Dr. Roosy Aulakh - Academia.edu (original) (raw)

Papers by Dr. Roosy Aulakh

Journal of Postgraduate Medicine, 2022

With the first MBBS batch admitted under the new National Medical Commission (NMC) undergraduate ... more With the first MBBS batch admitted under the new National Medical Commission (NMC) undergraduate curriculum entering pediatric clinical posting soon, creation of a Pediatric logbook in consonance with this competency-based curriculum was felt to be a need of the hour. No such document is yet available in the public domain. The logbook template, created after enormous brainstorming amongst authors, includes 176 Shows (S), Shows How (SH) and Perform (P) level competencies. These were further segregated into certifiable (23), affective domain (25) and clinic/field visits (9) leaving 51 as documentable competencies. The institutions may use this template to build their own institute-specific logbook based on the infrastructure, faculty strength, clinical patient load, student intake and preferred assessment method(s). It would also be worthwhile to integrate this with the internship logbook (and later the postgraduate one for students opting for post-graduation in pediatrics) to provide...

Chest, 2020

Educating children on proper usage of inhaler is essential for effective management of asthma as ... more Educating children on proper usage of inhaler is essential for effective management of asthma as incorrect technique is associated with poor control, increased exacerbations and hospitalizations. This study was undertaken to evaluate the efficacy of video-based inhaler technique education versus conventional physical instructions. METHODS: A randomized controlled trial was conducted on 120 children aged 6 to 11 years in an asthma outpatient clinic, who either watched a 2-minute instructional video or received physical demonstration of device technique at each visit. Correct steps of inhaler technique, FEV 1 , FEV 1 /FVC ratio and Asthma Control Questionnaire (ACQ) score were assessed at baseline and at 12 weeks. RESULTS: In the video group, there was significant improvement at 12 weeks from baseline in correct steps (5.78AE1.02 vs 7.31AE0.71, p<0.01), FEV 1 (90.9% vs 95.3%, p¼0.01), FEV 1 /FVC (95.5% vs 100.1%, p<0.01) and ACQ score (1.16 AE 0.76 vs 0.82 AE 0.61, p<0.01). In the control group, total correct steps (6.12AE0.88 vs 6.97AE1.31, p<0.01), FEV 1 (94.4% vs 98.4%, p<0.01) and ACQ score (1.12AE1.06 vs 0.74AE0.54, p<0.01) improved statistically from baseline to 12 weeks, while change in FEV 1 /FVC (96.2% vs 98.7%, p¼0.15) was not significant. There was no statistical difference between both groups at 12 weeks in mean correct steps (p¼0.08), FEV 1 (p¼0.12), FEV 1 /FVC (p¼0.45) or ACQ score (p¼0.3), implying that videos are not inferior to traditional physical demonstration. CONCLUSIONS: Repeated video instructions lead to improvement in inhaler technique, lung functions and asthma control. CLINICAL IMPLICATIONS: Videos being less time-consuming, more uniform and catering to multiple children simultaneously, could be tapped to impart device education.

Annals of Indian Academy of Neurology, 2011

Journal of Paediatrics and Child Health

International journal of scientific research, 2016

Formulations containing two or more drugs in combination in a fixed ratio are called fixed dose c... more Formulations containing two or more drugs in combination in a fixed ratio are called fixed dose combinations (FDCs) . FDCs can be both rational as well as irrational. These irrational FDCs have numerous consequences associated with them like increased and unnecessary drug adverse reactions due to harmful &/or useless components, increased medication cost, poor clinical response in patients due to inappropriate dosage of individual components and above all increase in antibiotic resistance due to overuse or unnecessary use of antibiotic(s) present in FDC. We have highlighted certain irrational FDCs commonly prescribed to pediatric population and described the basis of their irrationality to enable the pediatricians to make well informed decisions of not prescribing these irrational drugs. It is high time that comprehensive efforts are made to curb this increasing menace of irrational pediatric FDCs; which would help tackle issue of increasing drug resistance as well.

Recent years have witnessed innumerable scientific paper retractions. As per COPE guidelines, jou... more Recent years have witnessed innumerable scientific paper retractions. As per COPE guidelines, journal editors should consider scientific paper retractions if they have clear evidence that the findings are 1 unreliable, plagiarized, unethical or redundant. Cleansing of medical literature is the main motive behind such retractions. But does retracting scientific information which has been repeatedly accessed and cited prior to its retraction (and even post retraction at times!) serve this purpose?

Journal of Pediatric Neurology, 2020

Pediatric ocular myasthenia gravis (OMG) is difficult to diagnose and manage, owing to its rarity... more Pediatric ocular myasthenia gravis (OMG) is difficult to diagnose and manage, owing to its rarity and low index of suspicion in the early stage of the disease. Also, many other conditions having similar presentation cause a further delay in diagnosis. In this review, we have highlighted various pointers in history and described bedside clinical tests that can aid in its timely diagnosis. The antibody spectrum in myasthenia is ever increasing and includes anti-muscle specific kinase and low-density lipoprotein-receptor related protein 4 antibodies in addition to acetylcholine receptor antibodies besides many others. However, pediatric OMG patients often test negative for all three antibodies, making the diagnosis even more difficult in triple seronegative patients. Edrophonium and electrophysiological tests, which help in confirming myasthenia in adults, have a limited utility in diagnosing pediatric ocular myasthenia cases. Various practical difficulties are encountered like nonavai...

Acta Scientific Paediatrics, 2020

What is overweight and obesity? Obesity these days had become a major health problem with prevale... more What is overweight and obesity? Obesity these days had become a major health problem with prevalence both in developed as well as in developing countries. Overweight and obese children are likely to stay obese into adulthood [1]. While overweight and obesity are themselves risk factors to

Journal of Pediatric Neurology, 2016

Journal of Pediatric Neurosciences, 2019

Congenital heart diseases, hemolytic anemia, collagen vascular diseases, and neurometabolic disor... more Congenital heart diseases, hemolytic anemia, collagen vascular diseases, and neurometabolic disorders are known to be associated with the development of arterial ischemic stroke (AIS) in children. However, not all the children with the aforementioned conditions develop AIS. Hence, the possibility of interplay of various predisposing factors in children with inherent underlying medical conditions seems likely. Trauma, infections, and thrombophilic risk factors are well known to predispose to the development of AIS in children. Congenital hypoplasia of internal carotid artery (HICA) is a rare disorder in which patient may remain asymptomatic or may present with symptoms due to cerebrovascular insufficiency or compression by collateral vessels. We report a 7-year-old boy who presented with AIS and had a history of two transient ischemic attacks in the past 2 years. He was diagnosed to have congenital HICA. However, further evaluation revealed the presence of protein S deficiency as well. This case reemphasizes the need for investigation into multifactorial causation of pediatric AIS in every case.

Annals of Neurology, 2016

The diagnosis of neurocysticercosis (NCC) remains problematic because of the heterogeneity of its... more The diagnosis of neurocysticercosis (NCC) remains problematic because of the heterogeneity of its clinical, immunological, and imaging characteristics. Our aim was to develop and assess a new set of diagnostic criteria for NCC, which might allow for the accurate detection of, and differentiation between, parenchymal and extraparenchymal disease. Methods: A group of Latin American NCC experts developed by consensus a new set of diagnostic criteria for NCC. A multicenter, retrospective study was then conducted to validate it. The reference standard for diagnosis of active NCC was the disappearance or reduction of cysts after anthelmintic treatment. In total, three pairs of independent neurologists blinded to the diagnosis evaluated 93 cases (with NCC) and 93 controls (without NCC) using the new diagnostic criteria. Mixed-effects logistic regression models were used to estimate sensitivity and specificity. Results: Inter-rater reliability (kappa) of diagnosis among evaluators was 0.60. For diagnosis of NCC versus no NCC, the new criteria had a sensitivity of 93.2% and specificity of 81.4%. For parenchymal NCC, the new criteria had a sensitivity of 89.8% and specificity of 80.7% and for extraparenchymal NCC, the new criteria had a sensitivity of 65.9% and specificity of 94.9%. Interpretation: These criteria have acceptable reliability and validity and could be a new tool for clinicians and researchers. An advantage of the new criteria is that they consider parasite location (ie, parenchymal or extraparenchymal), which is an important factor determining the clinical, immunological, and radiological presentation of the disease, and importantly, its treatment and prognosis.

Journal of Child Neurology, 2013

We read with great interest the highly informative and relevant paper of Jain et al on children w... more We read with great interest the highly informative and relevant paper of Jain et al on children with developmental disabilities in India. The age at initial concern was noted to be 7 months and age at referral for rehabilitation services was noted to be 13 months for children with developmental disabilities. These data are reassuring and reflect the increasing recognition among parents and physicians about developmental delays in infancy despite lack of routine developmental screening in India. The recognition of children with adverse perinatal events as a high-risk group and an emphasis on regular neurologic assessment by physicians seems to be a major factor in early detection and appropriate referral of these children. In contrast, in children with autism spectrum disorders, the median age at initial concern was reported to be 24 months, with a further delay of 14 months before being referred to rehabilitation services. This reflects the lack of awareness about autism spectrum disorders, especially early red flag signs, among parents as well as physicians in India. This is of grave concern, especially with reports of an alarming rise in the prevalence of autism spectrum disorders. Per the National Health Statistics Reports, which are based on parent reports, the prevalence of diagnosed ASD in 2011-2012 was estimated to be 2.00% for children aged 6 to 17. This prevalence estimate (1 in 50) is significantly higher than the estimate (1.16%, or 1 in 86) for children in that age group in 2007. With autism spectrum disorders reaching epidemic proportions, preparedness is the need of the hour. With April being celebrated as the month for autism awareness, effective measures must be urgently taken to increase awareness of early warning signs in autism among parents, establishment of routine developmental and behavioral screening by primary care physicians in India, and provision of appropriate, accessible, and affordable early intervention services.

Journal of American Association for Pediatric Ophthalmology and Strabismus, 2009

Congenital anomalies, such as absence, hypoplasia, bifurcation, or reduplication of various extra... more Congenital anomalies, such as absence, hypoplasia, bifurcation, or reduplication of various extraocular muscles, including lateral rectus muscles have been reported previously. We report a 5-year-old girl who had posteriorly malinserted lateral rectus at 15 mm from the limbus in the right eye with multiple associated ocular and systemic congenital malformations.

Pediatric Review: International Journal of Pediatric Research, 2018

Subacute sclerosing panencephalitis (SSPE) is a devastating 'slow virus' disease of childhood and... more Subacute sclerosing panencephalitis (SSPE) is a devastating 'slow virus' disease of childhood and adolescence caused due to persistence of defective measles virus (MV) within the neurons and glial cells. Three drugs, i.e., inosiplex, ribavirin and interferon-alpha (IFN-alpha) were reported to be effective though none of them have been proven to be curative.

Indian Journal of Critical Care Medicine

Dystonia is a movement disorder characterized by involuntary sustained or intermittent muscle con... more Dystonia is a movement disorder characterized by involuntary sustained or intermittent muscle contraction causing repetitive twisting movements and abnormal postures. Status dystonicus (SD) is an enigmatic disease of cryptic etiology. We hereby report a child with West syndrome (WS) who went on to develop SD following intramuscular adrenocorticotropic hormone (ACTH) injection. An 11-month-old male child presented with complaints of flexor spasms for 2 months. The diagnosis of WS was confirmed by electroencephalography (EEG), which showed hypsarrhythmia. Intramuscular ACTH was added, and oral trihexyphenidyl was started for dystonia. On day 7 of ACTH, the child developed frequent opisthotonic posturing. Management protocol for grade IV SD was initiated. Administration of N-terminal of ACTH in rat locus coeruleus has been shown to produce human dystonia-like movement and abnormal posturing.

We report a 7-year-old incompletely immunized male child who presented with intermittent dyspnea,... more We report a 7-year-old incompletely immunized male child who presented with intermittent dyspnea, fever, and extensive muscle spasms following an alleged history of unprovoked Category III dog bite 20 days back with inadequate post-exposure prophylaxis. This case highlights the importance of detailed clinical evaluation including minor signs such as trismus, persistent tetanic muscle contraction in intervening period between muscle spasms and preservation of normal sensorium in the absence of aerophagia and hydrophobia in ruling out a possible diagnosis of rabies in this child, and establishment of diagnosis of less sinister treatable disease with better prognosis.

Pediatric Review: International Journal of Pediatric Research, 2016

Respiratory Distress Syndrome is a major contributor towards Neonatal Mortality Rate. Effective v... more Respiratory Distress Syndrome is a major contributor towards Neonatal Mortality Rate. Effective ventilation strategies which are safe, effective and low cost are required to manage neonates with Respiratory Distress Syndrome in resource limited low and middle income countries. Bubble Continuous Positive Airway Pressure has emerged recently as one such alternative.