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Rao P, Charki S, Aradhya AS, Diggikar S, Bilagi A, Venkatagiri P, Tyagaraj T, Kulkarni S, Nagareddy VG, Biradar VS, Lewis P, Patil MM. Prediction score for prolonged hospital stay in meconium aspiration syndrome: A multicentric collaborative cohort of south India. Pediatr Pulmonol 2022; 57:2383-2389. [PMID: 35759423 DOI: 10.1002/ppul.26044] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2022] [Revised: 06/15/2022] [Accepted: 06/18/2022] [Indexed: 11/10/2022]
Abstract
BACKGROUND AND OBJECTIVE With improved survival in neonates with meconium aspiration syndrome (MAS), the focus is currently on mitigating the morbidities. The objective of this study was to predict factors determining prolonged hospital stay in neonates with MAS. MATERIALS AND METHODS It was a retrospective cohort from five centers of south India between 2018 and 2020. Neonates ≥35 weeks of gestation admitted to neonatal intensive care unit with the diagnosis of MAS and requiring oxygen beyond 24 h of life were included in the study. The morbidities in the neonates with stay ≤7 days (short stay) were compared with >7 days (prolonged stay). Logistic regression by the backward stepwise method was used for predictive score creation. RESULTS Out of 347 neonates with MAS discharged home, 103 (29%) had a short stay and 244 (71%) had prolonged stay. The primary support beyond O2 (continuous positive airway pressure/mechanical ventilation) (42% vs. 83%, p < 0.001), fractional inspired oxygen (FiO2 ) at 1 h >30% (45% vs. 87%, p < 0.001), hypoxic ischemic encephalopathy (HIE) stage 2 or 3 (1% vs. 27%, p < 0.001), moderate-severe persistent pulmonary artery hypertension (PPHN) (3% vs. 31%, p < 0.001) were independent factors associated with prolonged stay on logistic regression. A prediction model was devised using weighted scores of these four associated morbidities. The clinical score thus developed had 83% sensitivity, 68% specificity for the prediction of prolonged stay (area under curve: 82%, 95% confidence interval [78-87], p < 0.001). CONCLUSION More than two-thirds of neonates with MAS had prolonged stay. The primary support beyond oxygen, FiO2 requirement >30%, Moderate to severe PPHN, HIE stage 2 or 3 were predictive of prolonged stay in neonates with MAS.
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Affiliation(s)
- Poornachandra Rao
- Department of Pediatrics, Ovum Woman & Child Speciality Hospital, Hoskote, Bangalore Rural, Karnataka, India
| | - Siddu Charki
- Department of Pediatrics, Shri B. M. Patil Medical College Hospital & Research Centre, Vijayapura, Karnataka, India
| | - Abhishek S Aradhya
- Department of Pediatrics, Ovum Woman & Child Speciality Hospital, Hoskote, Bangalore Rural, Karnataka, India
| | - Shivashankar Diggikar
- Department of Pediatrics, Ovum Woman & Child Speciality Hospital, Kalyan Nagar, Bangalore, Karnataka, India
| | - Archana Bilagi
- Department of Pediatrics, St. Philomena's Hospital, Bangalore, Karnataka, India
| | - Praveen Venkatagiri
- Department of Pediatrics, Chinmaya Mission Hospital, Bangalore, Karnataka, India
| | - Tanmaya Tyagaraj
- Department of Pediatrics, Shri B. M. Patil Medical College Hospital & Research Centre, Vijayapura, Karnataka, India
| | - Srikanth Kulkarni
- Department of Pediatrics, Ovum Woman & Child Speciality Hospital, Kalyan Nagar, Bangalore, Karnataka, India
| | - Vinutha G Nagareddy
- Department of Pediatrics, St. Philomena's Hospital, Bangalore, Karnataka, India
| | - Vijaykumar S Biradar
- Department of Pediatrics, Shri B. M. Patil Medical College Hospital & Research Centre, Vijayapura, Karnataka, India
| | - Patricia Lewis
- Department of Pediatrics, St. Philomena's Hospital, Bangalore, Karnataka, India
| | - M M Patil
- Department of Pediatrics, Shri B. M. Patil Medical College Hospital & Research Centre, Vijayapura, Karnataka, India
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Jagruthi P, Gobbur RH, Akki AS, Patil MM, Kalyanshettar SS, Patil SV. Interesting case series of severe anemia with marrow suppression. BLDE Univ J Health Sci 2020. [DOI: 10.4103/2468-838x.303789] [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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Charki S, Kulkarni T, Biradar V, Patil MM, Kalyanshettar SS. IV Paracetamol versus Oral Ibuprofen for Closure of Patent Ductus Arteriosus in Preterm Neonates Admitted To a Tertiary Care Centre in North Karnataka, India- A Randomized Control Trial. BLDE Univ J Health Sci 2020. [DOI: 10.4103/2468-838x.303807] [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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Tyagraj T, Charki S, Biradar V, Patil MM, Kulkarni T, Kalyanshettar SS, Patil SV. The utility of Foot Length as a Non-Invasive Anthropometric Measurement in Neonates Admitted in NICU in A Tertiary Care Centre in North Karnataka, India. BLDE Univ J Health Sci 2020. [DOI: 10.4103/2468-838x.303787] [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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Prakash VJ, Patil SV, Kalyanshettar SS, Patil MM. Re-Emerging Diphtheria: Clinical profile and outcome in Children with Diphtheria. BLDE Univ J Health Sci 2020. [DOI: 10.4103/2468-838x.303824] [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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Kadam ST, Dhaimodker VMN, Patil MM, Reddy Edla D, Kuppili V. EIQ: EEG based IQ test using wavelet packet transform and hierarchical extreme learning machine. J Neurosci Methods 2019; 322:71-82. [PMID: 31022416 DOI: 10.1016/j.jneumeth.2019.04.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2019] [Revised: 04/15/2019] [Accepted: 04/16/2019] [Indexed: 11/30/2022]
Abstract
BACKGROUND The use of electroencephalography has been perpetually incrementing and has numerous applications such as clinical and psychiatric studies, social interactions, brain computer interface etc. Intelligence has baffled us for centuries, and we have attempted to quantify using EEG signals. NEW METHOD This paper aims at devising a novel non-invasive method of measuring human intelligence. A newly devised scoring scheme is used to ultimately generate a score for the subjects. Wavelet packet transform approach for feature extraction is applied to 5 channel EEG data. This approach uses db-8 as the mother wavelet. Hierarchical extreme learning machine is used for classification of the EEG signals. RESULT 80.00% training accuracy and 73.33% testing accuracy was measured for the classifier. The average sensitivity and specificity across all three classes was measured to be 0.8133 and 0.8923 respectively. An aggregate score was determined from the classification of EEG data. The power spectral analysis of the EEG data was conducted and regions of the brain responsible for various activities was confirmed. In the memory test, theta and beta bands exhibit high power, for arithmetic test, alpha and beta bands are strong, whereas in linguistic test, theta, alpha and beta bands are equally strong. COMPARISON The traditional IQ test determines intelligence indirectly, based on the score obtained from Wechsler test. In this paper an attempt is made to measure intelligence based on various brain activities - memory, arithmetic, linguistic. CONCLUSION A new method to measure intelligence using direct approach by classifying the EEG signals is proposed.
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Affiliation(s)
- Shashikant T Kadam
- Department of Computer Science and Engineering, National Institute of Technology Goa, India.
| | - Vineet M N Dhaimodker
- Department of Computer Science and Engineering, National Institute of Technology Goa, India.
| | - Milind M Patil
- Department of Computer Science and Engineering, National Institute of Technology Goa, India.
| | - Damodar Reddy Edla
- Department of Computer Science and Engineering, National Institute of Technology Goa, India.
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Patil MM, Kamalanathan S, Sahoo JP, Vivekanandan M. Pseudo hypertension: Clue from Osler sign. J Family Med Prim Care 2017; 5:743. [PMID: 28217628 PMCID: PMC5290806 DOI: 10.4103/2249-4863.197277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Milind M Patil
- Department of Endocrinology and Metabolism, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Sadishkumar Kamalanathan
- Department of Endocrinology and Metabolism, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Jaya Prakash Sahoo
- Department of Endocrinology and Metabolism, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Muthupillai Vivekanandan
- Department of Endocrinology and Metabolism, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
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Patil MM, Patil SV, Akki AS, Lakhkar B, Badiger S. An Arrow Poison (Abrus Precatorius) Causing Fatal Poisoning in a Child. J Clin Diagn Res 2016; 10:SD03-4. [PMID: 27134959 DOI: 10.7860/jcdr/2016/18234.7439] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [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: 12/07/2015] [Accepted: 01/07/2016] [Indexed: 11/24/2022]
Abstract
Ingestion of whole seeds of Abrus precatorius often does not produce serious illness. It generally presents initially with gastrointestinal manifestations. Haemolysis, acute renal damage, hepatotoxicity and seizures are the other manifestations. Herewith we report a child with accidental ingestion of abrus precatorius seeds who presented with altered sensorium and convulsions. The case is being reported on account of its rarity in its initial neurological manifestation and has not been reported earlier in paediatric age group.
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Affiliation(s)
- M M Patil
- Associate Professor, Department of Paediatrics, Shri B M Patil Medical College , Vijayapur, Karnataka, India
| | - S V Patil
- Professor and HOD, Department of Paediatrics, Shri B M Patil Medical College , Vijayapur, Karnataka, India
| | - A S Akki
- Professor, Department of Paediatrics, Shri B M Patil Medical College , Vijayapur, Karnataka, India
| | - Bhavana Lakhkar
- Professor, Department of Paediatrics, Shri B M Patil Medical College , Vijayapur, Karnataka, India
| | - Sharan Badiger
- Professor, Department of Medicine, Shri B M Patil Medical College , Vijayapur, Karnataka, India
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Affiliation(s)
- M M Patil
- Department of Endocrinology and Metabolism, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Pondicherry 605 006, India
| | - S Kamalanathan
- Department of Endocrinology and Metabolism, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Pondicherry 605 006, India
| | - J Sahoo
- Department of Endocrinology and Metabolism, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Pondicherry 605 006, India
| | - N G Rajesh
- Department of Pathology, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Pondicherry, 605 006, India.
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Patil S V, Dhamangaonkar BR, Pattanshetti RC, Patil MM. Posterior reversible encephalopathy syndrome in early postpartum women: a case report. J Clin Diagn Res 2014; 8:RD01-2. [PMID: 24959491 DOI: 10.7860/jcdr/2014/7793.4230] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [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: 10/13/2013] [Accepted: 02/07/2014] [Indexed: 11/24/2022]
Abstract
Posterior reversible encephalopathy syndrome (PRES) is a rare acute neurologic condition, characterized by acute neurological symptoms. The radiological findings are predominantly seen in the posterior cerebral hemispheres and are reversible with appropriate management. We are reporting a case of a 21-year-old woman (primigravida), who presented with loss of vision, head ache and vomiting on 2nd day of post-caesarean section. Caesarean section was done due to fetal distress. On examination, patient appeared drowsy but arousable, had a blood pressure of 140/114 mmHg, rest of the examination was unremarkable. CT and MRI brain was performed to rule out cerebral venous sinus thrombosis and cortical blindness; imaging and clinical findings were suggestive of posterior reversible encephalopathy syndrome (PRES). She was treated successfully with antihypertensives and showed dramatic improvement.
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Affiliation(s)
- Vinod Patil S
- Postgraduate, Department of Radiology, Shri BM Patil Medical College, Hospital and Research Centre , Bijapur, Karnataka, India
| | - B R Dhamangaonkar
- Professor, Department of Radiology, Shri BM Patil Medical College, Hospital and Research Centre , Bijapur, Karnataka, India
| | - R C Pattanshetti
- Professor and Head, Department of Radiology, Shri BM Patil Medical College, Hospital and Research Centre , Bijapur, Karnataka, India
| | - M M Patil
- Senior Resident, Department of Radiology, Shri BM Patil Medical College, Hospital and Research Centre , Bijapur, Karnataka, India
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Patil MM, Akki AS. Dengue arthritis in a child. Indian Pediatr 2013; 50:523-524. [PMID: 23778738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
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Patil MM. No Crying Episode after DwPT- A Case of Congenital Hypothyroidism. J Clin Diagn Res 2013; 7:1536. [DOI: 10.7860/jcdr/2013/5446.3183] [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: 11/19/2012] [Accepted: 04/20/2013] [Indexed: 11/24/2022]
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Patil MM, Patil SV. Ataxia telangiectasia with hepatocellular carcinoma. Indian Pediatr 2009; 46:546. [PMID: 19556677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
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Abstract
Infantile Tremor Syndrome is a distinct clinical entity most commonly seen in Indian Subcontinent. Syndrome consists of tremors, mental and developmental retardation, abnormal skin pigmentation and anemia in children between 6 months to 2 years. The etiology is still elusive. Amongst various theories, nutritional theory is the most accepted. So far there are no cases reported of vitamin C deficiency in ITS. In this article, three cases of ITS associated with vitamin C deficiency are reported.
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Affiliation(s)
- Vinod H Ratageri
- Department of Pediatrics, Karnataka Institute of Medical Sciences, Hubli, Karnataka, India.
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Abstract
Modulation of inhibitory synaptic potentials in the piriform cortex. Intracellular recordings from pyramidal neurons in brain slice preparations of the piriform cortex were used to test results from a computational model about the effects of cholinergic agonists on inhibitory synaptic potentials induced by stimulation of afferent fibers in layer Ia and association/intrinsic fibers in layer Ib. A simple model of piriform cortex as an associative memory was used to analyze how suppression of inhibitory synaptic transmission influenced performance of the network. Levels of suppression of excitatory synaptic transmission were set at levels determined in previous experimental work. Levels of suppression of inhibitory synaptic transmission were then systematically varied within the model. This modeling work demonstrated that suppression of inhibitory synaptic transmission in layer Ib should be stronger than suppression of inhibitory synaptic transmission in layer Ia to keep activity levels high enough for effective storage. Experimental data showed that perfusion of the cholinergic agonist carbachol caused a significant suppression of inhibitory postsynaptic potentials (IPSPs) in the pyramidal neurons that were induced by stimulation of layer Ib, with a weaker effect on IPSPs induced by stimulation of layer Ia. As previously described, carbachol also selectively suppressed excitatory postsynaptic potentials (EPSPs) elicited by intrinsic but not afferent fiber stimulation. The decrease in amplitude of IPSPs induced by layer Ib stimulation did not appear to be directly related to the decrease in EPSP amplitude induced by layer Ib stimulation. The stimulation necessary to induce neuronal firing with layer Ia stimulation was reduced in the presence of carbachol, whereas that necessary to induce neuronal firing with layer Ib stimulation was increased, despite the depolarization of resting membrane potential. Thus physiological data on cholinergic modulation of inhibitory synaptic potentials in the piriform cortex is compatible with the functional requirements determined from computational models of piriform cortex associative memory function.
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Affiliation(s)
- M M Patil
- Department of Psychology, Boston University, Boston 02215, USA
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Patil MM, Durand DM, LaManna JC, Whittingham TS, Haxhiu MA. Effects of oxygen deprivation on parapyramidal neurons of the ventrolateral medulla in the rat. Respir Physiol 1999; 115:11-22. [PMID: 10344411 DOI: 10.1016/s0034-5687(98)00108-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
We characterized the electrophysiological properties and responses of neurons located in the parapyramidal region of the ventral aspect of the rat medulla oblongata (parapyramidal neurons, PP neurons) to oxygen deprivation, in order to understand the mechanisms involved in hypoxia induced respiratory depression. The responses of PP neurons to oxygen deprivation were compared to those of the functionally dissimilar neurons of the dentate gyrus (DG). Neurons from the PP region were found to fire spontaneously with a frequency of 3-3.5 spikes/sec in both adults and neonates and responded to an anoxic insult with a complete loss of spontaneous firing. Discrete metabolite analysis showed a small (about 17%) decrease in tissue adenosine triphosphate (ATP) levels of the PP neurons during an anoxic insult and the decrease was significantly smaller than in the DG cell region (28%). In contrast to the DG neurons, the PP neurons recovered from an anoxic insult lasting more than 30 min, indicating a greater survival capacity of the PP neurons during oxygen deprivation. The PP neurons were also capable of withstanding successive anoxic insults better than the DG cells as demonstrated by their complete recovery following reoxygenation. It is suggested that the PP neurons may depress their electrical activity as an energy conservation mechanism, and thereby survive anoxic insults longer than the dentate neurons, whereas the loss of cellular activity in the DG neurons may be a result of energy depletion.
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Affiliation(s)
- M M Patil
- Biomedical Engineering, School of Medicine, Case Western Reserve University, Cleveland, OH 44106-4938, USA
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Patil MM, Linster C, Lubenov E, Hasselmo ME. Cholinergic agonist carbachol enables associative long-term potentiation in piriform cortex slices. J Neurophysiol 1998; 80:2467-74. [PMID: 9819256 DOI: 10.1152/jn.1998.80.5.2467] [Citation(s) in RCA: 67] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Pyramidal cells in piriform (olfactory) cortex receive afferent input from the olfactory bulb as well as intrinsic association input from piriform cortex and other cortical areas. These two functionally distinct inputs terminate on adjacent apical dendritic segments of the pyramidal cells located in layer Ia and layer Ib of piriform cortex. Studies with bath-applied cholinergic agonists have shown suppression of the fast component of the inhibitory postsynaptic potentials (IPSPs) evoked by stimulation of the association fibers. It was previously demonstrated that an associative form of LTP can be induced by coactivation of the two fiber systems after blockade of the fast, gamma-aminobutyric acid-A-mediated IPSP. In this report, we demonstrate that an associative form of long-term potentiation can be induced by coactivation of afferent and intrinsic fibers in the presence of the cholinergic agonist carbachol.
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Affiliation(s)
- M M Patil
- Department of Psychology, Harvard University, Cambridge, Massachusetts 02138, USA
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