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Shankarrao Dekate P, Reddy S, Prasad VSV, Boda S, Saini L, Patil P. An Uncommon Cause of Hypertensive Urgency in Young Adolescent: Case Report. Indian J Crit Care Med 2019; 23:339-341. [PMID: 31406445 PMCID: PMC6686575 DOI: 10.5005/jp-journals-10071-23210] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Mid aortic syndrome is rare cause of hypertensive urgency in children with poor outcome if left untreated, high index of suspicion with prompt management is the key to survival with good outcome. A 12-year-old boy was presented with fever, puffiness of face, and breathing difficulty. Clinically, he had hypertension with differential pulsation and BP in upper and lower limbs. He had peak systolic gradient of 80 mm Hg between upper and lower limb. His echocardiography and CT angiography was suggestive of significant isolated 80% narrowing of abdominal aorta without involvement any other large vessels. Percutaneous balloon dilatation of aorta was done considering multiple parameters. Post procedure, there was significant improvement in BP and we could wean his multiple anti-hypertensive drugs to keep his blood pressures below 95th centile. His BP remained control with minimum upper and lower limb gradient on follow up of almost 1 year. HOW TO CITE THIS ARTICLE Dekate PS, Reddy S, Prasad VSV, Boda S, Saini L, Patil P. An Uncommon Cause of Hypertensive Urgency in Young Adolescent: Case Report. Indian J Crit Care Med 2019;23(7):339-341. KEY MESSAGE Mid aortic syndrome is most uncommon amongst them. With prompt diagnosis and proper selection of therapeutic options like balloon dilatation or surgical correction, it has good prognosis. Aortic narrowing because of different diseases is an uncommon cause of HT urgency in children.
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Affiliation(s)
- Parag Shankarrao Dekate
- Department of Pediatrics, PICU, Lotus Hospital for Women and Children, Lakdikapool, Hyderabad, Telangana, India
| | - Satyanarayana Reddy
- Department of Pediatrics, PICU, Lotus Hospital for Women and Children, Lakdikapool, Hyderabad, Telangana, India
| | - VSV Prasad
- Department of Pediatrics, PICU, Lotus Hospital for Women and Children, Lakdikapool, Hyderabad, Telangana, India
| | - Sudha Boda
- Department of Pediatrics, PICU, Lotus Hospital for Women and Children, Lakdikapool, Hyderabad, Telangana, India
| | - Lokesh Saini
- Department of Pediatrics, PICU, Lotus Hospital for Women and Children, Lakdikapool, Hyderabad, Telangana, India
| | - Prashant Patil
- Department of Pediatrics, PICU, Lotus Hospital for Women and Children, Lakdikapool, Hyderabad, Telangana, India
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152
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Banerjee A, Mukherjee S, Shah S, Saini L. Unilateral Bowing of Legs - Do not Forget to Examine the Skin. Pediatr Neurol 2019; 96:81-82. [PMID: 30922772 DOI: 10.1016/j.pediatrneurol.2019.01.022] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Revised: 01/25/2019] [Accepted: 01/31/2019] [Indexed: 11/30/2022]
Affiliation(s)
- Arundhati Banerjee
- Department of Pediatrics, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Swetlana Mukherjee
- Department of Pediatrics, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Sweta Shah
- Department of Pediatrics, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Lokesh Saini
- Department of Pediatrics, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
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153
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Affiliation(s)
- Indar Kumar Sharawat
- Pediatric Neurology Unit, Department of Pediatrics, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Thakurvir Singh Kohli
- Pediatric Neurology Unit, Department of Pediatrics, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Lokesh Saini
- Pediatric Neurology Unit, Department of Pediatrics, Post Graduate Institute of Medical Education and Research, Chandigarh, India
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154
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Madaan P, Krishnappa A, Yadav J, Saini L. Selective Eating: A Common Fuss in Neurodevelopmental Disorders. Pediatr Neurol 2019; 95:90. [PMID: 30792030 DOI: 10.1016/j.pediatrneurol.2019.01.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Revised: 01/08/2019] [Accepted: 01/10/2019] [Indexed: 11/28/2022]
Affiliation(s)
- Priyanka Madaan
- Child Neurology Division, Department of Pediatrics, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Archana Krishnappa
- Department of Pediatrics, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Jaivinder Yadav
- Department of Pediatrics, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Lokesh Saini
- Child Neurology Division, Department of Pediatrics, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
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155
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Hosur B, Vyas S, Saini L, Kesavan S. Extensive cerebellar necrosis. BMJ Case Rep 2019; 12:12/5/e230470. [PMID: 31154351 DOI: 10.1136/bcr-2019-230470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- Bharat Hosur
- Radiodiagnosis, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Sameer Vyas
- Radiodiagnosis, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Lokesh Saini
- Pediatrics, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Shivan Kesavan
- Pediatrics, Post Graduate Institute of Medical Education and Research, Chandigarh, India
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156
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Affiliation(s)
- Priyanka Madaan
- Pediatric Neurology Division, Department of Pediatrics, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Shivan Keshavan
- Pediatric Neurology Division, Department of Pediatrics, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Lokesh Saini
- Pediatric Neurology Division, Department of Pediatrics, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
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157
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Kesavan S, Sharawat IK, Dhawan SR, Saini L, Vyas S, Sahu JK, Sankhyan N. Teaching NeuroImages: Beaking in the brainstem: A diagnostic clue. Neurology 2019; 92:e2066-e2067. [PMID: 31010917 DOI: 10.1212/wnl.0000000000007374] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- Shivan Kesavan
- From the Pediatric Neurology Unit, Department of Pediatrics, Advanced Pediatrics Centre (S.K., I.K.S., S.R.D., L.S., J.K.S., N.S.), and Department of Radiodiagnosis and Imaging (S.V.), Post Graduate Institute of Medical Education & Research, Chandigarh, India
| | - Indar Kumar Sharawat
- From the Pediatric Neurology Unit, Department of Pediatrics, Advanced Pediatrics Centre (S.K., I.K.S., S.R.D., L.S., J.K.S., N.S.), and Department of Radiodiagnosis and Imaging (S.V.), Post Graduate Institute of Medical Education & Research, Chandigarh, India
| | - Sumeet R Dhawan
- From the Pediatric Neurology Unit, Department of Pediatrics, Advanced Pediatrics Centre (S.K., I.K.S., S.R.D., L.S., J.K.S., N.S.), and Department of Radiodiagnosis and Imaging (S.V.), Post Graduate Institute of Medical Education & Research, Chandigarh, India
| | - Lokesh Saini
- From the Pediatric Neurology Unit, Department of Pediatrics, Advanced Pediatrics Centre (S.K., I.K.S., S.R.D., L.S., J.K.S., N.S.), and Department of Radiodiagnosis and Imaging (S.V.), Post Graduate Institute of Medical Education & Research, Chandigarh, India.
| | - Sameer Vyas
- From the Pediatric Neurology Unit, Department of Pediatrics, Advanced Pediatrics Centre (S.K., I.K.S., S.R.D., L.S., J.K.S., N.S.), and Department of Radiodiagnosis and Imaging (S.V.), Post Graduate Institute of Medical Education & Research, Chandigarh, India
| | - Jitendra Kumar Sahu
- From the Pediatric Neurology Unit, Department of Pediatrics, Advanced Pediatrics Centre (S.K., I.K.S., S.R.D., L.S., J.K.S., N.S.), and Department of Radiodiagnosis and Imaging (S.V.), Post Graduate Institute of Medical Education & Research, Chandigarh, India
| | - Naveen Sankhyan
- From the Pediatric Neurology Unit, Department of Pediatrics, Advanced Pediatrics Centre (S.K., I.K.S., S.R.D., L.S., J.K.S., N.S.), and Department of Radiodiagnosis and Imaging (S.V.), Post Graduate Institute of Medical Education & Research, Chandigarh, India
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158
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Kumar S, Dhawan SR, Saini L, Singh P, Verma S, Singh M. Recurrent Paradoxical Tuberculosis with Chest Wall Abscess and Optochiasmatic Tuberculoma. J Pediatr Neurosci 2019; 13:500-502. [PMID: 30937100 PMCID: PMC6413591 DOI: 10.4103/jpn.jpn_90_18] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
New-onset clinical or radiological symptoms in a patient with tuberculosis pose diagnostic treatment challenges, which can be due to treatment failure, disease relapse, or paradoxical response. We describe an adolescent case of recurrent paradoxical response complicating tuberculous meningitis. The first paradoxical tuberculosis presented as chest wall abscess, which was complicated by uniocular, gradually progressive, painless loss of vision after 6 months.
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Affiliation(s)
- Suresh Kumar
- Department of Paediatric Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Sumeet R Dhawan
- Department of Paediatric Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Lokesh Saini
- Department of Paediatric Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Paramjeet Singh
- Department of Radiodiagnosis and Imaging, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Sanjay Verma
- Department of Paediatric Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Meenu Singh
- Department of Paediatric Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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159
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Affiliation(s)
- Priyanka Madaan
- Child Neurology Division, Department of Pediatrics, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Lokesh Saini
- Child Neurology Division, Department of Pediatrics, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
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160
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Dhawan SR, Saini L, Verma Attri S, Kumar A, Sankhyan N. Owl's Eye Sign in a Reversible Etiology of Spastic Quadriparesis. Neuropediatrics 2019; 50:135-136. [PMID: 30453355 DOI: 10.1055/s-0038-1675627] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Sumeet R Dhawan
- Department of Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Lokesh Saini
- Department of Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Savita Verma Attri
- Department of Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Ajay Kumar
- Department of Radiodiagnosis, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Naveen Sankhyan
- Department of Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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161
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Dhawan SR, Saini L, Ramachandran RP, Sankhyan N. Joint Hyperlaxity, Proximal Contractures, and Facial Weakness in Child With Spinal Muscular Atrophy. J Clin Neuromuscul Dis 2019; 20:138-140. [PMID: 30801486 DOI: 10.1097/cnd.0000000000000224] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Affiliation(s)
- Sumeet R Dhawan
- Department of Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Lokesh Saini
- Department of Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | | | - Naveen Sankhyan
- Department of Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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162
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Dhawan SR, Adhikari U, Singanamala B, Kumaran S, Saini AG, Saini L. Recurrent Cerebrospinal Fluid Pleocytosis. Indian J Pediatr 2019; 86:308-309. [PMID: 30334135 DOI: 10.1007/s12098-018-2798-6] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2018] [Accepted: 09/20/2018] [Indexed: 10/28/2022]
Affiliation(s)
- Sumeet R Dhawan
- Department of Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012, India
| | - Usnish Adhikari
- Department of Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012, India
| | - Bhanudeep Singanamala
- Department of Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012, India
| | - Senthil Kumaran
- Department of Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012, India
| | - Arushi Gahlot Saini
- Department of Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012, India
| | - Lokesh Saini
- Department of Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012, India.
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163
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Affiliation(s)
- Indar Kumar Sharawat
- Pediatric Neurology Unit, Department of Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Lokesh Saini
- Pediatric Neurology Unit, Department of Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
| | - Dipankar De
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Naveen Sankhyan
- Pediatric Neurology Unit, Department of Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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164
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Kathiravan M, Dhawan SR, Singanamala B, Saini L, Sahu JK. Levetiracetam Induced Neuropsychiatric Manifestation in a 5-year-old Boy. Indian J Pediatr 2019; 86:193. [PMID: 30209735 DOI: 10.1007/s12098-018-2788-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2018] [Accepted: 08/31/2018] [Indexed: 11/30/2022]
Affiliation(s)
- Kathiravan M
- Department of Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012, India
| | - Sumeet R Dhawan
- Department of Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012, India
| | - Bhanudeep Singanamala
- Department of Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012, India
| | - Lokesh Saini
- Department of Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012, India.
| | - Jitendra Kumar Sahu
- Department of Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012, India
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165
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Affiliation(s)
- Sumeet R Dhawan
- Division of Pediatric Neurology, Department of Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Shivan Kesavan
- Division of Pediatric Neurology, Department of Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Lokesh Saini
- Division of Pediatric Neurology, Department of Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Paramjeet Singh
- Department of Radiology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Jitendra K Sahu
- Division of Pediatric Neurology, Department of Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Naveen Sankhyan
- Division of Pediatric Neurology, Department of Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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166
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167
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Srinivasan S, Sharawat IK, Saini L. Junctional Epidermolysis Bullosa in a Neonate. Indian Pediatr 2018; 55:1107-1108. [PMID: 30745488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Affiliation(s)
- Santhiya Srinivasan
- Pediatric Neurology Unit, Department of Pediatrics, PGIMER, Chandigarh, India
| | | | - Lokesh Saini
- Pediatric Neurology Unit, Department of Pediatrics, PGIMER, Chandigarh, India.
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168
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Jauhari P, Saini L, Chakrabarty B, Kumar A, Gulati S. Juvenile Canavan Disease: A Leukodystrophy without White Matter Changes. Neuropediatrics 2018; 49:420-421. [PMID: 30304741 DOI: 10.1055/s-0038-1672175] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Prashant Jauhari
- Division of Child Neurology, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India
| | - Lokesh Saini
- Division of Child Neurology, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India
| | - Biswaroop Chakrabarty
- Division of Child Neurology, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India
| | - Atin Kumar
- Department of Radiodiagnosis, Jai Prakash Narayan Trauma Centre, All India Institute of Medical Sciences, New Delhi, India
| | - Sheffali Gulati
- Division of Child Neurology, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India
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169
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Sharawat IK, Subramani V, Kesavan S, Saini L. Rare vascular complication of acute meningococcal meningitis in a child. BMJ Case Rep 2018; 2018:bcr-2018-227069. [PMID: 30373900 DOI: 10.1136/bcr-2018-227069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- Indar Kumar Sharawat
- Department of Pediatrics, Post Graduate Institute of Medical Education and Research, Chandigarh, Punjab, India
| | - Vignesh Subramani
- Department of Pediatrics, Post Graduate Institute of Medical Education and Research, Chandigarh, Punjab, India
| | - Shivan Kesavan
- Department of Pediatrics, Post Graduate Institute of Medical Education and Research, Chandigarh, Punjab, India
| | - Lokesh Saini
- Department of Pediatrics, Post Graduate Institute of Medical Education and Research, Chandigarh, Punjab, India
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170
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Sharawat IK, Saini L, Kasinathan A, Kaur A, Sankhyan N. Teaching NeuroImages: Distinctive imaging in a paucisymptomatic child with leukodystrophy. Neurology 2018; 91:e1368-e1369. [PMID: 30275131 DOI: 10.1212/wnl.0000000000006280] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- Indar Kumar Sharawat
- From the Pediatric Neurology and Neurodevelopment Unit (I.K.S., L.S., A. Kasinathan, N.S.), Department of Pediatrics (A. Kaur), Advanced Pediatrics Centre, Post Graduate Institute of Medical Education & Research, Chandigarh, India
| | - Lokesh Saini
- From the Pediatric Neurology and Neurodevelopment Unit (I.K.S., L.S., A. Kasinathan, N.S.), Department of Pediatrics (A. Kaur), Advanced Pediatrics Centre, Post Graduate Institute of Medical Education & Research, Chandigarh, India.
| | - Ananthanarayanan Kasinathan
- From the Pediatric Neurology and Neurodevelopment Unit (I.K.S., L.S., A. Kasinathan, N.S.), Department of Pediatrics (A. Kaur), Advanced Pediatrics Centre, Post Graduate Institute of Medical Education & Research, Chandigarh, India
| | - Amrit Kaur
- From the Pediatric Neurology and Neurodevelopment Unit (I.K.S., L.S., A. Kasinathan, N.S.), Department of Pediatrics (A. Kaur), Advanced Pediatrics Centre, Post Graduate Institute of Medical Education & Research, Chandigarh, India
| | - Naveen Sankhyan
- From the Pediatric Neurology and Neurodevelopment Unit (I.K.S., L.S., A. Kasinathan, N.S.), Department of Pediatrics (A. Kaur), Advanced Pediatrics Centre, Post Graduate Institute of Medical Education & Research, Chandigarh, India
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171
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Affiliation(s)
- Arundhati Banerjee
- Pediatrics Neurology Unit, Post Graduate Medical Education and Research, Chandigarh, India
| | - Lokesh Saini
- Pediatrics Neurology Unit, Post Graduate Medical Education and Research, Chandigarh, India
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172
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Dhawan SR, Gupta S, Saini L. Unexplained Transaminitis and Hyperactivity: Do Not Forget the Musculoskeletal Examination. Indian J Pediatr 2018; 85:682-683. [PMID: 29170921 DOI: 10.1007/s12098-017-2523-x] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2017] [Accepted: 10/04/2017] [Indexed: 10/18/2022]
Affiliation(s)
- Sumeet R Dhawan
- Department of Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012, India
| | - Saniya Gupta
- Department of Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012, India
| | - Lokesh Saini
- Department of Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012, India.
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173
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Sharawat IK, Saini L, Randhawa MS, Ahuja CK. Extensive Mongolian spots and normocephaly: an uncommon presentation of infantile Sandhoff's disease. BMJ Case Rep 2018; 2018:bcr-2018-225013. [PMID: 30061129 DOI: 10.1136/bcr-2018-225013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- Indar Kumar Sharawat
- Pediatrics, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Lokesh Saini
- Pediatrics, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | | | - Chirag Kamal Ahuja
- Radiodiagnosis & Imaging, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
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174
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Affiliation(s)
- Indar Kumar Sharawat
- Pediatric Neurology and Neurodevelopment Unit, Department of Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012, India
| | - Shivan Kesavan
- Pediatric Neurology and Neurodevelopment Unit, Department of Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012, India
| | - Vignesh Subramani
- Pediatric Neurology and Neurodevelopment Unit, Department of Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012, India
| | - Sameer Vyas
- Department of Radio-diagnosis and Imaging, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Jitendra Kumar Sahu
- Pediatric Neurology and Neurodevelopment Unit, Department of Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012, India
| | - Lokesh Saini
- Pediatric Neurology and Neurodevelopment Unit, Department of Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012, India.
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175
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Konanki R, Gulati S, Prasad K, Saini L, Pandey RM, Paul VK. Comparison of telephone with face to face consultation for follow up of Neurocysticercosis. Epilepsy Res 2018; 145:110-115. [PMID: 29936301 DOI: 10.1016/j.eplepsyres.2018.06.005] [Citation(s) in RCA: 8] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2018] [Revised: 06/07/2018] [Accepted: 06/11/2018] [Indexed: 10/14/2022]
Abstract
OBJECTIVES There is significant scarcity of specialists to provide care for children with epilepsy in many parts of the world. Telemedicine is a potential future option. This study was planned to estimate the diagnostic accuracy of telephone consultation to identify Critical Clinical Events (breakthrough seizures, drug non-compliance, drug adverse events, features of raised intracranial pressure, and other disease-related events),compared to the Face-to-Face consultation (gold standard), in children with Neurocysticercosis (NCC) and symptomatic seizures, following the completion of cysticidal therapy. METHODS Children aged 2-15 years attending a tertiary health care facility with a diagnosis of NCC and symptomatic seizures were enrolled after completion of the cysticidal therapy. The parents were contacted by a Pediatric Neurology Resident on Telephone before the scheduled hospital visit. Subsequently, all the children were seen directly in hospital the next day by another Pediatric Neurology Resident. The information was noted on a structured questionnaire. The diagnostic accuracy of telephone consultation for identifying the Critical Clinical Events was estimated using Face-to-Face consultation as the gold standard. RESULTS A total of 1145 potential events were evaluated. Of these, the face-to-face consultation identified 56 events that would need hospital visit for detailed evaluation (breakthrough seizures in 19, drug non-compliance in 15, adverse drug events in 11, features of raised intracranial pressure in 8, and other disease-related events in 3), and 1089 events that did not require hospital consultation. The sensitivity, specificity, positive and negative predictive values of telephone consultation were 89.28% (78.12-95.96), 97.61% (96.52-98.43), 65.79% (54.01-76.30), and 99.43% (98.78-99.79) respectively. The likelihood ratios when telephone consultation was positive and negative were 37.3 and 0.11 respectively. SIGNIFICANCE Telephone consultation is an acceptable mode of follow-up for children with mild Neurocysticercosis and symptomatic seizures after completion of cysticidal therapy.
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Affiliation(s)
- Ramesh Konanki
- Division of Child Neurology, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India.
| | - Sheffali Gulati
- Division of Child Neurology, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India.
| | - Kameshwar Prasad
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India.
| | - Lokesh Saini
- Division of Child Neurology, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India.
| | | | - Vinod Kumar Paul
- Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India.
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176
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Bhattacharya D, Sharawat IK, Saini L. Intraventricular haemorrhage and obstructive hydrocephalus in a term neonate: an uncommon presentation of haemophilia B. BMJ Case Rep 2018; 2018:bcr-2018-225341. [PMID: 29848541 DOI: 10.1136/bcr-2018-225341] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- Deepanjan Bhattacharya
- Pediatric Neurology Unit, Department of Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Indar Kumar Sharawat
- Pediatric Neurology Unit, Department of Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Lokesh Saini
- Pediatric Neurology Unit, Department of Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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177
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Vellarikkal SK, Jayarajan R, Verma A, Ravi R, Senthilvel V, Kumar A, Saini L, Gulati S, Lal M, Mathur A, Chhetri MK, Faruq M, Scaria V, Sivasubbu S. A founder mutation MLC1 c.736delA associated with megalencephalic leukoencephalopathy with subcortical cysts-1 in north Indian kindred. Clin Genet 2018; 94:271-273. [PMID: 29667716 DOI: 10.1111/cge.13251] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2018] [Revised: 03/01/2018] [Accepted: 03/19/2018] [Indexed: 11/28/2022]
Affiliation(s)
- S K Vellarikkal
- Genomics and Molecular Medicine Unit, CSIR Institute of Genomics and Integrative Biology (CSIR-IGIB), New Delhi, India.,Academy of Scientific and Innovative Research (AcSIR), CSIR-IGIB South Campus, New Delhi, India
| | - R Jayarajan
- Genomics and Molecular Medicine Unit, CSIR Institute of Genomics and Integrative Biology (CSIR-IGIB), New Delhi, India
| | - A Verma
- Genomics and Molecular Medicine Unit, CSIR Institute of Genomics and Integrative Biology (CSIR-IGIB), New Delhi, India
| | - R Ravi
- Genomics and Molecular Medicine Unit, CSIR Institute of Genomics and Integrative Biology (CSIR-IGIB), New Delhi, India
| | - V Senthilvel
- Genomics and Molecular Medicine Unit, CSIR Institute of Genomics and Integrative Biology (CSIR-IGIB), New Delhi, India
| | - A Kumar
- Genomics and Molecular Medicine Unit, CSIR Institute of Genomics and Integrative Biology (CSIR-IGIB), New Delhi, India
| | - L Saini
- Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India
| | - S Gulati
- Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India
| | - M Lal
- Alshifa Multispeciality Hospital, New Delhi, India
| | - A Mathur
- Genomics and Molecular Medicine Unit, CSIR Institute of Genomics and Integrative Biology (CSIR-IGIB), New Delhi, India
| | - M K Chhetri
- Genomics and Molecular Medicine Unit, CSIR Institute of Genomics and Integrative Biology (CSIR-IGIB), New Delhi, India
| | - M Faruq
- Genomics and Molecular Medicine Unit, CSIR Institute of Genomics and Integrative Biology (CSIR-IGIB), New Delhi, India.,Academy of Scientific and Innovative Research (AcSIR), CSIR-IGIB South Campus, New Delhi, India
| | - V Scaria
- Academy of Scientific and Innovative Research (AcSIR), CSIR-IGIB South Campus, New Delhi, India.,GN Ramachandran Knowledge Center for Genome Informatics, CSIR Institute of Genomics and Integrative Biology, New Delhi, India
| | - S Sivasubbu
- Genomics and Molecular Medicine Unit, CSIR Institute of Genomics and Integrative Biology (CSIR-IGIB), New Delhi, India.,Academy of Scientific and Innovative Research (AcSIR), CSIR-IGIB South Campus, New Delhi, India
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178
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Saini L, Jauhari P, Chakrabarty B, Kumar A, Gulati S. Isolated striatal lesions: A rare imaging finding of neurofibromatosis type I. Neurol India 2018; 66:572-573. [PMID: 29547202 DOI: 10.4103/0028-3886.227305] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Lokesh Saini
- Child Neurology Division, Department of Pediatrics, All Institute of Medical Sciences, New Delhi, India
| | - Prashant Jauhari
- Child Neurology Division, Department of Pediatrics, All Institute of Medical Sciences, New Delhi, India
| | - Biswaroop Chakrabarty
- Child Neurology Division, Department of Pediatrics, All Institute of Medical Sciences, New Delhi, India
| | - Atin Kumar
- Department of Radiodiagnosis, Jai Prakash Narayan Trauma Centre, All Institute of Medical Sciences, New Delhi, India
| | - Sheffali Gulati
- Child Neurology Division, Department of Pediatrics, All Institute of Medical Sciences, New Delhi, India
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179
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Sharawat IK, Saini L. Recurrent Focal Seizures and Transient Hemiparesis: Think About Alternating Hemiplegia of Childhood. Pediatr Neurol 2018; 80:97-98. [PMID: 29395725 DOI: 10.1016/j.pediatrneurol.2017.11.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2017] [Revised: 11/15/2017] [Accepted: 11/17/2017] [Indexed: 11/26/2022]
Affiliation(s)
- Indar Kumar Sharawat
- Pediatric Neurology and Neurodevelopment Unit, Department of Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Lokesh Saini
- Pediatric Neurology and Neurodevelopment Unit, Department of Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
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180
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Affiliation(s)
- Lokesh Saini
- Department of Pediatrics, Lotus Children Hospital, Hyderabad, Telangana, India
| | | | - V S V Prasad
- Department of Pediatrics, Lotus Children Hospital, Hyderabad, Telangana, India
| | - Dandu Ravi Varma
- Department of Neuroradiology, Citi Neuro Center, Hyderabad, Telangana, India
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181
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Saini L, Patra MK, Dhaka MK, Jani RK, Gupta GK, Dixit A, Vadera SR. Ni/graphitic carbon core–shell nanostructure-based light weight elastomeric composites for Ku-band microwave absorption applications. CrystEngComm 2018. [DOI: 10.1039/c8ce00620b] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Graphitic carbon-coated Ni metal core nanoparticles with respective reflection loss for different thickness of Ni/C and rubber composites.
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Affiliation(s)
- Lokesh Saini
- Materials Development Group
- Defence Laboratory
- Jodhpur-342011
- India
- Department of Physics & Center for Solar Energy
| | | | | | - Raj Kumar Jani
- Materials Development Group
- Defence Laboratory
- Jodhpur-342011
- India
| | - Goutam Kumar Gupta
- Department of Physics & Center for Solar Energy
- Indian Institute of Technology Jodhpur
- Jodhpur-342037
- India
| | - Ambesh Dixit
- Department of Physics & Center for Solar Energy
- Indian Institute of Technology Jodhpur
- Jodhpur-342037
- India
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182
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Saini L, Patra MK, Jani RK, Gupta GK, Dixit A, Vadera SR. Tunable Twin Matching Frequency (f m1/f m2) Behavior of Ni 1-xZn xFe 2O 4/NBR Composites over 2-12.4 GHz: A Strategic Material System for Stealth Applications. Sci Rep 2017; 7:44457. [PMID: 28294151 PMCID: PMC5353733 DOI: 10.1038/srep44457] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2016] [Accepted: 02/07/2017] [Indexed: 11/09/2022] Open
Abstract
The gel to carbonate precipitate route has been used for the synthesis of Ni1-xZnxFe2O4 (x = 0, 0.25, 0.5 and 0.75) bulk inverse spinel ferrite powder samples. The optimal zinc (50%) substitution has shown the maximum saturation magnetic moment and resulted into the maximum magnetic loss tangent (tanδm) > -1.2 over the entire 2-10 GHz frequency range with an optimum value ~-1.75 at 6 GHz. Ni0.5Zn0.5Fe2O4- Acrylo-Nitrile Butadiene Rubber (NBR) composite samples are prepared at different weight percentage (wt%) of ferrite loading fractions in rubber for microwave absorption evaluation. The 80 wt% loaded Ni0.5Zn0.5Fe2O4/NBR composite (FMAR80) sample has shown two reflection loss (RL) peaks at 5 and 10 GHz. Interestingly, a single peak at 10 GHz for 3.25 mm thickness, can be scaled down to 5 GHz by increasing the thickness up to 4.6 mm. The onset of such twin matching frequencies in FMAR80 composite sample is attributed to the spin resonance relaxation at ~5 GHz (fm1) and destructive interference at λm/4 matched thickness near ~10 GHz (fm2) in these composite systems. These studies suggest the potential of tuning the twin frequencies in Ni0.5Zn0.5Fe2O4/NBR composite samples for possible microwave absorption applications.
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Affiliation(s)
- Lokesh Saini
- Camouglage Division, Defence Laboratory, Ratanada Palace, Jodhpur-342011, India.,Department of Physics &Center for Solar Energy, Indian Institute of Technology Jodhpur, Old Residency Road, Jodhpur-342011, India
| | - Manoj Kumar Patra
- Camouglage Division, Defence Laboratory, Ratanada Palace, Jodhpur-342011, India
| | - Raj Kumar Jani
- Camouglage Division, Defence Laboratory, Ratanada Palace, Jodhpur-342011, India
| | - Goutam Kumar Gupta
- Department of Physics &Center for Solar Energy, Indian Institute of Technology Jodhpur, Old Residency Road, Jodhpur-342011, India
| | - Ambesh Dixit
- Department of Physics &Center for Solar Energy, Indian Institute of Technology Jodhpur, Old Residency Road, Jodhpur-342011, India
| | - Sampat Raj Vadera
- Camouglage Division, Defence Laboratory, Ratanada Palace, Jodhpur-342011, India
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183
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Gulati S, Saini L, Chakrabarty B, Kumar A. Microcephaly with generalized dystonia: Exception to the rule. Neurol India 2017; 65:669-670. [DOI: 10.4103/neuroindia.ni_1368_15] [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]
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184
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Gulati S, Pastel H, Chakrabarty B, Saini L, Kumar A. A case of anti- N-methyl-D-aspartate (NMDA) receptor encephalitis possibly triggered by an episode of Japanese B encephalitis. Neurol India 2017; 65:895-897. [DOI: 10.4103/neuroindia.ni_340_16] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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185
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Saini L, Chakrabarty B, Kumar A, Gulati S. A genetically proven case of Pelizaeus-Merzbacher disease: Clinicoradiological clues. Ann Indian Acad Neurol 2016; 19:533-535. [PMID: 27994374 PMCID: PMC5144486 DOI: 10.4103/0972-2327.194470] [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: 11/05/2022] Open
Affiliation(s)
- Lokesh Saini
- Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India
| | | | - Atin Kumar
- Department of Radiodiagnosis, All India Institute of Medical Sciences, New Delhi, India
| | - Sheffali Gulati
- Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India
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186
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Sharma P, Sagar R, Patra B, Saini L, Gulati S, Chakrabarty B. Psychotic symptoms in anti-N-methyl-d-aspartate (NMDA) receptor encephalitis: A case report and challenges. Asian J Psychiatr 2016; 22:135-7. [PMID: 27520914 DOI: 10.1016/j.ajp.2016.06.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2016] [Revised: 05/20/2016] [Accepted: 06/19/2016] [Indexed: 11/17/2022]
Abstract
Anti-N-methyl-d-aspartate (NMDA) receptor encephalitis, only recently first described, is an increasingly well-recognized inflammatory encephalitis that is seen in children and adults. An 11-year old girl admitted to the psychiatry ward with a presentation of acute psychosis was diagnosed with NMDA receptor encephalitis following neurology referral and was treated accordingly. This case highlights psychiatric manifestations in encephalitis and the need for the psychiatrist to have high index of suspicion when atypical symptoms (e.g., dyskinesia, seizure, fever etc.) present in acutely psychotic patients.
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Affiliation(s)
- Pawan Sharma
- Department of Psychiatry, All India Institute of Medical Sciences, New Delhi, India.
| | - Rajesh Sagar
- Department of Psychiatry, All India Institute of Medical Sciences, New Delhi, India
| | - Bichitrananda Patra
- Department of Psychiatry, All India Institute of Medical Sciences, New Delhi, India
| | - Lokesh Saini
- Department of Pediatric Neurology, All India Institute of Medical Sciences, New Delhi, India
| | - Sheffali Gulati
- Department of Pediatric Neurology, All India Institute of Medical Sciences, New Delhi, India
| | - Biswaroop Chakrabarty
- Department of Pediatric Neurology, All India Institute of Medical Sciences, New Delhi, India
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187
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Dubey R, Chakrabarty B, Saini L, Madaan P, Gulati S. Bilateral ophthalmoplegia in a child with migraine. Brain Dev 2016; 38:525-8. [PMID: 26577169 DOI: 10.1016/j.braindev.2015.10.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [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: 07/23/2015] [Revised: 10/16/2015] [Accepted: 10/21/2015] [Indexed: 01/03/2023]
Abstract
BACKGROUND In children, migraine with or without aura is a common entity, however variants like recurrent painful optic neuropathy (RPON) is rarely encountered. CASE RESULT A 9 year old boy presented with headache for 1 week and restricted movements and drooping in both eyes for last 3 days. On examination he had bilateral ophthalmoplegia and ptosis. History of migrainous headache was present in the patient as well as his mother. His MRI brain with venogram, serum autoimmune markers, serum and urine toxicology screen and repetitive nerve stimulation test were normal. He received intravenous pulse followed by oral steroids for 6 weeks and was started on antimigraine prophylaxis. Eighteen months since the attack, he has improved completely with mild asymmetric mydriasis persisting. DISCUSSION AND CONCLUSION This may represent first attack of RPON in a child with migraine. Rarely this may herald the onset of migraine as well, index of suspicion should be high as it is a diagnosis of exclusion and a treatable entity.
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Affiliation(s)
- Rachana Dubey
- Division of Child Neurology, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi 110029, India
| | - Biswaroop Chakrabarty
- Division of Child Neurology, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi 110029, India
| | - Lokesh Saini
- Division of Child Neurology, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi 110029, India
| | - Priyanka Madaan
- Division of Child Neurology, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi 110029, India
| | - Sheffali Gulati
- Division of Child Neurology, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi 110029, India.
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188
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Abstract
Headache is infrequent in early childhood. Headache and neurological deficits associated with cerebrospinal fluid (CSF) lymphocytosis (HaNDL), a variant of migraine, is a rare disorder. A 5-year-old boy presented with recurrent episodes of headache for 6 months. Each episode lasted for a week and in the current episode, he was symptomatic for 3 days. All the episodes were associated with paresthesias and CSF lymplocytosis with normal protein and sugar. There was history of migraine in his family. His magnetic resonance imaging (MRI) brain with contrast with magnetic resonance (MR) angiography and venography were normal. Work-up for relevant causes of infection and vasculitis were negative. His symptoms subsided on oral antimigraine prophylaxis and he has been on remission for last 8 months. HaNDL should be considered in relevant clinical scenarios, as it prevents unnecessary investigations, therapy, and hospitalization.
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Affiliation(s)
- Lokesh Saini
- Department of Pediatrics, Child Neurology Division, All India Institute of Medical Sciences, New Delhi, India
| | - Ranjith M Kumar
- Department of Pediatrics, Child Neurology Division, All India Institute of Medical Sciences, New Delhi, India
| | - Biswaroop Chakrabarty
- Department of Pediatrics, Child Neurology Division, All India Institute of Medical Sciences, New Delhi, India
| | - Sheffali Gulati
- Department of Pediatrics, Child Neurology Division, All India Institute of Medical Sciences, New Delhi, India
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189
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Dubey R, Kaushik JS, Israni A, Saini L, Patel H, Chakrabarty B, Gulati S. Finger drop sign: Rare presentation of a common disorder. Brain Dev 2016; 38:250-2. [PMID: 26323550 DOI: 10.1016/j.braindev.2015.08.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [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: 06/18/2015] [Revised: 07/31/2015] [Accepted: 08/06/2015] [Indexed: 10/23/2022]
Abstract
BACKGROUND Guillain Barre syndrome (GBS) commonly presents with limb weakness and occasional cranial nerve, respiratory or autonomic involvement. Isolated or predominant bilateral finger drop as presenting feature has never been reported in the pediatric age group. CASE A 9-year-old boy presented with deformity of both hands for 7 days and leg pain with difficulty in getting up from floor for 3 days. On examination he had bilateral clawing with subtle hip flexor weakness and hyporeflexia. His nerve conduction study revealed motor axonal neuropathy. His serum lead levels and autoimmune markers were within normal limits. His cerebrospinal fluid examination revealed albuminocytological dissociation. He was diagnosed as GBS and was given intravenous immunoglobulin. He improved completely over next 8 weeks. CONCLUSIONS GBS is one of the commonest causes of acquired neuropathy in the tropics. In resource limited setting, where electrophysiological facilities may not be available, identification of finger drop sign may help in correct management.
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Affiliation(s)
- Rachana Dubey
- Division of Child Neurology, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi 110029, India
| | - Jaya Shankar Kaushik
- Division of Child Neurology, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi 110029, India
| | - Anil Israni
- Division of Child Neurology, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi 110029, India
| | - Lokesh Saini
- Division of Child Neurology, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi 110029, India
| | - Harsh Patel
- Division of Child Neurology, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi 110029, India
| | - Biswaroop Chakrabarty
- Division of Child Neurology, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi 110029, India
| | - Sheffali Gulati
- Division of Child Neurology, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi 110029, India.
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190
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Purohit S, Dutt N, Saini L, Panwar R, Kumar S. High resolution computed tomography in chronic obstructive pulmonary disease patients: Do not forget radiation hazard. Lung India 2016; 33:582-3. [PMID: 27625468 PMCID: PMC5006354 DOI: 10.4103/0970-2113.189006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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191
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Abstract
Objective: This is a retrospective chart review of consecutive children with acquired demyelinating disorders presenting to a north Indian tertiary care hospital over 4 years. The aim of this review is to describe all the patients (with single event as well as those with recurrences) with detailed description of those who recurred. Materials and Methods: Overall 35 cases were reviewed and their clinical presentations, diagnosis, management, and follow-up are being presented. Results: Out of 35 cases, 24 did not show any recurrences (seven acute disseminated encephalomyelitis (ADEM) and 17 clinically isolated syndromes). Amongst the 11 patients with recurrent demyelination, majority were multiple sclerosis (8/11, 72.7%) followed by neuromyelitis optica (NMO; 2/11), and multiphasic ADEM (1/11). The median disease duration and follow-up since onset for those with recurrent episodes is 4 years (2.5-4.5 years). Steroids caused significant improvement in acute episodes of demyelination. However, recurrent demyelinating disorders like multiple sclerosis and NMO required long-term immunomodulation. Azathioprine currently is the most favored long-term immunomodulator used in NMO. Interferon-β and glatiramer acetate are currently recommended for multiple sclerosis. However, azathioprine may be a suitable alternative in a resource-limited setting. Conclusion: The consensus definitions for these groups of disorders need further validation in the pediatric age group. Studies with larger population size are required to characterize features that predict future recurrences.
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Affiliation(s)
- Sheffali Gulati
- Department of Pediatrics, Jai Prakash Narayan Apex Trauma Centre, All India Institute of Medical Sciences, New Delhi, India
| | - Biswaroop Chakrabarty
- Department of Pediatrics, Jai Prakash Narayan Apex Trauma Centre, All India Institute of Medical Sciences, New Delhi, India
| | - Atin Kumar
- Department of Radio-Diagnosis, Jai Prakash Narayan Apex Trauma Centre, All India Institute of Medical Sciences, New Delhi, India
| | - Puneet Jain
- Department of Pediatrics, Jai Prakash Narayan Apex Trauma Centre, All India Institute of Medical Sciences, New Delhi, India
| | - Harsh Patel
- Department of Pediatrics, Jai Prakash Narayan Apex Trauma Centre, All India Institute of Medical Sciences, New Delhi, India
| | - Lokesh Saini
- Department of Pediatrics, Jai Prakash Narayan Apex Trauma Centre, All India Institute of Medical Sciences, New Delhi, India
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192
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Kumar RM, Saini L, Kaushik JS, Chakrabarty B, Kumar A, Gulati S. A Combination of Moyamoya Pattern and Cerebral Venous Sinus Thrombosis: A Case of Tubercular Vasculopathy. J Trop Pediatr 2015; 61:393-6. [PMID: 26136258 DOI: 10.1093/tropej/fmv036] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [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] [Indexed: 11/13/2022]
Abstract
BACKGROUND Moyamoya vasculopathy, arising secondary to tubercular meningitis (TBM) is unusual. There have also been a few reports of cerebral venous sinus thrombosis (CVST) in TBM. A case of TBM, complicated simultaneously by Moyamoya syndrome and CVST, is being presented here. CASE A 1-year-old girl presented with febrile encephalopathy, vomiting, seizures and left hemiparesis. Cerebrospinal fluid analysis was suggestive of TBM. Extensive infarcts were noted in the magnetic resonance imaging, involving right middle cerebral artery (MCA), anterior cerebral artery and the left MCA. Magnetic resonance venogram revealed left transverse venous sinus thrombosis and magnetic resonance angiography showed bilateral moyamoya pattern of arteriopathy. Patient was started on antitubercular therapy and low molecular weight heparin. CONCLUSIONS Early vascular involvement affecting both arterial and venous structures has not hitherto been reported in CNS tuberculosis. Early recognition of secondary complications of CNS tuberculosis is crucial to prevent the morbidity and mortality associated with TBM.
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Affiliation(s)
- Ranjith M Kumar
- Child Neurology Division, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi 110029, India
| | - Lokesh Saini
- Child Neurology Division, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi 110029, India
| | - Jaya Shankar Kaushik
- Child Neurology Division, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi 110029, India
| | - Biswaroop Chakrabarty
- Child Neurology Division, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi 110029, India
| | - Atin Kumar
- Department of Radiodiagnosis, All India Institute of Medical Sciences, New Delhi 110029, India
| | - Sheffali Gulati
- Child Neurology Division, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi 110029, India
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Affiliation(s)
- Lokesh Saini
- From the All India Institute of Medical Sciences, New Delhi, India
| | | | - Atin Kumar
- From the All India Institute of Medical Sciences, New Delhi, India
| | - Sheffali Gulati
- From the All India Institute of Medical Sciences, New Delhi, India.
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194
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Dubey R, Saini L, Manokaran RK, Chakrabarty B, Agrawal D, Kumar A, Gulati S. A Trembling Child at Rest, Action, and Intention: A Unique Treatable Entity. Pediatr Neurol 2015; 53:268-9. [PMID: 26164825 DOI: 10.1016/j.pediatrneurol.2015.05.007] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2015] [Revised: 05/14/2015] [Accepted: 05/15/2015] [Indexed: 11/16/2022]
Affiliation(s)
- Rachana Dubey
- Child Neurology Division, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India
| | - Lokesh Saini
- Child Neurology Division, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India
| | - Ranjith Kumar Manokaran
- Child Neurology Division, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India
| | - Biswaroop Chakrabarty
- Child Neurology Division, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India
| | - Deepak Agrawal
- Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India
| | - Atin Kumar
- Department of Radiodiagnosis, All India Institute of Medical Sciences, New Delhi, India
| | - Sheffali Gulati
- Child Neurology Division, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India.
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195
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Gulati S, Saini L, Chakrabarty B, Kumar A. A rare cause of occipital headache. J Pediatr Neurosci 2015; 10:416-7. [PMID: 26962363 PMCID: PMC4770669 DOI: 10.4103/1817-1745.174448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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196
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Patel H, Chakrabarty B, Gulati S, Sharma MC, Saini L. A case of congenital myopathy masquerading as paroxysmal dyskinesia. Ann Indian Acad Neurol 2014; 17:441-3. [PMID: 25506169 PMCID: PMC4251021 DOI: 10.4103/0972-2327.144034] [Citation(s) in RCA: 1] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2014] [Revised: 03/16/2014] [Accepted: 03/23/2014] [Indexed: 11/23/2022] Open
Abstract
Gastroesophageal reflux (GER) disease is a significant comorbidity of neuromuscular disorders. It may present as paroxysmal dyskinesia, an entity known as Sandifer syndrome. A 6-week-old neonate presented with very frequent paroxysms of generalized stiffening and opisthotonic posture since day 22 of life. These were initially diagnosed as seizures and he was started on multiple antiepileptics which did not show any response. After a normal video electroencephalogram (VEEG) was documented, possibility of dyskinesia was kept. However, when he did not respond to symptomatic therapy, Sandifer syndrome was thought of and GER scan was done, which revealed severe GER. After his symptoms got reduced to some extent, a detailed clinical examination revealed abnormal facies with flaccid quadriparesis. Muscle biopsy confirmed the diagnosis of a specific congenital myopathy. On antireflux measures, those episodic paroxysms reduced to some extent. Partial response to therapy in GER should prompt search for an underlying secondary etiology.
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Affiliation(s)
- Harsh Patel
- Department of Pediatrics (Division of Child Neurology), All India Institute of Medical Sciences, New Delhi, India
| | - Biswaroop Chakrabarty
- Department of Pediatrics (Division of Child Neurology), All India Institute of Medical Sciences, New Delhi, India
| | - Sheffali Gulati
- Department of Pediatrics (Division of Child Neurology), All India Institute of Medical Sciences, New Delhi, India
| | - Mehar C Sharma
- Department of Pathology, All India Institute of Medical Sciences, New Delhi, India
| | - Lokesh Saini
- Department of Pediatrics (Division of Child Neurology), All India Institute of Medical Sciences, New Delhi, India
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197
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Dayal D, Saini L, Attri SV, Singh B, Bhalla AK. Daily versus alternate day thyroxine therapy to maintain euthyroidism in children with congenital hypothyroidism. Int J Endocrinol Metab 2013; 11:e9499. [PMID: 24719634 PMCID: PMC3968978 DOI: 10.5812/ijem.9499] [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] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2012] [Revised: 04/06/2013] [Accepted: 04/21/2013] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Daily administration of thyroxine has proven efficacy in treatment of children with hypothyroidism. However, the possibility of treatment with longer dosing intervals that offers flexibility and choice in maintaining euthyroid state has not been tested in children. OBJECTIVES To study the efficacy of an alternate day regimen to maintain euthyroidism in children with congenital hypothyroidism. PATIENTS AND METHODS Forty patients given alternate day therapy, while 30 children continued on their daily regimen were followed up at monthly intervals for 3 months. Clinical and laboratory assessments were performed at each follow up visit. RESULTS The clinical and anthropometric parameters remained similar in both groups of patients during the study indicating a maintained euthyroid state clinically. The thyroid profiles also remained within normal limits suggesting biochemical euthyroidism status with alternate day therapy. However the baseline serum aminotransferase levels showed mild elevation in patients on alternate day regimen and the difference persisted during the follow up visits. Higher HDL and lower TC and LDL levels suggested some beneficial effect of alternate day schedule on lipid profiles. CONCLUSIONS In short-term, alternate day schedule can be effectively used to maintain clinical and biochemical euthyroid state in children with congenital hypothyroidism beyond 4 years of age.
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Affiliation(s)
- Devi Dayal
- Departments of Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, India
- Corresponding author: Devi Dayal, Department of Pediatrics, Advanced Pediatrics Center, Postgraduate Institute of Medical Education and Research,Chandigarh, India. Tel: +91-1722755657, Fax:+91-1722744401, E-mail:
| | - Lokesh Saini
- Departments of Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Savita Verma Attri
- Departments of Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Baljinder Singh
- Departments of Nuclear Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Anil Kumar Bhalla
- Departments of Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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198
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Ahsan MJ, Samy JG, Soni S, Jain N, Kumar L, Sharma LK, Yadav H, Saini L, Kalyansing RG, Devenda NS, Prasad R, Jain CB. Discovery of novel antitubercular 3a,4-dihydro-3H-indeno[1,2-c]pyrazole-2-carboxamide/carbothioamide analogues. Bioorg Med Chem Lett 2011; 21:5259-61. [PMID: 21807509 DOI: 10.1016/j.bmcl.2011.07.035] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2011] [Revised: 07/06/2011] [Accepted: 07/08/2011] [Indexed: 10/17/2022]
Abstract
In the present investigation, a series of 3a,4-dihydro-3H-indeno[1,2-c]pyrazole-2-carboxamide/carbothioamide analogues were synthesized and were evaluated for antitubercular activity by two fold serial dilution technique. All the newly synthesized compounds showed low to high inhibitory activities against Mycobacterium tuberculosis H(37)Rv and INH resistant M. tuberculosis. The compound 3-(4-fluorophenyl)-6,7-dimethoxy-3a,4-dihydro-3H-indeno[1,2-c]pyrazole-2-carbothioamide (4o) was found to be the most promising compound active against M. tuberculosis H(37)Rv and isoniazid resistant M. tuberculosis with minimum inhibitory concentration 3.12 μM and 6.25 μM, respectively.
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Affiliation(s)
- Mohamed Jawed Ahsan
- New Drug Discovery Research, Department of Medicinal Chemistry, Alwar Pharmacy College, Alwar, Rajasthan 301 030, India.
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199
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Migliori GB, Ambrosetti M, Besozzi G, Farris B, Nutini S, Saini L, Confalonieri M, Bugiani M, Codecasa LR. Microbiological confirmation of tuberculosis cases at diagnosis and at the end of treatment in Italy. Eur J Epidemiol 2001; 16:719-24. [PMID: 11142499 DOI: 10.1023/a:1026798000966] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [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: 11/12/2022]
Abstract
Microbiological findings at diagnosis and at the end of treatment are relevant for evaluating tuberculosis (TB) treatment programmes. The objectives of this study were to describe the microbiological findings at diagnosis and at the end of treatment in pulmonary and extrapulmonary TB patients treated under programme conditions in Italy. The study was a prospective monitoring activity based on the collection of standard recording and reporting forms from a representative sample of Italian TB Units. The forms with individual data were reviewed and analysed on a quarterly basis, 9 months after enrolment. The complete bacteriological profile of patients was analysed at diagnosis and at the completion of treatment. Individual data on 992 patients were analysed. At diagnosis 320 (32.2%) of cases were pulmonary sputum smear positive, 361 (36.4%) pulmonary smear negative or not done and 311 (33.4%) extrapulmonary; 424 (42.7%) of all TB cases were culture confirmed at diagnosis (368, 50.2%, of pulmonary cases); 575 (84.4%) of pulmonary cases had a culture done at diagnosis and 156 (22.9%) at the end of treatment (p < 0.001); 572 (84%) had a sputum smear done at diagnosis and 164 (24.1%) at the end of treatment (p < 0.001). Although the rate of bacteriologically confirmed cases is similar to that of other European countries, the bacteriological confirmation at diagnosis and, particularly, at the end of treatment, is sub-optimal. The importance of further disseminating national guidelines among physicians managing TB is emphasized, in order to achieve a higher proportion of TB cases bacteriologically confirmed at diagnosis and monitored at the end of treatment.
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Affiliation(s)
- G B Migliori
- Fondazione Salvatore Maugeri, Clinica del Lavoro e della Riabilitazione, Care and Research Institute, Tradate, VA , Italy.
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200
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Ambrosetti M, Besozzi G, Codecasa LR, Farris B, Nutini S, Saini L, Casali L, Nardini S, Migliori GB. The Italian AIPO study on tuberculosis treatment results, report 1997. National AIPO "Tuberculosis" Study Group. Monaldi Arch Chest Dis 1999; 54:407-12. [PMID: 10741100] [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: 02/16/2023] Open
Abstract
In Italy no national data have been available on tuberculosis (TB) treatment results. In 1995 the AIPO (Italian Association of Hospital Pneumologists) TB Study Group, in collaboration with the Istituto Superiore di Sanità (technical branch of the Ministry of Health) started a prospective monitoring activity based on the recommendations of the World Health Organization and the International Union Against Tuberculosis and Lung Disease. The aim of this study was to analyse the case findings and treatment results during 1997. Data were collected from a representative network of TB units nation-wide, managing a significant proportion of all TB cases notified in Italy each year. A total of 715 TB cases were reported (56% males; 24% immigrants), of which 635 (89%) were new cases. Of these cases 493 (69%) were pulmonary, 187 (26%) extra-pulmonary cases and 35 (5%) both pulmonary and extrapulmonary. The main risk factors for TB were history of recent contact and diabetes among native Italians, human immunodeficiency virus-seropositive status and a history of recent contact among immigrants. The majority of immigrants came from Africa and Central and South America, and stayed in Italy for more than 24 months before the diagnosis of TB was made. Thirty-six per cent of patients had a positive direct sputum smear examination for alcohol acid-fast bacilli and 27% were resistant to any drug (monoresistance to isoniazid: 2.4%; multi-drug resistance: 7.5%). In 97% of cases the duration of treatment was < 12 months. The overall success rate (cured plus treatment completed) was 78.1%. A significantly higher percentage of deaths, which was age related, was found in native Italians, while immigrants had a higher default rate. In conclusion, case finding and treatment results in Italy in 1997 are similar to those described in 1995 and 1996.
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Affiliation(s)
- M Ambrosetti
- Fondazione Salvatore Maugeri, Care and Research Institute, Tradate, Italy
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