151
|
Prakash C, Bhatia R, Kumari S, Verghese T, Datta KK. Response to hepatitis B vaccination in high risk population. THE JOURNAL OF COMMUNICABLE DISEASES 2000; 32:17-21. [PMID: 11129560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
Abstract
Hepatitis B vaccine is well established as very efficacious, but immune response to the vaccine is highly individual specific. A study involving fifty vaccinees was undertaken at the Hepatitis Laboratory, National Institute of Communicable Disease, Delhi. One ml (20 microgram) of Engerix B vaccine (recombinant yeast derived vaccine) was administered in the standard three dose schedule (0, 1 and 6 months). The sero-conversion of the vaccinees was 24%, 66%, 76% and 78% at 1 month, 6 months, 7 months, and 12 months respectively. There was no seroconversion in 22% of the vaccinees. Sero-conversion was assessed using Macro ELISA test (Ausab, Abbott Labs) for Anti HBs reactivity.
Collapse
|
152
|
Khosla A, Sen J, Kumari S. Incidence of vault haematoma after vaginal hysterectomy and its correlation with post operative morbidity. Int J Gynaecol Obstet 2000. [DOI: 10.1016/s0020-7292(00)81503-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
|
153
|
Kumari S, Simel EJ, Wolfe AJ. sigma(70) is the principal sigma factor responsible for transcription of acs, which encodes acetyl coenzyme A synthetase in Escherichia coli. J Bacteriol 2000; 182:551-4. [PMID: 10629211 PMCID: PMC94314 DOI: 10.1128/jb.182.2.551-554.2000] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Cells of Escherichia coli undergo a metabolic switch associated with the production and utilization of acetate. During exponential growth on tryptone broth, these cells excrete acetate via the phosphotransacetylase-acetate kinase (Pta-AckA) pathway. As they begin the transition to stationary phase, they instead resorb acetate, activate it to acetyl coenzyme A (acetyl-CoA) by means of the enzyme acetyl-CoA synthetase (Acs) and utilize it to generate energy and biosynthetic components via the tricarboxylic acid cycle and the glyoxylate shunt, respectively. This metabolic switch depends upon the induction of Acs. As part of our effort to dissect the mechanism(s) underlying induction and to identify the signal(s) that triggers that induction, we sought the sigma factor most responsible for acs expression. Using isogenic strains that carry a temperature sensitivity allele of the gene that encodes sigma(70) and either a wild-type or null allele of the gene that encodes sigma(S), we determined by immunoblotting, reverse transcriptase PCR, and acs::lacZ transcriptional fusion analyses that sigma(70) is the sigma factor primarily responsible for the acs transcription that cells induce during mid-exponential phase. In contrast, sigma(S) partially inhibits that transcription as cells enter stationary phase.
Collapse
|
154
|
Ahlawat SK, Jain S, Kumari S, Varma S, Sharma BK. Pheochromocytoma associated with pregnancy: case report and review of the literature. Obstet Gynecol Surv 1999; 54:728-37. [PMID: 10546277 DOI: 10.1097/00006254-199911000-00025] [Citation(s) in RCA: 103] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
UNLABELLED We report on a young woman with pheochromocytoma associated with pregnancy and review 41 other cases reported in the literature from 1988 to 1997. This review reveals that the overall maternal mortality was 4 percent and the fetal loss 11 percent; antenatal diagnosis of pheochromocytoma reduced maternal mortality to 2 percent; however, fetal loss was 14 percent. Diagnosis of pheochromocytoma was made antepartum in 83 percent of the cases. Although pheochromocytoma associated with pregnancy is rare, a high index of clinical suspicion must be kept and all those at risk must be investigated to achieve an early diagnosis and improved outcome. Once the diagnosis is confirmed, alpha-adrenergic blockade is essential and beta-blockade may be required. Magnetic resonance imaging and computerized tomography scan may be used to localize the tumor during the antenatal period. In early pregnancy, i.e., before 24 weeks, both tumor resection and medical treatment are associated with good fetal outcome; in later pregnancy, elective cesarean delivery followed by tumor resection results in favorable maternal and fetal outcome. TARGET AUDIENCE Obstetricians & Gynecologists, Family Physicians. LEARNING OBJECTIVES After completion of this article, the reader will be able to understand the clinical manifestations of a pheochromocytoma during pregnancy, how to make the diagnosis of a pheochromocytoma during pregnancy, and to know the medical and surgical management of a pheochromocytoma during pregnancy.
Collapse
|
155
|
Varma S, Bhansali A, Gill SS, Kumari S, Singh S. Peri-articular 'hard tumours' in soft tissues. Postgrad Med J 1999; 75:492-5. [PMID: 10646034 PMCID: PMC1741320 DOI: 10.1136/pgmj.75.886.492] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
|
156
|
Malhotra P, Kumari S, Kumar R, Jain S, Sharma BK. Prevalence and determinants of hypertension in an un-industrialised rural population of North India. J Hum Hypertens 1999; 13:467-72. [PMID: 10449211 DOI: 10.1038/sj.jhh.1000864] [Citation(s) in RCA: 46] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Recent studies have indicated a rising prevalence of hypertension in rural and urban areas of India. A population-based survey was carried out during 1994-1995 in seven rural and non-industrialised villages around RaipurRani block in the state of Haryana, India, to determine the prevalence of hypertension and its associated risk factors. A total of 2559 individuals (86% of the eligible population) in the 16 to 70-year age group were interviewed using a pre-tested structured questionnaire to find out the lifestyle characteristics. Three blood pressure (BP) readings were recorded with a random zero sphygmomanometer at three different times. One hundred and fourteen individuals (4.5%) were found to be hypertensive according to JNC V criteria (BP of > or = 140/90 mm Hg). Mean systolic and diastolic BPs were 116.9 and 71.7 mmHg in males and 119.1 and 72.7 mm Hg in female subjects respectively (P < 0.001). Females had significantly higher prevalence of hypertension than males (5.8% vs 3.0%, P < 0.05). Mean age of hypertensives (50.3 +/- 13.5 years) was higher than normotensives (34.9 +/- 14.5 years, P < 0.001). The prevalence of various risk factors among hypertensives as compared to normotensives were alcohol consumption (43.2% vs 23.1%, only among males, P < 0.001), higher economic status (P < 0.001) and smoking (43% vs 41.5%, P > 0.05). In addition hypertensives had higher mean weight (53.8 kg vs 48.4 kg, P < 0.001) and higher body mass index (21.5 vs 18.9 kg/m2, P < 0.001). Analysis showed that advancing age, sedentary lifestyle, higher alcohol consumption and higher body mass index are the risk factors for hypertension in the rural un-industrialised population of India.
Collapse
|
157
|
Singh SK, Dua T, Tandon A, Kumari S, Ray G, Batra S. Status of lipid peroxidation and antioxidant enzymes in hypoxic ischemic encephalopathy. Indian Pediatr 1999; 36:561-6. [PMID: 10736583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/15/2023]
Abstract
OBJECTIVE To compare the activities of key antioxidant enzymes [superoxide dismutase (SOD), glutathione peroxidase (GPx), catalase] and the level of malonyl dialdehyde (MDA) in neonates with hypoxic ischemic encephalopathy (HIE) and controls. DESIGN Prospective cross sectional study. SETTING Tertiary care level II neonatal unit of teaching hospital. METHODS Fifteen term new borns with HIE were registered for the study whereas normal term appropriate for gestational age babies were enrolled as controls. Clinical features were recorded. Activities of SOD, GPx, catalase and the content of MDA were estimated at 24 hours of age. The results obtained were statistically analyzed. RESULTS Activities of SOD and Catalase and the level of MDA were significantly higher in cases as compared to the controls. There was however no significant alternation in the activity of GPx levels in both the groups. CONCLUSION The increased activities of antioxidant enzymes are unable to counteract the excessively generated oxidants in vivo, as is evident from the increased MDA levels. Hence, oxygen free radicals may play a significant role in the pathogenesis of HIE.
Collapse
|
158
|
Singh S, Malhotra P, Venkatesh S, Kumari S, Varma S. Accidental methotrexate overdose. THE JOURNAL OF THE ASSOCIATION OF PHYSICIANS OF INDIA 1999; 47:651. [PMID: 10999176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
|
159
|
Chattopadhya D, Aggarwal RK, Baveja UK, Doda V, Kumari S. Evaluation of epidemiological and serological predictors of human immunodeficiency virus type-1 (HIV-1) infection among high risk professional blood donors with western blot indeterminate results. J Clin Virol 1998; 11:39-49. [PMID: 9784142 DOI: 10.1016/s0928-0197(98)00041-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Indeterminate pattern of results in Western blot (WBI) for human immunodeficiency virus type-1 (HIV-1) infection may represent early HIV-1 infection or may be non-specific in origin. This issue can be resolved by follow up testing upto at least 6 months resulting in psychological distress as well as in high drop out rates among those undergoing investigation pointing out the need for additional parameters that could help in determining the status of HIV-1 infection at the time of initial testing itself in individuals with WBI pattern. OBJECTIVE The objectives of the present study were: (i) to determine the frequency of HIV-1 infected individuals in a group of professional donors showing WBI patterns in initial testing on the basis of follow up serological studies; (ii) to find out if any HIV related epidemiological or serological characteristics recorded at the time of initial testing could be considered as predictor for HIV-1 infection in WBI specimens; and (iii) to evaluate two alternative serodiagnostic strategies for HIV-1 infection viz. multiple EIAs based on different antigen preparations/principles and a line immunoassay (LIA) employing recombinant antigens in resolving status of HIV-1 infection in specimens showing WBI results at initial testing. STUDY DESIGN Professional donors with WBI patterns belonging to EIA reactive and EIA nonreactive groups were subjected to study of epidemiological profile, prevalence of sexually transmitted diseases (STD) markers and follow up serological testing for HIV-1 at 6, 12, 24 and 48 weeks intervals to record any seroconversion. The initial and follow up specimens from the donors with initial WBI results were subjected to two EIAs (one based on dot immunoassay using synthetic HIV-1 antigens and other based on microwell EIA using recombinant HIV-1 proteins) as well as to LIA. RESULTS Professional donors with initial WBI results, from the EIA reactive group had higher proportion of unmarried individuals (90.3%), with history of heterosexual promiscuity (75%) and visit to STD clinics (36.1%) compared with the WBI donors from the EIA nonreactive group (72.7, 42.4 and 12.1%, respectively, P values < 0.001). Prevalence of antitreponemal antibodies was higher in the former group (16.7%) compared with the later group (1.5%, P value < 0.002). Seroconversion was recorded in 4 (7.3%) out of 55 EIA reactive WBI donors from the EIA reactive group that were characterised by high optical density (OD) values in EIA, 'p24 only' pattern of band in WB and positivity by LIA at the time of initial testing. LIA was found to be more reliable test compared with combination of EIAs to determine status of HIV-1 infection in WBI specimens at the time of initial testing. CONCLUSION The present study points out that parameters like history of heterosexual promiscuity, prevalence of STD markers, high OD values in screening EIA, 'p24' only pattern of bands in WB and positivity by LIA could have individual predictive values for HIV-1 infection in specimens showing WBI pattern of results at initial testing.
Collapse
|
160
|
Tandon A, Ramji S, Kumari S, Goyal A, Chandra D, Nigam VR. Cognitive abilities of asphyxiated survivors beyond 5 years of age. Indian Pediatr 1998; 35:605-12. [PMID: 10216669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
Abstract
OBJECTIVE To evaluate the intellectual, psychoeducational and social maturity of a cohort of unimpaired asphyxiated survivors beyond 5 years of age. DESIGN Case control study on hospital based cohorts on a longitudinal follow up at High Risk and Well Baby Clinics of a teaching hospital. METHODS The demographic data of these children was recorded. A detailed physical examination was performed. The tests of cognition included the Stanford Binet and the Raven's Progressive matrices. Academic achievement was evaluated by the Wide range achievement test-Revised (WRAT-R). Assessment of visuo-motor integration was done by the Bender Gestalt Test. The proportion of children having soft neurological signs was determined. Vineland Social Maturity Scale was performed on all children. RESULTS Fifty-four asphyxiated and 57 matched control children participated in the study. Of the 54 asphyxiated children, 27 were tested at a mean age of 7.2 +/- 1.6 years (Group 1) and 27 were tested at a mean age of 10.9 +/- 1.52 years (Group 2). The asphyxiated children as a group performed in the normal range on tests of cognition and academic achievement but were significantly disadvantaged (p < 0.005) as compared to controls. A higher percentage of asphyxiated children had low scores on the Bender Gestalt Test as compared to controls but the difference was not significant. A significantly higher proportion of asphyxiated children of both the groups showed the presence of soft neurological signs as compared to controls. Approximately 11% of the asphyxiated children performed in the abnormal range in the Vineland Social Maturity Scale. CONCLUSION Cognitive abilities of asphyxiated children beyond the age of 5 years are impaired in comparison to controls, emphasizing the need for early detection and referral for special education.
Collapse
|
161
|
Singh SK, Tandon A, Kumari S, Ravi RN, Ray GN, Batra S. Changes in anti-oxidant enzymes and lipid peroxidation in hyaline membrane disease. Indian J Pediatr 1998; 65:609-14. [PMID: 10773913 DOI: 10.1007/bf02730907] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
This study was conducted to elucidate the changes in key antioxidant enzymes e.g. Superoxide dismutase (SOD), Catalase and Glutathione peroxidase (GPx) along with lipid peroxidation (LPO) in preterm newborns having hyaline membrane disease (HMD) and thus to find out role of free radicals mediated injury in this disease. Twenty one preterm appropriate for gestational age newborns were included in the study. Eleven of them had hyaline membrane disease and ten were controls without any disease. Status of superoxide dismutase, glutathione peroxidase and catalase, the three main antioxidant enzymes and lipid peroxidation was monitored at 12-24 hours of age. SOD and catalase were found significantly elevated in cases having hyaline membrane disease along with significantly more lipid peroxidation. It is evident that free radicals result in the induction of the antioxidant enzymes; however, the elevated enzymes are unable to counteract the high concentration of the free radicals which are being produced in the diseased cases and leads to increase in lipid peroxidation in hyaline membrane disease. It is concluded that free radicals play a significant role in hyaline membrane disease and the preterm newborns have ability to induce antioxidant enzymes in response to oxidative stress.
Collapse
|
162
|
Malhotra P, Kumari S, Kumar R, Jain S, Ganguly NK, Sharma BK. Hypertension and insulin resistance in a native unindustrialised rural population of India. Int J Cardiol 1998; 65:91-9. [PMID: 9699937 DOI: 10.1016/s0167-5273(98)00110-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
A cross-sectional survey of 2964 individuals aged 16-70 years from a rural area of North India was carried out to test the hypothesis that a rural unindustrialised hypertensive population of North India has central obesity and hyperinsulinemia. Oral glucose tolerance test was carried out on 68 newly detected hypertensives, 82 age- and sex-matched community controls and 58 genetically related members of hypertensives (family controls). Fasting blood samples were examined for plasma glucose, serum insulin and lipids. Postglucose-load blood samples were examined for plasma glucose and serum insulin. Three blood pressure readings were recorded using Random Zero Sphygmomanometer. Anthropometric measurements (waist-hip ratio, subscapular and triceps skinfold thickness) of all three groups of individuals (hypertensives, community controls and family controls) were also recorded. The hypertensives had significantly higher fasting and postglucose-load serum insulin levels (P<0.05), body mass index (21.3 vs. 19 kg/m2: P<0.05), waist-hip ratio (0.89 vs. 0.85: P<0.001), subscapular (18.5 mm vs. 12.7 mm: P<0.001) and triceps fold thickness (17.6 mm vs. 12.9 mm: P<0.05) than community controls. The family controls had significantly higher systolic blood pressure than community controls (P<0.05). The lipids were not significantly different in all the three groups. Multiple logistic regression showed that both fasting and postglucose-load serum insulin were significantly associated with hypertension independent of waist-hip ratio and body mass index. The results of the present study suggest that hyperinsulinemia is related to hypertension in a rural unindustrialised population of North India.
Collapse
|
163
|
Agarwal K, Narayan S, Kumari S, Agarwal AK. Correlation of coagulation abnormalities with clinical outcome in neonates of mothers with pregnancy induced hypertension. JOURNAL OF THE INDIAN MEDICAL ASSOCIATION 1998; 96:171-3. [PMID: 9834564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
Abnormalities in coagulation profile were correlated with clinical outcome in neonates (n = 30) of mothers with pregnancy induced hypertension (PIH). Same number of neonates born to normotensive mothers was taken as control. Significant correlation was observed between decreasing gestational age and alterations in all coagulation parameters. Higher incidence of prematurity, hyperbilirubinaemia and significant prolongation in partial thromboplastin time with kaolin (PTTK) and thrombin time (TT) values were observed with increasing severity of PIH. Incidence of disseminated intravascular coagulation (DIC) was higher in preterm neonates than in term neonates.
Collapse
|
164
|
Goyal PK, Chandra J, Unnikrishnan G, Kumari S, Passah SM. Double blind randomized comparative evaluation of nimesulide and paracetamol as antipyretics. Indian Pediatr 1998; 35:519-22. [PMID: 10216646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
Abstract
OBJECTIVE To compare the efficacy and safety of nimesulide and paracetamol as antipyretic agents. DESIGN Double blind, randomized clinical trial. METHODS Hospitalized patients having fever due to a variety of infections were given either drug in a randomized manner. (Nimesulide group = 49, Paracetamol group = 50). Serial axillary temperature was recorded after drug administration and side effects monitored. RESULTS The mean temperature after one hour of drug administration was significantly lower in nimesulide group (p < 0.05). Significantly fewer doses of nimesulide were required to bring down the temperature on the first day (p < 0.001). The mean maximum temperature recorded on second and third day was significantly lower in the nimesulide group (p < 0.05). Adverse reactions were seen in the form of epigastric pain and vomiting in one patient in Nimesulide group and three in paracetamol group. CONCLUSION Nimesulide is more effective than paracetamol as an antipyretic agent and is safe for use in infants and children.
Collapse
|
165
|
Rattan A, Kumari S, Khanna N, Pandhi RK, Ray K, Bala M, Misra RS. Emergence of fluoroquinolone resistant Neisseria gonorrhoeae in New Delhi, India. Sex Transm Infect 1998; 74:229. [PMID: 9849566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023] Open
|
166
|
Mehta S, Tandon A, Dua T, Kumari S, Singh SK. Clinical assessment of nutritional status at birth. Indian Pediatr 1998; 35:423-8. [PMID: 10216623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
Abstract
OBJECTIVE Clinical assessment of nutritional status of neonate using CAN score and comparison with other methods of determining intrauterine growth. DESIGN Cross sectional study. SETTING Tertiary care hospital. SUBJECTS 637 consecutive, liveborn singleton neonates with known gestational age and no major congenital malformation. METHODS Birth weight, length, midarm circumference and head circumference recorded in newborns. Ponderal index and mid arm to head circumference ratio was calculated. Clinical assessment of nutritional status was done on the basis of CAN score and compared with other methods. RESULTS CAN score < 25 separated 60% of the babies as well nourished and 40% as malnourished. Weight for age and Ponderal Index classified 70-75% of babies as well nourished (AGA) and 25-30% as malnourished. Also MAC/HC classified nearly half the babies as well nourished and half as malnourished. CONCLUSION CAN score may be a simple clinical index for identifying fetal malnutrition and for prediction of neonatal morbidity associated with it, without the aid of any sophisticated equipments.
Collapse
|
167
|
Chakrabarti S, Varma S, Singh S, Kumari S. Low dose bolus aminocaproic acid: an alternative to platelet transfusion in thrombocytopenia? Eur J Haematol Suppl 1998; 60:313-4. [PMID: 9654162 DOI: 10.1111/j.1600-0609.1998.tb01046.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
168
|
Sharma N, Jain S, Kumari S, Varma S. Hypercalcaemia with radiographic abnormalities in chronic myeloid leukaemia. Postgrad Med J 1998; 74:301-3. [PMID: 9713619 PMCID: PMC2360905 DOI: 10.1136/pgmj.74.871.301] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
|
169
|
Nangia S, Saili A, Dutta AK, Gaur V, Singh M, Seth A, Kumari S. Neonatal mechanical ventilation--experience at a level II care centre. Indian J Pediatr 1998; 65:291-6. [PMID: 10771975 DOI: 10.1007/bf02752306] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
One hundred and fifty nine neonates were ventilated over a period of one year of whom 74 (46.54%) survived. This study aims to analyse the indications, complications and outcome of babies requiring mechanical ventilation. The early outcome measures were (i) survival rate with respect to birth weight, gestation and indication of ventilation, and (ii) Complications of assisted ventilation. One hundred and forty seven babies received IPPV and 34 received CPAP. Twenty two out of these 34 required IPPV later. Survival was cent percent on exclusive CPAP mode. HMD was the commonest indication for ventilation followed by Birth asphyxia, Apnea of prematurity, Meconium Aspiration Syndrome and Persistent Pulmonary Hypertension of the New born. Survival rates increased with increasing birth weight and gestational age, changing from 25% for < 1000 gm and 20% for < 28 wks to 53% for > 2500 gms and 50.2% for > 37 wks. Prolonged ventilatory support was needed for HMD (mean 114 hrs) and PPHN (mean 156 hrs). Commonest complication was Sepsis (26%) followed by Pulmonary hemorrhage, Pneumothorax and IVH. Lower success rates in ventilation is due to the poor survival of babies weighing < 1000 gms and those with a gestation of < 28 wks with nosocomial infections as a major complication of assisted ventilation being an additional factor.
Collapse
|
170
|
Juneja M, Dubey AP, Kumari S, Prakash C, Mittal SK. Hepatitis B and hepatitis C in multitransfused children. TROPICAL GASTROENTEROLOGY : OFFICIAL JOURNAL OF THE DIGESTIVE DISEASES FOUNDATION 1998; 19:34-6. [PMID: 9641034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
The study was conducted on 75 multitransfused children aged between 2 and 13 years who attended the Department of Paediatrics, LNJPN Hospital, New Delhi from July 1990 to July 1991. These included 64 cases of thalassaemia major, 4 cases of haemophilia, 3 patients of acute lymphatic leukaemia and one each of acute myeloid leukaemia, aplastic anemia, chronic idiopathic thrombocytopenic purpura and acute haemorrhagic pancreatitis. HBsAg was tested in all, Anti-HBc was tested in 44 patients and Anti-HCV in 43 patients. Anti HDV was tested in HBsAg positive patients and IgM anti-HAV was tested in patients suffering from hepatitis. Liver function tests were evaluated in all patients. HBsAg was positive in 31% of patients; 40% of males and 15% of females were HBsAg positive, the difference being statistically significant. 84% of patients were Anti-HBc positive, 21% were anti HCV positive, 4% were Anti HDV positive. 15% of the patients had post transfusion hepatitis. Anti HCV was present in 57% of the hepatitis patients; none had anti-HAV IgM.
Collapse
|
171
|
Singhal PC, Franki N, Kumari S, Sanwal V, Wagner JD, Mattana J. Extracellular matrix modulates mesangial cell apoptosis and mRNA expression of cathepsin-B and tissue transglutaminase. J Cell Biochem 1998; 68:22-30. [PMID: 9407311 DOI: 10.1002/(sici)1097-4644(19980101)68:1<22::aid-jcb3>3.0.co;2-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Mesangial matrix is a dynamic structure which modulates mesangial cell function. Since accumulation of matrix precedes the development of focal glomerulosclerosis, we studied the effect of different matrices on mesangial cell (MC) apoptosis. Suspended mesangial cells became apoptotic in a time dependent manner. Collagen type III did not modulate MC apoptosis when compared to cells grown on plastic. MCs grown on Matrigel, collagen type I and IV showed an increased number of apoptotic cells when compared to MCs grown on plastic. DNA end-labeling further confirmed these observations. MCs grown on Matrigel showed enhanced (P < 0.05) mRNA expression for tissue transglutaminase (TTG) and cathepsin-B. Mesangial cells grown on Matrigel also showed enhanced expression of superoxide dismutase (SOD). We conclude that mesangial cells require attachment to the matrix for their survival and alteration of the quality of matrix modulates mesangial cell apoptosis.
Collapse
|
172
|
Singh S, Wig N, Kumari S. Massive metallic mercury ingestion without toxicity. THE JOURNAL OF THE ASSOCIATION OF PHYSICIANS OF INDIA 1997; 45:897. [PMID: 11229202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
|
173
|
Singh SK, Chandra D, Ravi RN, Kumari S. Femoral hypoplasia-unusual facies syndrome. Indian Pediatr 1997; 34:747-8. [PMID: 9492409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
|
174
|
Gupta N, Jani KK, Kumari S, Sood M. Early neonatal morbidity and mortality in 'at-risk' and 'normal' term pregnancies. Indian J Pediatr 1997; 64:523-7. [PMID: 10771882 DOI: 10.1007/bf02737761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
It is a universally known fact that maternal well-being is related to neonatal health. This case-control study aims to assess the pattern and strength of association of neonatal morbidity and mortality (in first 7 days of life) in relation to the presence of obstetric & medical risk factors in the mother (indicating maternal ill-health). In 250 cases (at-risk pregnancies), 75 (30%) developed neonatal illnesses while 17 (6.8%) perinatal deaths occurred in first seven days. In the same number of controls (uncomplicated pregnancies) there were only two perinatal deaths and lesser number of newborns (45/250, 16.4%) developed neonatal diseases in the first 7 days. Perinatal deaths, (still births and early neonatal deaths), (OR = 9.05; AR = 88.2%) and neonatal illnesses (OR = 2.2 and AR = 45) were strongly associated with presence of maternal risk factors. This study supports the fact that 'at risk' pregnancies have highly significant chances of developing early (first 7 days) neonatal morbidity (p < 0.001) and mortality (p < 0.001). Still births also occurred significantly more (p < 0.005) in number among 'at risk' (cases) than normal term pregnancies (controls).
Collapse
|
175
|
Chattopadhya D, Aggarwal R, Prakash C, Sen S, Kumari S. Sexually-transmitted disease (STD) markers in multitransfused children in relation to human immunodeficiency virus type-1 (HIV-1) infection: impact of STD markers in blood donors. J Trop Pediatr 1997; 43:178-81. [PMID: 9231641 DOI: 10.1093/tropej/43.3.178] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Association of serological markers for various sexually transmitted diseases (STDs) with Human Immunodeficiency Virus type 1 (HIV-1) infection among heterosexually promiscuous blood donors is well recognized. However, possibility of similar association among children receiving transfusion from these donors has not been adequately explored. Study on the association of some STD markers with HIV-1 infection in multitransfused (MT) children showed that both HIV-1 positive and HIV-1 negative groups of children had significantly higher prevalence of hepatitis B virus (HBV) markers, i.e. HBsAg (23 and 30 per cent), anti-HBs (46 and 57 per cent), anti-HBc (18 and 23 per cent), antibodies to cytomegalovirus of IgM class (36 and 37 per cent) and IgG class (72.7 and 70 per cent), IgG antibodies to Herpes Simplex Virus type-2 (23 and 23 per cent) compared to control group. However, seropositivity for HIV-1 infection could not be attributed as a risk factor for any of these markers in the group of MT children. On the contrary, significant association of anti HBc, anti HCV, CMV IgG and antitreponemal antibody with HIV-1 infection could be recorded in the group of blood donors. It appeared that due to low prevalence of HIV-1 infection among blood donors in India, both HIV-1 positive and HIV-1 negative groups of MT children received transfusion from HIV negative donors predominantly resulting in a comparable prevalence of STD markers in both the groups of MT children due to cumulative effect of transfusion from HIV-1 negative donors.
Collapse
|