Meenu Singh - Academia.edu (original) (raw)

Papers by Meenu Singh

Objective: To conduct an umbrella review collating the existing evidence to determine whether the... more Objective: To conduct an umbrella review collating the existing evidence to determine whether there is an association between exposure of paracetamol in utero or in infancy, and the development of childhood asthma. Methods: In this review, systematic reviews with or without meta-analysis that reported the association between paracetamol and asthma in children were included. To identify relevant reviews, a search was performed in the electronic databases PubMed, the Cochrane Central Register of Controlled Trials Library, and Ovid. Results: The search strategy in various databases identified 1913 conceivably significant studies for inclusion. After removal of 493 duplicates ,1420 studies were screened for titles and abstracts against a standard

The Cochrane database of systematic reviews, Aug 10, 2017

Cystic fibrosis is a life-limiting autosomal recessive genetic illness. A feeling of shortness of... more Cystic fibrosis is a life-limiting autosomal recessive genetic illness. A feeling of shortness of breath is common in cystic fibrosis, especially as the disease progresses. Reversing the underlying cause is the priority when treating breathlessness (dyspnoea), but when it is not feasible, palliation (easing) becomes the primary goal to improve an individual's quality of life. A range of drugs administered by various routes have been used, but no definite guidelines are available. A systematic review is needed to evaluate such treatments. To assess the efficacy and safety of drugs used to ease breathlessness in people with cystic fibrosis. We searched the Cochrane Cystic Fibrosis Trials Register, compiled from electronic database searches and handsearching of journals and conference abstract books.Date of last search: 24 July 2017.We searched databases (clinicaltrials.gov, the ISRCTN registry, the Clinical Trials Registry India and WHO ICTRP) for ongoing trials. These searches we...

CHEST Journal, 2006

PURPOSE: Role of gamma delta T cells at the pulmonary level in children with CF remains unexplore... more PURPOSE: Role of gamma delta T cells at the pulmonary level in children with CF remains unexplored. We studied the invitro intracellular cytokine expression in children with CF and normal controls to correlate the cytokine expression by alpha beta gamma delta T-cells with the clinical status.

Indian pediatrics, 2004

This prospective, hospital based, descriptive study was designed to compare improvement in qualit... more This prospective, hospital based, descriptive study was designed to compare improvement in quality of life (QOL) score with objective measures of pulmonary function in children with persistent bronchial asthma receiving inhaled corticosteroid (ICS) therapy. QOL score (measured by an indigenous tool), forced expiratory volume in first second (FEV1), forced vital capacity (FVC), peak expiratory flow rate (PEFR) and asthma symptom score were measured in 20 newly diagnosed children with persistent asthma- before, during and eight weeks after ICS therapy. There was a significant improvement in all parameters compared at each follow up visit and at termination of the study (p less than 0.05). The magnitude of improvement in QOL was similar to improvement in objective measures of pulmonary function; although these changes were not similar to changes in asthma symptom score. Improvement in QOL score is likely to be a sensitive measurement of functional improvement in asthmatic children on t...

Indian pediatrics, 2007

A 9-year-old male child presented with a gradually increasing swelling of left cheek for 3 months... more A 9-year-old male child presented with a gradually increasing swelling of left cheek for 3 months associated with pain for initial few days. There was no history of fever, anorexia, any discharge from swelling, difficulty in chewing or swallowing. Child had received multiple courses of oral antimicrobials. Family history revealed possible contact with tuberculosis. Child had received BCG vaccine in infancy. Anthropometry, general physical and systemic examinations were unremarkable. On local examination, the swelling was diffuse, nontender, and hard in consistency with smooth surface. There was no restriction of movements at temporomandibular joint. There was significant submandibular lymphadenopathy.

BMC pediatrics, Jan 17, 2015

Pneumonia is the leading cause of child mortality under five years of age worldwide. For pneumoni... more Pneumonia is the leading cause of child mortality under five years of age worldwide. For pneumonia with chest indrawing in children aged 3-59 months, injectable penicillin and hospitalization was the recommended treatment. This increased the health care cost and exposure to nosocomial infections. We compared the clinical and cost outcomes of a seven day treatment with oral amoxicillin with the first 48 h of treatment given in the hospital (hospital group) or at home (home group). We conducted an open-label, multi-center, two-arm randomized clinical trial at six tertiary hospitals in India. Children aged 3 to 59 months with chest indrawing pneumonia were randomized to home or hospital group. Clinical outcomes, treatment adherence, and patient safety were monitored through home visits on day 3, 5, 8, and 14 with an additional visit for the home group at 24 h. Clinical outcomes included treatment failure rates up to 7 days (primary outcome) and between 8-14 days (secondary outcome) usi...

Journal of Tropical Pediatrics, 2006

Perinatal tuberculosis is insufficiently understood and has been rarely reported even in areas en... more Perinatal tuberculosis is insufficiently understood and has been rarely reported even in areas endemic for the disease, and unless a high index of suspicion is maintained the diagnosis can be missed. Differentiation of congenital from early postnatally acquired tuberculosis is only of epidemiological importance. We hereby report one case of congenital tuberculosis and three cases of perinatal tuberculosis, and problems faced during investigation and management and emphasize need for improved screening of women at risk and sensitization of the medical community about this entity.

Clinical Pediatric Endocrinology, 2015

There is scarcity of data on spectrum and outcome of invasive filamentous fungal infections (IFIs... more There is scarcity of data on spectrum and outcome of invasive filamentous fungal infections (IFIs) in children with Type 1 diabetes (T1D) from developing countries. A retrospective review of medical records of children with T1D hospitalized with IFI over the past decade at the Pediatric Endocrinology and Diabetes Unit of a large tertiary care hospital of North India was performed with an aim to study their clinical spectrum, hospital course and final outcome. Of the 10 patients studied, nasal/paranasal involvement was seen in 6 and pulmonary involvement in 5 patients. One patient developed disseminated disease. Majority of the identified mycoses belonged to Class Zygomycetes Order Mucorales. Early surgery along with antifungal therapy helped limit the extension of infection and achieve a good outcome in majority of patients. Two patients died; one with a late diagnosis of pulmonary mucormycosis and the other with disseminated disease. The longterm morbidity in the survivors was minimal. In conclusion, rapid diagnosis followed by a multimodal approach involving aggressive surgical debridement, appropriate antifungal therapy and control of hyperglycemic state is the key to good outcome in this otherwise lethal infection.

Annals of the National Academy of Medical Sciences (India)

Pediatric Emergency Care, 2007

We present 3 cases of bilateral vocal cord palsy who presented with acute respiratory distress wi... more We present 3 cases of bilateral vocal cord palsy who presented with acute respiratory distress with features of upper airway obstruction requiring tracheostomy. No cause could be found despite clinical evaluation and laboratory investigations. This diagnosis should be considered when child presents with upper airway obstruction emergency after ruling out other important causes of stridor and laryngoscopic examination is warranted in such cases for diagnosis.

JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH, 2015

In patients with tuberculosis, abnormal extrarenal production of 1,25-dihydroxyvitamin D3 by acti... more In patients with tuberculosis, abnormal extrarenal production of 1,25-dihydroxyvitamin D3 by activated macrophages in granulomatous tissues may result in hypercalcaemia. More commonly reported in adults with active pulmonary tuberculosis, this complication may rarely occur in extrapulmonary tuberculosis, and children. The hypercalcaemia may be precipitated by usually recommended vitamin D and calcium supplementation in patients with tuberculosis. We report here an infant with tubercular meningitis who developed hypercalcaemia 12 days after starting routine vitamin D and calcium supplementation. This communication highlights the importance of close monitoring of calcium levels in patients with tuberculosis, especially if started on vitamin D and calcium replacement before anti-tubercular therapy.

Information technology is changing at a rapid rate. It thus provides many benefits for organizati... more Information technology is changing at a rapid rate. It thus provides many benefits for organizations. However, it also causes problems for IT managers and staff. Structured interviews with 16 F professionals at different organizations identified 142 problems resulting from 3 1 unique projects that used 86 new ITS. Nine categories summarized the problems. The categories were: training demands, errors, vendor oversell, new integration, support burden, resistance, acquisition dilemmas, vendor neglect, and cascading needs. The research provides suggestions for practicing IT managers and future researchers.

Indian journal of pediatrics, 1999

LOWER RESPIRATORY tract infections in children This Update discusses in detail conditions causing... more LOWER RESPIRATORY tract infections in children This Update discusses in detail conditions causing recurrent lower respiratory tract infection. A system for the evaluation of this condition is outlined.

International Journal of Telemedicine and Applications

Objective. Rheumatoid arthritis (RA) is a chronic autoimmune condition associated with a potentia... more Objective. Rheumatoid arthritis (RA) is a chronic autoimmune condition associated with a potential for deformities. It is one of the common conditions to seek health care. Hence, the present study was conducted to assess the telemedicine services for patients suffering from rheumatoid arthritis during the COVID-19 pandemic in an Asian Indian population. Methods. A prospective study was conducted (March 2020–June 2020) in the telemedicine department of a premier northern Indian tertiary care institution. Out of the total patients enrolled ( N = 7577 ) in telemedicine services, 122 rheumatoid arthritis patients (1.6%) were followed for 1 month to assess change in functional status by modified Health Assessment Questionnaire (mHAQ). Telephonic interviews of the enrolled patients were conducted to determine the level of understanding of advice given by consultants, barriers during the consultation, and satisfaction with teleconsultations for rheumatology clinics. Results. For the native...

Environmental Science and Pollution Research

The Indian Journal of Pediatrics

There is a small oversight in the abstract of the paper. Results section: Cases having AA + Aa ge... more There is a small oversight in the abstract of the paper. Results section: Cases having AA + Aa genotype = 48.8% [39(Aa) + 5(AA) = 44] and not 43.3% as noted. Publisher's Note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Medical Mycology

Invasive fungal infections (IFI) cause considerable morbidity and mortality in pediatric patients... more Invasive fungal infections (IFI) cause considerable morbidity and mortality in pediatric patients. Serum biomarkers such as 1,3-beta-D glucan (BDG) and galactomannan (GM) have been evaluated for the IFI diagnosis. However, most evidence regarding their utility is derived from studies in adult oncology patients. This systematic review aimed to compare the diagnostic accuracy of BDG and GM individually or in combination for diagnosing IFI in pediatric patients. PubMed, CINAHL, Embase, and Cochrane Library were searched until March 2019 for diagnostic studies evaluating both serum GM and BDG for diagnosing pediatric IFI. The pooled diagnostic odds ratio (DOR), specificity and sensitivity were computed. Receiver operating characteristics (ROC) curve and area under the curve (AUC) were used for summarizing overall assay performance. Six studies were included in the meta-analysis. The summary estimates of sensitivity, specificity, pooled DOR, AUC of the GM assay for proven or probable IFI...

The Indian Journal of Pediatrics

Objective: To conduct an umbrella review collating the existing evidence to determine whether the... more Objective: To conduct an umbrella review collating the existing evidence to determine whether there is an association between exposure of paracetamol in utero or in infancy, and the development of childhood asthma. Methods: In this review, systematic reviews with or without meta-analysis that reported the association between paracetamol and asthma in children were included. To identify relevant reviews, a search was performed in the electronic databases PubMed, the Cochrane Central Register of Controlled Trials Library, and Ovid. Results: The search strategy in various databases identified 1913 conceivably significant studies for inclusion. After removal of 493 duplicates ,1420 studies were screened for titles and abstracts against a standard

The Cochrane database of systematic reviews, Aug 10, 2017

Cystic fibrosis is a life-limiting autosomal recessive genetic illness. A feeling of shortness of... more Cystic fibrosis is a life-limiting autosomal recessive genetic illness. A feeling of shortness of breath is common in cystic fibrosis, especially as the disease progresses. Reversing the underlying cause is the priority when treating breathlessness (dyspnoea), but when it is not feasible, palliation (easing) becomes the primary goal to improve an individual's quality of life. A range of drugs administered by various routes have been used, but no definite guidelines are available. A systematic review is needed to evaluate such treatments. To assess the efficacy and safety of drugs used to ease breathlessness in people with cystic fibrosis. We searched the Cochrane Cystic Fibrosis Trials Register, compiled from electronic database searches and handsearching of journals and conference abstract books.Date of last search: 24 July 2017.We searched databases (clinicaltrials.gov, the ISRCTN registry, the Clinical Trials Registry India and WHO ICTRP) for ongoing trials. These searches we...

CHEST Journal, 2006

PURPOSE: Role of gamma delta T cells at the pulmonary level in children with CF remains unexplore... more PURPOSE: Role of gamma delta T cells at the pulmonary level in children with CF remains unexplored. We studied the invitro intracellular cytokine expression in children with CF and normal controls to correlate the cytokine expression by alpha beta gamma delta T-cells with the clinical status.

Indian pediatrics, 2004

This prospective, hospital based, descriptive study was designed to compare improvement in qualit... more This prospective, hospital based, descriptive study was designed to compare improvement in quality of life (QOL) score with objective measures of pulmonary function in children with persistent bronchial asthma receiving inhaled corticosteroid (ICS) therapy. QOL score (measured by an indigenous tool), forced expiratory volume in first second (FEV1), forced vital capacity (FVC), peak expiratory flow rate (PEFR) and asthma symptom score were measured in 20 newly diagnosed children with persistent asthma- before, during and eight weeks after ICS therapy. There was a significant improvement in all parameters compared at each follow up visit and at termination of the study (p less than 0.05). The magnitude of improvement in QOL was similar to improvement in objective measures of pulmonary function; although these changes were not similar to changes in asthma symptom score. Improvement in QOL score is likely to be a sensitive measurement of functional improvement in asthmatic children on t...

Indian pediatrics, 2007

A 9-year-old male child presented with a gradually increasing swelling of left cheek for 3 months... more A 9-year-old male child presented with a gradually increasing swelling of left cheek for 3 months associated with pain for initial few days. There was no history of fever, anorexia, any discharge from swelling, difficulty in chewing or swallowing. Child had received multiple courses of oral antimicrobials. Family history revealed possible contact with tuberculosis. Child had received BCG vaccine in infancy. Anthropometry, general physical and systemic examinations were unremarkable. On local examination, the swelling was diffuse, nontender, and hard in consistency with smooth surface. There was no restriction of movements at temporomandibular joint. There was significant submandibular lymphadenopathy.

BMC pediatrics, Jan 17, 2015

Pneumonia is the leading cause of child mortality under five years of age worldwide. For pneumoni... more Pneumonia is the leading cause of child mortality under five years of age worldwide. For pneumonia with chest indrawing in children aged 3-59 months, injectable penicillin and hospitalization was the recommended treatment. This increased the health care cost and exposure to nosocomial infections. We compared the clinical and cost outcomes of a seven day treatment with oral amoxicillin with the first 48 h of treatment given in the hospital (hospital group) or at home (home group). We conducted an open-label, multi-center, two-arm randomized clinical trial at six tertiary hospitals in India. Children aged 3 to 59 months with chest indrawing pneumonia were randomized to home or hospital group. Clinical outcomes, treatment adherence, and patient safety were monitored through home visits on day 3, 5, 8, and 14 with an additional visit for the home group at 24 h. Clinical outcomes included treatment failure rates up to 7 days (primary outcome) and between 8-14 days (secondary outcome) usi...

Journal of Tropical Pediatrics, 2006

Perinatal tuberculosis is insufficiently understood and has been rarely reported even in areas en... more Perinatal tuberculosis is insufficiently understood and has been rarely reported even in areas endemic for the disease, and unless a high index of suspicion is maintained the diagnosis can be missed. Differentiation of congenital from early postnatally acquired tuberculosis is only of epidemiological importance. We hereby report one case of congenital tuberculosis and three cases of perinatal tuberculosis, and problems faced during investigation and management and emphasize need for improved screening of women at risk and sensitization of the medical community about this entity.

Clinical Pediatric Endocrinology, 2015

There is scarcity of data on spectrum and outcome of invasive filamentous fungal infections (IFIs... more There is scarcity of data on spectrum and outcome of invasive filamentous fungal infections (IFIs) in children with Type 1 diabetes (T1D) from developing countries. A retrospective review of medical records of children with T1D hospitalized with IFI over the past decade at the Pediatric Endocrinology and Diabetes Unit of a large tertiary care hospital of North India was performed with an aim to study their clinical spectrum, hospital course and final outcome. Of the 10 patients studied, nasal/paranasal involvement was seen in 6 and pulmonary involvement in 5 patients. One patient developed disseminated disease. Majority of the identified mycoses belonged to Class Zygomycetes Order Mucorales. Early surgery along with antifungal therapy helped limit the extension of infection and achieve a good outcome in majority of patients. Two patients died; one with a late diagnosis of pulmonary mucormycosis and the other with disseminated disease. The longterm morbidity in the survivors was minimal. In conclusion, rapid diagnosis followed by a multimodal approach involving aggressive surgical debridement, appropriate antifungal therapy and control of hyperglycemic state is the key to good outcome in this otherwise lethal infection.

Annals of the National Academy of Medical Sciences (India)

Pediatric Emergency Care, 2007

We present 3 cases of bilateral vocal cord palsy who presented with acute respiratory distress wi... more We present 3 cases of bilateral vocal cord palsy who presented with acute respiratory distress with features of upper airway obstruction requiring tracheostomy. No cause could be found despite clinical evaluation and laboratory investigations. This diagnosis should be considered when child presents with upper airway obstruction emergency after ruling out other important causes of stridor and laryngoscopic examination is warranted in such cases for diagnosis.

JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH, 2015

In patients with tuberculosis, abnormal extrarenal production of 1,25-dihydroxyvitamin D3 by acti... more In patients with tuberculosis, abnormal extrarenal production of 1,25-dihydroxyvitamin D3 by activated macrophages in granulomatous tissues may result in hypercalcaemia. More commonly reported in adults with active pulmonary tuberculosis, this complication may rarely occur in extrapulmonary tuberculosis, and children. The hypercalcaemia may be precipitated by usually recommended vitamin D and calcium supplementation in patients with tuberculosis. We report here an infant with tubercular meningitis who developed hypercalcaemia 12 days after starting routine vitamin D and calcium supplementation. This communication highlights the importance of close monitoring of calcium levels in patients with tuberculosis, especially if started on vitamin D and calcium replacement before anti-tubercular therapy.

Information technology is changing at a rapid rate. It thus provides many benefits for organizati... more Information technology is changing at a rapid rate. It thus provides many benefits for organizations. However, it also causes problems for IT managers and staff. Structured interviews with 16 F professionals at different organizations identified 142 problems resulting from 3 1 unique projects that used 86 new ITS. Nine categories summarized the problems. The categories were: training demands, errors, vendor oversell, new integration, support burden, resistance, acquisition dilemmas, vendor neglect, and cascading needs. The research provides suggestions for practicing IT managers and future researchers.

Indian journal of pediatrics, 1999

LOWER RESPIRATORY tract infections in children This Update discusses in detail conditions causing... more LOWER RESPIRATORY tract infections in children This Update discusses in detail conditions causing recurrent lower respiratory tract infection. A system for the evaluation of this condition is outlined.

International Journal of Telemedicine and Applications

Objective. Rheumatoid arthritis (RA) is a chronic autoimmune condition associated with a potentia... more Objective. Rheumatoid arthritis (RA) is a chronic autoimmune condition associated with a potential for deformities. It is one of the common conditions to seek health care. Hence, the present study was conducted to assess the telemedicine services for patients suffering from rheumatoid arthritis during the COVID-19 pandemic in an Asian Indian population. Methods. A prospective study was conducted (March 2020–June 2020) in the telemedicine department of a premier northern Indian tertiary care institution. Out of the total patients enrolled ( N = 7577 ) in telemedicine services, 122 rheumatoid arthritis patients (1.6%) were followed for 1 month to assess change in functional status by modified Health Assessment Questionnaire (mHAQ). Telephonic interviews of the enrolled patients were conducted to determine the level of understanding of advice given by consultants, barriers during the consultation, and satisfaction with teleconsultations for rheumatology clinics. Results. For the native...

Environmental Science and Pollution Research

The Indian Journal of Pediatrics

There is a small oversight in the abstract of the paper. Results section: Cases having AA + Aa ge... more There is a small oversight in the abstract of the paper. Results section: Cases having AA + Aa genotype = 48.8% [39(Aa) + 5(AA) = 44] and not 43.3% as noted. Publisher's Note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Medical Mycology

Invasive fungal infections (IFI) cause considerable morbidity and mortality in pediatric patients... more Invasive fungal infections (IFI) cause considerable morbidity and mortality in pediatric patients. Serum biomarkers such as 1,3-beta-D glucan (BDG) and galactomannan (GM) have been evaluated for the IFI diagnosis. However, most evidence regarding their utility is derived from studies in adult oncology patients. This systematic review aimed to compare the diagnostic accuracy of BDG and GM individually or in combination for diagnosing IFI in pediatric patients. PubMed, CINAHL, Embase, and Cochrane Library were searched until March 2019 for diagnostic studies evaluating both serum GM and BDG for diagnosing pediatric IFI. The pooled diagnostic odds ratio (DOR), specificity and sensitivity were computed. Receiver operating characteristics (ROC) curve and area under the curve (AUC) were used for summarizing overall assay performance. Six studies were included in the meta-analysis. The summary estimates of sensitivity, specificity, pooled DOR, AUC of the GM assay for proven or probable IFI...

The Indian Journal of Pediatrics