC3727208 DOI: 10.1155/2013/231979] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/04/2013] [Accepted: 06/19/2013] [Indexed: 11/17/2022] [Imported: 08/29/2023]
Abstract
BACKGROUND We conducted a systematic review to find out the role of probiotics in treatment of allergic airway diseases. METHODS A comprehensive search of the major electronic databases was done till March 2013. Trials comparing the effect of probiotics versus placebo were included. A predefined set of outcome measures were assessed. Continuous data were expressed as standardized mean difference with 95% CI. Dichotomous data were expressed as odds ratio with 95% CI. P value < 0.05 was considered as significant. RESULTS A total of 12 studies were included. Probiotic intake was associated with a significantly improved quality of life score in patients with allergic rhinitis (SMD -1.9 (95% CI -3.62, -0.19); P = 0.03), though there was a high degree of heterogeneity. No improvement in quality of life score was noted in asthmatics. Probiotic intake also improved the following parameters: longer time free from episodes of asthma and rhinitis and decrease in the number of episodes of rhinitis per year. Adverse events were not significant. CONCLUSION As the current evidence was generated from few trials with high degree of heterogeneity, routine use of probiotics as an additive on therapy in subjects with allergic airway diseases cannot be recommended.
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