Sasidharan Ponthenkandath | University of California, Riverside (original) (raw)

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Papers by Sasidharan Ponthenkandath

EC Paediatrics, Sep 22, 2021

Journal of Paediatrics and Child Health, 2020

Aim: Our aim was to identify the clinical features and outcome of multidrug resistant Candida aur... more Aim: Our aim was to identify the clinical features and outcome of multidrug resistant Candida auris (CA) infection in neonates. Methods: This is a retrospective case cohort study of 17 neonates who developed sepsis caused by CA infection in a tertiary care neonatal intensive care unit over 3 years. The risk factors, clinical features, treatment and outcome were studied. Results: The mean gestation was 32.4 AE 4.9 weeks with overall mortality of 41%. Clinical features were indistinguishable from other causes of sepsis. CA was sensitive to micafungin but resistant to fluconazole and had variable sensitivity to voriconazole and amphotericin. Survival improved to 83% when infants were treated with a combination of micafungin and amphotericin. Non-survivors were of lower birthweights and had other risk factors. Conclusions: The management guidelines and infection control measures are described in this largest series of neonatal CA infection. Treatment with a combination of amphotericin and micafungin improved the outcome.

International Journal of Advanced Research, 2019

Preterm very low birth infants are not fed early if there is shock or severe sepsis or respirator... more Preterm very low birth infants are not fed early if there is shock or severe sepsis or respiratory distress. Traditionally if infants are sick enteral feedings are introduced slowly (at 4-5 days of age). Infants born with history of AREDF are given parenteral nutrition till enteral intake is adequate (7-10 days). We studied the effect of early MEN (at 24 hours of age) in VLBW (<32 weeks gestation) infants with AREDF (MEN group-n=12;controls-n=14). The results of this study reveals that the outcome of infants fed with early MEN is better with shorter length of stay, faster regaining of birth weight, shorter duration of parenteral nutrition and better tolerance of feedings. These data suggest that early MEN can be safely implemented in preterm VLBW infants with history of AREDF with no adverse outcomes.

Indian Pediatrics, 2018

Background: Intractable obstructive apneas requiring multiple intubations are rare in newborns. C... more Background: Intractable obstructive apneas requiring multiple intubations are rare in newborns. Case characteristics: We report a pair of twins born at 29 weeks gestation who had severe obstructive apneas due to Paradoxical Vocal Cord Motion (PVCM). Outcome: The symptoms resolved promptly with ipratropium nebulization. Follow-up at 12 months of age revealed normal development. Message: PVCM should be considered in the differential diagnosis of intractable obstructive apneas in very low birth weight preterm infants.

Journal of Pediatric Hematology/Oncology, 2020

The authors are reporting a case of autoimmune lymphoproliferative syndrome in a newborn who pres... more The authors are reporting a case of autoimmune lymphoproliferative syndrome in a newborn who presented with massive hepatosplenomegaly, thrombocytopenia, and anemia at birth. Antenatal ultrasound revealed a fetus with hepatosplenomegaly. The infant was treated with steroids and sirolimus and is doing well at 4 years of age. This is the first case report of autoimmune lymphoproliferative syndrome presenting as hepatosplenomegaly during fetal life.

Journal of Neonatal Surgery, 2020

Background: Congenital diaphragmatic hernia (CDH) is a complex malformation with a challenging pe... more Background: Congenital diaphragmatic hernia (CDH) is a complex malformation with a challenging perioperative care. The outcome is still not very impressive in developing countries despite its remarkable improvement in developed countries. Methods: We analyzed outcomes, and factors associated with morbidity and mortality of 120 newborns with CDH, managed at our institution. Results: The overall survival was 73.4%. Chromosomal aberrations, pneumothorax within 24 hours, left ventricular hypoplasia, biventricular dysfunction, fetal lung to head ratio (LHR) Conclusion: This is the largest series of a retrospective cohort study of CDH reported in India. We have briefly reviewed the topic and the management guidelines along with prognostic markers derived from this study.

Journal of neonatal surgery, 2020

International Journal of Pediatric Otorhinolaryngology, 2017

Pediatric Review: International Journal of Pediatric Research, Jan 31, 2017

Isolated esophagitis is very rare in newborn infants at birth, although it may occur a few days o... more Isolated esophagitis is very rare in newborn infants at birth, although it may occur a few days or weeks later but is generally associated with gastritis or gastroesophageal reflux, infections or trauma. Respiratory distress is a very unusual clinical feature of esophagitis. We hereby report two newborns who presented with symptoms of respiratory distress at birth and had isolated erosive esophagitis. Symptoms resolved with treatment of esophagitis.

International Journal of Contemporary Pediatrics, Feb 22, 2017

The VDRs and vitamin D metabolizing enzymes have also been identified in both the vasculature and... more The VDRs and vitamin D metabolizing enzymes have also been identified in both the vasculature and the heart ABSTRACT Background: The association of serum vitamin D levels to clinical outcome in VLBW infants has not been studied. Our objective was to measure the cord blood levels, and the dose response for two doses of vitamin D in preterm infants and correlate the relationship of vitamin D levels to the clinical outcome. Methods: We prospectively obtained cord blood levels in 80 preterm infants under 34 weeks gestation (mean gestation age 29±2 weeks and BW: 1210±350 gms). Infants were supplemented with 400 IU or 800-1000 IU vitamin D daily. Serun vitamin D levels were obtained at 2-3 weeks after supplementation and levels were correlated to clinical outcome. Results: The mean cord blood vitamin D level was 12±8.5 ng/ml. Babies who developed sepsis and compared to those who did not develop these morbidities, ROP had vitamin D levels: 13.5±6 (ng/ml) versus 30.5±10 (ng/ml) (p < 0.01) and 15.7±11 (ng/ml) versus 34±18 (ng/ml) (p <0.03) respectively. Supplementation with 400 IU vitamin D resulted in levels of 17±8.6 (ng/ml) and infants given 800-1000 IU vitamin D had levels 46±17(ng/ml) (p <0.001). Conclusions: These data suggest that cord blood vitamin D levels are low in preterm infants and 800-1000 IU vitamin D supplementation is advisable to achieve levels >30 ng/ml. Infants with low levels of vitamin D have higher incidence of sepsis, and ROP.

Case Reports in Perinatal Medicine

Objectives We are presenting a unique case of severe laryngo-tracheo-esophageal cleft in a preter... more Objectives We are presenting a unique case of severe laryngo-tracheo-esophageal cleft in a preterm infant who remained asymptomatic for several days after birth. Laryngo-tracheo-esophageal cleft (LTEC) is a rare congenital anomaly, representing approximately 0.2–1.5% of congenital laryngeal malformations [Merei JM, Hutson JM. Embryogenesis of tracheo esophageal anomalies: a review. Pediatr Surg Int 2002;18:319–26]. There is an abnormal, posterior, sagittal communication between the larynx and the pharynx, which may extend downward between the trachea and the esophagus. Case presentation We report a case of LTEC in a preterm newborn whose mother had severe polyhydramnios. A preterm 34-week gestation female newborn was born in our institution whose mother had severe polyhydramnios during third trimester. She was postnatally diagnosed to have type 3 LTEC by the 19th day after birth. In the presence of a large common tracheo-esophageal cavity, the baby did not develop aspiration or resp...