Manoj Malviya - Academia.edu (original) (raw)

Papers by Manoj Malviya

NeoReviews, 2017

A 1.07-kg male infant with severe growth restriction is born at 30 weeks’ gestational age to a 36... more A 1.07-kg male infant with severe growth restriction is born at 30 weeks’ gestational age to a 36-year-old gravida 3, para 2 mother by emergency cesarean delivery for nonreassuring heart tracing. The parents are of low socioeconomic status and are first-degree consanguineous relatives. The mother received steroids and her membranes ruptured at delivery. At birth, the infant’s cord clamping was delayed, and after an initial weak cry he underwent intubation for poor respiratory efforts. Apgar scores were 4 and 7 at 1 and 5 minutes, respectively. His initial stabilization included surfactant administration, mechanical ventilation with volume guarantee, catheter line placement (umbilical venous and arterial catheters), initiation of total parenteral nutrition, antibiotics, and inotropic support. On day 3, he underwent extubation and received noninvasive intermittent positive pressure ventilation (NIPPV), inotropic support was discontinued, and antibiotics were stopped, because his blood culture was sterile. He demonstrated steady clinical improvement in the next 3 days, was weaned from NIPPV to nasal continuous positive pressure, and nasogastric feeds progressed gradually. On day 6, the bedside nurse noticed a small macule and blister with surrounding erythema over the lateral aspect of his right thigh, which progressed rapidly in hours to blackish-gray discoloration of skin in an area 4 × 1 cm in size with a small hemorrhagic lesion in the center (Fig 1). The infant’s clinical condition worsened rapidly in the next 24 hours; he became lethargic, hypothermic, tachycardic, hypotensive with poor perfusion, and apneic with increased oxygen requirement. He underwent elective reintubation for recurrent apnea and mixed respiratory and metabolic acidosis. A limited sepsis screening (complete blood cell count and cultures from blood, skin wound, and urine) was performed. Empiric antibiotic treatment with piperacillin-tazobactam was commenced. The infant received a bolus of normal saline, and dopamine treatment was commenced for low mean blood pressure. …

Saudi journal of pathology and microbiology, Dec 4, 2023

The emergence of Carbapenem-resistant Enterobacteriaceae (CRE)is a public health concern worldwid... more The emergence of Carbapenem-resistant Enterobacteriaceae (CRE)is a public health concern worldwide. It is associated with increased mortality due to limited antibiotics available to treat CRE infections. The aim of this study was to understand the epidemiology of CRE infections, associated mortality, and available treatment options. All patients with CRE isolated in blood culture were identified between December 2011 and October 2019. Risk factors and mortality associated with each risk factor at 14 and 30 days were determined.55 cases of CRE bloodstream infections were isolated, with a median age of 56 years. Eighty-four percent of patients received treatment in the ICU. All cases were caused by Klebsiella pneumonia. The rate of resistance to the tested antibiotics was as follows: meropenem 92% (50/54), imipenem 75% (40/53), etrapenam 95% (19/20), Amikacin 71% (37/52), cotrimoxazole 73% (40/53), Gentamicin 47% (25/53) and colistin 7% (3/41). Major risk factors associated were the presence of a urinary catheter (84%), central venous catheter (78%), mechanical ventilation (74%) and post-surgery (67%). Mortality at 14 days and 30 days was 41%, and 52%, respectively. Univariate analysis showed that 14 days mortality was higher in patients with central venous catheter (P=0.01). Charlson's comorbidity index was associated with an increased risk of death at 30 days (P=0.04). There was no statistically increased survival in those treated with combination therapy at 30 days (P=0.5). The mortality of CRE infections seems to be high and optimal therapy is not yet well defined. Combination therapy is not associated with increased survival in this cohort of patients.

The Cochrane library, Mar 28, 2013

Surgical versus medical treatment with cyclooxygenase inhibitors for symptomatic patent ductus ar... more Surgical versus medical treatment with cyclooxygenase inhibitors for symptomatic patent ductus arteriosus in preterm infants (Review)

The Cochrane library, Jul 28, 2023

The Cochrane library, Jun 4, 2019

Analysis 2.4. Comparison 2 Fish oil LE versus non-fish oil LE in infants with cholestasis, Outcom... more Analysis 2.4. Comparison 2 Fish oil LE versus non-fish oil LE in infants with cholestasis, Outcome 4 Growth rate (g/week).......... Analysis 2.5. Comparison 2 Fish oil LE versus non-fish oil LE in infants with cholestasis, Outcome 5 Head growth velocity (cm/ week

American Journal of Perinatology

Objective The overuse of antimicrobials in neonates is not uncommon and has resulted in a global ... more Objective The overuse of antimicrobials in neonates is not uncommon and has resulted in a global health crisis of antibiotic resistance. This study aimed to evaluate changes associated with a neonatologist-driven antimicrobial stewardship program (ASP) in antibiotic usage. Study Design We conducted a pre–post retrospective cohort study in a tertiary care hospital in Oman. Neonates admitted in 2014 to 2015 were considered as the pre-ASP cohort. In 2016, a neonatologist-driven ASP was launched in the unit. The program included the optimization and standardization of antibiotic use for early- and late-onset sepsis using the Centers for Disease Control and Prevention's “broad principles,” an advanced antimicrobial decision-support system to resolve contentious issues, and placed greater emphasis on education and behavior modification. Data from the years 2016 to 2019 were compared with previous data. The outcome of interest included days of therapy (DOT) for antimicrobials. Baseline...

Indian Journal of Neonatal Medicine and Research, 2013

Background: Both conventional ventilation (CMV) and CPAP are frequently used as the primary modal... more Background: Both conventional ventilation (CMV) and CPAP are frequently used as the primary modality for infant presenting with Acute respiratory failure, however, evidence regarding the "best" primary ventilatory modality is lacking. Aims: To report our experience of nasal CPAP as primary ventilator support strategy in infants admitted for ARF. Design: Retrospective comparative audit over a period of 2 years. Methods: All the infants admitted to NICU requiring respiratory support, in the form of CPAP and/ or CMV, were included in the study. Two cohort chosen for comparison were 1. The CMV era (January-December 2007): CMV as the primary modality. 2. The CPAP era (January-December 2008): CPAP as the primary modality with standardised ventilator regimen. Results: The numbers of infants requiring respiratory support (CMV and/or CPAP) were almost similar (CMV era: 77/308, (25%), CPAP era: 94/372, (25.2%). No statistically significant differences were found in the baseline char...

Pediatric Infectious Disease Journal, 2020

T he novel coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome-coron... more T he novel coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2), is one of the worst pandemics the human race has ever experienced. COVID-19 infection affects all age groups, including newborn infants and pregnant women. Most of the SARS-CoV-2 infections in pregnancy are mild, occur in the third trimester, and 1% develop severe disease. 1 COVID-19 infection in the third trimester of pregnancy may be associated with premature rupture of membranes and preterm delivery. 2 The precise incidence of vertical transmission (VT) of SARS-CoV-2 infection is unknown. A systemic review of 18 studies comprising 114 pregnant women with COVID-19 infection demonstrated a lack of VT. 3 A recent study, contrary to the previous one, revealed that the human placenta minimally expresses the angiotensin-converting enzyme 2 receptors (aid in viral cell attachment), and also for an enzyme transmembrane serine protease known as type II (TMPRSS2) (essential for viral replication); this may explain the low occurrence of VT. 4 There is limited convincing data regarding the VT of SARS-CoV-2 and systematic analysis of published studies reported only 28 cases of possible VT from 665 COVID-19 positive mothers. 5 We report the first case of VT in preterm trichorionic triamniotic triplet pregnancy, with all triplets, tested positive for SARS-CoV-2 by reverse transcriptase-polymerase chain reaction (RT-PCR) from nasopharyngeal and throat swabs, taken at 20 hours and day 5 of life. The mother's timeline of infection indicates that COVID-19 possibly triggered preterm labor.

European Journal of Pediatrics, 2020

We aimed to demonstrate the value of monitoring infants with arteriovenous malformation (AVM) dur... more We aimed to demonstrate the value of monitoring infants with arteriovenous malformation (AVM) during endovascular embolization with integrated evaluation of hemodynamics (IEH) and guiding decisions according to the underlying pathophysiology. This is a retrospective analysis of the perioperative hemodynamics data for 2 complex cases of AVM transferred to Khaula Hospital in Oman for interventional management. We described the value of novel physiological insights gained from comprehensive IEH and provided a systematic approach to the perioperative management. Postoperative targeted neonatal echo (TNE) was used to guide the weaning of the cardiovascular medications within 24 h. Both cases showed significant right ventricle (RV) volume overload before surgery. Narrowing of the pulse pressure (PP) during or after endovascular embolization was used as a marker of compromised systemic blood flow in real time followed by an assessment by TNE to guide the appropriate therapy. Conclusion: Integrated evaluation of hemodynamics is helpful to guide perioperative physiologic-based management of AVM.

Cochrane Database of Systematic Reviews, 2018

Analysis 1.3. Comparison 1 Fish oil lipid emulsion (LE) versus non-fish oil LE (see Appendix 3), ... more Analysis 1.3. Comparison 1 Fish oil lipid emulsion (LE) versus non-fish oil LE (see Appendix 3), Outcome 3 Parenteral nutritionassociated liver disease (PNALD)/cholestasis (conjugated bilirubin ≥ 2 mg/dL

The Cochrane database of systematic reviews, Jan 2, 2015

The pure soybean oil based lipid emulsions (S-LE) conventionally used for parenteral nutrition (P... more The pure soybean oil based lipid emulsions (S-LE) conventionally used for parenteral nutrition (PN) in preterm infants have high polyunsaturated fatty acid (PUFA) content. The newer lipid emulsions (LE) from alternative lipid sources with reduced PUFA content may improve clinical outcomes in preterm infants. To determine the safety and efficacy of the newer alternative LE compared with the conventional S-LE for PN in preterm infants. We used the standard search strategy of the Cochrane Neonatal Review Group (CNRG) to search the Cochrane Central Register of Controlled Trials (CENTRAL; Issue 7), MEDLINE (1946 to 31 July 2015), EMBASE (1947 to 31 July 2015), CINAHL (1982 to 31 July 2015), Web of Science (31 July 2015), conference proceedings, trial registries (clinicaltrials.gov, controlled-trials.com, WHO's ICTRP), and the reference lists of retrieved articles for randomised controlled trials and quasi-randomised trials. Randomised or quasi-randomised controlled trials in preterm ...

Cochrane Database of Systematic Reviews, 2013

Protocols, 2011

... parenterally fed preterm infants Vishal Kapoor1, Rebecca Glover2, Manoj N Malviya3 ... Nature... more ... parenterally fed preterm infants Vishal Kapoor1, Rebecca Glover2, Manoj N Malviya3 ... Nature 2005;437(7055):45–6. Bell 1978 Bell MJ, Ternberg JL, Feigin RD, Keating JP, Marshall R, Barton L, Brotherton T. Neonatal necrotizing enterocolitis. ...

$Research paper thumbnail of Familial Idiopathic infantile arterial calcification presenting as a refractory hypertension and hypercalcemia in neonatal period$

The Southeast Asian Journal of Case Report and Review, 2016