Bhavana Jagannatha | Indira Gandhi Institute Of Child Health (original) (raw)

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Papers by Bhavana Jagannatha

Research paper thumbnail of Infantile erythroderma with a crazy pavement-like pattern complicated by candida sepsis: An unusual presentation

Indian Dermatology Online Journal, 2023

Research paper thumbnail of Entomophthoromycosis in a young child postcleft lip surgery: A rare case with diagnostic dilemma

Indian Journal of Paediatric Dermatology, 2022

Entomophthoromycosis is a rare yet potentially life-threatening, chronic deep fungal infection af... more Entomophthoromycosis is a rare yet potentially life-threatening, chronic deep fungal infection affecting immunocompetent host, primarily children, and young adults. The infection commonly affects trauma-prone sites mainly extremities and trunk with regional lymph node involvement. We report a 1.5-year-old child with postcleft lip surgery presenting with painless swelling on the right side of the face for the past 4 months. Although culture showed no growth in our case, histopathological examination was diagnostic of entomophthoromycosis which aided the treatment. There was partial improvement in the size of the swelling with amphotericin B and a complete resolution with oral potassium iodide.

Research paper thumbnail of Infantile erythroderma with a crazy pavement-like pattern complicated by candida sepsis: An unusual presentation

Indian Dermatology Online Journal

Research paper thumbnail of Diagnostic Utility of Cerebrospinal Fluid Procalcitonin in Neonatal Meningitis

We aimed to study the diagnostic utility of cerebrospinal fluid (CSF) procalcitonin in neonates w... more We aimed to study the diagnostic utility of cerebrospinal fluid (CSF) procalcitonin in neonates with meningitis. All the neonates with sepsis who qualified for lumbar puncture were prospectively evaluated. The neonates were classified as Meningitis and No meningitis group based on predefined criteria. CSF procalcitonin was estimated in these neonates along with cytological and biochemical parameters. A total of 113 neonates were included in the study with 29 in meningitis group and 84 in no meningitis group. The median procalcitonin levels was higher in babies with meningitis as compared to those without meningitis [0.194 (0.034 - 0.534) in meningitis group vs 0.012 (0.012-0.012) ng/ml in no meningitis group, p< 0.001]. The area under curve (AUC) for CSF procalcitonin was 0.867 (0.77 -0.95) and at a cut off level of 0.120 ng/ml CSF procalcitonin had a sensitivity of 83%, specificity of 84% and positive and negative predictive likelihood ratios of 5.35 and 0.20 respectively for th...

Research paper thumbnail of Ventilator-associated pneumonia in a paediatric intensive care unit in a developing country with high HIV prevalence

Journal of Paediatrics and Child Health, 2009

Aim: To obtain preliminary prevalence, aetiological and outcome data on South African paediatric ... more Aim: To obtain preliminary prevalence, aetiological and outcome data on South African paediatric patients with ventilator-associated pneumonia (VAP). Methods: Non-bronchoscopic bronchoalveolar lavage (BAL) specimens taken between January 2004 and September 2005 were prospectively recorded and related clinical data were retrospectively reviewed. VAP was defined as a new isolate on BAL and a modified Clinical Pulmonary Infection Score Ն5. Results: A total of 230 patients aged 3.9 (2.2-9.1) months (median interquartile range (IQR)) underwent 309 BALs during 244 paediatric intensive care unit (PICU) admissions. Most patients (84%) were admitted with acute infectious diseases, with a 70% incidence of comorbidity. Thirty-three patients (14.3%) were HIV-exposed but uninfected and 58 (25.2%) were HIV-infected. Of 172 BALs taken Ն48 h after intubation, 63 specimens from 55 patients fulfilled VAP criteria. Acinetobacter baumannii was the most common VAP pathogen, followed by Klebsiella pneumoniae, viruses, yeasts and Staphylococcus aureus. Patients who developed VAP had a higher proportion of comorbid conditions (76% vs. 55%, P = 0.01) and reintubations (39% vs. 12%, P < 0.0001) when compared with non-VAP patients. Median (IQR) length of PICU stay was 12.5 (5-21) days versus 8 (5-14) days (P = 0.03); and the risk adjusted PICU mortality was 1.38 versus 0.79 (P = 0.002) in VAP versus non-VAP patients, respectively. Conclusions: VAP is associated with significant morbidity and mortality and may relate to the high incidence of comorbid conditions in this population. Primary VAP pathogens differ from developed countries.

Research paper thumbnail of Entomophthoromycosis in a young child postcleft lip surgery: A rare case with diagnostic dilemma

Indian Journal of Paediatric Dermatology

Research paper thumbnail of Ventilator -Associated Pneumonia in Paediatric Intensive Care Unit at the Indira Gandhi Institute of Child Health

IP Innovative Publication Pvt. Ltd, Jun 1, 2017

Introduction: This is prospective study undertaken at the PICU of Indira Gandhi Institute of Chil... more Introduction: This is prospective study undertaken at the PICU of Indira Gandhi Institute of Child health to assess the risk factors causative organisms and outcome of paediatric Ventilator-Associated Pneumonia (VAP). Materials and Method: A total of 1079 patients who received Mechanical Ventilation (MV) were included in this prospective study during the period from January 2015 till September 2016. Cases were defined as VAP as per CDC guidelines. The causative organisms were isolated and identified along with their antibiogram. The clinical details and prognosis was noted of each patient until discharge or death. Results: VAP was detected in 74 patients among 1079 ventilated patients. VAP rate was 6.85 %, incidence density was 16.04. Gram negative bacteria was most frequent causative organism, Acinetobacter was the common causative 46 (62.1%); Pseudomonas aeroginousa 23(31%); Klebsiella 17 (22.97%); Enterobacter 10 (13.51%); E. coli 3(4 %) and Citrobacter in 2 (2.7%). Staphylococcus aureus and Candida were isolated in 1 sample each. Polymicrobial infection in 23 cases. Most of the isolates were multidrug resistant. The mortality rate was 28.38%. Conclusions: Identification of risk factors, causative organisms along with their antibiotic sensitivity pattern and outcome of patients with VAP in PICUs may help in reducing the incidence. This shall further help in formulating better Hospital infection control Policies and practices in the Paediatric intensive care unit.

Research paper thumbnail of Infantile erythroderma with a crazy pavement-like pattern complicated by candida sepsis: An unusual presentation

Indian Dermatology Online Journal, 2023

Research paper thumbnail of Entomophthoromycosis in a young child postcleft lip surgery: A rare case with diagnostic dilemma

Indian Journal of Paediatric Dermatology, 2022

Entomophthoromycosis is a rare yet potentially life-threatening, chronic deep fungal infection af... more Entomophthoromycosis is a rare yet potentially life-threatening, chronic deep fungal infection affecting immunocompetent host, primarily children, and young adults. The infection commonly affects trauma-prone sites mainly extremities and trunk with regional lymph node involvement. We report a 1.5-year-old child with postcleft lip surgery presenting with painless swelling on the right side of the face for the past 4 months. Although culture showed no growth in our case, histopathological examination was diagnostic of entomophthoromycosis which aided the treatment. There was partial improvement in the size of the swelling with amphotericin B and a complete resolution with oral potassium iodide.

Research paper thumbnail of Infantile erythroderma with a crazy pavement-like pattern complicated by candida sepsis: An unusual presentation

Indian Dermatology Online Journal

Research paper thumbnail of Diagnostic Utility of Cerebrospinal Fluid Procalcitonin in Neonatal Meningitis

We aimed to study the diagnostic utility of cerebrospinal fluid (CSF) procalcitonin in neonates w... more We aimed to study the diagnostic utility of cerebrospinal fluid (CSF) procalcitonin in neonates with meningitis. All the neonates with sepsis who qualified for lumbar puncture were prospectively evaluated. The neonates were classified as Meningitis and No meningitis group based on predefined criteria. CSF procalcitonin was estimated in these neonates along with cytological and biochemical parameters. A total of 113 neonates were included in the study with 29 in meningitis group and 84 in no meningitis group. The median procalcitonin levels was higher in babies with meningitis as compared to those without meningitis [0.194 (0.034 - 0.534) in meningitis group vs 0.012 (0.012-0.012) ng/ml in no meningitis group, p< 0.001]. The area under curve (AUC) for CSF procalcitonin was 0.867 (0.77 -0.95) and at a cut off level of 0.120 ng/ml CSF procalcitonin had a sensitivity of 83%, specificity of 84% and positive and negative predictive likelihood ratios of 5.35 and 0.20 respectively for th...

Research paper thumbnail of Ventilator-associated pneumonia in a paediatric intensive care unit in a developing country with high HIV prevalence

Journal of Paediatrics and Child Health, 2009

Aim: To obtain preliminary prevalence, aetiological and outcome data on South African paediatric ... more Aim: To obtain preliminary prevalence, aetiological and outcome data on South African paediatric patients with ventilator-associated pneumonia (VAP). Methods: Non-bronchoscopic bronchoalveolar lavage (BAL) specimens taken between January 2004 and September 2005 were prospectively recorded and related clinical data were retrospectively reviewed. VAP was defined as a new isolate on BAL and a modified Clinical Pulmonary Infection Score Ն5. Results: A total of 230 patients aged 3.9 (2.2-9.1) months (median interquartile range (IQR)) underwent 309 BALs during 244 paediatric intensive care unit (PICU) admissions. Most patients (84%) were admitted with acute infectious diseases, with a 70% incidence of comorbidity. Thirty-three patients (14.3%) were HIV-exposed but uninfected and 58 (25.2%) were HIV-infected. Of 172 BALs taken Ն48 h after intubation, 63 specimens from 55 patients fulfilled VAP criteria. Acinetobacter baumannii was the most common VAP pathogen, followed by Klebsiella pneumoniae, viruses, yeasts and Staphylococcus aureus. Patients who developed VAP had a higher proportion of comorbid conditions (76% vs. 55%, P = 0.01) and reintubations (39% vs. 12%, P < 0.0001) when compared with non-VAP patients. Median (IQR) length of PICU stay was 12.5 (5-21) days versus 8 (5-14) days (P = 0.03); and the risk adjusted PICU mortality was 1.38 versus 0.79 (P = 0.002) in VAP versus non-VAP patients, respectively. Conclusions: VAP is associated with significant morbidity and mortality and may relate to the high incidence of comorbid conditions in this population. Primary VAP pathogens differ from developed countries.

Research paper thumbnail of Entomophthoromycosis in a young child postcleft lip surgery: A rare case with diagnostic dilemma

Indian Journal of Paediatric Dermatology

Research paper thumbnail of Ventilator -Associated Pneumonia in Paediatric Intensive Care Unit at the Indira Gandhi Institute of Child Health

IP Innovative Publication Pvt. Ltd, Jun 1, 2017

Introduction: This is prospective study undertaken at the PICU of Indira Gandhi Institute of Chil... more Introduction: This is prospective study undertaken at the PICU of Indira Gandhi Institute of Child health to assess the risk factors causative organisms and outcome of paediatric Ventilator-Associated Pneumonia (VAP). Materials and Method: A total of 1079 patients who received Mechanical Ventilation (MV) were included in this prospective study during the period from January 2015 till September 2016. Cases were defined as VAP as per CDC guidelines. The causative organisms were isolated and identified along with their antibiogram. The clinical details and prognosis was noted of each patient until discharge or death. Results: VAP was detected in 74 patients among 1079 ventilated patients. VAP rate was 6.85 %, incidence density was 16.04. Gram negative bacteria was most frequent causative organism, Acinetobacter was the common causative 46 (62.1%); Pseudomonas aeroginousa 23(31%); Klebsiella 17 (22.97%); Enterobacter 10 (13.51%); E. coli 3(4 %) and Citrobacter in 2 (2.7%). Staphylococcus aureus and Candida were isolated in 1 sample each. Polymicrobial infection in 23 cases. Most of the isolates were multidrug resistant. The mortality rate was 28.38%. Conclusions: Identification of risk factors, causative organisms along with their antibiotic sensitivity pattern and outcome of patients with VAP in PICUs may help in reducing the incidence. This shall further help in formulating better Hospital infection control Policies and practices in the Paediatric intensive care unit.