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Papers by Siddarameshwar Kalyanshettar

Journal of Nepal Paediatric Society, 2020

Introduction: Phototherapy is used to manage neonatal hyperbilirubinemia in early life. We aimed ... more Introduction: Phototherapy is used to manage neonatal hyperbilirubinemia in early life. We aimed to compare between intermittent and continuous phototherapy in reducing TSB, rate of fall of bilirubin, duration of phototherapy and duration of hospitalisation in neonates with non-haemolytic hyperbilirubinemia. Methods: Total 190 neonates who were > 34 weeks and birth weight ≥ 2000 gm were included. They were randomised into group A (continuous phototherapy) and group B (intermittent phototherapy). Group A received phototherapy for three hours and 45 minutes off and group B received phototherapy for three hours and then three hours off. TSB levels estimation were done in both groups and compared after each 12 hours, 24 hours, and 48 hours of commencing phototherapy. Results: The mean TSB at presentation was 15.64 ± 2.19 mg/dl for continuous and 15.03 ± 1.07 mg/dl for intermittent group. Mean TSB at 12, 24, 48 hours were 13.26 ± 2.4 mg/dl, 10.8 ± 1.72 mg/dl, 10.16 ± 0.95 mg/dl respec...

Journal of Neonatal Biology, 2020

Introduction: Pre-term birth is the main determinant of neonatal morbidity and mortality with lon... more Introduction: Pre-term birth is the main determinant of neonatal morbidity and mortality with long-term adverse health consequences. Infants born pre-term compared to term infants experience more difficulty with temperature instability, feeding intolerance, blood glucose regulation, jaundice, apnea, respiratory distress (RDS) and sepsis. Aim: To study the early neonatal morbidities of all pre-term neonates admitted in NICU and to know the immediate outcome during their stay. Also to compare rate of early morbidities and mortality among SGA and AGA pre-term neonates. Material and methods: It’s a prospective observational study carried out in a NICU of a Medical college in South India, for a period of 18 months. Preterm babies (less than 37 weeks gestation using Modified Ballard score) divided into SGA and AGA using growth charts. Total 100 preterm babies included of which SGA and AGA were 50 each. Neonates with TTN (Transient Tachypnea of the Newborn), Birth asphyxia, Neonatal sepsis, Hypoglycemia, Hypothermia, Neonatal hyperbilirubinemia, Respiratory insufficiency, Feed intolerance were included in present study. Results: Hyperbilirubinemia constituted 61% of morbidities, among which 47.5% are AGA neonates and 52.5% are SGA neonates. 24 newborns presented with sepsis, 15 newborns with feed intolerance. 80 newborns had hypoxia at admission. RDS was commonly seen in AGA neonates when compared to SGA neonates. 6 babies among AGA and 8 among SGA had mortality. One baby was discharged AGAinst medical advice. Conclusion: Most common morbidities among the SGA neonates were sepsis, hyperbilirubinemia, feed intolerance, hypoglycemia, Apnea, PDA, hypoxia. AGA neonates had metabolic disorders and RDS.

Journal of Nepal Paediatric Society

ALERD (Acute leukoencephalopathy with restricted diffusion) is a clinico – radiological diagnosis... more ALERD (Acute leukoencephalopathy with restricted diffusion) is a clinico – radiological diagnosis. Many novel causes of acute encephalopathy are emerging in children. MRI plays an important role in the diagnosis and management of such children. Many infectious and non-infectious conditions and poisonings are known to precipitate acute leukoencephalopathy. A commonly used drug like paracetamol ingested in large quantities is known to cause varied effects. We describe one such child who presented to us with paracetamol poisoning and developed acute leukoencephalopathy. He was later found to have restricted diffusion on magnetic resonance imaging.

Iranian Journal of Neonatology IJN, 2021

Background: The majority of the neonates in the Neonatal Intensive Care Unit (NICU) would be on r... more Background: The majority of the neonates in the Neonatal Intensive Care Unit (NICU) would be on respiratory support either invasive or non-invasive ventilation. Therefore, it is difficult to measure anthropometries, such as weight, length, and head circumference in these sick newborns. This study aimed to determine the correlation of foot length with occipitofrontal head circumference (OFC), crown-heel length (CHL), and weight of the newborn. Methods: A cross-sectional study was conducted at the level IIb NICU of Shri B M Patil Medical College Hospital and Research center, Vijayapur, India. The foot length, OFC, and CHL of the neonates with gestational ages of 28-42 weeks were measured between 12 hours and 7 days of life. Results: Out of 350 neonates enrolled, 61% and 39% of the newborns were preterm and term, respectively. The correlation between foot length and birth weight (r=0.90) and foot length and length (r=0.89) was pronounced in premature neonates. Moreover, a positive line...

Journal of Neonatal Biology, 2020

Introduction: Pre-term birth is the main determinant of neonatal morbidity and mortality with lon... more Introduction: Pre-term birth is the main determinant of neonatal morbidity and mortality with long-term adverse health consequences. Infants born pre-term compared to term infants experience more difficulty with temperature instability, feeding intolerance, blood glucose regulation, jaundice, apnea, respiratory distress (RDS) and sepsis. Aim: To study the early neonatal morbidities of all pre-term neonates admitted in NICU and to know the immediate outcome during their stay. Also to compare rate of early morbidities and mortality among SGA and AGA pre-term neonates. Material and methods: It’s a prospective observational study carried out in a NICU of a Medical college in South India, for a period of 18 months. Preterm babies (less than 37 weeks gestation using Modified Ballard score) divided into SGA and AGA using growth charts. Total 100 preterm babies included of which SGA and AGA were 50 each. Neonates with TTN (Transient Tachypnea of the Newborn), Birth asphyxia, Neonatal sepsis...

Journal of Nepal Paediatric Society, 2021

Becker's muscular dystrophy (BMD) has wide spectrum of presentation from asymptomatic to seve... more Becker's muscular dystrophy (BMD) has wide spectrum of presentation from asymptomatic to severe progressive muscular weakness. Subtle weakness can be missed in busy outpatient units. Traditionally muscle biopsy is used for definitive diagnosis. But it is invasive and less helpful in genetic counseling of inherited dystrophinopathies compared to genetic studies. Newer techniques like next generation sequencing (NGS) also help in understanding many phenotype-genotype co-relations. We describe here a seven year boy who presented with mild weakness, without any evidence of cardiomyopathy and had exon 46 - 48 deletion on NGS.

Case reports in pediatrics, 2016

Minor head injuries in children are common, resulting in brain concussion, and these injuries mos... more Minor head injuries in children are common, resulting in brain concussion, and these injuries mostly end up without complications. Usually head trauma results in hemorrhagic stroke. Here we present a case of ischemic stroke following a trivial head trauma. A 10-month-old girl presented with posttraumatic right sided hemiparesis with right sided facial palsy. MRI brain revealed an area of acute infarct in the left capsuloganglionic region. The child was initially managed conservatively, as the hematological parameters were normal, and was started on anticoagulant therapy. An improvement in the clinical condition was achieved in 12 hrs of treatment with gain in power and resolution of weakness in 10 days. The specific cause for hemiparesis in the child is not elicited; possibility of genetic and environmental factors can be attributable.

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.

Journal of clinical and diagnostic research : JCDR, 2014

Over the last few years there is a rise in use of button batteries in various toys and other elec... more Over the last few years there is a rise in use of button batteries in various toys and other electronic gadgets. Easy availability and small size of these batteries pose a significant risk of ingestion in small children. Button battery ingestion can lead to serious health hazards very rapidly. A case of button battery ingestion is presented in this paper.

Indian Pediatrics, 2012

We report a 3-year old boy with acute onset of left sided facial palsy secondary to tick infestat... more We report a 3-year old boy with acute onset of left sided facial palsy secondary to tick infestation in the left ear. On 7th day of follow-up, following tick removal, the facial palsy had resolved.

Journal of Nepal Paediatric Society, 2020

Introduction: Phototherapy is used to manage neonatal hyperbilirubinemia in early life. We aimed ... more Introduction: Phototherapy is used to manage neonatal hyperbilirubinemia in early life. We aimed to compare between intermittent and continuous phototherapy in reducing TSB, rate of fall of bilirubin, duration of phototherapy and duration of hospitalisation in neonates with non-haemolytic hyperbilirubinemia. Methods: Total 190 neonates who were > 34 weeks and birth weight ≥ 2000 gm were included. They were randomised into group A (continuous phototherapy) and group B (intermittent phototherapy). Group A received phototherapy for three hours and 45 minutes off and group B received phototherapy for three hours and then three hours off. TSB levels estimation were done in both groups and compared after each 12 hours, 24 hours, and 48 hours of commencing phototherapy. Results: The mean TSB at presentation was 15.64 ± 2.19 mg/dl for continuous and 15.03 ± 1.07 mg/dl for intermittent group. Mean TSB at 12, 24, 48 hours were 13.26 ± 2.4 mg/dl, 10.8 ± 1.72 mg/dl, 10.16 ± 0.95 mg/dl respec...

Journal of Neonatal Biology, 2020

Introduction: Pre-term birth is the main determinant of neonatal morbidity and mortality with lon... more Introduction: Pre-term birth is the main determinant of neonatal morbidity and mortality with long-term adverse health consequences. Infants born pre-term compared to term infants experience more difficulty with temperature instability, feeding intolerance, blood glucose regulation, jaundice, apnea, respiratory distress (RDS) and sepsis. Aim: To study the early neonatal morbidities of all pre-term neonates admitted in NICU and to know the immediate outcome during their stay. Also to compare rate of early morbidities and mortality among SGA and AGA pre-term neonates. Material and methods: It’s a prospective observational study carried out in a NICU of a Medical college in South India, for a period of 18 months. Preterm babies (less than 37 weeks gestation using Modified Ballard score) divided into SGA and AGA using growth charts. Total 100 preterm babies included of which SGA and AGA were 50 each. Neonates with TTN (Transient Tachypnea of the Newborn), Birth asphyxia, Neonatal sepsis, Hypoglycemia, Hypothermia, Neonatal hyperbilirubinemia, Respiratory insufficiency, Feed intolerance were included in present study. Results: Hyperbilirubinemia constituted 61% of morbidities, among which 47.5% are AGA neonates and 52.5% are SGA neonates. 24 newborns presented with sepsis, 15 newborns with feed intolerance. 80 newborns had hypoxia at admission. RDS was commonly seen in AGA neonates when compared to SGA neonates. 6 babies among AGA and 8 among SGA had mortality. One baby was discharged AGAinst medical advice. Conclusion: Most common morbidities among the SGA neonates were sepsis, hyperbilirubinemia, feed intolerance, hypoglycemia, Apnea, PDA, hypoxia. AGA neonates had metabolic disorders and RDS.

Journal of Nepal Paediatric Society

ALERD (Acute leukoencephalopathy with restricted diffusion) is a clinico – radiological diagnosis... more ALERD (Acute leukoencephalopathy with restricted diffusion) is a clinico – radiological diagnosis. Many novel causes of acute encephalopathy are emerging in children. MRI plays an important role in the diagnosis and management of such children. Many infectious and non-infectious conditions and poisonings are known to precipitate acute leukoencephalopathy. A commonly used drug like paracetamol ingested in large quantities is known to cause varied effects. We describe one such child who presented to us with paracetamol poisoning and developed acute leukoencephalopathy. He was later found to have restricted diffusion on magnetic resonance imaging.

Iranian Journal of Neonatology IJN, 2021

Background: The majority of the neonates in the Neonatal Intensive Care Unit (NICU) would be on r... more Background: The majority of the neonates in the Neonatal Intensive Care Unit (NICU) would be on respiratory support either invasive or non-invasive ventilation. Therefore, it is difficult to measure anthropometries, such as weight, length, and head circumference in these sick newborns. This study aimed to determine the correlation of foot length with occipitofrontal head circumference (OFC), crown-heel length (CHL), and weight of the newborn. Methods: A cross-sectional study was conducted at the level IIb NICU of Shri B M Patil Medical College Hospital and Research center, Vijayapur, India. The foot length, OFC, and CHL of the neonates with gestational ages of 28-42 weeks were measured between 12 hours and 7 days of life. Results: Out of 350 neonates enrolled, 61% and 39% of the newborns were preterm and term, respectively. The correlation between foot length and birth weight (r=0.90) and foot length and length (r=0.89) was pronounced in premature neonates. Moreover, a positive line...

Journal of Neonatal Biology, 2020

Introduction: Pre-term birth is the main determinant of neonatal morbidity and mortality with lon... more Introduction: Pre-term birth is the main determinant of neonatal morbidity and mortality with long-term adverse health consequences. Infants born pre-term compared to term infants experience more difficulty with temperature instability, feeding intolerance, blood glucose regulation, jaundice, apnea, respiratory distress (RDS) and sepsis. Aim: To study the early neonatal morbidities of all pre-term neonates admitted in NICU and to know the immediate outcome during their stay. Also to compare rate of early morbidities and mortality among SGA and AGA pre-term neonates. Material and methods: It’s a prospective observational study carried out in a NICU of a Medical college in South India, for a period of 18 months. Preterm babies (less than 37 weeks gestation using Modified Ballard score) divided into SGA and AGA using growth charts. Total 100 preterm babies included of which SGA and AGA were 50 each. Neonates with TTN (Transient Tachypnea of the Newborn), Birth asphyxia, Neonatal sepsis...

Journal of Nepal Paediatric Society, 2021

Becker's muscular dystrophy (BMD) has wide spectrum of presentation from asymptomatic to seve... more Becker's muscular dystrophy (BMD) has wide spectrum of presentation from asymptomatic to severe progressive muscular weakness. Subtle weakness can be missed in busy outpatient units. Traditionally muscle biopsy is used for definitive diagnosis. But it is invasive and less helpful in genetic counseling of inherited dystrophinopathies compared to genetic studies. Newer techniques like next generation sequencing (NGS) also help in understanding many phenotype-genotype co-relations. We describe here a seven year boy who presented with mild weakness, without any evidence of cardiomyopathy and had exon 46 - 48 deletion on NGS.

Case reports in pediatrics, 2016

Minor head injuries in children are common, resulting in brain concussion, and these injuries mos... more Minor head injuries in children are common, resulting in brain concussion, and these injuries mostly end up without complications. Usually head trauma results in hemorrhagic stroke. Here we present a case of ischemic stroke following a trivial head trauma. A 10-month-old girl presented with posttraumatic right sided hemiparesis with right sided facial palsy. MRI brain revealed an area of acute infarct in the left capsuloganglionic region. The child was initially managed conservatively, as the hematological parameters were normal, and was started on anticoagulant therapy. An improvement in the clinical condition was achieved in 12 hrs of treatment with gain in power and resolution of weakness in 10 days. The specific cause for hemiparesis in the child is not elicited; possibility of genetic and environmental factors can be attributable.

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.

Journal of clinical and diagnostic research : JCDR, 2014

Over the last few years there is a rise in use of button batteries in various toys and other elec... more Over the last few years there is a rise in use of button batteries in various toys and other electronic gadgets. Easy availability and small size of these batteries pose a significant risk of ingestion in small children. Button battery ingestion can lead to serious health hazards very rapidly. A case of button battery ingestion is presented in this paper.

Indian Pediatrics, 2012

We report a 3-year old boy with acute onset of left sided facial palsy secondary to tick infestat... more We report a 3-year old boy with acute onset of left sided facial palsy secondary to tick infestation in the left ear. On 7th day of follow-up, following tick removal, the facial palsy had resolved.