Bhavana Lakhkar - Academia.edu (original) (raw)

Papers by Bhavana Lakhkar

Research paper thumbnail of Therapeutic Hypothermia in Moderate and Severe Hypoxic-Ischemic Encephalopathy: Use of LowCost vs High Technology Cooling Technique

International Journal of Current Research and Review, 2020

In the immediate period following insult primary energy failure(first 6 hrs after birth) occurs w... more In the immediate period following insult primary energy failure(first 6 hrs after birth) occurs where there is depletion of oxidative metabolites leading to neuronal cell injury and toxic oedema. A large number of neurons die but many survive only to enter into the process of re-deterioration after a latent period. 2 This period during which secondary energy failure occurs is more severe and prolonged causing .

Research paper thumbnail of Is it now time to screen your baby for spinomuscular muscular atrophy?

Journal of Pediatrics & Neonatal Care

Research paper thumbnail of Probiotics / Prebiotics and Preterm Baby: A Literature Review

Fetal & neonatal medicine, 2016

Research paper thumbnail of Inborn Errors of Metabolism: An Approach

Recent Advances in Pediatrics—25: Hot Topics, 2018

Research paper thumbnail of Osteogenesis Imperfecta: Dreadful Infantile Dysplasia

JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH, 2021

Research paper thumbnail of Lactate Dehydrogenase as Predictor for Severity in Sickle Cell Disease

International Journal of Current Research and Review, 2020

Pyruvate to lactate in a glycolytic pathway is caused by enzyme lactate dehydrogenase (LDH) with ... more Pyruvate to lactate in a glycolytic pathway is caused by enzyme lactate dehydrogenase (LDH) with the conversion of NADH TO NAD+. Lactate dehydrogenase can be found in different body tissues. For hemolysis marker lactate dehydrogenase levels can be used. In sickle cell anaemia patient those who are in the steady-state (SS) there will be an increase in the level of lactate dehydrogenase(LDH). In sickle cell disease, the life of the patient is hampered due to crisis and it is very difficult to predict the crisis. Hence in our study, we used a marker lactate dehydrogenase (LDH) to predict the severity of the crisis. Objectives: To study the ability of serum LDH levels in predicting the severity of disease in sickle cell anaemia. Methodology: To achieve the objective we assess serum LDH levels during steady-state and crisis and to correlate above with chronic complications (PH, Microalbuminuria, Liver functions) and severity of the crisis.Patients fulfilling selection criteria will be recruited after obtaining written consent. Detailed history including the age of onset, frequency and severity of the crisis, frequency of admissions and transfusions, quality of follow up, quality of treatment received will be taken. Detailed examination including anthropometry will be recorded. The severity of the acute crisis will be decided based on the duration of pain more than 2 days, need for admission & stay more than 3 days, death, need for surgery, need for support and need for other procedure. Expected Results: We expect the LDH level to be significantly higher during the crisis. If steady-state patients are considered LDH level will be high in patients with moderate and severe disease (frequency more than 3/ year).

Research paper thumbnail of Dexamethasone and outcome of meconium aspiration syndrome: Vijayapur, Karnataka experience

Sri Lanka Journal of Child Health, Mar 5, 2018

Introduction: Meconium aspiration is an important cause of respiratory distress and mortality in ... more Introduction: Meconium aspiration is an important cause of respiratory distress and mortality in the newborn. Steroid therapy is one of the strategies in management due to its anti-inflammatory action. So far enough evidence is not available in its favour. Objectives: To assess the utility of intravenous (IV) dexamethasone in meconium aspiration syndrome (MAS) and to study any immediate adverse outcome and/or increase in sepsis in newborns receiving dexamethasone. Method: A prospective, interventional study was carried out in the neonatal intensive care unit (NICU) of a tertiary hospital. Newborns were enrolled using selection criteria and were randomized into an intervention group and a control group. After collecting baseline data, the intervention group was administered 0.5mg/kg IV dexamethasone in two divided doses starting from the age of 24 to 36 hours. A total of 6 doses were administered. Outcome measures noted were: period of oxygen dependency, duration of NICU stay, initiation of oral feeds and development of sepsis in both intervention group and control group. Any adverse effects with dexamethasone therapy was noted in babies randomized as intervention group. Investigations and management were carried out as per unit protocol. SPSS Software version 23 was used for statistical purposes. A p value of <0.05 was considered significant. Results: Both intervention group and control group were comparable in subject characteristics. Duration of NICU stay less than 6 days and oxygen requirement less than 50 hours were significantly more in the intervention group. There was no _________________________________________ 1

Research paper thumbnail of A study to assess the nutritional status of children with cleft lip and/or cleft palate and its correlation with breast feeding at a tertiary health care centre

International Journal of Contemporary Pediatrics, 2018

Background: Cleft lip with or without cleft palate is one of the most common congenital anomalies... more Background: Cleft lip with or without cleft palate is one of the most common congenital anomalies. In 2008, the World Health Organization included cleft lip and palate in their Global Burden of Disease initiative. The incidence of cleft lip and palate in India is enormous: one in 781 live births. The growth of children with these deformities is often impaired in comparison to healthy children. Several studies describe a growth lag in either weight or height of cleft children. The objective of the study was to observe the nutritional status of children with cleft lip and/or cleft palate and its correlation with breastfeeding.Methods: A cross sectional study was conducted at Department of Pediatrics, AVBRH Sawangi (Meghe), Wardha for the period of two years from August 2010 to March 2012. All children below 15 years with cleft lip and/or palate admitted in the pediatric ward, NICU or postnatal ward were included in the study. A Total of 200 children were included in the study and ana...

Research paper thumbnail of Point of Care Neurosonogram in Neonates - Utility and Prognostic Value

American Journal of Sonography, 2019

Objective The study aimed to utilize the neurosonographic findings in neonates in early diagnosis... more Objective The study aimed to utilize the neurosonographic findings in neonates in early diagnosis, prediction of their long-term outcome, parental counseling, and early intervention. Methods The study was carried out in neonatal intensive care unit (NICU) of Shri BM Patil Medical College and Hospital. All preterms and term babies with neurological clinical findings were included in the study. Neurosonogram was done within first 7 days in preterms and when indicated in terms. Philips HD11XE ultrasound and color Doppler unit were used with a small footprint probe. Color Doppler images for vessels were performed for screening of vascular changes. Results A total of 215 babies were included, of which 80 (32%) were term and the rest were preterm. Mean weight of term babies was 2.8 kg and that of preterm was 1.2 kg.Among term babies, 78% showed ultrasound abnormality, and among preterm, 42%showed abnormalities. Among term babies, 60% and, among preterms, 30% had birth asphyxia. Periventri...

Research paper thumbnail of Scorpion Sting Envenomation

Journal of Nepal Paediatric Society, 2017

Scorpion sting envenomation is very common problem in rural India especially where the climate is... more Scorpion sting envenomation is very common problem in rural India especially where the climate is hot and dry. Management techniques have improved tremendously over the time leading to reduced morbidity and mortality. Mortality is mainly when ignorant patients go to the traditional faith healers (Tantrics) and come late to the facility where better management is available. Indian red scorpion (Mesobhuthustamulus) is the main species in India. Autonomic storm caused by venom acting on sodium gated and other channels is the main cause of manifestations in a scorpion sting victim. Cardio-myopathy is the main cause for morbidity and mortality. Many grading systems have been suggested for categorizing and simplifying the treatment. The mainstay of treatment where systemic involvement is there are alpha-1 blocker Prazosin hydrochloride, Fluids and newly arrived purified anti-venom. Scorpion envenomation being a problem of rural remote areas and most patients being from lower socio-economi...

Research paper thumbnail of Clinico-Epidemiological And Hematological Profile Of Sickle Cell Anemia With Special Reference To Penicillin Prophylaxis In A Rural Hospital Of Central India

The Internet Journal of Epidemiology, 2011

Research questions: clinical, epidemiological and Hematological characteristics of a cohort of ch... more Research questions: clinical, epidemiological and Hematological characteristics of a cohort of children with sickle cell anemia attending a specialist outpatient clinic in a rural hospital?Objectives:1. To study the pattern, type and frequency of crises/ infections in sickle cell anemia children.2. To observe the effect of intervention (penicillin prophylaxis, folic acid, regular follow up) on the pattern of crisis and infections in disease 3. To study the hematological values in sickle cell anemia children at recruitment.4. To correlate hemoglobin and hematocrit values to number of crisis/ infections in disease.5. To study the effect of intervention on academic performance in disease.Study design: prospective studySetting: Study was conducted in Department of Pediatrics, Jawahar Lal Nehru Medical College and Acharya Vinoba Bhave Rural Hospital, sawangi (wardha)Participants: Children up to14 years of age.Study variables: Age, sex, clinical profile. Hematological profile, scholastic performance, penicillin prophylaxisResults: A prospective study on 131 children revealed that 44.27% were of disease and 55.73% were traits. Most patients, in both disease and trait, belonged to the age group of 4-8 years comprising 47.32% of total patients. Patients of lower socioeconomic status constitute the most common class in both in disease (67.24%) and trait patients (65.75%). Recurrent fever (51.14%) was the most common symptom in both group, Splenomegaly (44.27%) was the most common sign. Patients with sickle cell disease presented most commonly with vaso-occlusive crisis (51.72%) of which hand-foot syndrome was most common (20.69%). Hemoglobin less than 5gm% and age group 0-4yr is associated with highest number of crisis or infection but there is statistically significant decrease in episodes of crisis/infection following penicillin prophylaxis

Research paper thumbnail of Suboptimal Performance in Cleft Lip/ Palate Children- Who is Responsible?

JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH, 2016

Research paper thumbnail of Lizard Bite Masquerading as Scorpion Sting Envenomation

Journal of clinical and diagnostic research : JCDR, 2016

Lizard bite is very infrequent in children. Lizards tend to avoid confrontation. Bites are only i... more Lizard bite is very infrequent in children. Lizards tend to avoid confrontation. Bites are only inflicted when they are manipulated or when they are cornered and feel threatened. Lizard bites may be frightening but most do not cause serious health problems. The wall lizard or gecko, found in most homes, is not poisonous at all. It only checks insect population. A two-year-old boy was brought with history of lizard bite over right hand when he was trying to capture it. The child had experienced excessive sweating and irritability within two hours of bite. He was treated with supportive care. Prazosin hydrochloride was administered in the dose of 30μ/kg as his symptoms mimicked the autonomic storm which is typically seen with scorpion sting envenomation. To the best of our knowledge autonomic storm following lizard bite has not been reported in the Indian literature so far.

Research paper thumbnail of Study of respiratory distress in newborn

International Journal of Contemporary Pediatrics, 2017

Background: Respiratory distress is one of the most common reasons an infant is admitted to the n... more Background: Respiratory distress is one of the most common reasons an infant is admitted to the neonatal intensive care unit. Fifteen percent of term infants and 29% of late preterm infants admitted to the neonatal intensive care unit develop significant respiratory morbidity; this is even higher for infants born before 34 weeks ‘gestation. Certain risk factors increase the likelihood of neonatal respiratory disease. These factors include prematurity, meconium-stained amniotic fluid (MSAF), caesarean section delivery, gestational diabetes, maternal chorioamnionitis, or prenatal ultrasonographic findings, such as oligohydramnios or structural lung abnormalities. Aim of the study was to study the, etiology and outcome of respiratory distress in newborns.Methods: The present study was conducted at the Department of Pediatrics, Acharya Vinoba Bhave Rural Hospital, Jawaharlal Nehru Medical College, Sawangi (Meghe),Wardha, Maharashtra, India. Sample size was decided on the basis of prevale...

Research paper thumbnail of Scorpion sting envenomation, Vijayapur, Karnataka, India experience: new observations

International Journal of Contemporary Pediatrics, 2016

The mortality and severity of envenomation also depends upon cardiac involvement which might cont... more The mortality and severity of envenomation also depends upon cardiac involvement which might continue in spite of Prazosin administered in usual doses. Possibility of higher dose requirement when there is cardiac involvement remains to be studied. The present study analyses the epidemiological and clinical features in patients presenting to a tertiary care hospital to assess whether these can be used to judge the prognosis. The children are often brought to our hospital after visiting rural health centers or local doctors who ABSTRACT Background: Scorpion sting is a very common problem in rural areas of Vijayapur. Financial status of people and non-availability of antivenin are concerns. The present study enumerates risk factors and experience of using drug Prazosin hydrochloride (Prazosin) at higher initial dose (80-90 microgram/kg) in scorpion sting envenomation. Methods: A retrospective study was carried out at Shri BM Patil Medical College Hospital and Research Centre Vijayapur Karnataka during the period of September 2014 to August 2015. Case records of 40 cases of scorpion sting envenomation were reviewed. Risk factors were correlated with outcome. Effect of accidental administration of high dose of Prazosin was studied. Results: Local pain, profuse sweating, vomiting, cold extremities were common presentations. Six patients had myocarditis and one had neurological involvement. One patient was brought dead. Age of patient, time interval between symptoms and treatment, use of steroids and other drugs were main risk factors. High dose Prazosin reduced the time for first response (p= <0.001), total recovery time (p= <0.001), Pediatric Intensive Care Unit stay (p= <0.001) and use of inotropes (P=0.042). Conclusions: High dose Prazosin is useful and safe in severe cases of scorpion sting envenomation in the resource poor settings.

Research paper thumbnail of Renal involvement and its detection in sickle cell disease children

International Journal of Contemporary Pediatrics, 2015

Sickle-cell anaemia is caused by a point mutation in the β-globin chain of haemoglobin, leading t... more Sickle-cell anaemia is caused by a point mutation in the β-globin chain of haemoglobin, leading to replacement of glutamine by valine at 6 th position in the molecule. The loss of elasticity of red blood cell is the main phenomenon in pathophysiology of disease. Elasticity of normal cell, allows it to change its shape so that it passes through capillaries. In sickle-cell disease, hypoxia causes sickling and repeated episodes, harm the cell membrane permanently and decrease elasticity. These cells also fail to return to normal shape on restoration of oxygen tension. The rigid cells are unable to pass through small capillaries, leading to vaso-occlusion. The crises in sickle cell disease affect different organs including kidneys. The kidney is an organ of considerable impact on the clinical course of sickle cell patients. The renal manifestations of Sickle Cell Disease (SCD) have been described to range from various functional abnormalities to gross anatomic alterations. The environment of renal medulla which is hypoxic and hypertonic is known to predispose to sickling, which significantly decreases renal medullary blood flow through vaso-occlusion. 1 This is the main mechanism of renal involvement. Apart from that hyperfiltration hyperperfusion injury also causes progressive glomerular damage 2 leading to ABSTRACT Background: Sickle cell disease is common in this part of India. Study tries to find extent of renal involvement, risk factors and screening tests in sickle cell disease. Methods: Convenient Prospective, cross sectional, observational study among known sickle cell anemia (homo and heterozygous) children and Fifty controls. Demographic and clinical findings were recorded. Renal function tests including serum sodium and potassium, eGFR were studied. Presence of microalbuminuria was checked and renal Doppler study was performed. Results: Total 110 homozygous (SS type), 55 heterozygous (AS type) and 50 normal children were recruited. Majority belonged to low socioeconomic state with male preponderance. More patients in crisis had high Urea (23%) and Creatinine (43%) than in steady state (high urea 3.38%, high creatinine 15%). In AS type children also high urea (3.6%) and creatinine (11%) was found. A subgroup in SS and AS type had lower than normal urea and creatinine. Sodium and potassium abnormality also was found in both groups. eGFR was high below 5 years and then came down. All parameters worsened with age. Renal Doppler was better indicator of renal damage than microalbuminuria. Conclusions: Renal involvement is common in sickle cell anemia. Increasing age, male sex and homozygous state were risk factors. Renal Doppler and micro-albuminuria are good screening tests. Renal Doppler was marginally superior.

Research paper thumbnail of Epiphora, dystrophic nails and telangiectatic erythematous

Pediatric Oncall, 2013

A 4years 6 months old male child born of non-consanguineous marriage presented with dysmorphic fe... more A 4years 6 months old male child born of non-consanguineous marriage presented with dysmorphic features excessive tearing from eyes. He had been operated for cleft palate. His development and birth history were normal. On examination, he had alopecia, epiphora, increased salivation, hypertelorism, low set ears, loss of eye lashes, bald tongue, oral leukoplakia, dystrophic nails, dental caries, loss of teeth, hypoplastic nipples, kyphosis and telangiectatic erythematosus. What is the diagnosis? Dyskeratosis congenita. It is an inherited multisystem disorder characterized by mucocutaneous abnormalities, bone marrow failure and predisposition to cancer and myelodysplastic syndrome. The diagnostic mucocutaneous (ectodermal) triad is reticulate skin pigmentation of upper body, mucosal leukoplakia and nail dystrophy. About 73 percent patients are males compatible with X-linked recessive inheritance. The remainder has either an autosomal dominant or autosomal recessive mode of inheritance. (1)The X-linked recessive form maps to Xq28, and many mutations have been identified in the DKC1 gene, which codes for the nuclear protein dyskerin. Because of impaired telomere maintenance in all 3 inherited forms, short telomeres are demonstrated in the peripheral blood cells of all patients and are a cardinal marker for marrow failure. Androgens combined with low-dose prednisone, can induce improvement of marrow function in approximately 50 percent of patients. Allogeneic hemopoetic stem cell transplantation corrects marrow failure, but with only a 50 percent survival rate. (1) .

Research paper thumbnail of Swelling at bridge of nose

Research paper thumbnail of Multifocal Musculoskeletal Tuberculosis in a Nonimmunocompromised Child

Infectious Diseases in Clinical Practice, 2008

DISCUSSION The skeletal system is the most common extrapulmonary site for tuberculous infection w... more DISCUSSION The skeletal system is the most common extrapulmonary site for tuberculous infection with an incidence ranging from 1% to 10%. 4 Spine is the most common involved site (50%) followed by hip or knee (30%), and less commonly, the pubis, wrist, shoulder, and sacroiliac joint. 5 As in the present case, the thoracolumbar junction is the most commonly involved site, but many levels may be involved at presentation. 6 As in our case also, features of spinal tuberculosis that can be seen on CT scans include anterior vertebral ...

Research paper thumbnail of Traumatic dural sinus thrombosis causing persistent headache in a child

Journal of Emergencies, Trauma, and Shock, 2010

Detailed blood investigations including hemoglobin, platelet count, prothrombin time, bleeding, a... more Detailed blood investigations including hemoglobin, platelet count, prothrombin time, bleeding, and clotting time were within normal limits. We did not anticipate the diagnosis of sinus thrombosis clinically; only after radiological investigations, the diagnosis was made. The child was managed with intravenous fluids, anticoagulation (injection heparin followed by oral anticoagulants-tab coumarin), antiedema measures (mannitol),

Research paper thumbnail of Therapeutic Hypothermia in Moderate and Severe Hypoxic-Ischemic Encephalopathy: Use of LowCost vs High Technology Cooling Technique

International Journal of Current Research and Review, 2020

In the immediate period following insult primary energy failure(first 6 hrs after birth) occurs w... more In the immediate period following insult primary energy failure(first 6 hrs after birth) occurs where there is depletion of oxidative metabolites leading to neuronal cell injury and toxic oedema. A large number of neurons die but many survive only to enter into the process of re-deterioration after a latent period. 2 This period during which secondary energy failure occurs is more severe and prolonged causing .

Research paper thumbnail of Is it now time to screen your baby for spinomuscular muscular atrophy?

Journal of Pediatrics & Neonatal Care

Research paper thumbnail of Probiotics / Prebiotics and Preterm Baby: A Literature Review

Fetal & neonatal medicine, 2016

Research paper thumbnail of Inborn Errors of Metabolism: An Approach

Recent Advances in Pediatrics—25: Hot Topics, 2018

Research paper thumbnail of Osteogenesis Imperfecta: Dreadful Infantile Dysplasia

JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH, 2021

Research paper thumbnail of Lactate Dehydrogenase as Predictor for Severity in Sickle Cell Disease

International Journal of Current Research and Review, 2020

Pyruvate to lactate in a glycolytic pathway is caused by enzyme lactate dehydrogenase (LDH) with ... more Pyruvate to lactate in a glycolytic pathway is caused by enzyme lactate dehydrogenase (LDH) with the conversion of NADH TO NAD+. Lactate dehydrogenase can be found in different body tissues. For hemolysis marker lactate dehydrogenase levels can be used. In sickle cell anaemia patient those who are in the steady-state (SS) there will be an increase in the level of lactate dehydrogenase(LDH). In sickle cell disease, the life of the patient is hampered due to crisis and it is very difficult to predict the crisis. Hence in our study, we used a marker lactate dehydrogenase (LDH) to predict the severity of the crisis. Objectives: To study the ability of serum LDH levels in predicting the severity of disease in sickle cell anaemia. Methodology: To achieve the objective we assess serum LDH levels during steady-state and crisis and to correlate above with chronic complications (PH, Microalbuminuria, Liver functions) and severity of the crisis.Patients fulfilling selection criteria will be recruited after obtaining written consent. Detailed history including the age of onset, frequency and severity of the crisis, frequency of admissions and transfusions, quality of follow up, quality of treatment received will be taken. Detailed examination including anthropometry will be recorded. The severity of the acute crisis will be decided based on the duration of pain more than 2 days, need for admission & stay more than 3 days, death, need for surgery, need for support and need for other procedure. Expected Results: We expect the LDH level to be significantly higher during the crisis. If steady-state patients are considered LDH level will be high in patients with moderate and severe disease (frequency more than 3/ year).

Research paper thumbnail of Dexamethasone and outcome of meconium aspiration syndrome: Vijayapur, Karnataka experience

Sri Lanka Journal of Child Health, Mar 5, 2018

Introduction: Meconium aspiration is an important cause of respiratory distress and mortality in ... more Introduction: Meconium aspiration is an important cause of respiratory distress and mortality in the newborn. Steroid therapy is one of the strategies in management due to its anti-inflammatory action. So far enough evidence is not available in its favour. Objectives: To assess the utility of intravenous (IV) dexamethasone in meconium aspiration syndrome (MAS) and to study any immediate adverse outcome and/or increase in sepsis in newborns receiving dexamethasone. Method: A prospective, interventional study was carried out in the neonatal intensive care unit (NICU) of a tertiary hospital. Newborns were enrolled using selection criteria and were randomized into an intervention group and a control group. After collecting baseline data, the intervention group was administered 0.5mg/kg IV dexamethasone in two divided doses starting from the age of 24 to 36 hours. A total of 6 doses were administered. Outcome measures noted were: period of oxygen dependency, duration of NICU stay, initiation of oral feeds and development of sepsis in both intervention group and control group. Any adverse effects with dexamethasone therapy was noted in babies randomized as intervention group. Investigations and management were carried out as per unit protocol. SPSS Software version 23 was used for statistical purposes. A p value of <0.05 was considered significant. Results: Both intervention group and control group were comparable in subject characteristics. Duration of NICU stay less than 6 days and oxygen requirement less than 50 hours were significantly more in the intervention group. There was no _________________________________________ 1

Research paper thumbnail of A study to assess the nutritional status of children with cleft lip and/or cleft palate and its correlation with breast feeding at a tertiary health care centre

International Journal of Contemporary Pediatrics, 2018

Background: Cleft lip with or without cleft palate is one of the most common congenital anomalies... more Background: Cleft lip with or without cleft palate is one of the most common congenital anomalies. In 2008, the World Health Organization included cleft lip and palate in their Global Burden of Disease initiative. The incidence of cleft lip and palate in India is enormous: one in 781 live births. The growth of children with these deformities is often impaired in comparison to healthy children. Several studies describe a growth lag in either weight or height of cleft children. The objective of the study was to observe the nutritional status of children with cleft lip and/or cleft palate and its correlation with breastfeeding.Methods: A cross sectional study was conducted at Department of Pediatrics, AVBRH Sawangi (Meghe), Wardha for the period of two years from August 2010 to March 2012. All children below 15 years with cleft lip and/or palate admitted in the pediatric ward, NICU or postnatal ward were included in the study. A Total of 200 children were included in the study and ana...

Research paper thumbnail of Point of Care Neurosonogram in Neonates - Utility and Prognostic Value

American Journal of Sonography, 2019

Objective The study aimed to utilize the neurosonographic findings in neonates in early diagnosis... more Objective The study aimed to utilize the neurosonographic findings in neonates in early diagnosis, prediction of their long-term outcome, parental counseling, and early intervention. Methods The study was carried out in neonatal intensive care unit (NICU) of Shri BM Patil Medical College and Hospital. All preterms and term babies with neurological clinical findings were included in the study. Neurosonogram was done within first 7 days in preterms and when indicated in terms. Philips HD11XE ultrasound and color Doppler unit were used with a small footprint probe. Color Doppler images for vessels were performed for screening of vascular changes. Results A total of 215 babies were included, of which 80 (32%) were term and the rest were preterm. Mean weight of term babies was 2.8 kg and that of preterm was 1.2 kg.Among term babies, 78% showed ultrasound abnormality, and among preterm, 42%showed abnormalities. Among term babies, 60% and, among preterms, 30% had birth asphyxia. Periventri...

Research paper thumbnail of Scorpion Sting Envenomation

Journal of Nepal Paediatric Society, 2017

Scorpion sting envenomation is very common problem in rural India especially where the climate is... more Scorpion sting envenomation is very common problem in rural India especially where the climate is hot and dry. Management techniques have improved tremendously over the time leading to reduced morbidity and mortality. Mortality is mainly when ignorant patients go to the traditional faith healers (Tantrics) and come late to the facility where better management is available. Indian red scorpion (Mesobhuthustamulus) is the main species in India. Autonomic storm caused by venom acting on sodium gated and other channels is the main cause of manifestations in a scorpion sting victim. Cardio-myopathy is the main cause for morbidity and mortality. Many grading systems have been suggested for categorizing and simplifying the treatment. The mainstay of treatment where systemic involvement is there are alpha-1 blocker Prazosin hydrochloride, Fluids and newly arrived purified anti-venom. Scorpion envenomation being a problem of rural remote areas and most patients being from lower socio-economi...

Research paper thumbnail of Clinico-Epidemiological And Hematological Profile Of Sickle Cell Anemia With Special Reference To Penicillin Prophylaxis In A Rural Hospital Of Central India

The Internet Journal of Epidemiology, 2011

Research questions: clinical, epidemiological and Hematological characteristics of a cohort of ch... more Research questions: clinical, epidemiological and Hematological characteristics of a cohort of children with sickle cell anemia attending a specialist outpatient clinic in a rural hospital?Objectives:1. To study the pattern, type and frequency of crises/ infections in sickle cell anemia children.2. To observe the effect of intervention (penicillin prophylaxis, folic acid, regular follow up) on the pattern of crisis and infections in disease 3. To study the hematological values in sickle cell anemia children at recruitment.4. To correlate hemoglobin and hematocrit values to number of crisis/ infections in disease.5. To study the effect of intervention on academic performance in disease.Study design: prospective studySetting: Study was conducted in Department of Pediatrics, Jawahar Lal Nehru Medical College and Acharya Vinoba Bhave Rural Hospital, sawangi (wardha)Participants: Children up to14 years of age.Study variables: Age, sex, clinical profile. Hematological profile, scholastic performance, penicillin prophylaxisResults: A prospective study on 131 children revealed that 44.27% were of disease and 55.73% were traits. Most patients, in both disease and trait, belonged to the age group of 4-8 years comprising 47.32% of total patients. Patients of lower socioeconomic status constitute the most common class in both in disease (67.24%) and trait patients (65.75%). Recurrent fever (51.14%) was the most common symptom in both group, Splenomegaly (44.27%) was the most common sign. Patients with sickle cell disease presented most commonly with vaso-occlusive crisis (51.72%) of which hand-foot syndrome was most common (20.69%). Hemoglobin less than 5gm% and age group 0-4yr is associated with highest number of crisis or infection but there is statistically significant decrease in episodes of crisis/infection following penicillin prophylaxis

Research paper thumbnail of Suboptimal Performance in Cleft Lip/ Palate Children- Who is Responsible?

JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH, 2016

Research paper thumbnail of Lizard Bite Masquerading as Scorpion Sting Envenomation

Journal of clinical and diagnostic research : JCDR, 2016

Lizard bite is very infrequent in children. Lizards tend to avoid confrontation. Bites are only i... more Lizard bite is very infrequent in children. Lizards tend to avoid confrontation. Bites are only inflicted when they are manipulated or when they are cornered and feel threatened. Lizard bites may be frightening but most do not cause serious health problems. The wall lizard or gecko, found in most homes, is not poisonous at all. It only checks insect population. A two-year-old boy was brought with history of lizard bite over right hand when he was trying to capture it. The child had experienced excessive sweating and irritability within two hours of bite. He was treated with supportive care. Prazosin hydrochloride was administered in the dose of 30μ/kg as his symptoms mimicked the autonomic storm which is typically seen with scorpion sting envenomation. To the best of our knowledge autonomic storm following lizard bite has not been reported in the Indian literature so far.

Research paper thumbnail of Study of respiratory distress in newborn

International Journal of Contemporary Pediatrics, 2017

Background: Respiratory distress is one of the most common reasons an infant is admitted to the n... more Background: Respiratory distress is one of the most common reasons an infant is admitted to the neonatal intensive care unit. Fifteen percent of term infants and 29% of late preterm infants admitted to the neonatal intensive care unit develop significant respiratory morbidity; this is even higher for infants born before 34 weeks ‘gestation. Certain risk factors increase the likelihood of neonatal respiratory disease. These factors include prematurity, meconium-stained amniotic fluid (MSAF), caesarean section delivery, gestational diabetes, maternal chorioamnionitis, or prenatal ultrasonographic findings, such as oligohydramnios or structural lung abnormalities. Aim of the study was to study the, etiology and outcome of respiratory distress in newborns.Methods: The present study was conducted at the Department of Pediatrics, Acharya Vinoba Bhave Rural Hospital, Jawaharlal Nehru Medical College, Sawangi (Meghe),Wardha, Maharashtra, India. Sample size was decided on the basis of prevale...

Research paper thumbnail of Scorpion sting envenomation, Vijayapur, Karnataka, India experience: new observations

International Journal of Contemporary Pediatrics, 2016

The mortality and severity of envenomation also depends upon cardiac involvement which might cont... more The mortality and severity of envenomation also depends upon cardiac involvement which might continue in spite of Prazosin administered in usual doses. Possibility of higher dose requirement when there is cardiac involvement remains to be studied. The present study analyses the epidemiological and clinical features in patients presenting to a tertiary care hospital to assess whether these can be used to judge the prognosis. The children are often brought to our hospital after visiting rural health centers or local doctors who ABSTRACT Background: Scorpion sting is a very common problem in rural areas of Vijayapur. Financial status of people and non-availability of antivenin are concerns. The present study enumerates risk factors and experience of using drug Prazosin hydrochloride (Prazosin) at higher initial dose (80-90 microgram/kg) in scorpion sting envenomation. Methods: A retrospective study was carried out at Shri BM Patil Medical College Hospital and Research Centre Vijayapur Karnataka during the period of September 2014 to August 2015. Case records of 40 cases of scorpion sting envenomation were reviewed. Risk factors were correlated with outcome. Effect of accidental administration of high dose of Prazosin was studied. Results: Local pain, profuse sweating, vomiting, cold extremities were common presentations. Six patients had myocarditis and one had neurological involvement. One patient was brought dead. Age of patient, time interval between symptoms and treatment, use of steroids and other drugs were main risk factors. High dose Prazosin reduced the time for first response (p= <0.001), total recovery time (p= <0.001), Pediatric Intensive Care Unit stay (p= <0.001) and use of inotropes (P=0.042). Conclusions: High dose Prazosin is useful and safe in severe cases of scorpion sting envenomation in the resource poor settings.

Research paper thumbnail of Renal involvement and its detection in sickle cell disease children

International Journal of Contemporary Pediatrics, 2015

Sickle-cell anaemia is caused by a point mutation in the β-globin chain of haemoglobin, leading t... more Sickle-cell anaemia is caused by a point mutation in the β-globin chain of haemoglobin, leading to replacement of glutamine by valine at 6 th position in the molecule. The loss of elasticity of red blood cell is the main phenomenon in pathophysiology of disease. Elasticity of normal cell, allows it to change its shape so that it passes through capillaries. In sickle-cell disease, hypoxia causes sickling and repeated episodes, harm the cell membrane permanently and decrease elasticity. These cells also fail to return to normal shape on restoration of oxygen tension. The rigid cells are unable to pass through small capillaries, leading to vaso-occlusion. The crises in sickle cell disease affect different organs including kidneys. The kidney is an organ of considerable impact on the clinical course of sickle cell patients. The renal manifestations of Sickle Cell Disease (SCD) have been described to range from various functional abnormalities to gross anatomic alterations. The environment of renal medulla which is hypoxic and hypertonic is known to predispose to sickling, which significantly decreases renal medullary blood flow through vaso-occlusion. 1 This is the main mechanism of renal involvement. Apart from that hyperfiltration hyperperfusion injury also causes progressive glomerular damage 2 leading to ABSTRACT Background: Sickle cell disease is common in this part of India. Study tries to find extent of renal involvement, risk factors and screening tests in sickle cell disease. Methods: Convenient Prospective, cross sectional, observational study among known sickle cell anemia (homo and heterozygous) children and Fifty controls. Demographic and clinical findings were recorded. Renal function tests including serum sodium and potassium, eGFR were studied. Presence of microalbuminuria was checked and renal Doppler study was performed. Results: Total 110 homozygous (SS type), 55 heterozygous (AS type) and 50 normal children were recruited. Majority belonged to low socioeconomic state with male preponderance. More patients in crisis had high Urea (23%) and Creatinine (43%) than in steady state (high urea 3.38%, high creatinine 15%). In AS type children also high urea (3.6%) and creatinine (11%) was found. A subgroup in SS and AS type had lower than normal urea and creatinine. Sodium and potassium abnormality also was found in both groups. eGFR was high below 5 years and then came down. All parameters worsened with age. Renal Doppler was better indicator of renal damage than microalbuminuria. Conclusions: Renal involvement is common in sickle cell anemia. Increasing age, male sex and homozygous state were risk factors. Renal Doppler and micro-albuminuria are good screening tests. Renal Doppler was marginally superior.

Research paper thumbnail of Epiphora, dystrophic nails and telangiectatic erythematous

Pediatric Oncall, 2013

A 4years 6 months old male child born of non-consanguineous marriage presented with dysmorphic fe... more A 4years 6 months old male child born of non-consanguineous marriage presented with dysmorphic features excessive tearing from eyes. He had been operated for cleft palate. His development and birth history were normal. On examination, he had alopecia, epiphora, increased salivation, hypertelorism, low set ears, loss of eye lashes, bald tongue, oral leukoplakia, dystrophic nails, dental caries, loss of teeth, hypoplastic nipples, kyphosis and telangiectatic erythematosus. What is the diagnosis? Dyskeratosis congenita. It is an inherited multisystem disorder characterized by mucocutaneous abnormalities, bone marrow failure and predisposition to cancer and myelodysplastic syndrome. The diagnostic mucocutaneous (ectodermal) triad is reticulate skin pigmentation of upper body, mucosal leukoplakia and nail dystrophy. About 73 percent patients are males compatible with X-linked recessive inheritance. The remainder has either an autosomal dominant or autosomal recessive mode of inheritance. (1)The X-linked recessive form maps to Xq28, and many mutations have been identified in the DKC1 gene, which codes for the nuclear protein dyskerin. Because of impaired telomere maintenance in all 3 inherited forms, short telomeres are demonstrated in the peripheral blood cells of all patients and are a cardinal marker for marrow failure. Androgens combined with low-dose prednisone, can induce improvement of marrow function in approximately 50 percent of patients. Allogeneic hemopoetic stem cell transplantation corrects marrow failure, but with only a 50 percent survival rate. (1) .

Research paper thumbnail of Swelling at bridge of nose

Research paper thumbnail of Multifocal Musculoskeletal Tuberculosis in a Nonimmunocompromised Child

Infectious Diseases in Clinical Practice, 2008

DISCUSSION The skeletal system is the most common extrapulmonary site for tuberculous infection w... more DISCUSSION The skeletal system is the most common extrapulmonary site for tuberculous infection with an incidence ranging from 1% to 10%. 4 Spine is the most common involved site (50%) followed by hip or knee (30%), and less commonly, the pubis, wrist, shoulder, and sacroiliac joint. 5 As in the present case, the thoracolumbar junction is the most commonly involved site, but many levels may be involved at presentation. 6 As in our case also, features of spinal tuberculosis that can be seen on CT scans include anterior vertebral ...

Research paper thumbnail of Traumatic dural sinus thrombosis causing persistent headache in a child

Journal of Emergencies, Trauma, and Shock, 2010

Detailed blood investigations including hemoglobin, platelet count, prothrombin time, bleeding, a... more Detailed blood investigations including hemoglobin, platelet count, prothrombin time, bleeding, and clotting time were within normal limits. We did not anticipate the diagnosis of sinus thrombosis clinically; only after radiological investigations, the diagnosis was made. The child was managed with intravenous fluids, anticoagulation (injection heparin followed by oral anticoagulants-tab coumarin), antiedema measures (mannitol),