Saradha Suresh - Academia.edu (original) (raw)

Papers by Saradha Suresh

Bjog-an International Journal of Obstetrics and Gynaecology, 2004

Objective To determine the prevalence of physical violence during pregnancy and the factors assoc... more Objective To determine the prevalence of physical violence during pregnancy and the factors associated with it.

The Indian journal of medical research, 2008

Irrational use of antimicrobials is a key factor behind rapidly spreading antimicrobial resistanc... more Irrational use of antimicrobials is a key factor behind rapidly spreading antimicrobial resistance in microorganisms. This study was undertaken to determine the rate and pattern of antimicrobial prescribing in patients with uncomplicated acute respiratory infections, fever and diarrhoea attending a few rural and urban health settings. The study was done in primary and secondary health care facilities of public/government and private settings at four sites in India. Patients with fever, cough, diarrhoea or ear, nose or throat infections of < 7 days were included. Pregnant women, lactating mothers, infants, seriously ill patients and patients with bloody diarrhoea or purulent nasal or ear discharge were excluded. Overall antimicrobial prescription rate was 69.4 per cent (95% CI 67.1, 71.7). Wide variation was observed (Thiruvananthapuram 47.6%, Lucknow 81.8%, Chennai 73.1% and Vellore 76.5%). Physicians practicing in rural and public/government settings prescribed antimicrobials mo...

Indian journal of pediatrics, 2010

To study the prevalence of associated airway anomalies in infants presenting with moderate to sev... more To study the prevalence of associated airway anomalies in infants presenting with moderate to severe laryngomalacia. Eighty three (83) symptomatic infants with recurrent respiratory symptoms including wheeze and cough diagnosed as moderate to severe laryngomalacia based on their clinical and direct laryngoscopic findings were subjected to fiberoptic bronchoscopy (FOB) during the period March 2007 to February 2009 in the Department of Pulmonology, Institute of Child Health and Hospital for Children, Chennai, India. Analysis of the clinical features, radiological findings and associated lower airway anomalies by FOB was done. Lower airway anomalies were demonstrated in 40 (48%) infants of the study population. Tracheomalacia was the most common lower airway anomaly 24 (29%) followed by bronchomalacia 8(10%) and tracheobronchomalacia 6 (7%). (4:1:1). Infants with moderate and severe laryngomalacia should be evaluated with flexible fibreoptic bronchoscopy to rule out associated lower ai...

The Indian journal of medical research, 2010

The Indian Journal of Pediatrics, 2007

PLoS ONE, 2008

Background: WHO-defined pneumonias, treated with antibiotics, are responsible for a significant p... more Background: WHO-defined pneumonias, treated with antibiotics, are responsible for a significant proportion of childhood morbidity and mortality in the developing countries. Since substantial proportion pneumonias have a viral etiology, where children are more likely to present with wheeze, there is a concern that currently antibiotics are being over-prescribed for it. Hence the current trial was conducted with the objective to show the therapeutic equivalence of two treatments (placebo and amoxycillin) for children presenting with non-severe pneumonia with wheeze, who have persistent fast breathing after nebulisation with salbutamol, and have normal chest radiograph.

Journal of Clinical Epidemiology, 1998

Objective: To increase the rational use of blood transfusion in a teaching hospital by intensive ... more Objective: To increase the rational use of blood transfusion in a teaching hospital by intensive training. In 1992 we analyzed the administration of Objective: To identify risk factors for unsatisfactory growth and develop-1644 units of blood to 613 patients. We set the ''rational'' trigger to start mental delay in infancy for planning appropriate and early intervention. transfusion at Hemoglobin value of 8 gm/dl or less and/or to stop transfusion Design: Prospective cohort study. at Hb of 10 gm/dl or higher. We found rational use in 55% and 60% of Setting: Urban slum in Chennai, India under Integrated Child Developcases. Considering that approx. 35,000 units of blood were given to 17,000 ment Scheme. patients annually, there were large unnecessary risks of disease transmission. Participants: All live births from November 1995 to April 1996 in the Design: Multiple cross-sectional descriptive studies to analyze the change randomly selected 36 Anganwadi centers in the project area. in residents' opinions toward trigger factors of blood transfusion after Intervention: 310 babies were registered within one month of birth. Pregtraining.

Indian Pediatrics, 2012

To determine the case fatality rate and factors for death in community acquired pneumonia among c... more To determine the case fatality rate and factors for death in community acquired pneumonia among children aged 1 month to 59 months admitted in a referral Hospital. Hospital based retrospective study. Institute of Child Health and Hospital for Children, Chennai. Case records of children aged 1 month to 59 months of age with pneumonia (clinically diagnosed pneumonia, radiologically diagnosed pneumonia, and clinically and radiologically diagnosed pneumonia), from January 2006 to December 2008. Outcome measures Case fatality rate (CFR) was calculated. Risk factors for mortality analyzed were young age of 1 to 6 months old, female sex, wheeze, respiratory rate &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt;70/min, chest indrawing, altered level of consciousness, convulsions, shock, associated heart disease, recent measles, weight for age &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;-2 Z score and need for assisted ventilation. The association of risk factors to mortality was arrived at for all three categories of pneumonia cases separately. Case fatality rate was 8.2% (95% CI: 7.37- 8.99%). There was no significant difference in the CFR among the three study groups. Need for assisted ventilation alone was found to be an independent risk factor for mortality in children with pneumonia among all the study groups. Other risk factors like young age, weight for age &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;-2 Z score, altered level of consciousness, and congenital heart disease were also observed among these groups. Among 1 month to 59 months old hospitalized children with pneumonia, CFR was 8.2%. Need for assisted ventilation was a significant risk factor associated with mortality.

Indian Journal of Critical Care Medicine, 2013

Pediatric index of mortality (PIM) 2 score is one of the severity scoring systems being used for ... more Pediatric index of mortality (PIM) 2 score is one of the severity scoring systems being used for predicting outcome of patients admitted to intensive care units (ICUs). The aim of the present study was to evaluate the usefulness of PIM2 score in predicting mortality in a tertiary care pediatric ICU (PICU) and to assess the associated factors in predicting mortality such as presence of shock, need for assisted ventilation and Glasgow coma scale &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;8. This was a prospective observation study done at tertiary care PICU from May 2011 to July 2011. Consecutive 119 patients admitted to PICU (aged 1 month to 12 years) were enrolled in the study. PIM2 scoring was done for all patients. The outcome was recorded as death or discharge. The associated factors for mortality were analyzed with SPSS 17. PIM2 score discriminated between death and survival at a 99.8 cut-off, with area under receiver operating characteristic curve 0.843 with 95% confidence interval (CI) (0.765, 0.903). Most patients were referred late to this hospital, which explains higher death rate (46.2%), lesser length of hospital stay (mean 2.98 days) in the mortality group, and increased rate of mechanical ventilation (68.1%). Presence of shock was independently associated with mortality, as evidenced by binary logistic regression. PIM2 score discriminated well between survivors and death at PICU. Presence of shock was significantly associated with mortality.

The Indian journal of medical research, 2013

Haemophilus influenzae type b (Hib) is one of the leading bacterial causes of invasive disease in... more Haemophilus influenzae type b (Hib) is one of the leading bacterial causes of invasive disease in populations without access to Hib conjugate vaccines (Hib-CV). India has recently decided to introduce Hib-CV into the routine immunization programme in selected States. Longitudinal data quantifying the burden of bacterial meningitis and the proportion of disease caused by various bacteria are needed to track the impact of Hib-CV once introduced. A hospital-based sentinel surveillance network was established at four places in the country and this study reports the results of this ongoing surveillance. Children aged 1 to 23 months with suspected bacterial meningitis were enrolled in Chennai, Lucknow, New Delhi, and Vellore between July 2008 and June 2010. All cerebrospinal fluid (CSF) samples were tested using cytological, biochemical, and culture methods. Samples with abnormal CSF (≥10 WBC per μl) were tested by latex agglutination test for common paediatric bacterial meningitis pathog...