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Kaushik A, Kest H, Sood M, Steussy BW, Thieman C, Gupta S. Biofilm Producing Methicillin-Resistant Staphylococcus aureus (MRSA) Infections in Humans: Clinical Implications and Management. Pathogens 2024; 13:76. [PMID: 38251383 PMCID: PMC10819455 DOI: 10.3390/pathogens13010076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Revised: 01/10/2024] [Accepted: 01/13/2024] [Indexed: 01/23/2024] Open
Abstract
Since its initial description in the 1960s, methicillin-resistant Staphylococcus aureus (MRSA) has developed multiple mechanisms for antimicrobial resistance and evading the immune system, including biofilm production. MRSA is now a widespread pathogen, causing a spectrum of infections ranging from superficial skin issues to severe conditions like osteoarticular infections and endocarditis, leading to high morbidity and mortality. Biofilm production is a key aspect of MRSA's ability to invade, spread, and resist antimicrobial treatments. Environmental factors, such as suboptimal antibiotics, pH, temperature, and tissue oxygen levels, enhance biofilm formation. Biofilms are intricate bacterial structures with dense organisms embedded in polysaccharides, promoting their resilience. The process involves stages of attachment, expansion, maturation, and eventually disassembly or dispersion. MRSA's biofilm formation has a complex molecular foundation, involving genes like icaADBC, fnbA, fnbB, clfA, clfB, atl, agr, sarA, sarZ, sigB, sarX, psm, icaR, and srtA. Recognizing pivotal genes for biofilm formation has led to potential therapeutic strategies targeting elemental and enzymatic properties to combat MRSA biofilms. This review provides a practical approach for healthcare practitioners, addressing biofilm pathogenesis, disease spectrum, and management guidelines, including advances in treatment. Effective management involves appropriate antimicrobial therapy, surgical interventions, foreign body removal, and robust infection control practices to curtail spread within healthcare environments.
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Affiliation(s)
- Ashlesha Kaushik
- Division of Pediatric Infectious Diseases, St. Luke’s Regional Medical Center, Unity Point Health, 2720 Stone Park Blvd, Sioux City, IA 51104, USA
- Department of Pediatrics, University of Iowa Carver College of Medicine, Iowa City, IA 52242, USA
- Master of Science, Healthcare Quality and Safety, Harvard Medical School, Boston, MA 02115, USA
| | - Helen Kest
- Division of Pediatric Infectious Diseases, St. Joseph’s Children’s Hospital, 703 Main Street, Paterson, NJ 07503, USA;
| | - Mangla Sood
- Department of Pediatrics, Indira Gandhi Medical College, Shimla 171006, India;
| | - Bryan W. Steussy
- Division of Microbiology, St. Luke’s Regional Medical Center, Unity Point Health, 2720 Stone Park Blvd, Sioux City, IA 51104, USA;
| | - Corey Thieman
- Division of Pharmacology, St. Luke’s Regional Medical Center, Unity Point Health, 2720 Stone Park Blvd, Sioux City, IA 51104, USA;
| | - Sandeep Gupta
- Division of Pulmonary and Critical Care, St. Luke’s Regional Medical Center, Unity Point Health, 2720 Stone Park Blvd, Sioux City, IA 51104, USA;
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Joseph J, Jalal R, Sood M, Chellani H, Pandey RM, Goyal R, Ramji S, Dasgupta R. Turning the Gaze from Survive to Thrive for Children in India: Learnings from Two Case Studies. Indian J Pediatr 2023; 90:71-76. [PMID: 37540471 DOI: 10.1007/s12098-023-04712-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Accepted: 04/19/2023] [Indexed: 08/05/2023]
Abstract
Despite significant efforts and progress made in newborn care programs in India, implementation gaps persist across the continuum of care. The present case studies of two districts in Himachal Pradesh revealed that pathways of care were often fragmented with inconsistent linkages between facility and community due to poor documentation, lack of tiered referral, health system weaknesses, low utilization of primary level institutions, and inadequate post-natal home visits by Accredited Social Health Activists (ASHAs). Involvement of healthcare providers (HCPs) and frontline health workers (FHWs) was low and uneven in generating awareness across the districts with limited participation in supporting care in the community. Ensuring functionality of health centers and first-level care facilities; strengthening referral systems; adequate/trained human resources; strengthening routine health management systems, discharge processes and community-based care with adequate integration with facilities are necessary in closing access gaps.
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Affiliation(s)
- Jessy Joseph
- Global Access Research, International AIDS Vaccine Initiative (IAVI), New Delhi, India
| | - Ruchita Jalal
- Global Access Research, International AIDS Vaccine Initiative (IAVI), New Delhi, India
| | - Mangla Sood
- Department of Pediatrics, Indira Gandhi Medical College, Shimla, India
| | - Harish Chellani
- (Former) Department of Pediatrics, Vardhman Mahavir Medical College, New Delhi, India
| | - R M Pandey
- (Former) Department of Biostatistics, All India Institute of Medical Science (AIIMS), New Delhi, India
| | - Rajat Goyal
- International AIDS Vaccine Initiative (IAVI), New Delhi, India
| | - Siddarth Ramji
- (Former) Department of Neonatology, Maulana Azad Medical College, New Delhi, India
| | - Rajib Dasgupta
- Centre of Social Medicine and Community Health, School of Social Sciences, Jawaharlal Nehru University, Room No 204, New Delhi, India.
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Sood M, Sharma S, Sood S, Sharma V. Diagnostic accuracy of urine based lipoarabinomannan point of care tuberculosis diagnostic test in HIV negative children: a systematic review and meta-analysis. Diagn Microbiol Infect Dis 2023; 105:115879. [PMID: 36657360 DOI: 10.1016/j.diagmicrobio.2022.115879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Revised: 11/15/2022] [Accepted: 12/04/2022] [Indexed: 12/13/2022]
Abstract
Tuberculosis is predicted to be a major undocumented cause of mortality in children. This systematic review with meta-analysis assessed the diagnostic accuracy of Lipoarabinomannan antigen testing (FujiLAM) in urine in HIV-negative children with TB-like signs and symptoms. PubMed, EMBASE, Scopus, Cochrane database and Google Scholar search engine were searched to identify relevant studies from earliest records to June 2022 without any language restriction. Three studies were finalized, patients were recruited from Africa and Haiti. Among microbiologically confirmed pediatric TB patients, pooled sensitivity and specificity of FujiLAM (with 95% CI) was 52% (35%-69%) and 90% (85%-93%) respectively. In both clinical (unconfirmed) and microbiological confirmed TB cases, sensitivity reduced to 24% (16%-34%) while specificity was 91%(80%-97%). We concluded that due to ease in obtaining urine sample, FujiLAM can be used as point-of-care TB test in HIV negative children, however more data from different population is needed.
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Affiliation(s)
- Mangla Sood
- Department of Paediatrics, Indira Gandhi Medical College, Shimla, Himachal Pradesh, India.
| | - Seema Sharma
- Department of Pediatrics, Dr RPGMC, Tanda at Kangra, Himachal Pradesh, India
| | - Sandeep Sood
- Department of Obst and Gynae, Military Hospital, Chennai, India
| | - Vipin Sharma
- Department of Orthopaedics, Dr Rajendra Prasad Government Medical College, Kangra at Tanda, Himachal Pradesh, India
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Bagri NK, Khan M, Pandey RM, Lodha R, Kabra SK, Angurana SK, Awasthi S, Bamnawat H, Bhat JI, Bhutia TD, Charoo BA, Choudhary A, Choudhary B, Das RR, Dwibedi B, Ghosh S, Girish M, Gulla KM, Goyal JP, Gupta P, I S, Jindal A, John J, Joshi P, Kaur R, Khera D, Kumar A, Kumar P, Kumar P, Lalitha AV, Maheshwari M, Malik S, Mondal R, Muralidharan J, Pawar G, Prasad A, Rao SK, Ratageri VH, Sarkar M, Satpathy AK, Sankar J, Sharma S, Singh A, Singh K, Singhal T, Sood M, Sudeepthi SV, Tiwari L, Verma N, Yonzon R. Initial Immunomodulation and Outcome of Children with Multisystem Inflammatory Syndrome Related to COVID-19: A Multisite Study from India. Indian J Pediatr 2022; 89:1236-1242. [PMID: 35699843 PMCID: PMC9192925 DOI: 10.1007/s12098-022-04254-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Accepted: 04/11/2022] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To determine the outcomes in children with MIS-C receiving different immunomodulatory treatment. METHODS In this multicentric, retrospective cohort study, data regarding treatment and outcomes of children meeting the WHO case definition for MIS-C, were collected. The primary composite outcome was the requirement of vasoactive/inotropic support on day 2 or beyond or need of mechanical ventilation on day 2 or beyond after initiation of immunomodulatory treatment or death during hospitalization in the treatment groups. Logistic regression and propensity score matching analyses were used to compare the outcomes in different treatment arms based on the initial immunomodulation, i.e., IVIG alone, IVIG plus steroids, and steroids alone. RESULTS The data of 368 children (diagnosed between April 2020 and June 2021) meeting the WHO case definition for MIS-C, were analyzed. Of the 368 subjects, 28 received IVIG alone, 82 received steroids alone, 237 received IVIG and steroids, and 21 did not receive any immunomodulation. One hundred fifty-six (42.39%) children had the primary outcome. On logistic regression analysis, the treatment group was not associated with the primary outcome; only the children with shock at diagnosis had higher odds for the occurrence of the outcome [OR (95% CI): 11.4 (5.19-25.0), p < 0.001]. On propensity score matching analysis, the primary outcome was comparable in steroid (n = 45), and IVIG plus steroid (n = 84) groups (p = 0.515). CONCLUSION While no significant difference was observed in the frequency of occurrence of the primary outcome in different treatment groups, data from adequately powered RCTs are required for definitive recommendations.
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Affiliation(s)
- Narendra Kumar Bagri
- Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, 110029, India
| | - M Khan
- Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, India
| | - R M Pandey
- Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, India
| | - Rakesh Lodha
- Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, 110029, India.
| | - S K Kabra
- Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, 110029, India
| | | | - Suresh Kumar Angurana
- Department of Pediatrics, Advanced Pediatric Center, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Shally Awasthi
- Department of Pediatrics, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Harshita Bamnawat
- Department of Pediatrics, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Javeed Iqbal Bhat
- Department of Pediatrics, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, Jammu & Kashmir, India
| | - Tsultem D Bhutia
- Department of Pediatrics, New STNMMS Hospital, Gangtok, Sikkim, India
| | - Bashir Ahmad Charoo
- Department of Pediatrics, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, Jammu & Kashmir, India
| | - Abhijit Choudhary
- Department of Pediatrics, All India Institute of Medical Sciences, Nagpur, Maharashtra, India
| | - Bharat Choudhary
- Department of Pediatrics, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Rashmi Ranjan Das
- Department of Pediatrics, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Bhagirathi Dwibedi
- Department of Pediatrics, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Sanajit Ghosh
- Department of Pediatrics, Medical College Kolkata, Kolkata, West Bengal, India
| | - Meenakshi Girish
- Department of Pediatrics, All India Institute of Medical Sciences, Nagpur, Maharashtra, India
| | - Krishna Mohan Gulla
- Department of Pediatrics, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Jagdish Prasad Goyal
- Department of Pediatrics, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Prakriti Gupta
- Department of Pediatrics, All India Institute of Medical Sciences, Patna, Bihar, India
| | - Shivanand I
- Department of Pediatrics, KIMS, Hubbali, Karnataka, India
| | - Atul Jindal
- Department of Pediatrics, All India Institute of Medical Sciences, Raipur, India
| | - Joseph John
- Department of Pediatrics, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Preetha Joshi
- Department of Pediatrics, Kokilaben Dhirubhai Ambani Hospital and Medical Research Institute, Mumbai, India
| | - Ravleen Kaur
- Department of Pediatrics, Dr Rajendra Prasad Government Medical College Kangra at Tanda, Himachal Pradesh, India
| | - Daisy Khera
- Department of Pediatrics, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Amit Kumar
- Department of Pediatrics, All India Institute of Medical Sciences, Patna, Bihar, India
| | - Pradeep Kumar
- Department of Pediatrics, All India Institute of Medical Sciences, Patna, Bihar, India
| | - Prawin Kumar
- Department of Pediatrics, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - A V Lalitha
- Department of Pediatric Intensive Care, St. John's Medical College and Hospital, Bangalore, Karanataka, India
| | - Mahesh Maheshwari
- Department of Pediatrics, All India Institute of Medical Sciences, Bhopal, India
| | - Shikha Malik
- Department of Pediatrics, All India Institute of Medical Sciences, Bhopal, India
| | - Rakesh Mondal
- Department of Pediatrics, Medical College Kolkata, Kolkata, West Bengal, India
| | - Jayashree Muralidharan
- Department of Pediatrics, Advanced Pediatric Center, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Gayatri Pawar
- Department of Pediatrics, KIMS, Hubbali, Karnataka, India
| | - Arun Prasad
- Department of Pediatrics, All India Institute of Medical Sciences, Patna, Bihar, India
| | - Sunil Kumar Rao
- Department of Pediatrics, Institute of Medical Sciences, BHU, Varanasi, Uttar Pradesh, India
| | | | - Mihir Sarkar
- Department of Pediatrics, Medical College Kolkata, Kolkata, West Bengal, India
| | - Amit Kumar Satpathy
- Department of Pediatrics, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Jhuma Sankar
- Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, 110029, India
| | - Seema Sharma
- Department of Pediatrics, Dr Rajendra Prasad Government Medical College Kangra at Tanda, Himachal Pradesh, India
| | - Ankur Singh
- Department of Pediatrics, Institute of Medical Sciences, BHU, Varanasi, Uttar Pradesh, India
| | - Kuldeep Singh
- Department of Pediatrics, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Tanu Singhal
- Department of Pediatrics, Kokilaben Dhirubhai Ambani Hospital and Medical Research Institute, Mumbai, India
| | - Mangla Sood
- Department of Pediatrics, IGMC, Shimla, Himachal Pradesh, India
| | | | - Lokesh Tiwari
- Department of Pediatrics, All India Institute of Medical Sciences, Patna, Bihar, India
| | - Nishant Verma
- Department of Pediatrics, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Ruth Yonzon
- Department of Pediatrics, New STNMMS Hospital, Gangtok, Sikkim, India
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Joseph J, Jalal R, Nagrath M, Dasgupta R, Chellani H, Pandey RM, Sood M, Goyal R, Ramji S. Growth Faltering Among Discharged Babies from Inpatient Newborn Care Facilities: Learnings from Two Districts of Himachal Pradesh. Indian Pediatr 2022; 59:763-768. [PMID: 35822489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
OBJECTIVE To determine the burden of early growth faltering and understand the care practices for small and sick babies discharged from newborn units in the district. STUDY DESIGN Observational and follow-up study. PARTICIPANTS 512 babies discharged from two Special Newborn Care Units (SNCUs) and four Newborn Stabilization Units (NBSUs) in two districts of Himachal Pradesh. METHODS Anthropometric assessments, interview of mothers and Accredited Social Health Activists (ASHAs) conducted between August, 2018 and March, 2019. Change in weight-for-age z-score (DWAZ) of <-0.67SD between birth and assessment was used to define growth faltering. OUTCOMES Proportion of growth faltering (or catch-down growth) in small and sick babies discharged from SNCUs and NBSUs, and infant care practices. RESULTS Growth faltering was observed in a significant proportion of both term (30%) and preterm (52.6%) babies between 1 to 4 months of age. Among babies with growth faltering (n=180), 73.9% received a home visit by ASHA, and only 36.7% received a follow-up visit at a facility. There were 71.3% mothers counselled at discharge (mostly informed about breast feeding). Most (96.7%) mothers did not perceive inadequate weight gain in their babies post-discharge. During home visits, ASHAs weighed 61.6% of the infants with growth faltering. Amongst infants who had growth faltering, only 49.6% of mothers had been provided information about their infant's growth and 57.1% mothers had received breastfeeding counselling. CONCLUSION Small and sick newborn infants (both term and preterm babies) discharged from special care newborn units are at increased risk of early growth faltering. Follow-up care provided to these infants is inadequate. There is a need to strengthen both facility-based and home-based follow up of small and sick newborn infants discharged from newborn care facilities.
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Affiliation(s)
- Jessy Joseph
- International Aids Vaccine Initiative (IAVI), India
| | | | | | - Rajib Dasgupta
- Department of Community Health, Jawaharlal Nehru University, New Delhi
| | - Harish Chellani
- Department of Pediatrics, Vardhman Mahavir Medical College, New Delhi
| | - R M Pandey
- Department of Biostatistics, All India Institute of Medical Science (AIIMS), New Delhi
| | - Mangla Sood
- Department of Pediatrics, Indira Gandhi Medical College, Shimla, Himachal Pradesh
| | - Rajat Goyal
- International Aids Vaccine Initiative (IAVI), India
| | - Siddarth Ramji
- Department of Neonatology, Maulana Azad Medical College, New Delhi. Correspondence to: Dr Siddarth Ramji, 9/10 Chandrabagh Avenue 2nd Street, Dr RK Salai, Chennai 600004, Tamil Nadu.
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Joseph J, Jalal R, Nagrath M, Dasgupta R, Chellani H, Pandey RM, Sood M, Goyal R, Ramji S. Growth Faltering Among Discharged Babies from Inpatient Newborn Care Facilities: Learnings from Two Districts of Himachal Pradesh. Indian Pediatr 2022. [DOI: 10.1007/s13312-022-2618-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Kaushik A, Gupta S, Sood M, Steussy BW, Noll BW. Smart and connected devices in point-of-care molecular diagnostics: what role can they play in the response to COVID-19? Expert Rev Mol Diagn 2022; 22:775-781. [PMID: 36069357 DOI: 10.1080/14737159.2022.2122711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
INTRODUCTION Coronavirus disease-2019 (COVID-19) has been a huge public health challenge that has led to significant morbidity and mortality across the globe. Given the high prevalence and continued circulation of SARS-CoV-2 infection globally, accurate and rapid point-of-care testing is critical. AREAS COVERED Knowledge of role of digital technology including smart and connected devices in rapid diagnosis of COVID-19 is an evolving area of scientific investigation. This review discusses the importance of rapid at-home point-of-care testing, highlighting the possible role of smart and connected device-based molecular diagnostics for COVID-19. EXPERT OPINION Accurate and rapid diagnostic modalities have the potential to improve accessibility and efficiency of diagnosis of symptomatic and asymptomatic patients and could be instrumental in timely implementation of appropriate therapeutic interventions as well as public health measures to mitigate spread of infection. With emerging challenges like newer, virulent viral variants, global vaccine shortages and vaccine hesitancy, accurate diagnostic testing with the ability to rapidly identify infection remains critical and has the potential to be pivotal in pandemic control. Digital technologies are likely to become important tools in future of healthcare and technological advancements may play a crucial role in response to COVID-19 with the goal of ultimately overcoming this pandemic.
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Affiliation(s)
- Ashlesha Kaushik
- Unity Point Health at St. Luke's Regional Medical Center.,University of Iowa Carver College of Medicine
| | - Sandeep Gupta
- Unity Point Health at St. Luke's Regional Medical Center
| | - Mangla Sood
- Indira Gandhi Medical College, Shimla, India
| | | | - Bryce W Noll
- Unity Point Health at St. Luke's Regional Medical Center
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Bhardwaj P, Sood M, Singh R. Pediatric Scrub Typhus Manifesting with Multisystem Inflammatory Syndrome: A New Cause for Confusion or Concern—A Case Series. Indian J Crit Care Med 2022; 26:723-727. [PMID: 35836621 PMCID: PMC9237145 DOI: 10.5005/jp-journals-10071-24200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
The pandemic of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has discovered a new disease called multisystem inflammatory syndrome in children (MIS-C). In developing nations, pediatricians must be mindful of the similarities between MIS-C and other tropical fevers such as scrub typhus. Not only should such patients be kept on high alert to rule out tropical diseases and receive appropriate treatment, such as steroids or immunomodulatory medications, but this is also concerning because, if rickettsial or bacterial infection is not detected through cultures and serology, steroid, or immunomodulatory treatment alone can be fatal. How to cite this article: Bhardwaj P, Sood M, Singh R. Pediatric Scrub Typhus Manifesting with Multisystem Inflammatory Syndrome: A New Cause for Confusion or Concern—A Case Series. Indian J Crit Care Med 2022;26(6):723–727.
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Affiliation(s)
- Parveen Bhardwaj
- Department of Pediatrics, Indira Gandhi Medical College, Shimla, Himachal Pradesh, India
| | - Mangla Sood
- Department of Pediatrics, Indira Gandhi Medical College, Shimla, Himachal Pradesh, India
- Mangla Sood, Department of Pediatrics, Indira Gandhi Medical College, Shimla, Himachal Pradesh, India, Phone: +91 9418453465, e-mail:
| | - Rajender Singh
- Department of Pediatrics, Indira Gandhi Medical College, Shimla, Himachal Pradesh, India
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Sharma S, Sood M, Sharma K, Sood I. Effect of a quality improvement package on reducing newborn mortality from 26 to 14 in a Himalayan North Indian State. Indian J Public Health 2022; 66:176-181. [PMID: 35859501 DOI: 10.4103/ijph.ijph_1647_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023] Open
Abstract
BACKGROUND In India, newborn mortality remains high due to a number of factors, including poor quality of care at health facilities. The experience of executing complete neonatal care quality improvement (QI) package at selected hospitals in Himachal Pradesh and reduction in newborn mortality rate (NMR) is described in this study. OBJECTIVE The short-term objective was the participants' retention of knowledge and skills, and the achievement of uniform QI objectives following training and after a minimum of 6 months. Overall reduction in NMR was long-term objective. METHODS Newborn care QI package was implemented according to India Newborn Action Plan over a period of 48 months from 2013 to 2016, through infrastructure, trainings, and supportive supervision. RESULTS Total 13 health facilities were upgraded; 350 staff nurses and medical officers were trained. The mean posttraining knowledge score was 75% compared to 29% in the pretraining test, and 63% 1 year later. The competencies of health workers in the care of high-risk babies and 12 QI targets had improved, resulting in a 46% reduction in neonatal mortality in the state across all gestations and weights based on sample registration survey. CONCLUSION Implementation of a bundle of evidence-based practices in low-resource setting for health system strengthening for intrapartum and neonatal care was linked to changed care behaviors among health-care providers, and reduction in NMR.
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Affiliation(s)
- Seema Sharma
- Associate Professor, Department of Pediatrics, Dr. RPG Medical College, Kangra, Himachal Pradesh, India
| | - Mangla Sood
- Associate Professor, Department of Pediatrics, Indira Gandhi Medical College, Shimla, Himachal Pradesh, India
| | - Kavya Sharma
- Medical Student, Department of Pediatrics, MM Medical College, Solan, Himachal Pradesh, India
| | - Ishaan Sood
- Medical Student, Department of Pediatrics, Indira Gandhi Medical College, Shimla, Himachal Pradesh, India
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Sood M, Singh R, Bhardwaj P, Sood I. Burden of disease and survival rate amongst hospitalized newborns in Himalayan region in North India. J Family Med Prim Care 2022; 11:3058-3065. [PMID: 36119271 PMCID: PMC9480672 DOI: 10.4103/jfmpc.jfmpc_2025_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2021] [Revised: 01/15/2022] [Accepted: 02/03/2022] [Indexed: 11/21/2022] Open
Abstract
Objective: To describe the patient population, priority diseases, and outcomes in neonates admitted to neonatal unit in the Himalayan region of North India. Study Design: The retrospective study was conducted at a University teaching hospital in Himachal Pradesh, and captured anonymized data on all admissions in newborn unit over 6-year period. Results: Total 12449 newborns were admitted, 4669 were outborn, M:F of 1.35:1 and 81% of them were discharged successfully. Overall admissions surged by 76 percent in six years, preterm admissions increased by 41%. During the same period delivery load grew by 24.7%. Majority 64.9% were full-term; 50.4% (6279/12449) of neonates were low birthweight (LBW; <2.5 kg) and 3.8% were Extreme LBW (ELBW; <1.0 kg). Among intramural, out of 20.2% preterm, 1.8% were <28 week; compared to 1.5% <28 week and 14.1% preterm in extramural. The intrauterine growth restriction rate was 17.6% for intramural and 19.3% for extramural, respectively. The most common morbidities were prematurity (40.2% & 27%), jaundice (32.6% & 27.5%), RDS and respiratory problems (19.2% & 9.8%), sepsis (11.3% & 23.5%), and perinatal asphyxia (6.2% and 7.5%) among inborn and outborn respectively. Total 798 (6.4%) newborns died, 10.5% of all deaths happened within 24 hours; mortality was very high amongst ELBW (110/205, 53.7%) and very preterm infants <28 weeks (81/135,60%). Only 993 inborn and 18 outborn received antenatal corticosteroids, with only 383 inborn and 4 outborn receiving four doses of Dexamethasone. Low gestational age, LBW, less of antenatal corticosteroids, outborns, male sex, and congenital deformity were all found to have a significant association with death (P < 0.001). Conclusion: Preterm accounts for a considerable majority of our total admissions. Greater efforts and investment in better prenatal care, infrastructure, therapeutic facilities, manpower, and periodic training and review of staff nurses are all urgently needed to address the extremely high burden of illnesses and mortality among hospitalized newborns; otherwise, lowering the NMR will remain an unattainable goal.
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Soorya RK, Sood M, Dhiman D. Clinicolaboratory Profile and Outcome of Serologically Confirmed Scrub Typhus among Children from Sub Himalayan Tribal District of India: A Hospital-based Cross-sectional Study. J Clin Diagn Res 2022. [DOI: 10.7860/jcdr/2022/57061.16778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Introduction: Scrub typhus is transmitted by the bite of the larva (chigger) of a microscopic trombiculidae mite (Leptotrombidium) found in moist areas and vegetation, which serves as both vector and reservoir. Scrub typhus is an often neglected and misdiagnosed febrile illness; clinical suspicion is the only key to diagnosis. Aim: To study clinicolaboratory profile and outcome of serologically confirmed scrub typhus in children from sub Himalayan tribal district of India. Materials and Methods: This cross-sectional observational study was conducted in Department of Paediatrics at Government District Hospital, Chamba, Himachal Pradesh, India, from May 2019 to April 2020. Children upto 18 years admitted with positive Immunoglobulin M (IgM) antibodies for scrub typhus were enrolled. The observational data including detail history and examination, relevant laboratory investigation and treatment was analysed by Statistical Package for Social Sciences (SPSS) software version 18.0 and Chi-square test with p-value <0.05 was considered statistically significant. Results: There were total 55 patients with scrub typhus, mean age was 9.2 years, most common age group was 7-12 years, 51% were male. Fever was most common complaint, followed by vomiting (27.3%), abdomen pain (25.4%), respiratory (1.8%), and rash (9%). Clinical examination findings were generalised lymphadenopathy in 46 (83.6%) patients and splenomegaly in 29 (52.7%). Eight patients presented with respiratory signs and tachypnea at the time of admission. Eschar was present in only 3 (5.5%) patients. Sign of meningeal irritation was present in 4 (7.3% cases and low GCS score (below 9) observed in 7 (12.7%) patients. Eight patients required mechanical ventilatory support. Nineteen patients were prescribed doxycycline alone; while 34 were given both azithromycin and doxycycline. There were total five deaths; on multivariate logistic regression, respiratory complaint, need for mechanical ventilation, pain abdomen with liver damage, history of seizures and duration of fever more than 4 days before presentation to hospital were associated with adverse outcome. Conclusion: The prevalence of scrub typhus is considerably high during rainy season, and should be considered as a differential diagnosis of fever among children in this period regardless of the presence of an eschar. Immediate medical care, treatment with doxycycline with early defervescence of fever reduce mortality
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Rai S, Sood M, Kaur A. Is perinatal asphyxia associated with an increase in serum bilirubin in neonates? A case-control study. J Family Med Prim Care 2022; 11:3840-3843. [DOI: 10.4103/jfmpc.jfmpc_1018_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2021] [Revised: 10/18/2021] [Accepted: 10/20/2021] [Indexed: 11/04/2022] Open
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Miranda B, Jica R, Pinto-Lopes R, Mopuri N, Sood M, Tare M, Shelley O, El-Muttardi N. 1164 St Andrew’s COVID Surgery Safety (StACS) Study: Skin Cancer. Br J Surg 2021. [DOI: 10.1093/bjs/znab258.058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abstract
Background
Skin cancer represents the most common malignancy worldwide and it is imperative that we develop strategies to ensure safe and sustained delivery of cancer care which are resilient to the ongoing impact of COVID-19.
Objective
This study prospectively evaluates the COVID-19 related patient risk and skin cancer management at a single tertiary referral centre, which rapidly implemented national COVID-safety guidelines.
Method
A prospective cohort study was performed in all patients who underwent surgery for elective skin cancer service management, during the UK COVID-19 pandemic peak (April-May 2020). ‘Real-time’ 30-day hospital database deceased data were collected. Random selection was undertaken for patients who either underwent operative (surgery group) management or remained on the waiting list (control group); these groups were also prospectively followed-up within a controlled cohort study design and telephoned at the end of June 2020 for the control group or 30 days post-operatively.
Results
Of the 767 patients who had operations, there were no COVID-19 related deaths. Both the surgery (n = 384) and control (n = 100) groups were matched for age, sex, ethnicity, BMI, presence of comorbidities, smoking and positive COVID-19 contact. There were no differences in post-operative versus any symptom development (1.3%, 5/384 vs. 4%, 4/100, p = 0.093), or proportion of positive tests (8.6%, 33/384 vs. 8%, 8/100; p = 0.849), between the surgery and control groups.
Conclusions
These data support continued and safe service provision, and no increased risk to skin cancer patients who require surgical management, which is vital for continuation of cancer treatment in the context of a pandemic.
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Affiliation(s)
- B Miranda
- Mid and South Essex Hospital, Chelmsford, United Kingdom
| | - R Jica
- Mid and South Essex Hospital, Chelmsford, United Kingdom
| | - R Pinto-Lopes
- Mid and South Essex Hospital, Chelmsford, United Kingdom
| | - N Mopuri
- Mid and South Essex Hospital, Chelmsford, United Kingdom
| | - M Sood
- Mid and South Essex Hospital, Chelmsford, United Kingdom
| | - M Tare
- Mid and South Essex Hospital, Chelmsford, United Kingdom
| | - O Shelley
- Mid and South Essex Hospital, Chelmsford, United Kingdom
| | - N El-Muttardi
- Mid and South Essex Hospital, Chelmsford, United Kingdom
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Sood M, Sharma S. “Authors’ Reply: Emerging Evidence on Multisystem Inflammatory Syndrome in Children Associated with SARS-CoV-2 Infection”. SN Compr Clin Med 2021; 3:2000-2001. [PMID: 34254052 PMCID: PMC8264164 DOI: 10.1007/s42399-021-01010-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Accepted: 06/25/2021] [Indexed: 11/29/2022]
Abstract
With increased patients of severe acute respiratory syndrome coronavirus 2 infection, more children with multisystem inflammatory syndrome (MIS-C) are being reported worldwide. Our focus is to share the new evidence-based findings and experiences during the early stage of the pandemic with the researchers on a larger platform . We hope this review will help to frame appropriate strategies and guidelines for management of MIS-C.
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Affiliation(s)
- Mangla Sood
- Department of Pediatrics, Indira Gandhi Medical College, Shimla, Himachal Pradesh 171001 India
| | - Seema Sharma
- Department of Pediatrics, Dr RP Govt. Medical College, at Kangra, Tanda, India
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HUNDEMER G, Talarico R, Sood M. POS-100 OUTPATIENT PHARMACOLOGIC TREATMENTS FOR RAAS INHIBITOR-RELATED HYPERKALEMIA AND THE RISK OF RECURRENCE. Kidney Int Rep 2021. [DOI: 10.1016/j.ekir.2021.03.108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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MASSICOTTE-AZARNIOUCH D, Petrcich W, Walsh M, Canney M, Hundemer G, Milman N, Hladunewich M, Fairhead T, Sood M. POS-154 ASSOCIATION OF ANCA VASCULITIS AND CARDIOVASCULAR EVENTS: A POPULATION-BASED COHORT STUDY. Kidney Int Rep 2021. [DOI: 10.1016/j.ekir.2021.03.164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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17
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Akbari A, Kunkel E, Bota S, Harel Z, Le Gal G, Cox C, Hundemer G, Canney M, Clark E, Massicotte-Azarinouch D, Eddeen A, Knoll G, Sood M. POS-468 PROTEINURIA AND VENOUS THROMBOEMBOLISM IN PREGNANCY: A POPULATION-BASED COHORT STUDY. Kidney Int Rep 2021. [DOI: 10.1016/j.ekir.2021.03.495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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18
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Sood M, Sharma S. Cutaneous manifestations among COVID-19 patients. Indian J Paediatr Dermatol 2021. [DOI: 10.4103/ijpd.ijpd_116_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Sood M, Roach V, Sood I. Paraquat poisoning case series during Covid-19 pandemic. J Pediatr Crit Care 2021. [DOI: 10.4103/jpcc.jpcc_177_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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20
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Goyal N, Rongsen-Chandola T, Sood M, Sinha B, Kumar A, Qazi SA, Aboubaker S, Nisar YB, Bahl R, Bhan MK, Bhandari N. Management of possible serious bacterial infection in young infants closer to home when referral is not feasible: Lessons from implementation research in Himachal Pradesh, India. PLoS One 2020; 15:e0243724. [PMID: 33351810 PMCID: PMC7755274 DOI: 10.1371/journal.pone.0243724] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Accepted: 11/28/2020] [Indexed: 11/18/2022] Open
Abstract
Background Government of India and the World Health Organization have guidelines for outpatient management of young infants 0–59 days with signs of Possible Serious Bacterial Infection (PSBI), when referral is not feasible. Implementation research was conducted to identify facilitators and barriers to operationalizing these guidelines. Methods Himachal Pradesh government implemented the guidelines in program settings supported by Centre for Health Research and Development, Society for Applied Studies. The strategy included community sensitization, skill enhancement of Accredited Social Health Activists (ASHA), Auxiliary Nurse Midwives (ANMs) and Medical Officers (MOs) to identify PSBI and treat when referral was not feasible. The research team collected information on facilitators and barriers. A technical support unit provided training and oversight. Findings Among 1997 live births from June 2017 to January 2019, we identified 160 cases of PSBI in young infants resulting in a coverage of 80%, assuming an incidence of 10%. Of these,29(18.1%) had signs of critical illness (CI), 92 (57.5%) had clinical severe infection (CSI), 5 (3.1%)had severe pneumonia (only fast breathing in young infants 0–6 days), while 34 (21%) had pneumonia (only fast breathing in young infants 7–59 days). Hospital referral was accepted by 48/160 (30%), whereas 112/160 (70%) were treated with the simplified treatment regimens at primary level facilities. Of the 29 infants with CI, 18 (62%) accepted referral; 26 (90%) recovered while 3 (10%) who had accepted referral, died. Of the 92 infants who had CSI, 86 (93%) recovered, 65 (71%) received simplified treatment and one infant who had accepted referral, died. All the five infants who had severe pneumonia, recovered; 3 (60%) had received simplified treatment. Of the 34 pneumonia cases, 33 received simplified treatment of which 5 (15%) failed treatment; two out of these 5 died. Overall, 6/160 infants died (case-fatality-rate 3.4%); 2 in the simplified treatment (case-fatality-rate 1.8%) and 4 in the hospital group (case-fatality-rate 8.3%). Delayed identification and care-seeking by families and health system weaknesses like manpower gaps and interrupted supplies were challenges in implementation. Conclusions Implementation of the guidelines in program settings is possible and acceptable. Scaling up would require creating community awareness, early identification and appropriate care-seeking, strengthening ASHA home-visitation program, building skills and confidence of MOs and ANMs, uninterrupted supplies and a dependable referral system.
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Affiliation(s)
- Nidhi Goyal
- Centre for Health Research and Development, Society for Applied Studies, Kalu Sarai, New Delhi, India
| | - Temsunaro Rongsen-Chandola
- Centre for Health Research and Development, Society for Applied Studies, Kalu Sarai, New Delhi, India
- * E-mail:
| | - Mangla Sood
- Department of Pediatrics, Indira Gandhi Medical College, Shimla and Child Health, National Health Mission, Himachal Pradesh, India
| | - Bireshwar Sinha
- Centre for Health Research and Development, Society for Applied Studies, Kalu Sarai, New Delhi, India
| | - Amit Kumar
- Centre for Health Research and Development, Society for Applied Studies, Kalu Sarai, New Delhi, India
| | - Shamim Ahmad Qazi
- Department of Maternal, Newborn, Child and Adolescent Health and Ageing, World Health Organization, Geneva, Switzerland
| | - Samira Aboubaker
- Department of Maternal, Newborn, Child and Adolescent Health and Ageing, World Health Organization, Geneva, Switzerland
| | - Yasir Bin Nisar
- Department of Maternal, Newborn, Child and Adolescent Health and Ageing, World Health Organization, Geneva, Switzerland
| | - Rajiv Bahl
- Department of Maternal, Newborn, Child and Adolescent Health and Ageing, World Health Organization, Geneva, Switzerland
| | - Maharaj Kishan Bhan
- Indian Institute of Technology-Delhi, New Delhi, India
- Knowledge Integration and Translational Platform (KnIT), Biotechnology Industry Research Assistance Council (BIRAC), New Delhi, India
| | - Nita Bhandari
- Centre for Health Research and Development, Society for Applied Studies, Kalu Sarai, New Delhi, India
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Affiliation(s)
- Ashlesha Kaushik
- Chief, Pediatric Infectious Diseases and COVID-19 Incident Command, Unity Point Health at St. Lukes Regional Medical Center; Department of Pediatrics, University of Iowa, Carver College of Medicine, Iowa, IA, USA.
| | - Sandeep Gupta
- Director, Pulmonary Rehabilitation, COVID-19 Critical Care Incident Command; Division of Pulmonary and Critical Care, Unity Point Health at St. Lukes Regional Medical Center, Iowa, IA, USA
| | - Mangla Sood
- Former State Child Health Lead; Department of Pediatrics, Indira Gandhi Medical College, Shimla, Himachal Pradesh, India
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22
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Gupta S, Kaushik A, Sood M. Recent developments in COVID-19 therapeutics & current evidence for COVID-19-associated multisystem inflammatory syndrome. Indian J Med Res 2020; 152:149-151. [PMID: 32883919 PMCID: PMC7853286 DOI: 10.4103/ijmr.ijmr_2785_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2020] [Indexed: 01/09/2023] Open
Affiliation(s)
- Sandeep Gupta
- Division of Pulmonary and Critical Care and COVID-19 Critical Care Incident Command, Unity Point Health at St. Luke's Regional Medical Center, Sioux City, Iowa, USA
| | - Ashlesha Kaushik
- Pediatric Infectious Disease and COVID-19 Incident Command, Unity Point Health at St. Luke's Regional Medical Center, Sioux City, Iowa, USA
- Department of Pediatrics, University of Iowa Carver College of Medicine, Sioux City, Iowa, USA
| | - Mangla Sood
- Department of Pediatrics, Indira Gandhi Medical College, Shimla 171 001, Himachal Pradesh, India
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23
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Kaushik A, Gupta S, Sood M. COVID-19 Pandemic in India: What Lies Ahead-Letter to the Editor: Mitra P, Misra S, Sharma P. COVID-19 Pandemic in India: What Lies Ahead [published online ahead of print, 2020 Apr 20]. Indian J Clin Biochem. 2020;1-3. doi: https://doi.org/10.1007/s12291-020-00886-6. Indian J Clin Biochem 2020; 35:380-381. [PMID: 32641878 PMCID: PMC7286206 DOI: 10.1007/s12291-020-00899-1] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Accepted: 06/03/2020] [Indexed: 12/24/2022]
Affiliation(s)
- Ashlesha Kaushik
- Pediatric Infectious Diseases and COVID-19 Incident Command, Unity Point Health at St. Luke's Regional Medical Center, Department of Pediatrics, University of Iowa Carver College of Medicine, 2720 Stone Park Blvd, Sioux City, IA 51104 USA
| | - Sandeep Gupta
- Pulmonary Rehabiliation, COVID-19 Critical Care Incident Command, Division of Pulmonary and Critical Care, Unity Point Health at St. Luke's Regional Medical Center, 2720 Stone Park Blvd, Sioux City, IA 51104 USA
| | - Mangla Sood
- Department of Pediatrics, Former State Child Health Lead, Indira Gandhi Medical College, Shimla, Himachal Pradesh 171001 India
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24
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Das MK, Sood M, Tambe MP, Sharma TD, Parande MAG, Surwade JB, Salunkhe NM, Patil SS, Pawar B, Guleri R, Kaushal C, Sindhu M. Documentation of vaccine wastage in two different geographic contexts under the universal immunization program in India. BMC Public Health 2020; 20:556. [PMID: 32334554 PMCID: PMC7183620 DOI: 10.1186/s12889-020-08637-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2020] [Accepted: 04/01/2020] [Indexed: 11/20/2022] Open
Abstract
Background Government of India is introducing new and relatively costly vaccines under immunization program. Monitoring of vaccine wastage is needed to guide the program implementation and forecasting. Under pilot introduction of rotavirus vaccine in two districts both 5- and 10-doses vials were used, which was considered as an opportunity for documenting the wastage. The wastage rates for other routine vaccines were also documented. Methods A survey conducted in two districts (Kangra, Himachal Pradesh and Pune, Maharashtra) covered 49 vaccine stores, 34 sub-centres and 34 outreach sessions collected vaccine receipt, distribution and usage data for two complete years 2016 and 2017. Results The overall wastage rates for almost all vaccines were higher in Kangra district (BCG 37.1%, DPT 32.1%, Measles 32.2%, OPV 50.8%, TT 34.1% and pentavalent 18.4%) than Pune district (BCG 35.1%, DPT 25.4%, Measles 21.7%, OPV 14.3%, TT 23.1% and pentavalent 13.2%). Wastage for pneumococcal conjugate and measles-rubella vaccines in Kangra district were 27 and 40.5%, respectively. With transition from 5- to 10-doses vials for rotavirus vaccine, wastage at stores levels increased in both Kangra (29 to 33.2%) and Pune (17.8 to 25.7%) districts. With transition from intramuscular to intradermal fractional inactivated polio vaccine, the wastage increased from 36.1 to 54.8% in Kangra and 18.4 to 26.9% in Pune district. Conclusions The observed vaccine wastage rates for several vaccines were relatively higher than program assumption for forecasting. The observed variations in the vaccine wastage indicates need for state or region based documentation and monitoring in India for appropriate programmatic action.
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Affiliation(s)
- Manoja Kumar Das
- The INCLEN Trust International, F1/5, Okhla Industrial Area, Phase 1, New Delhi, 110020, India.
| | - Mangla Sood
- Indira Gandhi Medical College, Shimla, Himachal Pradesh, India.,Department of Health and Family Welfare, Government of Himachal Pradesh, Shimla, Himachal Pradesh, India
| | | | - Thakur Dutt Sharma
- The INCLEN Trust International, F1/5, Okhla Industrial Area, Phase 1, New Delhi, 110020, India
| | | | | | | | | | - Bhagwan Pawar
- Department of Health and Family Welfare, Government of Maharashtra, Pune, Maharashtra, India
| | - Rajesh Guleri
- Department of Health and Family Welfare, Government of Himachal Pradesh, Kangra, Himachal Pradesh, India
| | - Chitra Kaushal
- Department of Health and Family Welfare, Government of Himachal Pradesh, Kangra, Himachal Pradesh, India
| | - Monica Sindhu
- The INCLEN Trust International, F1/5, Okhla Industrial Area, Phase 1, New Delhi, 110020, India
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Sood M, Mohd Zain Z, Abu NA, Chee SC, Mohd Nor NS. Maternal and neonatal effects of Acinetobacter colonisation in preterm premature rupture of membrane and term labour. Med J Malaysia 2019; 74:40-44. [PMID: 30846661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
INTRODUCTION Some anecdotal reports suggest that maternal colonisation with Acinetobacter baumannii during pregnancy is associated with adverse maternal and neonatal effects, including preterm premature rupture of membrane (PPROM). The objective of this study was to compare the maternal and neonatal effects of A. baumannii colonisation in cases with PPROM and those with spontaneous onset of labour at term. METHODS The recruitment of participants' was carried out at Selayang Hospital, Selangor, Malaysia. Vaginal swabs were prospectively taken from 104 patients of PPROM and 111 with spontaneous onset of labour at term. Swabs were also taken from the axillae and ears of their babies. These swabs were cultured to isolate A. baumannii. Maternal and neonatal adverse outcomes were documented. RESULTS Sixteen mothers were A. baumannii positive, eight from each group respectively. None of the cases developed chorioamnionitis or sepsis. Those positive were four cases of PPROM and two babies of term labour. None of the babies developed sepsis. CONCLUSIONS This study does not support the suggestion that A. baumannii colonisation during pregnancy is associated with adverse maternal and neonatal outcomes.
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Affiliation(s)
- M Sood
- Monash University Malaysia, Jeffrey Cheah School of Medicine and Health Sciences, Bandar Sunway, Selangor, Malaysia.
| | - Z Mohd Zain
- Universiti Teknologi MARA (UiTM), Faculty of Medicine, Sungai Buloh, Selangor, Malaysia
| | - N A Abu
- Universiti Teknologi MARA (UiTM), Faculty of Medicine, Sungai Buloh, Selangor, Malaysia
| | - S C Chee
- Selayang Hospital, Department of Paediatric, Lebuhraya Kepong Selayang, Batu Caves, Selangor, Malaysia
| | - N S Mohd Nor
- Universiti Teknologi MARA (UiTM), Faculty of Medicine, Sungai Buloh, Selangor, Malaysia
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Abstract
The presence of common physical comorbidities, their demographic and clinical correlates and impact on functioning was assessed in 100 patients with schizophrenia. The patients had a mean age of 35.12±10.7 yr with mean duration of illness of 8.3±0.58 years. Seventy per cent were detected to have a comorbid physical condition. Common conditions included hypertension (21%), diabetes mellitus (15%) and anaemia (12%). Increasing age, being female, being married, longer duration of illness and longer duration of treatment were associated with higher risk of having a comorbid physical illness. Further studies need to be done with a large sample to confirm these findings.
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Affiliation(s)
- K N Nishanth
- Department of Psychiatry, All India Institute of Medical Sciences, New Delhi, India
| | - R K Chadda
- Department of Psychiatry, All India Institute of Medical Sciences, New Delhi, India
| | - M Sood
- Department of Psychiatry, All India Institute of Medical Sciences, New Delhi, India
| | - A Biswas
- Department of Internal Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - R Lakshmy
- Department of Cardiac Biochemistry, All India Institute of Medical Sciences, New Delhi, India
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Rodriguez L, Sood M, Di Lorenzo C, Saps M. An ANMS-NASPGHAN consensus document on anorectal and colonic manometry in children. Neurogastroenterol Motil 2017; 29. [PMID: 27723185 DOI: 10.1111/nmo.12944] [Citation(s) in RCA: 82] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2016] [Accepted: 08/18/2016] [Indexed: 02/08/2023]
Abstract
BACKGROUND Over the last few years, the study of the colon and anorectal function has experienced great technical advances that have facilitated the performance of the tests and have allowed a more detailed characterization of reflexes and motor patterns. As a result, we have achieved a much better understanding of the pathophysiology of children with defecation problems. Anorectal and colonic manometry are now commonly used in all major pediatric referral centers as diagnostic tools and to guide the management of children with intractable constipation and fecal incontinence, particularly when a surgical intervention is being considered. PURPOSE This review highlights some of the recent advances in pediatric colon and anorectal motility testing including indications and preparation for the studies, and how to perform and interpret the tests. This update has been endorsed by the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition (NASPGHAN).
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Affiliation(s)
- L Rodriguez
- Department of Gastroenterology, Hepatology and Nutrition, Boston Children's Hospital, Boston, MA, USA
| | - M Sood
- Department of Pediatric Gastroenterology, Children's Hospital of Wisconsin, Milwaukee, WI, USA
| | - C Di Lorenzo
- Department of Pediatric Gastroenterology, Hepatology, and Nutrition, Nationwide Children's Hospital, Columbus, OH, USA
| | - M Saps
- Department of Pediatric Gastroenterology, Hepatology, and Nutrition, Nationwide Children's Hospital, Columbus, OH, USA
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Sood M, Ranjan R, Chadda R, Khandelwal S. Changing Pattern of Clinical Profile of First Contact Patients Attending Outpatient Services At the General Hospital Psychiatric Units In India Over the Last 50 Years. Eur Psychiatry 2016. [DOI: 10.1016/j.eurpsy.2016.01.1784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
IntroductionOver the last eight decades, general hospital psychiatric units (GHPUs) have become important mental health service set-ups in India. This period has seen a large number of radical changes in the Indian society. In this background, it is important to know if it had any effects on the patients attending the GHPUs.MethodologyA total of five hundred subjects, attending a GHPU were recruited prospectively for the study. The subjects were assessed using a semi-structured proforma. A comparison was made with similar studies conducted in GHPU settings over the last 5 decades.ResultsNeurotic, stress related and somatoform disorders was the commonest diagnostic group (33%) followed by psychotic disorders (17%) and mood disorders (15%). The finding is broadly similar to the studies done at different times in the last 5 decades. However, there were lesser number of patients with mental retardation, organic brain syndrome and seizure disorder.ConclusionThe study highlights the strengths of GHPU set-ups like inter-speciality referrals, fewer stigmas, patients travelling from far off places to seek treatment and involvement of family in the care of mentally ill.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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Bews H, Zhang Y, Rigatto C, Sood M, Tangri N, Eng A, Komenda P, Jassal D. THE UTILITY OF BEDSIDE CLINICAL ASSESSMENT OF INTRAVASCULAR VOLUME STATUS WITH HAND CARRIED ULTRASOUND DEVICES IN HEMODIALYSIS CLINICS. Can J Cardiol 2015. [DOI: 10.1016/j.cjca.2015.07.430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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Majumder P, Khandelwal SK, Sood M, Nehra A, Sharma BS. A comparative study of cognitive function following traumatic brain injury: Significance of initial Glasgow coma scale score to predict cognitive outcome. J Mental Health Hum Behav 2015. [DOI: 10.4103/0971-8990.174593] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Griva K, Mooppil N, Pala Krishnan DS, McBain H, Newman SP, Tripepi G, Pannier B, Mallamaci F, London G, Zoccali C, Sood M, Manns B, Kappel J, Naimark D, Dart A, Komenda P, Rigatto C, Hiebert B, Tangri N, Perl J, Karaboyas A, Tentori F, Morgenstern H, Sen A, Rayner H, Vanholder R, Combe C, Hasegawa T, Mapes D, Robinson B, Pisoni R, Tentori F, Zepel L, Karaboyas A, Mendelssohn D, Ikizler T, Pisoni R, Fukuhara S, Gillespie B, Bieber B, Robinson B, Wilkie M, Karaboyas A, Rayner H, Fluck R, Morgenstern H, Li Y, Kerr P, Mendelssohn D, Wikstrom B, Tentori F, Pisoni R, Robinson B, Vanita Jassal S, Comment L, Karaboyas A, Bieber B, Morgenstern H, Sen A, De Sequera P, Marshall M, Fukuhara S, Robinson B, Pisoni R, Jin HM, Pan Y, Raimann JG, Etter M, Kooman J, Levin N, Marcelli D, Marelli C, van der Sande F, Thijssen S, Usvyat L, Kotanko P, Lu KC, Yang HY, Su SL, Palmer S, Saglimbene V, Ruospo M, Craig J, Celia E, Gelfman R, Stroumza P, Bednarek A, Dulawa J, Frazao J, Del Castillo D, Ecder T, Hegbrant J, Strippoli GFM, Hecking M, Bieber B, Ethier J, Kautzky-Willer A, Jadoul M, Saito A, Sunder-Plassmann G, Saemann M, Gillespie B, Horl W, Mariani L, Ramirez S, Pisoni R, Robinson B, Port F, Mallamaci F, Tripepi G, Leonardis D, Zoccali C, Fukuma S, Akizawa T, Akiba T, Saito A, Kurokawa K, Fukuhara S, Pannier B, Tripepi G, Mallamaci F, Zoccali C, London G, Stack AG, Casserly LF, Abdalla AA, Murthy BVR, Hegarty A, Cronin CJ, Hannigan A, Shaw C, Pitcher D, Sandford R, Spoto B, Pizzini P, Cutrupi S, D'Arrigo G, Tripepi G, Zoccali C, Mallamaci F, Ghalia K, Gubensek J, Arnol M, Ponikvar R, Buturovic-Ponikvar J, Palmer S, de Berardis G, Craig JC, Pellegrini F, Ruospo M, Tong A, Tonelli M, Hegbrant J, Strippoli GFM, Pizzini P, Torino C, Cutrupi S, Spoto B, D'Arrigo G, Tripepi R, Tripepi G, Zoccali C, Mallamaci F, von Gersdorff G, Usvyat L, Schaller M, Wong M, Thijssen S, Marcelli D, Barth C, Kotanko P, Torino C, D'Arrigo G, Postorino M, Tripepi G, Mallamaci F, Zoccali C, Chanouzas D, Ng KP, Baharani J, Endo M, Nakamura Y, Hara M, Murakami T, Tsukahara H, Watanabe Y, Matsuoka Y, Fujita K, Inoue M, Simizu T, Gotoh H, Goto Y, Delanaye P, Cavalier E, Moranne O, Krzesinski JM, Warling X, Smelten N, Pottel H, Schneider S, Malecki AK, Haller HG, Boenisch O, Kielstein JT, Movilli E, Camerini C, Gaggia P, Zubani R, Feller P, Poiatti P, Pola A, Carli O, Valzorio B, Possenti S, Bregoli L, Foini P, Cancarini G, Palmer S, Ruospo M, Natale P, Gargano L, Saglimbene V, Pellegrini F, Johnson DW, Craig JC, Hegbrant J, Strippoli GFM, Brunelli S, Krishnan M, Van Wyck D, Provenzano R, Goykhman I, Patel C, Nissenson A, De Mauri A, Conte MM, Chiarinotti D, David P, Capurro F, De Leo M, Postorino M, Marino C, Vilasi A, Tripepi G, Zoccali C, Dialysis C, Helps A, Edwards G, Mactier R, Coia J, Abe Y, Ito K, Ogahara S, Sasatomi Y, Saito T, Nakashima H, Jean-Charles C, Morgane V, Leila P, Carole S, Pierre-Louis C, Philippe Z, Jean-Francois T, Couchoud C, Dantony E, Guerrin MH, Villar E, Ecochard R, Nishi S, Goto S, Nakai K, Kono K, Yonekura Y, Ito J, Fujii H, Korkmaz S, Ersoy A, Gulten S, Ercan I, Koca N, Serdengecti K, Suleymanlar G, Altiparmak M, Seyahi N, Jager K, Trabulus S, Erek E, Cobo Jaramillo G, Gallar P, Di Gioia C, Rodriguez I, Ortega O, Herrero JC, Oliet A, Vigil A, Pechter U, Luman M, Ilmoja M, Sinimae E, Auerbach A, Lilienthal K, Kallaste M, Sepp K, Piel L, Seppet E, Muliin M, Telling K, Seppet E, Kolvald K, Veermae K, Ots-Rosenberg M, Ambrus C, Kerkovits L, Szegedi J, Benke A, Toth E, Nagy L, Borbas B, Rozinka A, Nemeth J, Varga G, Kulcsar I, Gergely L, Szakony S, Kiss I, Koo JR, Choi MJ, Yoon MH, Park JY, No EY, Seo JW, Lee YK, Noh JW. Epidemiology - CKD 5D II. Nephrol Dial Transplant 2013. [DOI: 10.1093/ndt/gft151] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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MacCall CA, Ritchie G, Sood M. Oral fluid testing as an alternative to urine testing for drugs of abuse in inpatient forensic settings: giving patients choice. Scott Med J 2013; 58:99-103. [DOI: 10.1177/0036933013482640] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background and aims The abuse of illicit substances is very common amongst forensic psychiatry populations and is known to be one of the most potent risk factors for interpersonal violence. Forensic psychiatry units hence strive to keep themselves as free as possible from illicit substances and in Scotland drugs of abuse have traditionally been screened for by means of urine testing. The aim of this study is to examine patients’ preferences for drug testing methods and to compare the acceptability of urine testing versus oral fluid testing (OFT) within a secure hospital setting. Methods Patients in three continuing care wards at the State Hospital, Carstairs were offered the choice of either urine or oral fluid testing. We developed protocols and recording forms and trained staff in the administration of the OFT. We recorded the sampling time for OFT and urine, and the views of patients and staff on the testing procedures over a six month period. Results Sixty-two samples were taken, with 53 (85%) opting for OFT and nine (15%) opting for urine sampling. The average time taken for OFT was 13 minutes, while the average time taken for urine sampling was 33 minutes. The majority of patients and staff rated oral fluid and urine testing as comfortable and easy. Patients recorded comments on 46 (87%) of OFT samples, only two of which were negative. In general they preferred the OFT because it was quicker and easier and they commented on it being more dignified and private. Patients recorded comments on five (55%) of urine samples, with one of the primary reasons for opting for urine sampling appearing to be a reluctance to try new things, though a few said they did not want to have anything in their mouths. Staff returned comments on 24 (45%) of OFT samples and one (11%) of urine samples. Comments on the OFT were overwhelmingly positive and pointed out the relative speed and ease of this sampling method. Conclusions We concluded that the pilot study was successful. OFT was found to be generally preferred by patients and staff. Although there was an additional financial cost, this was considered to be outweighed by the significant benefits arising from offering patients choice, the preservation of patient dignity and staff time savings. The option of OFT has now been extended to all patients within the State Hospital. Practitioners will wish to consider the value of OFT in forensic psychiatry inpatient settings given the benefits identified within this study.
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Affiliation(s)
- CA MacCall
- Consultant Forensic Psychiatrist, Department of Forensic Psychiatry, State Hospital, UK
| | - G Ritchie
- Consultant Nurse, Department of Nursing, State Hospital, UK
| | - M Sood
- Specialist Registrar in Forensic Psychiatry, Department of Forensic Psychiatry, Rowanbank Clinic, UK
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Saeed M, Lim V, Malik A, Cordova F, Tappia P, Rigatto C, Shafer L, Sood M, Zieroth S. 488 Serial Measures of the Fractional Excretion of Urea(FEurea), Fractional Excretion of Sodium(FEna) and the Urea/Creatinine Ratio(UCr) for Predicting Changes in Renal Function in Ambulatory Heart Failure Patients. Can J Cardiol 2012. [DOI: 10.1016/j.cjca.2012.07.446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Saeed M, Lim V, Tappia P, Cordova F, Malik A, Rigatto C, Shafer L, Sood M, Zieroth S. 492 Urinary NGAL is not Associated With Renal Function Changes or Hospitalization in Ambulatory Heart Failure Patients. Can J Cardiol 2012. [DOI: 10.1016/j.cjca.2012.07.450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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Saeed M, Lim V, Tappia P, Cordova F, Malik A, Rigatto C, Shafer L, Sood M, Zieroth S. 490 Change in Renal Function and Association With Acute Hospitalization in Chronic Ambulatory Heart Failure Patients. Can J Cardiol 2012. [DOI: 10.1016/j.cjca.2012.07.448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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Rizkallah J, Sood M, Reslerova M, Cordova F, Malik A, Zieroth S. 696 Peritoneal dialysis for the treatment of refractory congestive heart failure. Can J Cardiol 2011. [DOI: 10.1016/j.cjca.2011.07.580] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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Nagpal SJS, Mishra N, Chadda RK, Sood M, Garg R. Changing trends of services used as first contact by patients with mental health problems. Natl Med J India 2011; 24:148-150. [PMID: 21786843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
BACKGROUND In the past, traditional faith healers and practitioners of alternative medicine have often been reported to be the first source of contact for Indian patients with mental health problems. However, over the past few decades, this trend seems to be changing. METHOD Using a semi-structured questionnaire, we assessed 200 new patients at a psychiatric outpatient service in a general hospital for the first service contact used by them for their mental health problems. RESULTS Psychiatrists, non-psychiatric physicians, traditional faith healers and practitioners of alternative medicine were the first service contact for 91 (45.5%), 88 (44%), 16 (8%) and 5 (2.5%) patients, respectively. Patients suffering from severe mental illnesses were more likely to choose a psychiatrist as the first contact, whereas those with neurotic, stress-related and organic mental disorders contacted a non-psychiatric physician. CONCLUSION In the current scenario, psychiatrists and nonpsychiatric physicians serve as the first service contact for most patients with mental health problems in India, though traditional faith healers and practitioners of alternative medicine are contacted by a minority.
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Affiliation(s)
- S J S Nagpal
- Department of Psychiatry, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India
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Abstract
US Preventive Services Task Force recommends universal screening of all newborns for early detection of hearing impairment and early intervention to prevent its effects on normal development and acquisition of language skills. During comparison of universal screening of all newborns versus targeted screening of high risk cases to detect hearing impairment, it emphasized the importance of Universal newborn hearing screening (UNHS) among neonatologists, pediatricians as well as ENT specialists taking care of newborns and young children. Among those who had early versus late confi rmation of hearing loss and those who had undergone universal newborn screening versus none, better language outcomes at school age were found than those not screened. Infants identifi ed with hearing loss through universal newborn screening had earlier referral, diagnosis, and treatment than those not screened. Targeted screening of newborns with high risk criteria missed 50% of cases of hearing impairment, either because infants were hearing impaired but did not meet any of the high- risk criteria, or because they developed hearing loss after the newborn period.
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Affiliation(s)
- Mangla Sood
- Indira Gandhi Medical College, Shimla, India
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Bedi P, Kaur H, Gupta B, Talreja J, Sood M. A Website Recommender System Based on an Analysis of the User's Access Log. Journal of Intelligent Systems 2009. [DOI: 10.1515/jisys.2009.18.4.333] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Sood M, Chadda RK. Women physicians in India. Natl Med J India 2008; 21:154. [PMID: 19004152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
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Saldanha D, Chaudhury S, Pawar AA, Ryali V, Srivastava K, Sood M, Bedi HK. Changing Pattern of Alcohol Abuse in the Army before and after AO 3&11/2001. Med J Armed Forces India 2007; 63:160-2. [PMID: 27407976 PMCID: PMC4925368 DOI: 10.1016/s0377-1237(07)80064-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2004] [Accepted: 12/26/2005] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND The Army Order 3&11/2001 was introduced to curb alcoholism and to weed out habitual alcoholics. Hence a study was carried out in a zonal referral hospital from 01 Jan 2001 to 30 Jun 2003 to assess its effectiveness. METHODS The subjects consisted of officers, junior commisioned officers and other ranks who satisfied the International Classification of Diseases (ICD) 10 criteria for alcohol dependence. RESULT Out of 1023 consecutive admissions, alcohol dependent cases numbered 245 (23.95%). They were disposed as under: 57/ 245 (23.6%) in S1 (fit for all duties), 67/245 (27.35%) in S2 (fit for duties with few restrictions), 72/245 (29.39%) in S3 (fit for duties with more restrictions), and 32/245 (13.06%) in S5 (unfit for further service.). CONCLUSION The data showed that the percentage of cases disposed under fit for all duties had risen four times (23.80 vs 5.86), those invalided out increased by two times (12.70 vs 6.64) and those retained in S2 had reduced (26.46 vs 41.21) after the new policy.
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Affiliation(s)
- D Saldanha
- Professor and Head, Armed Forces Medical College, Pune
| | - S Chaudhury
- Professor (Psychiatry), Ranchi Institute of Neuropsychiatry and Allied Sciences, Ranchi, Jharkhand
| | - A A Pawar
- Senior Advisor (Psychiatry), INHS Asvini, Mumbai
| | - Vssr Ryali
- Associate Professor, Armed Forces Medical College, Pune
| | - K Srivastava
- Scientist "E" (Dept of Psychiatry), Armed Forces Medical College, Pune
| | - M Sood
- Assistant Professor (Psychiatry), AIIMS, New Delhi
| | - H K Bedi
- Graded Specialist (Psychiatry), Military Hospital, Bareilly
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Vasisht SK, Sood M, Verma PK, Kaur T, Usha K. SILYL-NITROGEN COMPOUNDS,1 11: SYNTHESIS AND CHARACTERISATION OF TETRASILAPHOSPHA AND TETRASILA-ARSA TETRAZENES. PHOSPHORUS SULFUR 2006. [DOI: 10.1080/10426509008037989] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- S. K. Vasisht
- a Department of Chemistry , Panjab Universiry , Chandigarh , 160014 , India
| | - M. Sood
- a Department of Chemistry , Panjab Universiry , Chandigarh , 160014 , India
| | - P. K. Verma
- a Department of Chemistry , Panjab Universiry , Chandigarh , 160014 , India
| | - T. Kaur
- a Department of Chemistry , Panjab Universiry , Chandigarh , 160014 , India
| | - K. Usha
- a Department of Chemistry , Panjab Universiry , Chandigarh , 160014 , India
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Wynn RF, Sood M, Theilgaard-Mönch K, Jones CJ, Gombart AF, Gharib M, Koeffler HP, Borregaard N, Arkwright PD. Intractable diarrhoea of infancy caused by neutrophil specific granule deficiency and cured by stem cell transplantation. Gut 2006; 55:292-3. [PMID: 16407388 PMCID: PMC1856503 DOI: 10.1136/gut.2005.081927] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/08/2022]
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Amin AA, Bartlett W, Gooding CR, Sood M, Skinner JA, Carrington RWJ, Briggs TWR, Bentley G. The use of autologous chondrocyte implantation following and combined with anterior cruciate ligament reconstruction. Int Orthop 2005; 30:48-53. [PMID: 16320051 PMCID: PMC2254665 DOI: 10.1007/s00264-005-0025-3] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/16/2005] [Accepted: 08/24/2005] [Indexed: 10/25/2022]
Abstract
We report our experience of using autologous chondrocyte implantation (ACI) to treat osteochondral defects of the knee in combination with anterior cruciate ligament (ACL) reconstruction. The outcome of symptomatic osteochondral lesions treated with ACI following previous successful ACL reconstruction is also reviewed. Patients were followed for a mean of 23 months. Nine patients underwent ACL reconstruction in combination with ACI. Mean modified Cincinnati knee scores improved from 42 to 69 following surgery. Seven patients described their knee as better and two as the same. A second group of nine patients underwent ACI for symptomatic articular cartilage defects following previous ACL reconstruction. In this group, the mean modified Cincinnati knee score improved from 53 to 62 after surgery. Six patients described their knee as better and three as worse. Combined treatment using ACI with ACL reconstruction is technically feasible and resulted in sustained improvement in pain and function. The results following previous ACL reconstruction also resulted in clinical improvement, although results were not as good as following the combined procedure.
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Affiliation(s)
- A A Amin
- Joint Reconstruction and Bone Tumour Unit, Royal National Orthopaedic Hospital, Brockley Hill, HA7 4LP Stanmore, UK.
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Abstract
Avascular necrosis is a serious complication of slipped capital femoral epiphysis and is difficult to treat. The reported incidence varies from 3% to 47% of patients. The aims of treatment are to maintain the range of movement of the hip and to prevent collapse of the femoral head. At present there are no clear guidelines for the management of this condition and treatment can be difficult and unrewarding. We have used examination under anaesthesia and dynamic arthrography to investigate avascular necrosis and to determine the appropriate method of treatment. We present 20 consecutive cases of avascular necrosis in patients presenting with slipped capital femoral epiphysis and describe the results of treatment with a mean follow-up of over eight years (71 to 121 months). In patients who were suitable for joint preservation (14), we report a ten-year survivorship of the hip joint of 75% and a mean Harris hip score of 82 (44 to 98).
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Affiliation(s)
- M M Mullins
- The Roayla National Orthopaedic Hospital, Stanmore, England.
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Abstract
UNLABELLED Confirmation of the diagnosis of coeliac disease requires unequivocal evidence of recovery on a gluten-free diet. The lactose H2 breath test is a non-invasive technique for detecting lactose malabsorption, and this may occur in untreated coeliac disease. The utility of this test was investigated in objectively confirming a response to gluten exclusion. The study included 44 children from 0.9 to 14.75 y of age (median 3.2) with coeliac disease. Five children were asymptomatic, being identified through coeliac antibody screening. Breath tests were performed prior to dietary treatment. If positive, they were repeated at 4-wk intervals following gluten exclusion. Overall, 21/44 (48%) children had positive breath tests at presentation. In 18/21 children on a gluten-free diet, this became negative after 4 wk (86%) and in all the children by 8 wk. In two children with positive tests at 4 wk, problems with dietary adherence were identified. A positive test before treatment was not associated with significant differences in individual symptoms, height, weight and body mass index standard deviation scores, serum haemoglobin or albumin. However, no positive results were found in the asymptomatic patients (p = 0.05). Lactose malabsorption was associated with earlier age of presentation (p = 0.008). CONCLUSION The lactose H2 breath test objectively confirms a response to gluten exclusion. In selected cases it can help confirm a diagnosis of coeliac disease. However, the test tends to be less informative in asymptomatic patients, and in older children.
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Affiliation(s)
- M S Murphy
- Institute of Child Health, University of Birmingham, Department of Gastroenterology and Nutrition, UK.
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Affiliation(s)
- S Ridgeway
- Department of Orthopaedics, Queen Mary's Hospital, Sidcup, DA14 6LT, Kent, UK.
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Abstract
Inferior vena cava (IVC) aneurysms are extremely rare, with only 18 reported cases in the world literature. These aneurysms are categorized as acquired, congenital, or associated with arteriovenous fistulae. Thrombosis of an IVC aneurysm can lead to IVC syndrome characterized by massive lower extremity edema, pulmonary embolism, or even death. Therapeutic alternatives range from watchful waiting to operative resection. This report presents a case of an IVC aneurysm noted incidentally at the time of diagnostic computed tomography for the evaluation of blunt chest trauma following a motor vehicle collision. In addition, the classification, embryology, diagnosis, and management of this unusual clinical entity are reviewed.
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Affiliation(s)
- V V Sullivan
- Department of Vascular Surgery, St. Joseph Mercy Hospital, Ann Arbor, MI 48106, USA
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Villarreal J, Sood M, Zangen T, Flores A, Michel R, Reddy N, Di Lorenzo C, Hyman PE. Colonic diversion for intractable constipation in children: colonic manometry helps guide clinical decisions. J Pediatr Gastroenterol Nutr 2001; 33:588-91. [PMID: 11740234 DOI: 10.1097/00005176-200111000-00014] [Citation(s) in RCA: 63] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Colonic manometry helps discriminate functional and behavioral causes for childhood constipation from colonic neuromuscular disease. METHODS Of 375 colonic manometries performed for clinical indications, 12 could not be interpreted because of chronic colonic dilation. Based on colonic manometries that showed either no contractions or an absence of the gastrocolonic response or an absence of high-amplitude propagating contractions, the authors recommended diverting colostomies or ileostomies in 12 chronically constipated children (mean age, 4 years; range, 2-14 years, 5 boys). Before study, medical treatment was ineffective in all children. These children had persistently dilated colons with pathologic diagnoses of intestinal neuronal dysplasia (n = 4), hypoganglionosis (n = 2), hollow visceral myopathy (n = 1), and normal (n = 5). RESULTS Six to 30 months after diversion, the authors restudied all the children. Eleven of 12 diverted colons were no longer dilated. In two patients, abnormal motility involving the entire colon was unchanged from the initial study, small bowel motility was abnormal, and we recommended no further surgery. In two cases, the colon remained abnormal but small bowel motility was normal, and we recommended subtotal colectomy and ileoproctostomy. In four cases, the left colon remained abnormal, but the right colon was normal, and we recommended reanastomosis after left hemicolectomy. In four cases, motility in the diverted colons was normal, including a gastrocolonic response and high-amplitude propagating contractions, and the authors recommended reanastomosis. Defecation problems resolved in 10 of 12 when followed up 5 to 30 months after treatment. CONCLUSION These data suggest that in some cases of intractable childhood constipation associated with colonic distention, temporary diversion improved colonic motility. Colonic manometry may be used to predict which patients will benefit from resection or reanastomosis.
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Affiliation(s)
- J Villarreal
- Pediatric Gastrointestinal Motility Center, Children's Hospital of Orange County, Orange, California, U.S.A
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