Tauhid Iqbali | Patna medical college (original) (raw)

Papers by Tauhid Iqbali

International Journal of Contemporary Pediatrics, 2017

Background: An inflammatory response is a two edge sword in pneumonia as reasonable inflammatory ... more Background: An inflammatory response is a two edge sword in pneumonia as reasonable inflammatory response is required for microorganism clearance but excessive inflammation can cause ongoing local and systemic damage. Because of this, despite appropriate antibiotic therapy, adjuvant therapy that can positively modify the immune response has become a relevant approach to improve pneumonia prognosis. The objectives of this study was to document the beneficial effects of adjunctive dexamethasone therapy in patients admitted with community-acquired pneumonia (in terms of length of hospital stay) and to study what patients admitted with CAP benefit most from dexamethasone therapy, based on predefined subgroup of disease severity (PSI 1-5) and C-reactive protein level at admission as well to evaluate utility of CRP in monitoring resolution of CAP. Methods: In this prospective case-control trial, 100 children aged 1 to 14 years were enrolled randomly with confirmed community-acquired pneumonia, who presented to emergency department of paediatrics PMCH Patna. We randomly allocated patients on a one-to-one basis to adjuvant dexamethasone with antibiotics and antibiotics alone groups by drawing lots. Results: The median length of hospital-stay in both the adjuvant dexamethasone group and antibiotics alone group was 7 days with IQR in adjuvant dexamethasone group of 6.0-8.0 days and antibiotics group of 7.0-9.0 days (95% CI of difference in means 0.3-1.2 days; p = 0.001931 and was significant at p value of ≤ 0.01). There was a positive correlation between length of hospital-stay and CRP at the time of admission in adjuvant dexamethasone and antibiotics alone group with R value = 0.0261 and 0.3541 respectively. There also exist a positive correlation between length of hospital-stay and PSI at admission in adjuvant dexamethasone and antibiotics alone group with R value = 0.3555 and 0.1196 respectively. Median length of hospital-stay in those admitted with high PSI (PSI 4-5) and high CRP were 8.0 days in antibiotics alone group compared to 7.0 days in adjuvant dexamethasone group. The mean CRP on day 1, 3 and 5 was 7.734 (SEM 0.664), 3.974 (SEM 0.412) and 1.440 (SEM 0.133) respectively. Conclusions: There was no significant difference in length of hospital-stay in CAP patient treated with adjuvant dexamethasone with antibiotics and antibiotics alone. However it is clearly evident from this study that using adjuvant dexamethasone reduced the length of hospital-stay in those who admitted with higher PSI as well as higher CRP compared to antibiotics alone group. Moreover there was a definite decremental relationship between CRP and resolution of CAP. So use of adjuvant dexamethasone in those presenting with high PSI and high CRP can be consider. Since the sample size of our study was small, further evaluation is warranted.

International Journal of Contemporary Pediatrics

Background: Acute Encephalitis Syndrome (AES) is defined as a person of any age, at any time of y... more Background: Acute Encephalitis Syndrome (AES) is defined as a person of any age, at any time of year with the acute onset of fever and a change in mental status (including symptoms such as confusion, disorientation, coma, or inability to talk) and/or new onset of seizures (excluding simple febrile seizures). Viruses have been mainly attributed to be the cause of AES in India although other etiologies such as bacteria, fungus, parasites, spirochetes, leptospira, toxoplasma, rickettsia, chemical, and toxins have also been reported over the past few years. The causative agent of AES varies with season and geographical location, owing to wide range of causative agents and the rapid neurological impairment due to pathogenesis, clinicians face the challenge of a small window period between diagnosis and treatment. The present study is dedicated to knowing the present epidemiological pattern of AES in Bihar aiming to help in diagnosis and treatment.Methods: This is a prospective study cond...

International Journal of Contemporary Pediatrics

Background: Acute Encephalitis Syndrome (AES) is defined as a person of any age, at any time of y... more Background: Acute Encephalitis Syndrome (AES) is defined as a person of any age, at any time of year with the acute onset of fever and a change in mental status (including symptoms such as confusion, disorientation, coma, or inability to talk) and/or new onset of seizures (excluding simple febrile seizures). Viruses have been mainly attributed to be the cause of AES in India although other etiologies such as bacteria, fungus, parasites, spirochetes, leptospira, toxoplasma, rickettsia, chemical, and toxins have also been reported over the past few years. The causative agent of AES varies with season and geographical location, owing to wide range of causative agents and the rapid neurological impairment due to pathogenesis, clinicians face the challenge of a small window period between diagnosis and treatment. The present study is dedicated to knowing the present epidemiological pattern of AES in Bihar aiming to help in diagnosis and treatment.Methods: This is a prospective study cond...

Objective: To find the common causes of seizure and to classify seizure types in various age grou... more Objective: To find the common causes of seizure and to classify seizure types in various age groups as well to predict outcome in relation to different variables. Design: Retrospective hospital-based, analytic and descriptive study. Setting: The Department of Paediatrics, PMCH, Patna. Participants/patients: This study includes all children in the age group 6 months to 15 years presented in the department of paediatrics with seizure. Outcome Measure(s): Demographic analysis and analysis of different seizure types, analysis of patient based on the cause of seizure as well as outcome of patient presented with seizure in relation to demographic, fever diagnosis and status epilepticus. Results: The total number of patient presented with seizure are 956 of them 574 were males and 382 were females. 562 had fever on presentation and most of them were less than 5 years of age amount to 562. The most common clinical seizure type were generalized tonic-clonic (60.5%). Seizure disorder (14.4%), febrile seizures (16.1%), central nervous system infections and neurocysticercosis were common etiologies. Tubercular meningitis was more common etiology in 6–10 years age group. Neurocysticercosis were more common in 11-15 years age group. Encephalitis were more common in children below 5 years of age. Conclusions: seizures are one of the common cause of hospitalization and high mortality. It can be inferred from this study that CNS infection are the most common cause of acute symptomatic seizure. Thus improvement in health care facilities like sanitation and immunization is warranted to prevent it.

Objective: To find the common causes of seizure and to classify seizure types in various age grou... more Objective: To find the common causes of seizure and to classify seizure types in various age groups as well to predict outcome in relation to different variables. Design: Retrospective hospital-based, analytic and descriptive study. Setting: The Department of Paediatrics, PMCH, Patna. Participants/patients: This study includes all children in the age group 6 months to 15 years presented in the department of paediatrics with seizure. Outcome Measure(s): Demographic analysis and analysis of different seizure types, analysis of patient based on the cause of seizure as well as outcome of patient presented with seizure in relation to demographic, fever diagnosis and status epilepticus. Results: The total number of patient presented with seizure are 956 of them 574 were males and 382 were females. 562 had fever on presentation and most of them were less than 5 years of age amount to 562. The most common clinical seizure type were generalized tonic-clonic (60.5%). Seizure disorder (14.4%), febrile seizures (16.1%), central nervous system infections and neurocysticercosis were common etiologies. Tubercular meningitis was more common etiology in 6–10 years age group. Neurocysticercosis were more common in 11-15 years age group. Encephalitis were more common in children below 5 years of age. Conclusions: seizures are one of the common cause of hospitalization and high mortality. It can be inferred from this study that CNS infection are the most common cause of acute symptomatic seizure. Thus improvement in health care facilities like sanitation and immunization is warranted to prevent it.

International Journal of Contemporary Pediatrics, 2017

Background: An inflammatory response is a two edge sword in pneumonia as reasonable inflammatory ... more Background: An inflammatory response is a two edge sword in pneumonia as reasonable inflammatory response is required for microorganism clearance but excessive inflammation can cause ongoing local and systemic damage. Because of this, despite appropriate antibiotic therapy, adjuvant therapy that can positively modify the immune response has become a relevant approach to improve pneumonia prognosis. The objectives of this study was to document the beneficial effects of adjunctive dexamethasone therapy in patients admitted with community-acquired pneumonia (in terms of length of hospital stay) and to study what patients admitted with CAP benefit most from dexamethasone therapy, based on predefined subgroup of disease severity (PSI 1-5) and C-reactive protein level at admission as well to evaluate utility of CRP in monitoring resolution of CAP. Methods: In this prospective case-control trial, 100 children aged 1 to 14 years were enrolled randomly with confirmed community-acquired pneumonia, who presented to emergency department of paediatrics PMCH Patna. We randomly allocated patients on a one-to-one basis to adjuvant dexamethasone with antibiotics and antibiotics alone groups by drawing lots. Results: The median length of hospital-stay in both the adjuvant dexamethasone group and antibiotics alone group was 7 days with IQR in adjuvant dexamethasone group of 6.0-8.0 days and antibiotics group of 7.0-9.0 days (95% CI of difference in means 0.3-1.2 days; p = 0.001931 and was significant at p value of ≤ 0.01). There was a positive correlation between length of hospital-stay and CRP at the time of admission in adjuvant dexamethasone and antibiotics alone group with R value = 0.0261 and 0.3541 respectively. There also exist a positive correlation between length of hospital-stay and PSI at admission in adjuvant dexamethasone and antibiotics alone group with R value = 0.3555 and 0.1196 respectively. Median length of hospital-stay in those admitted with high PSI (PSI 4-5) and high CRP were 8.0 days in antibiotics alone group compared to 7.0 days in adjuvant dexamethasone group. The mean CRP on day 1, 3 and 5 was 7.734 (SEM 0.664), 3.974 (SEM 0.412) and 1.440 (SEM 0.133) respectively. Conclusions: There was no significant difference in length of hospital-stay in CAP patient treated with adjuvant dexamethasone with antibiotics and antibiotics alone. However it is clearly evident from this study that using adjuvant dexamethasone reduced the length of hospital-stay in those who admitted with higher PSI as well as higher CRP compared to antibiotics alone group. Moreover there was a definite decremental relationship between CRP and resolution of CAP. So use of adjuvant dexamethasone in those presenting with high PSI and high CRP can be consider. Since the sample size of our study was small, further evaluation is warranted.

International Journal of Contemporary Pediatrics

Background: Acute Encephalitis Syndrome (AES) is defined as a person of any age, at any time of y... more Background: Acute Encephalitis Syndrome (AES) is defined as a person of any age, at any time of year with the acute onset of fever and a change in mental status (including symptoms such as confusion, disorientation, coma, or inability to talk) and/or new onset of seizures (excluding simple febrile seizures). Viruses have been mainly attributed to be the cause of AES in India although other etiologies such as bacteria, fungus, parasites, spirochetes, leptospira, toxoplasma, rickettsia, chemical, and toxins have also been reported over the past few years. The causative agent of AES varies with season and geographical location, owing to wide range of causative agents and the rapid neurological impairment due to pathogenesis, clinicians face the challenge of a small window period between diagnosis and treatment. The present study is dedicated to knowing the present epidemiological pattern of AES in Bihar aiming to help in diagnosis and treatment.Methods: This is a prospective study cond...

International Journal of Contemporary Pediatrics

Background: Acute Encephalitis Syndrome (AES) is defined as a person of any age, at any time of y... more Background: Acute Encephalitis Syndrome (AES) is defined as a person of any age, at any time of year with the acute onset of fever and a change in mental status (including symptoms such as confusion, disorientation, coma, or inability to talk) and/or new onset of seizures (excluding simple febrile seizures). Viruses have been mainly attributed to be the cause of AES in India although other etiologies such as bacteria, fungus, parasites, spirochetes, leptospira, toxoplasma, rickettsia, chemical, and toxins have also been reported over the past few years. The causative agent of AES varies with season and geographical location, owing to wide range of causative agents and the rapid neurological impairment due to pathogenesis, clinicians face the challenge of a small window period between diagnosis and treatment. The present study is dedicated to knowing the present epidemiological pattern of AES in Bihar aiming to help in diagnosis and treatment.Methods: This is a prospective study cond...

Objective: To find the common causes of seizure and to classify seizure types in various age grou... more Objective: To find the common causes of seizure and to classify seizure types in various age groups as well to predict outcome in relation to different variables. Design: Retrospective hospital-based, analytic and descriptive study. Setting: The Department of Paediatrics, PMCH, Patna. Participants/patients: This study includes all children in the age group 6 months to 15 years presented in the department of paediatrics with seizure. Outcome Measure(s): Demographic analysis and analysis of different seizure types, analysis of patient based on the cause of seizure as well as outcome of patient presented with seizure in relation to demographic, fever diagnosis and status epilepticus. Results: The total number of patient presented with seizure are 956 of them 574 were males and 382 were females. 562 had fever on presentation and most of them were less than 5 years of age amount to 562. The most common clinical seizure type were generalized tonic-clonic (60.5%). Seizure disorder (14.4%), febrile seizures (16.1%), central nervous system infections and neurocysticercosis were common etiologies. Tubercular meningitis was more common etiology in 6–10 years age group. Neurocysticercosis were more common in 11-15 years age group. Encephalitis were more common in children below 5 years of age. Conclusions: seizures are one of the common cause of hospitalization and high mortality. It can be inferred from this study that CNS infection are the most common cause of acute symptomatic seizure. Thus improvement in health care facilities like sanitation and immunization is warranted to prevent it.

Objective: To find the common causes of seizure and to classify seizure types in various age grou... more Objective: To find the common causes of seizure and to classify seizure types in various age groups as well to predict outcome in relation to different variables. Design: Retrospective hospital-based, analytic and descriptive study. Setting: The Department of Paediatrics, PMCH, Patna. Participants/patients: This study includes all children in the age group 6 months to 15 years presented in the department of paediatrics with seizure. Outcome Measure(s): Demographic analysis and analysis of different seizure types, analysis of patient based on the cause of seizure as well as outcome of patient presented with seizure in relation to demographic, fever diagnosis and status epilepticus. Results: The total number of patient presented with seizure are 956 of them 574 were males and 382 were females. 562 had fever on presentation and most of them were less than 5 years of age amount to 562. The most common clinical seizure type were generalized tonic-clonic (60.5%). Seizure disorder (14.4%), febrile seizures (16.1%), central nervous system infections and neurocysticercosis were common etiologies. Tubercular meningitis was more common etiology in 6–10 years age group. Neurocysticercosis were more common in 11-15 years age group. Encephalitis were more common in children below 5 years of age. Conclusions: seizures are one of the common cause of hospitalization and high mortality. It can be inferred from this study that CNS infection are the most common cause of acute symptomatic seizure. Thus improvement in health care facilities like sanitation and immunization is warranted to prevent it.