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2.
Indian J Dermatol Venereol Leprol ; 2007 Jul-Aug; 73(4): 218-21
Artículo en Inglés | IMSEAR | ID: sea-53209

RESUMEN

Corticosteroids are potent drugs used in management of various inflammatory and autoimmune disorders. The antiinflammatory effects of corticosteroids cannot however be separated from their metabolic effects. Children are more vulnerable to their side effects, particularly the effects on growth, immunity and adrenal suppression. It is essential for the treating physician to be aware of the side effects and the measures to be taken to minimize them. A side effect that is unique to children is growth suppression, which is helped by alternate day treatment. Administration of small doses of prednisolone (10-15 mg/day or velocity significantly. The potency of dexamethasone and betamethasone in suppressing growth is nearly 18 times higher than that of prednisolone. There is some evidence that the administration of growth hormone can reverse these changes.


Asunto(s)
Insuficiencia Suprarrenal/inducido químicamente , Factores de Edad , Niño , Esquema de Medicación , Glucocorticoides/administración & dosificación , Trastornos del Crecimiento/inducido químicamente , Humanos , Lactante , Recién Nacido , Enfermedades Metabólicas/inducido químicamente , Osteoporosis/inducido químicamente
3.
Indian J Pediatr ; 2006 May; 73(5): 427-9
Artículo en Inglés | IMSEAR | ID: sea-79829

RESUMEN

Moebius syndrome is characterized by congenital complete or partial facial nerve palsy with or without paralysis of cranial nerves and often associated with other malformations. Cardiac anomalies though known are very rare and till date only 4 cases have been reported. We present a case of Moebius syndrome with supracardiac total anomalous pulmonary venous connection which has not yet been reported in literature.


Asunto(s)
Anomalías Cardiovasculares/complicaciones , Femenino , Humanos , Lactante , Síndrome de Mobius/complicaciones , Venas Pulmonares/anomalías
4.
Indian Pediatr ; 2006 May; 43(5): 393-400
Artículo en Inglés | IMSEAR | ID: sea-10330

RESUMEN

OBJECTIVE: To assess the glycometabolic function in chronically transfused patients of beta- thalassemia major in terms of glucose tolerance, insulin secretion, insulin resistance index, and beta cell function index and to determine their relationship with clinical and biochemical profile. METHODS: 30 homozygous thalassemia major children (aged 8-15 years) receiving regular blood transfusion and 10 age and sex matched normal children attending a tertiary level hospital were subjected to glucose tolerance test, estimation of fasting plasma insulin level, insulin resistance index and beta cell function index. Liver enzymes, liver size and indicators of iron overload (serum ferritin, total units of blood transfused, splenic size) were recorded. RESULTS: There was no diabetes mellitus or impaired glucose tolerance test in either the cases or the controls. Fasting plasma insulin levels were significantly higher in cases than controls (P = 0.004), and correlated well with indicators of iron overload like total units of blood transfused (r = 0.41, P = 0.03), serum ferritin (r = 0.38, P = 0.038) and splenic size (r = 0.43, P = 0.03). Insulin resistance was higher in cases compared to controls (P = 0.01). It correlated well with age (r = 0.56, P = 0.006), fasting blood glucose (r = 0.8, P = 0.003), fasting plasma insulin (r = 0.95, P = 0.00001), total units of blood transfused (r = 0.52, P = 0.005), serum ferritin (r = 0.4, P = 0.02) and splenomegaly (r = 0.51, P = 0.004). Insulin resistance was higher in patients not on chelation therapy compared with those on chelation therapy (P = 0.003). The beta cell function index was higher in cases compared to the controls, but not of statistic significance (P = 0.077). It did not correlate well with total amount of blood transfused (r = -0.32, P = 0.08), serum ferritin (r = -0.138, P = 0.46), spleen size (r = 0.16, P = 0.36), or chelation therapy (P = 0.98). CONCLUSION: Diabetes mellitus or impaired glucose was not seen in chronically transfused patients of thalassemia major (between 8 and 15 years of age), in our study. Insulin resistance, compensated by hyperinsulinemia, sets in early even before the onset of frank diabetes mellitus and correlated well with age, chelation therapy and indicators of iron overload like total units of blood transfused, splenomegaly and serum ferritin.


Asunto(s)
Adolescente , Transfusión Sanguínea , Niño , Diabetes Mellitus/epidemiología , Femenino , Intolerancia a la Glucosa/epidemiología , Humanos , Incidencia , Resistencia a la Insulina , Células Secretoras de Insulina/fisiología , Masculino , Talasemia beta/terapia
5.
Indian J Pediatr ; 2005 Aug; 72(8): 667-70
Artículo en Inglés | IMSEAR | ID: sea-81302

RESUMEN

OBJECTIVE: To determine effectiveness of intramuscular midazolam to control acute seizures in children as compared to intravenous diazepam. METHODS: 115 children in the age group of 1 month to 12 years who presented with acute convulsions were enrolled in the study. Patients who already had an intravenous access present were treated intravenous diazepam. Patients without an i.v. access at the time of convulsions were randomised into 2 groups and treated with either intramuscular midazolam or intravenous diazepam for control of seizures. Time interval from administration of drug to cessation of seizures was compared. Effectiveness of i.m. midazolam in various age groups, types of convulsions and etiology of convulsions was analyzed. Side effects of both drugs were evaluated. RESULTS: The mean interval to cessation of convulsions with i.m. midazolam was 97.22 seconds whereas in diazepam group without prior i.v. access it was 250.35 seconds and in diazepam group with prior i.v. access it was 119.4 seconds. i.m. midazolam acted faster in all age groups and in patients with febrile convulsions, which was statistically significant. i.m. midazolam was equally effective in various types of convulsions be it GTC or focal convulsions. 7 patients (10.8%) had thrombophlebitis associated with i.v. diazepam administration whereas none of the patients in the midazolam group had any side effects, which was statistically significant. CONCLUSION: i.m. midazolam is an effective agent for controlling acute convulsions in children especially in children with febrile convulsions. It has relatively no side effects as compared to Intravenous diazepam and can be used as a first line agent for treatment of acute convulsions in patients with difficult intravenous access.


Asunto(s)
Anticonvulsivantes/administración & dosificación , Niño , Preescolar , Diazepam/administración & dosificación , Humanos , Lactante , Inyecciones Intramusculares , Inyecciones Intravenosas , Midazolam/administración & dosificación , Estudios Prospectivos , Convulsiones/tratamiento farmacológico , Convulsiones Febriles/tratamiento farmacológico , Tromboflebitis/inducido químicamente
6.
Artículo en Inglés | IMSEAR | ID: sea-68291

RESUMEN

We report here a 2.5-year-old male child with community-acquired Pseudomonal sepsis showing the characteristic lesions of ecthyma gangrenosum. The child had development of gangrenous changes of the nose and face - the 'cancrum oris' or 'Noma'. We highlight the possible association of Pseudomonas sepsis and Noma, with malnutrition playing a central role in causing both the diseases.


Asunto(s)
Trastornos de la Nutrición del Niño/complicaciones , Preescolar , Humanos , Masculino , Noma/complicaciones , Infecciones por Pseudomonas/complicaciones , Sepsis/complicaciones
7.
Indian Pediatr ; 2004 Nov; 41(11): 1148-51
Artículo en Inglés | IMSEAR | ID: sea-6684

RESUMEN

We conducted this study to determine efficacy of Parasight-F (an HRP-II antigen dipstick method to detect P. Falciparum) in children. A total of 30 children were enrolled in the age group of 2 months to 12 years whose peripheral smear showed asexual forms of Plasmodium falciparum. All patients were tested for presence of HRP-II antigen of Plasmodium falciparum in their blood by the Parasight-F dipstick test by either an EDTA sample or a finger prick blood sample. The sensitivity of Parasight-F was 83.3 % However, the sensitivity of Parasight-F to detect Plasmodium Falciparum in case of mixed Plasmodium (Vivax + Falciparum) infection was only 25 %. Also, all patients less than 6 months of age had a negative Parasight-F test. Parasitic index, prior treatment with antimalarials or severity of Falciparum malaria have no effect on the sensitivity of Parasight-F test. We conclude that Parasight-F is an effective tool for diagnosis of Plasmoduim falciparum malaria in children.


Asunto(s)
Animales , Antígenos de Protozoos/sangre , Niño , Preescolar , Humanos , Lactante , Malaria/diagnóstico , Plasmodium falciparum/inmunología , Sistemas de Atención de Punto , Proteínas , Sensibilidad y Especificidad
9.
Indian J Cancer ; 2003 Jan-Mar; 40(1): 31-3
Artículo en Inglés | IMSEAR | ID: sea-49955

RESUMEN

Colloid cyst is a rare benign intracranial neoplasm, commonly located in the third ventricle. Though headache and visual symptoms are classical, the patients may present with sudden neurological deterioration. We present a ten-year-old male child who presented with sudden neurological deterioration due to colloid cyst of the third ventricle resulting in death. The child had intermittent headache for three months, for which medical attention was not sought. This report details the case and a short review of the condition is presented (with emphasis on the clinical features and importance of early diagnosis). Management (including surgical methods and conservative treatment) of third ventricle colloid cysts is briefly reviewed.


Asunto(s)
Adulto , Encefalopatías/complicaciones , Ventrículos Cerebrales , Quistes/complicaciones , Diagnóstico Diferencial , Resultado Fatal , Cefalea/etiología , Humanos , Masculino
10.
Indian Pediatr ; 2003 Jan; 40(1): 36-40
Artículo en Inglés | IMSEAR | ID: sea-9804

RESUMEN

Vitamin K deficiency is known to cause coagulopathy and bleeding in patients on prolonged antibiotic therapy. This study was conducted to evaluate the status of vitamin K deficiency in hospitalized children on prolonged antibiotic therapy and its role in reversing the coagulopathy. A prospective non-randomized study was conducted on children on antibiotic therapy at a tertiary care hospital. Children in the 1 month-1 year age group developed significant coagulopathy as compared to other age groups. Coagulation abnormalities were also seen to be more in children with greater grades of malnutrition, on a more prolonged course of antibiotics and in children who were critically ill in intensive care. Hypoprothrombinemia previously reported to be due to B-lactam antibiotics containing the N-Methyl Thio Tetrazole (NMTT) group also resulted from antibiotics without this side chain. Inhibition of intestinal microorganisms by antibiotics was thought to be a likely explanation of this phenomenon. We suggest Vitamin K prophylaxis in severely ill patients, on extended periods of antibiotics and inadequate diet to prevent morbidity and mortality.


Asunto(s)
Antibacterianos/efectos adversos , Antifibrinolíticos/uso terapéutico , Niño , Preescolar , Hospitalización , Humanos , Hipoprotrombinemias/inducido químicamente , Lactante , Lactamas , Estudios Prospectivos , Resultado del Tratamiento , Vitamina K/uso terapéutico , Deficiencia de Vitamina K/inducido químicamente
11.
Indian J Pediatr ; 2001 Sep; 68(9): 891-4
Artículo en Inglés | IMSEAR | ID: sea-84656

RESUMEN

Pulmonary arteriovenous malformations rarely present in childhood. Two cases are presented in this report. Both the cases presented clinically with cyanosis and clubbing without a cardiac murmur. The second case had cerebral abscess in addition. Both the cases underwent a contrast-enhanced echocardiography which suggested the presence of pulmonary arteriovenous malformations. The first case also underwent 99mTc radionuclide scan and pulmonary angiography. The cases are being reported for their characteristic clinical features and for emphasizing the role of non-invasive modalities like contrast-enhanced echocardiography and radionuclide scan in reaching the diagnosis.


Asunto(s)
Angiografía , Malformaciones Arteriovenosas/diagnóstico , Niño , Preescolar , Ecocardiografía , Femenino , Humanos , Arteria Pulmonar/anomalías , Venas Pulmonares/anomalías
13.
J Postgrad Med ; 2000 Jul-Sep; 46(3): 179-80
Artículo en Inglés | IMSEAR | ID: sea-115730

RESUMEN

AIMS: To determine incidence and risk factors for hypomagnesaemia in children admitted in Paediatric Intensive Care Unit, (PICU). SUBJECTS AND METHODS: Prospective study was carried out on 80 children admitted in PICU. The patients were clinically assessed for nutritional status, neurological status on Glasgow coma scale, congestive cardiac failure, etc. and relevant biochemical parameters including serum and red cell magnesium levels were done. 25 patients of the same age group admitted in general ward who were not in critical state were included as a control group. RESULTS: 70% of PICU patients had hypomagnesaemia, which was more common in patients on aminoglycosides and diuretics. CONCLUSION: In view of complications of magnesium depletion and benign nature of appropriate magnesium therapy critically ill children should have their magnesium level monitored.


Asunto(s)
Distribución por Edad , Estudios de Casos y Controles , Niño , Preescolar , Femenino , Humanos , Incidencia , India/epidemiología , Lactante , Recién Nacido , Unidades de Cuidado Intensivo Pediátrico/estadística & datos numéricos , Magnesio/sangre , Deficiencia de Magnesio/diagnóstico , Masculino , Probabilidad , Estudios Prospectivos , Valores de Referencia , Factores de Riesgo , Distribución por Sexo , Tasa de Supervivencia
15.
J Postgrad Med ; 2000 Apr-Jun; 46(2): 149-52
Artículo en Inglés | IMSEAR | ID: sea-117600

RESUMEN

Monitoring respiratory function is important in a Paediatrics Intensive Care Unit (PICU), as majority of patients have cardio-respiratory problems. Non-invasive monitoring is convenient, accurate, and has minimal complications. Along with clinical monitoring, oxygen saturation using pulse oximetry, transcutaneous oxygenation (PtcO2) and transcutaneous PCO2 (PtcCO2) using transcutaneous monitors and end-tidal CO2 using capnography are important and routine measurements done in most PICUs. Considering the financial and maintenance constraints pulse oximetry with end tidal CO2 monitoring can be considered as most feasible.


Asunto(s)
Capnografía , Niño , Humanos , Unidades de Cuidado Intensivo Pediátrico , Monitoreo Fisiológico , Oximetría , Pruebas de Función Respiratoria
16.
J Postgrad Med ; 2000 Jan-Mar; 46(1): 18-22
Artículo en Inglés | IMSEAR | ID: sea-117560

RESUMEN

AIMS: To determine the incidence, risk factors, mortality and organisms causing nosocomial pneumonia (NP) in intubated patients in Paediatric Intensive Care Unit (PICU). MATERIALS & METHODS: All patients with endotracheal (ET) tube with or without mechanical ventilation (MV) in a PICU of a tertiary care teaching hospital were included in this prospective study. Clinical parameters and investigations were evaluated in patients who developed nosocomial pneumonia (NP). Colonisation of the ET tube tip was studied by culture and the antibiotic susceptibility pattern of the isolates was determined. RESULTS: Sixty-nine patients had an ET tube inserted and fifty-nine of these underwent MV. ET tube tip colonisation was seen in 70 out of 88 ET tubes inserted. The incidence of NP in patients with ET tube was 27.54% (7.96/100 days of ET intubation). NP developed only in patients undergoing MV. The main risk factors for developing NP were - duration of MV and duration of stay in the PICU. Age, sex, immunocompromised status and altered sensorium did not increase the risk of NP. The mortality in cases with NP was 47. 37%. E. coli and Klebsiella were the commonest organisms isolated from the ET tube tip cultures with maximum susceptibility to amikacin and cefotaxime. CONCLUSIONS: NP developed only in patients undergoing MV. Duration of MV and duration of stay in the PICU increased the risk of developing NP.


Asunto(s)
Distribución de Chi-Cuadrado , Niño , Preescolar , Infección Hospitalaria/etiología , Femenino , Humanos , Incidencia , Lactante , Unidades de Cuidado Intensivo Pediátrico , Intubación Intratraqueal/efectos adversos , Tiempo de Internación , Masculino , Pruebas de Sensibilidad Microbiana , Neumonía/etiología , Probabilidad , Respiración Artificial/efectos adversos , Factores de Riesgo , Factores de Tiempo
20.
J Postgrad Med ; 1999 Oct-Dec; 45(4): 120-2
Artículo en Inglés | IMSEAR | ID: sea-115201

RESUMEN

A two and half year-old-male child, known case of steroid responsive nephrotic syndrome presented with fever and vomiting of acute onset. He was diagnosed to have superior sagittal sinus thrombosis on a contrast computerised tomographic scan of brain. Recovery was complete without anticoagulant therapy. Superior sagittal sinus thrombosis is an extremely rare complication of nephrotic syndrome.


Asunto(s)
Preescolar , Humanos , Masculino , Síndrome Nefrótico/complicaciones , Trombosis del Seno Sagital/etiología , Tomografía Computarizada por Rayos X
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