Snehamayee nayak - Academia.edu (original) (raw)

Papers by Snehamayee nayak

Journal of pediatric critical care, 2019

Mothballs are commonly used household product that contain an aromatic hydrocarbon named naphthal... more Mothballs are commonly used household product that contain an aromatic hydrocarbon named naphthalene. On systemic exposure it causes oxidant injury to hemoglobin molecules resulting in oxidized forms of hemoglobin like methaemoglobin and further hemoglobinuria. Most commonly naphthalene poisoning cases present as hemolytic anaemia with hemoglobinuria and methemoglobinemia following oral ingestion of moth balls. Here we are reporting an unusual case of methemoglobinemia without hemolytic anaemia following absorption of the aromatic hydrocarbon from skin after application of powdered mothballs mixed with coconut oil.

Pediatric Infectious Disease

Frontiers in Pediatrics

BackgroundFew single center studies from resource-poor settings have reported about the epidemiol... more BackgroundFew single center studies from resource-poor settings have reported about the epidemiology, clinical feature and outcome of multisystem inflammatory syndrome in children (MIS-C). However, larger data from multi-center studies on the same is lacking including from Indian setting.MethodsThis retrospective collaborative study constituted of data collected on MIS-C from five tertiary care teaching hospitals from Eastern India. Children ≤ 15 years of age with MIS-C as per the WHO criteria were included. Primary outcome was mortality.ResultsA total of 134 MIS-C cases were included (median age, 84 months; males constituted 66.7%). Fever was a universal finding. Rash was present in 40%, and conjunctivitis in 71% cases. Gastro-intestinal and respiratory symptoms were observed in 50.7% and 39.6% cases, respectively. Co-morbidity was present in 23.9% cases. Shock at admission was noted in 35%, and 27.38% required mechanical ventilation. Fifteen (11.2%) children died. The coronary abn...

Annals of Pediatric Cardiology

American Journal of Pediatrics

Corticosteroids have been the main treatment of nephrotic syndrome (NS) for decades however many ... more Corticosteroids have been the main treatment of nephrotic syndrome (NS) for decades however many patients fail to respond. In such children, alternative immunosuppressive medications such as rituximab is used to maintain remission of NS. However, antibodies to rituximab develops during treatment reduces its efficacy. Therefore, this study aimed to measure anti-rituximab antibody (ARA) levels and efficacy of rituximab in children treated for NS. This prospective observational study was conducted among children with difficult to treat nephrotic syndrome. After baseline assessment, patients received single dose of intravenous infusion of 375 mg/m 2 rituximab. ARA levels were determined at base line, 3-month, 6-month, and 12-month interval. Thirty-four patients with a mean age of 7 years were evaluated in this study. During follow up visits five patients developed ARA; two patients detected ARA of 23.7 IU/ µL at 3-month, one patient had ARA level of 53.2 IU/µL at 6-month and during last follow up visit (at 12 month) two patients had mean ARA level of 24.1 IU/µL. The number of relapses per person year before rituximab was 1.5 (Incidence density) which changed to 0.14 per person year after the rituximab administration in the study subjects. Twenty-Nine patients became relapse-free during rituximab treatment. Out of five patients with ARA, one had relapse during follow up. There was no major adverse effect observed during and post-rituximab therapy. In conclusion, the study demonstrated ARA levels in few patients who were treated with rituximab having sustained clinical outcomes without any major adverse events.

Berardinelli-Seip congenital lipodystrophy (BSCL) is an inherited form of generalized lipodystrop... more Berardinelli-Seip congenital lipodystrophy (BSCL) is an inherited form of generalized lipodystrophy characterized by loss of subcutaneous fat, hypertriglyceridemia, insulin resistance and acanthosis nigricans. Rare cases of BSCL type 2 present during infancy or early childhood. It is caused by mutation in Seipin gene. It is a severe phenotype with premature death occurring in 15% cases. We present such a rare case of BSCL in a five month old infant.

Pediatric Nephrology, 2022

Inherited tubulopathies are a heterogeneous group of genetic disorders making whole-exome sequenc... more Inherited tubulopathies are a heterogeneous group of genetic disorders making whole-exome sequencing (WES) the preferred diagnostic methodology. This was a multicenter descriptive study wherein children (< 18 years) with clinically suspected tubular disorders were recruited for molecular testing through WES. Multiplex ligation-dependent probe amplification (MLPA) and Sanger sequencing were done when required. Variants were classified as per American College of Medical Genetics 2015 guidelines and pathogenic (P)/likely pathogenic (LP) variants were considered causative. There were 77 index cases (male =73%). Median age at diagnosis was 48 months (IQR 18.5 to 108 months). At recruitment, the number of children in each clinical group was as follows: distal renal tubular acidosis (dRTA) = 25; Bartter syndrome = 18; isolated hypophosphatemic rickets (HP) = 6; proximal tubular dysfunction (pTD) = 12; nephrogenic diabetes insipidus (NDI) = 6; kidney stone/nephrocalcinosis (NC) = 6; others = 4. We detected 55 (24 novel) P/LP variants, providing genetic diagnoses in 54 children (70%). The diagnostic yield of WES was highest for NDI (100%), followed by HP (83%; all X-linked HP), Bartter syndrome (78%), pTD (75%), dRTA (64%), and NC (33%). Molecular testing had a definite impact on clinical management in 24 (31%) children. This included revising clinical diagnosis among 14 children (26% of those with a confirmed genetic diagnosis and 18% of the overall cohort), detection of previously unrecognized co-morbidities among 8 children (sensorineural deafness n = 5, hemolytic anemia n = 2, and dental changes n = 1) and facilitating specific medical treatment for 7 children (primary hyperoxaluria n = 1, cystinosis n = 4, tyrosinemia n = 2). WES is a powerful tool in the diagnosis and management of children with inherited tubulopathies in the Indian population. A higher resolution version of the Graphical abstract is available as Supplementary information

Asian Journal of Pediatric Nephrology, 2021

International Journal of Biomedical and Advance Research, 2017

To find out the correlation between Body mass Index and Peak Expiratory Flow Rate(PEFR) in overwe... more To find out the correlation between Body mass Index and Peak Expiratory Flow Rate(PEFR) in overweight and obese school going children of Cuttack city. Total 480 children were studied which included 240 obese and overweight children and 240 normal age and height matched control group. PEFR was measured in all children using mini wrights peak expiratory flow meter. Statistical analysis was done using SPSS 16 and correlation co-efficient was calculated. PEFR was found to increase linearly with increasing BMI in all children. But PEFR in overweight and obese children was found to have negative linear correlation. In overweight children it was not statistically significant but in obese children with increasing BMI, PEFR was found to decrease and the correlation coefficient was statistically significant. PEFR is lower in obese and overweight children. There is increased predisposition to obstructive airway disease and childhood asthma in obese children. Hence weight management should be s...

Asian Journal of Psychiatry, 2021

'Double-positive' with anti-glomerular basement membrane (anti-GBM) antibody and anti-neutrophil ... more 'Double-positive' with anti-glomerular basement membrane (anti-GBM) antibody and anti-neutrophil cytoplasmic antibody (ANCA) is an extremely rare cause of small vessel vasculitis in children. Studies have reported a distinct hybrid phenotype in double-positive patients which requires an aggressive treatment approach. The data on double positive children are scarce with few case reports available with varied outcomes. A case of 9-year-old girl from India who had double-positive anti-GBM disease is reported here. The patient presented with complaints of edema, oliguria, gross hematuria with rising creatine and was diagnosed as rapidly progressive glomerulonephritis (RPGN). Histological examinations of linear immunoglobulin G deposits along with glomerular capillaries were suggestive of anti-GBM disease. The anti-GBM and p-ANCA antibody titers were also high, and the aforementioned findings led to a diagnosis of 'double-positive' anti-GBM with RPGN. She was treated with standard plasma exchange therapy along with pulse methyl prednisolone (3 doses of 30 mg/kg/day on Days 1 to 3), oral prednisolone (1.5 mg/kg on Day 4), single intravenous injection of cyclophosphamide (500 mg/m 2 on Day 5) and mycophenolate mofetil (MMF; 1000 mg/m 2 on Day 6) followed by maintenance treatment with oral prednisolone (1 mg/kg/day) and MMF (800 mg/m 2 /day) from Day 7 onwards. Overall, the anti-GBM and p-ANCA levels declined throughout the treatment period but the patient progressed towards end stage renal disease.

Journal of pediatric nephrology, 2021

Children with nephrotic syndrome (NS) develop complications due to either the disease state or it... more Children with nephrotic syndrome (NS) develop complications due to either the disease state or its treatment. Infections, thromboembolism and acute kidney injury are the most common complications in children with NS. Several studies in children with NS have reported that urinary tract infections, upper respiratory tract infections, peritonitis and sepsis are the most commonly reported infections. Infection is one of the common triggering factors for relapse, and prophylaxis against infections is required in patients unresponsive to steroids or with frequently relapsing disease. In this review article, we summarize the strategies for prevention of infections in NS. The most commonly studied drug for the prevention of infection in NS is intravenous immunoglobulin G (IVIg), while other drugs include thymosin, oral transfer factor, Bacillus Calmette-Guerin (BCG) vaccine, mannan peptide tablet, polyvalent bacterial vaccine and Chinese herbal medications (Tiaojining and Huangqui granules)...

International Journal of Contemporary Pediatrics, 2017

Background: Sickle cell disease (SCD) is the most common single gene disorder resulting in hemoly... more Background: Sickle cell disease (SCD) is the most common single gene disorder resulting in hemolytic anemia. Aim of the study was to describe the clinico-haematological profile of children with sickle cell anaemia admitted to Paediatric ward/PICU with any acute clinical event and to find out the association between high HbF level, frequency of crises episodes and requirement of blood transfusion in sickle cell anemia.Methods: Hospital based descriptive study. Retrospective data analysis was done from medical records of patients between 0-15 years age group admitted to hospital from March 2014 to August 2017.Results: Total 68 clinical events were recorded in 60 patients during the study period. More than half of the children were in 0-5 years age group. Mean age of diagnosis was 2.79 years. Severe anemia requiring blood transfusion was the most common cause of hospitalization followed by painful crises. Mean Hb level in the children was 6.65(±2.38). More than one third of children ha...

Indian Journal of Case Reports, 2015

International Journal Of Community Medicine And Public Health, 2018

Background: Most tobacco users initiate their smoking habit quite young, upto 10 yrs of age. The ... more Background: Most tobacco users initiate their smoking habit quite young, upto 10 yrs of age. The physiological and psychological changes in this phase of life with an inquisitiveness to become autonomous enhance their vulnerability for addiction, tobacco use and dependency. its use during adolescence are likely to continue the use into adulthood and contribute to the 90 per cent of premature deaths among tobacco users. In this context the prevalence, patterns and correlates of tobacco use are studied among adolescent of urban slums of Bhilai city, Chhattisgarh India.Methods: Total 172 adolescents within the age group of 10-19 yrs, across 30 slums of Bhilai city are taken by cluster random sampling. They have been administered a self-administered questionnaire incorporating standardized instruments.Results: Of the 172 study respondents, the overall lifetime prevalence of tobacco use is 25 per cent (18% boys and 7% girls). Among users category the prevalence of tobacco use increased f...

Journal of Integrative Nephrology and Andrology, 2017

Urinary tract infection (UTI) is one of the common causes of hospital visit in infants and childr... more Urinary tract infection (UTI) is one of the common causes of hospital visit in infants and children. Vesicoureteral reflux (VUR) predisposes to UTI and renal scarring. VUR is usually diagnosed after an episode of UTI. VUR is the most common underlying etiology responsible for febrile UTIs or pyelonephritis in children. Along with the morbidity of pyelonephritis, long-term sequelae of recurrent renal infections include renal scarring, proteinuria, and hypertension. Treatment is directed toward the prevention of recurrent infection through the use of continuous antibiotic prophylaxis during a period of observation for spontaneous resolution or by surgical correction. In children, bowel and bladder dysfunction (BBD) plays a significant role in the occurrence of UTI and the rate of VUR resolution. Effective treatment of BBD leads to higher rates of spontaneous resolution and decreased risk of UTI.

Journal of Integrative Nephrology and Andrology, 2015

ABSTRACT Myoglobin is a heme protein present in muscle tissues and responsible for binding and de... more ABSTRACT Myoglobin is a heme protein present in muscle tissues and responsible for binding and delivery of oxygen in the muscle cells for oxidative metabolism. Whenever muscle tissue is injured, that is, rhabdomyolysis occurs free myoglobin enters into circulation along with other enzymes and electrolytes and myoglobinuria occurs when the renal threshold is crossed. There are many causes of rhabdomyolysis including physical damage, infective, inflammatory, toxic, and metabolic problems. Clinically, myoglobinuria presents as muscle pain, weakness, cola colored urine, and laboratory diagnosis is done by elevated serum creatine kinase, urine dipstick positive for blood without RBC in microscopy examination. These myoglobin molecules can cause renal injury by renal vasoconstriction, proximal tubular necrosis, and distal tubular obstruction. Early anticipation of myoglobinuria and aggressive fluid resuscitation during the initial stage of injury is the mainstay of management of myoglobinuric acute kidney injury (AKI). There is lesser role of forced alkaline diuresis and mannitol than diuresis by normal crystalloid solution in myoglobinuric AKI. Renal replacement therapy should be considered in cases with life- threatening dyselectrolytemia and acidosis.

Indian Journal of Critical Care Medicine, 2014

A 19-year-old male presented with history of massive hemoptysis. The patient was kept on mechanic... more A 19-year-old male presented with history of massive hemoptysis. The patient was kept on mechanical ventilation because of severe hypoxia. Lung protective ventilation with low tidal volume was given in view of very poor pulmonary compliance. During the course of treatment, the patient developed a very high CO 2 level of 373 mmHg. The patient was successfully weaned off on the 9 th day without any obvious adverse consequences.

Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine, 2014