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Papers by Narayanan Parameswaran

Virusdisease, Feb 13, 2017

Indian Journal of Clinical Biochemistry, Jan 16, 2017

Indian Journal of Pediatrics, Feb 19, 2022

Indian Journal of Hematology and Blood Transfusion, Jun 12, 2013

Indian Journal of Critical Care Medicine, 2021

British Journal of Haematology, 2020

The Indian Journal of Pediatrics, 2006

Kidney International, 2015

The Journal of Infection in Developing Countries, 2015

Infectious diseases are one of the major causes of morbidity and mortality in developing countrie... more Infectious diseases are one of the major causes of morbidity and mortality in developing countries. Sometimes concurrent infections with multiple infectious agents may occur in one patient, which make the diagnosis and management a challenging task. The authors here present a case of co-infection of typhoid fever with dengue fever in a ten-year-old child and discuss the pertinent issues. The authors emphasize that the risk factors predicting the presence of such co-infections, if developed, will be immensely useful in areas where dengue outbreak occurs in the background of high transmission of endemic infections.

Revista do Instituto de Medicina Tropical de São Paulo, 2015

SUMMARY The role of trace elements in dengue virulence is not yet known. The present study assess... more SUMMARY The role of trace elements in dengue virulence is not yet known. The present study assessed the serum levels of two micronutrients, copper and iron, in cases of dengue fever. The study involved 96 patients of whom 48 had either severe or non-severe forms of dengue (with and without warning signs), and the remaining 48 were patients with other febrile illnesses (OFI), used as controls. Serum levels of copper and iron were evaluated at admission and by the time of defervescence using commercially available kits. At admission, no difference in the level of serum copper was observed between cases and controls. In the group of dengue cases, the copper level was found to be significantly decreased in severe and non-severe cases with warning signs, compared to non-severe cases without warning signs. In contrast, by the time of defervescence the copper level was found to be increased in all dengue cases compared to OFI controls, but no difference was observed among dengue cases. Unl...

Indian journal of pediatrics, 2009

To report causes, clinical feature and outcome of children with Acute Respiratory Distress Syndro... more To report causes, clinical feature and outcome of children with Acute Respiratory Distress Syndrome (ARDS). The case records of children admitted with ARDS from June 2003 to June 2006 were retrospectively reviewed and the data collected was analyzed. A total of 17 children were diagnosed as ARDS during study period giving an incidence of 22.7/1,000 admissions. The mean (SD) age was 74.5 (56.32) mo [range 6-144 mo]. Primary lung pathology contributed to a (53%) cases of ARDS while the rest (47%) had non pulmonary causes. There was not any significant different in mortality between these two groups. Similarly when infections and non infections conditions were considered separately there was no difference in survival. All children were ventilated using Pressure Controlled Ventilation. The mean (SD) duration of ventilation was 5.0 days [range 1-10 days]. The maximum PEEP (SD) used during the course of ventilation was 10 (3.37) cm H2O [range 7-18], while the maximum PIP (SD) used was 31 ...

Indian pediatrics, 2006

This study was designed to examine the effect of nitroglycerine infusion in children hospitalized... more This study was designed to examine the effect of nitroglycerine infusion in children hospitalized for scorpion sting with severe myocardial dysfunction and decompensated shock. Children satisfying the inclusion criteria were started on nitroglycerine infusion under hemodynamic monitoring and other supportive measures. The effects of nitroglycerine, including improvement in oxygenation and decrease in pulmonary congestion and liver size were recorded. Seven out of 11 children responded well to nitroglycerine therapy and the clinical response was evident within 30 to 60 minutes. The first parameter to improve was oxygen saturation, followed by an improvement in the blood pressure and respiratory rate. Heart rate was the last parameter to improve after nitroglycerine infusion. The average duration of nitroglycerine infusion was 25 hours (12 - 36 hours). It was seen that the non-survivors had significant tachycardia at admission, and a greater need for assisted ventilation compared to t...

The Indian Journal of Pediatrics, 2007

Acute lupus pneumonitis in an 11-year-old girl with lupus nephritis is reported. Chest radiograph... more Acute lupus pneumonitis in an 11-year-old girl with lupus nephritis is reported. Chest radiograph and arterial blood gas parameters were suggestive of Acute Respiratory Distress Syndrome (ARDS). Definitive pulmonary infection was excluded by investigations and poor clinical response to antibiotics. The respiratory worsening warranted ventilatory support with very high pressures. A trial of intravenous immunoglobulin was given following which there was improvement in the ventilatory requirements by 36 hours. The child was successfully weaned off ventilator and discharged from ICU by day 7. The role of intravenous immunoglobulin during acute life threatening pulmonary emergencies in a case of SLE prompted this clinical brief.