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Giri S, Chhabra P, Kulkarni R, Reju S, Sabapathy SK, Selvarajan S, Varghese T, Kalaivanan M, Dorairaj P, Kalrao V, Mankar S, Sangamnerkar M, Purushothaman GKC, Srikanth P, Kang G, Vinjé J. Hospital-based norovirus surveillance in children <5 years of age from 2017 to 2019 in India. J Med Virol 2024; 96:e29384. [PMID: 38235830 PMCID: PMC10875411 DOI: 10.1002/jmv.29384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 11/17/2023] [Accepted: 12/28/2023] [Indexed: 01/19/2024]
Abstract
After the introduction of the rotavirus vaccine into the Universal Immunization Program in India in 2016, relatively few studies have assessed the prevalence and epidemiological patterns of acute gastroenteritis (AGE) among hospitalized children ≤5 years of age. We used a uniform protocol to recruit children with AGE as well as standardized testing and typing protocols. Stool specimens from children with AGE younger than 5 years of age admitted to six hospitals in three cities in India were collected from January 2017 through December 2019. Norovirus was detected by real-time reverse transcription-polymerase chain reaction (RT-qPCR) followed by typing positive specimens by conventional RT-PCR and Sanger sequencing. Norovirus was detected in 322 (14.8%) of 2182 specimens with the highest rate in 2018 (17.6%, 146/829), followed by 2019 (14.4%, 122/849) and 2017 (10.7%, 54/504). Rotavirus vaccine status was known for 91.6% of the children of which 70.4% were vaccinated and 29.6% not. Norovirus positivity in rotavirus-vaccinated children was 16.3% and 12% in unvaccinated children. GII.4 Sydney[P16] (39.3%), GII.4 Sydney[P31] (18.7%), GII.2[P16] (10%), GI.3[P13] (6.8%), GII.3[P16] (5.9%), and GII.13[P16] (5%) accounted for 85.8% (188/219) of the typed strains. Our data highlight the importance of norovirus in Indian children hospitalized with AGE.
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Affiliation(s)
- Sidhartha Giri
- Division of Gastrointestinal Sciences, Christian Medical College, Vellore, India
| | - Preeti Chhabra
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Ruta Kulkarni
- Interactive Research School for Health Affairs (IRSHA), Bharati Vidyapeeth, Pune, India
| | - Sudhabharathi Reju
- Department of Microbiology, Sri Ramachandra Institute of Higher Education and Research (SRIHER), Chennai, India
| | - Satheesh Kumar Sabapathy
- Indian Council of Medical Research (ICMR)-National Institute of Epidemiology (NIE), Chennai, India
| | - Sribal Selvarajan
- Department of Microbiology, Sri Ramachandra Institute of Higher Education and Research (SRIHER), Chennai, India
| | - Tintu Varghese
- Division of Gastrointestinal Sciences, Christian Medical College, Vellore, India
| | | | | | - Vijay Kalrao
- Bharati Hospital, Bharati Vidyapeeth (Deemed to be University) Medical College, Pune, India
| | | | | | | | - Padma Srikanth
- Department of Microbiology, Sri Ramachandra Institute of Higher Education and Research (SRIHER), Chennai, India
| | - Gagandeep Kang
- Division of Gastrointestinal Sciences, Christian Medical College, Vellore, India
| | - Jan Vinjé
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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Kalrao V, Srivastava L, Kumar S. Parenting stress and associated factors in healthcare workers after the second wave of COVID-19 in India: a two-center cross-sectional study. Front Psychiatry 2023; 14:1246540. [PMID: 37766928 PMCID: PMC10520724 DOI: 10.3389/fpsyt.2023.1246540] [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] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2023] [Accepted: 08/16/2023] [Indexed: 09/29/2023] Open
Abstract
Background High parenting stress (PS) in members of the general population during the COVID-19 pandemic was exacerbated by work-, family-, and child-related factors. However, the negative effects of PS on the mental health and work participation of healthcare workers (HCWs) have received limited attention. This study aimed to examine the proportion of severe PS among HCWs and identify its contributory factors. Methods This cross-sectional survey was conducted in two COVID-19-care hospitals attached to medical colleges in India between November 1 and December 24, 2021, following the delta variant-driven second wave of COVID-19. The study recruited 662 HCW parent and child dyads (aged 1.5-18 years) and assessed workplace, family, and child-related characteristics. The Parenting Stress Scale (PSS) and Child Behavior Checklist (CBCL) were used to identify severe PS and child behavioral issues, respectively. Univariable and multivariable logistic regression analyzes were used to identify the significant and independent risk factors associated with severe PS, respectively. Results Equal proportions of medical and paramedical HCWs completed the survey [mean age: 36.96 ± 5.89; female: 466 (70%)]. The median PSS score of HCWs was 33 [interquartile range (IQR): 28-39], and 23% (155/662) of the HCW parents experienced severe PS. The independent predictors of severe PS included the female sex [adjusted odds ratio (aOR): 3.31; 95% confidence interval (CI): 1.74-6.29], HCWs with >15-day postings in COVID-19 care (aOR: 3.74; 95% CI: 1.53-9.16), having children with behavioral issues (aOR: 3.49; 95% CI: 1.29-9.48), HCWs at the Dehradun center (aOR: 2.25; 95% CI: 1.24-4.10), having an HCW spouse simultaneously working in COVID-19 care (aOR: 1.88; 95% CI: 1.01-3.49), and HCWs with joint families (aOR: 1.93; 95% CI: 1.17-3.18). Conclusion Overall, 23% of the cohort of HCWs continued to experience severe PS after the second COVID-19 wave driven by the delta variant in India. Routine screening of HCWs for PS using the PSS or similar measures, anticipatory guidance for parenting, and targeting at-risk HCWs with appropriate supportive measures may help reduce the incidence of severe PS and optimize the participation of HCWs in the fight against current and future pandemic-like situations.
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Affiliation(s)
- Vijay Kalrao
- Department of Pediatrics, Bharati Vidyapeeth (Deemed to be University) Medical College, Pune, India
| | - Leena Srivastava
- Department of Pediatrics, Bharati Vidyapeeth (Deemed to be University) Medical College, Pune, India
| | - Shruti Kumar
- Department of Pediatrics, Shri Guru Ram Rai Institute of Medical and Health Sciences, Dehradun, India
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Lohiya N, Srivastava L, Lohiya N, Kalrao V. Stress among mothers of children with Autism Spectrum Disorder in comparison to children with & without special health care needs. J Pediatr Rehabil Med 2023; 16:473-481. [PMID: 36776080 DOI: 10.3233/prm-220014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/10/2023] Open
Abstract
PURPOSE Parenting a child with special health care needs (SHCN) is often stressful. This study aimed to measure and compare stress among mothers of children with (a) Autism Spectrum Disorder (ASD) - ASD group, (b) Developmental delay without ASD group, (c) SHCN without developmental delay group, and (d) Typically developing group. To assess factors associated with maternal stress in children with developmental disorders. METHODS A cross-sectional analytical study was performed with children aged 2-12 years and their mothers. The study population was classified into four groups as defined above help of detailed history, developmental & behavioral assessments, psychological assessments, and Child Special Health Care Needs Screener (CSHCN). Parental Stress Scale (PSS) Questionnaire was administered. The main outcome measurement was the PSS and various factors affecting it. RESULTS The mothers of the ASD group reported a high stress score (50.4±11.4) compared to SHCN without developmental delay group (38.2±8.8) and the Typically developing group (22.3±3.3) (p < 0.05) and higher but not significant stress than Developmental delay without ASD group (45.3±9.6, p > 0.05). Maladaptive behavioral issues and irregular interventions were the factors contributing to higher parental stress in the ASD group (p < 0.05). A moderate positive correlation was observed in rewarding and challenging scores of PSS among mothers of the ASD group, Developmental delay without ASD group, and SHCN without developmental delay group. CONCLUSION Mothers of the ASD group perceived higher stress as compared to SHCN without developmental delay group and Typically developing group. Evaluation of stress and stressors is crucial for holistic management of ASD.
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Affiliation(s)
- Nirali Lohiya
- Division of Developmental & Behavioral Pediatrics, Silver Lining Pediatric Super Speciality Center, Nagpur, India
| | - Leena Srivastava
- Department of Pediatrics, Bharati Vidyapeeth Deemed University, Pune, India
| | - Nikhil Lohiya
- Division of Growth & Endocrinology Silver Lining Pediatric Super Speciality Center, Nagpur, India
| | - Vijay Kalrao
- Department of Pediatrics, Bharati Vidyapeeth Deemed University, Pune, India
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Panda B, Suryawanshi V, Kalrao V, Sarangi B. Atypical presentation of pediatric Rasmussen's encephalitis complicated by super-refractory status epilepticus: A case report. J Pediatr Crit Care 2022. [DOI: 10.4103/jpcc.jpcc_92_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Rajan R, Peter SM, Kurian VM, Ansari R, Pawar S, Kalrao V. The practice of off label prescribing and associated adverse drug reactions in pediatric inpatients in a tertiary care hospital in India. Journal of Pharmaceutical Health Services Research 2019. [DOI: 10.1111/jphs.12286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Abstract
Objectives
To assess the extent of use, patterns, variables and Adverse Drug Reactions associated with off label prescribing in Pediatrics.
Methods
A prospective observational study was conducted for a period of 6 months for children of the age group 0-17 years in a tertiary care Hospital in Maharashtra, India. Off label drug use was assessed using Micromedex and British National Formulary for Children (BNFC 2016–2017). Adverse Drug Reactions (ADRs) were assessed according to the physicians' notes, recorded during the patient's hospital stay. Pearson correlation coefficient was computed to assess the relationship between age and the number of off-label drugs. Odds ratio was calculated for the occurrence of ADRs in on-label prescriptions Vs off label-prescriptions. A P value of <0.05 was considered as significant.
Key findings
A total of 1514 prescriptions were evaluated in 300 patients. Out of which 542 (35.79%) and 423 (27.9%) were off label according to Micromedex and BNFC respectively. The number of patients who received at least one off label was found to be 225 (75%) – Micromedex and 223 (74.3%) – BNFC Unspecified indication and use of drugs outside the specified age limit were identified as the main variables associated with off label prescribing. Highest proportion of off-label drugs was found in Alimentary system. A total of 35 ADRs (OR 6.92 CI 95%(OR 6.92, 95% CI, 3.13-15.27)) were identified in 31 patients.
Conclusions
Off-label drug use is prevalent in the pediatric population and warrants an evidence-based approach to improve prescribing practices in pediatrics.
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Affiliation(s)
- Rebecca Rajan
- Department of Clinical Pharmacy, Poona College of Pharmacy, Bharati Vidyapeeth University, Pune, Maharashtra, India
| | - Sharlin M. Peter
- Department of Clinical Pharmacy, Poona College of Pharmacy, Bharati Vidyapeeth University, Pune, Maharashtra, India
| | - Vincey M. Kurian
- Department of Clinical Pharmacy, Poona College of Pharmacy, Bharati Vidyapeeth University, Pune, Maharashtra, India
| | - Roohinaz Ansari
- Department of Clinical Pharmacy, Poona College of Pharmacy, Bharati Vidyapeeth University, Pune, Maharashtra, India
| | - Sunita Pawar
- Department of Clinical Pharmacy, Poona College of Pharmacy, Bharati Vidyapeeth University, Pune, Maharashtra, India
| | - Vijay Kalrao
- Bharati Vidyapeeth Medical College, Pune, Maharashtra, India
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Mahankar P, bafna V, bartakke S, Lalwani S, Kalrao V, Oswal J. Undifferentiated embryonal sarcoma of liver (UESL) - a case report. Pediatric Hematology Oncology Journal 2019. [DOI: 10.1016/j.phoj.2019.08.150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
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Mahankar P, Bafna V, Bartakke S, Lalwani S, Kalrao V, Oswal J. Vitamin D Deficiency Rickets Induced Myelofibrosis- A case report. Pediatric Hematology Oncology Journal 2019. [DOI: 10.1016/j.phoj.2019.08.108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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8
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Patel P, Bafna V, Bartakke S, Gupta P, Mankar S, Oswal J, Kalrao V, Lalwani S. Pure red cell aplasia due to parvovirus B19 in pediatric malignancies – a report of two cases. Pediatric Hematology Oncology Journal 2017. [DOI: 10.1016/j.phoj.2017.11.065] [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: 11/29/2022] Open
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Patel P, Bafna V, Bartakke S, Singh D, Jahagirdar R, Oswal J, Kalrao V, Lalwani S. Pleuropulmonary blastoma – Report of two cases. Pediatric Hematology Oncology Journal 2017. [DOI: 10.1016/j.phoj.2017.11.084] [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: 11/29/2022] Open
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10
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Jain P, Varanasi G, Ghuge R, Kalrao V, Dhongade R, Bavdekar A, Mehendale S, Chitambar S. Rotavirus infections in children vaccinated against rotavirus in Pune, Western India. Indian Pediatr 2016; 53:589-93. [DOI: 10.1007/s13312-016-0893-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Gandhi K, Mankar S, Purandare B, lalwani S, Oswal J, Kalrao V. HIV missed …CMV shows the way. Int J Infect Dis 2016. [DOI: 10.1016/j.ijid.2016.02.577] [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: 12/01/2022] Open
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12
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Khamkar AM, Suryawanshi PB, Maheshwari R, Patnaik S, Malshe N, Kalrao V, Lalwani S, Surwade J. Functional Neonatal Echocardiography: Indian Experience. J Clin Diagn Res 2015; 9:SC11-4. [PMID: 26816962 DOI: 10.7860/jcdr/2015/14440.6971] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2015] [Accepted: 10/12/2015] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Functional echocardiography, as opposed to echocardiography as performed by the cardiologist, is the bedside utilization of cardiac ultrasound to take after functional and haemodynamic changes longitudinally. Information reflecting cardiovascular capacity and systemic and pulmonary blood flow in sick preterm and term neonates can be observed utilizing this strategy. Information is lacking on its use in neonatal units in India. AIM To characterize the impact of Functional neonatal echocardiography (FnECHO) programme on decision making in a tertiary care centre in India by evaluating its frequency of use, patient characteristics, and indications. MATERIALS AND METHODS Prospective observational study of neonates in a tertiary Neonatal Intensive Care Unit (NICU) in Pune (India) from February 2014 to January 2015. All the neonates undergoing FnECHO during this 12 month period based on clinical findings were included in the study. Data extracted from the review of the clinical notes included gestational age, birth-weight, mode of delivery, Apgar scores, details of respiratory and cardiovascular support, timing of FnECHO and any other clinical diagnosis. The findings of echocardiography were recorded and correlated with the clinical and other laboratory or X-ray findings. If these findings indicated a change in management, it was instituted. RESULTS A total of 348 echocardiographic studies were performed in 187 neonates (mean 1.86; SD 2.02). The most frequent indication was Patent Ductus Arteriosus (PDA) assessment (n= 174, 50%), followed by haemodynamic instability (n=43, 12.36%). The results of FnECHO modified treatment in 148 cases (42.50%) in the form of addition and/or change in the treatment or avoidance of unnecessary intervention. CONCLUSION FnECHO is frequently used in the NICU setting and may be a useful tool to guide treatment. PDA assessment and haemodynamic instability are the most frequent indications. To validate its usefulness, well co-ordinated large prospective studies are needed.
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Affiliation(s)
- Anilkumar Mohan Khamkar
- Assistant Professor, Department of Neonatology, BVU Medical College , Pune, Maharashtra, India
| | - Pradeep B Suryawanshi
- Professor and Head, Department of Neonatology, BVU Medical College , Pune, Maharashtra, India
| | - Rajesh Maheshwari
- Consultant Neonatologist, Westmead Hospital , Westmead, NSW, Australia
| | - Suprabha Patnaik
- Assistant Professor, Department of Neonatology, BVU Medical College , Pune, Maharashtra, India
| | - Nandini Malshe
- Associate Professor, Department of Neonatology, BVU Medical College , Pune, Maharashtra, India
| | - Vijay Kalrao
- Professor, Department of Paediatrics, BVU Medical College , Pune, Maharashtra, India
| | - Sanjay Lalwani
- Professor and Head, Department of Pediatrics, BVU Medical College , Pune, Maharashtra, India
| | - Jitendra Surwade
- Assistant Professor, Department of PSM, MNR Medical college and Hospital , Sangareddy, Andhra Pradesh, India
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Abstract
Thymoma is a rare case presenting in the paediatric age group. Only 30 cases have been reported so far. Our case is a 14 month old female, presented with respiratory distress. CT scan showed gross widening of superior mediastinum with a homogeneous opacity. Immunohistochemistry was suggestive of thymoma. She underwent excision of the thymic mass and is well at present.J Nepal Paediatr Soc 2015;35(1):76-78
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Suryawanshi P, Nagpal R, Meshram V, Malshe N, Kalrao V. Pulmonary Hemorrhage (PH) in Extremely Low Birth Weight (ELBW) Infants: Successful Treatment with Surfactant. J Clin Diagn Res 2015; 9:SD03-4. [PMID: 25954676 DOI: 10.7860/jcdr/2015/8596.5691] [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: 01/21/2014] [Accepted: 02/04/2015] [Indexed: 11/24/2022]
Abstract
We report a case of an extremely low birth weight (ELBW) infant presenting with pulmonary hemorrhage (PH) in which we have given surfactant after an acute episode of bleeding with severe intractable hypoxemia. Surfactant replacement therapy showed improvement in Mean Airway Pressure (MAP) and oxygenation indices. Our case suggests that surfactant replacement therapy is useful in PH.
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Affiliation(s)
- Pradeep Suryawanshi
- Head & Professor, Department of Neonatology, BVU Medical College , Katraj-Dhankawadi, Pune, India
| | - Rema Nagpal
- Assistant Professor, Department of Neonatology, BVU Medical College , Katraj-Dhankawadi, Pune, India
| | - Vaibhav Meshram
- Clinical Fellow, Department of Neonatology, BVU Medical College , Katraj-Dhankawadi, Pune, India
| | - Nandini Malshe
- Associate Professor, Department of Neonatology, BVU Medical College , Katraj-Dhankawadi, Pune, India
| | - Vijay Kalrao
- Professor, Department of Pediatrics, BVU Medical College , Katraj-Dhankawadi, Pune, India
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Suryawanshi P, Dahat A, Nagpal R, Malshe N, Kalrao V. A rare case of accidental esophageal perforation in an extremely low birth weight neonate. J Clin Diagn Res 2014; 8:PD01-2. [PMID: 25121037 PMCID: PMC4129303 DOI: 10.7860/jcdr/2014/8554.4460] [Citation(s) in RCA: 2] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2014] [Accepted: 05/09/2014] [Indexed: 11/24/2022]
Abstract
Spontaneous perforation of esophagus in neonates is a rare occurrence. However iatrogenic perforation of the esophagus is not that uncommon, and is most frequently seen in preterm and low birth weight infants. In premature infants, an esophageal perforation (EP) mainly occurs while inserting an orogastric tube. The commonly reported symptoms of EP are sudden onset respiratory distress, due to the pleural effusion and pneumothorax. In our case neonate presented with apnea requiring ventilation. We present a rare case of an Extremely Low Birth Weight (ELBW) neonate with an iatrogenic esophageal perforation who presented with recurrent apneas, outlining aspects of diagnosis and management.
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Affiliation(s)
- Pradeep Suryawanshi
- NICU Incharge, Associate Professor & Consultant Neonatologist, Division of Neonatology, Department of Pediatrics,Bharati Vidyapeeth University Medical College,Pune, MS , India
| | - Amit Dahat
- Neonatal Fellow, Division of Neonatology, Department of Pediatrics,Bharati Vidyapeeth University Medical College,Pune, MS , India
| | - Rema Nagpal
- Assistant Professor, Division of Neonatology, Department of Pediatrics,Bharati Vidyapeeth University Medical College,Pune, MS , India
| | - Nandini Malshe
- Associate Professor & Consultant Neonatologist, Division of Neonatology, Department of Pediatrics,Bharati Vidyapeeth University Medical College,Pune, MS , India
| | - Vijay Kalrao
- Professor, Department of Pediatrics,Bharati Vidyapeeth University Medical College,Pune, MS , India
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Abstract
BACKGROUND Acute kidney injury (AKI) is common in patients in the pediatric intensive care unit (PICU) and is associated with poor outcome. We conducted the present study to determine the incidence, risk factors and outcomes of AKI in the PICU. MATERIALS AND METHODS We collected data retrospectively from case records of children admitted to the PICU during one year. We defined and classified AKI according to modified pRIFLE criteria. We used multivariate logistic regression to determine risk factors of AKI and association of AKI with mortality and morbidity. RESULTS Of the 252 children included in the study, 103 (40.9%) children developed AKI. Of these 103 patients with AKI, 39 (37.9%) patients reached pRIFLE max of Risk, 37 (35.9%) patients reached Injury, and 27 (26.2%) had Failure. Mean Pediatric Risk of Mortality (PRISM III) score at admission was higher in patients with AKI than in controls (P < 0.001).
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Affiliation(s)
- Shweta Naik
- Department of Pediatrics, BVDUMC, Consultant Nephrologist, Viva Kidney Suraksha, Pune, Maharashtra, India
| | - Jyoti Sharma
- Department of Pediatrics, BVDUMC, Consultant Nephrologist, Viva Kidney Suraksha, Pune, Maharashtra, India
| | - Rameshwor Yengkom
- Department of Pediatrics, BVDUMC, Consultant Nephrologist, Viva Kidney Suraksha, Pune, Maharashtra, India
| | - Vijay Kalrao
- Department of Pediatrics, BVDUMC, Consultant Nephrologist, Viva Kidney Suraksha, Pune, Maharashtra, India
| | - Atul Mulay
- Department of Pediatrics, MD Medicine, Consultant Nephrologist, Viva Kidney Suraksha, Pune, Maharashtra, India
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Chitambar SD, Tatte VS, Dhongde R, Kalrao V. High frequency of rotavirus viremia in children with acute gastroenteritis: discordance of strains detected in stool and sera. J Med Virol 2008; 80:2169-76. [PMID: 19040295 DOI: 10.1002/jmv.21338] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Recently, rotavirus antigenemia and viremia have been identified in patients with acute gastroenteritis. This study examined rotavirus viremia in children hospitalized for acute gastroenteritis in order to establish its association with fecal shedding of rotavirus, infecting genotypes and antibody marker of acute infection. Thirty-one pairs of stool-serum specimens were collected from November 2004 to February 2005 together with clinical information. All paired specimens were screened for rotavirus RNA by RT-PCR using the VP6 gene primers. All stool and serum specimens were tested for rotavirus antigen and anti-rotavirus IgM respectively by ELISA. Sixteen of 31 stool-serum pairs showed the presence of rotavirus RNA. Nine stool and two serum specimens were positive only by RT-PCR. The total positivity in rotavirus RNA was significantly higher in both stools (80.6%) and sera (58.1%) than that of stool antigen (38.7%) and anti-rotavirus IgM (25.8%) (P < 0.01). All PCR positive paired specimens were typed for the VP7 (G) and VP4 (P) genes. Five of sixteen pairs could be typed for both genes. Three of the five pairs showed concordance (G2P[4]/G2P[4]) while two showed discordance (G12P[8]/G2P[4], G8P[4]/G2P[4]) in the genotypes detected in stool and serum specimens respectively. The study documents a high frequency of rotavirus viremia in patients with acute diarrhea. The discordance of rotavirus strains at the genotypic level in the serum and stool of individual patients with diarrhea suggests the susceptibility of extra-intestinal sites for rotavirus infection and the possibility of differential dissemination of rotavirus strains from the intestine.
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Abstract
Mayer Rokitansky Kuster Houser syndrome (MRKH syndrome) is characterized by Mullerian duct structures agenesis, vaginal atresia being the commonest variant. It can be associated with renal, skeletal, spine and other malformations. Patient with Mayer Rokitansky syndrome has a varied presentation from newborn period to adolescence. Thorough investigations are required for classification of the syndrome and diagnosis of associated anomalies. The MRKH syndrome patient may require complex vaginal reconstructive surgery and a detailed counseling about the potentials of menstruation and fertility. Here we are presenting a patient having association of anorectal malformation, Mullerian duct agenesis and renal anomaly.
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Affiliation(s)
- Shreeprasad P Patankar
- Department of Pediatric Surgery, Bharati Vidyapith Deemed University's Bharati Medical College, Pune, India.
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