Atharva Scientific Publications (E-Jounals)
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Prevalence of urinary tract infection in febrile infants
No full textBackground: Urinary tract infection (UTI) is one of the most common bacterial infections in infancy, with a high risk of recurrence, and maybe an indicator of underlying urinary tract abnormality. It is often misdiagnosed due to irregular and unrelated symptomatology in the absence of directed screening. Objectives: The objectives of the study were to assess the feasibility of mid-stream clean catch method in infants for collecting a urine sample, compare the reliability of urinalysis in comparison with urine culture and to determine the prevalence of UTI among febrile infants in a rural setting. Materials and Methods: The study was conducted in a level-2 pediatric hospital involving 320 febrile infants attending the out-patient department from January 1, 2018, to June 30, 2018. Urine specimens were collected using midstream clean-catch urine (CCU) method and tested by urinalysis and culture. Results: Urine sample was successfully obtained by the CCU method in 320 (88.9%) out of 360 infants, of which only 8 (2.5%) showed contamination in culture. A total of 20 (6.25%) infants were culture positive for UTI. Only 14 (70%) of these showed positive urinalysis, while 17 (85%) of the culture-positive cases had a provisional diagnosis other than UTI. Further radiological examination revealed renal abnormalities in two out of six culture-positive infants who underwent subsequent studies. Conclusion: CCU method is reliable method for successful collection of urine and low contamination and can be used reliably in the absence of supra pubic aspiration/catheterization. Urinalysis lacks sensitivity in comparison with urine culture, necessitating the use of urine culture to diagnose/rule out UTI in infants. Culture-positive infants need to undergo a radiological examination to screen for abnormalities of the renal tract
Behavioral problems in children with asthma and their association – A cross-sectional study
No full textBackground: Asthma is a chronic illness involving the airways in the lungs and children are more susceptible. A strong link between asthma and psychiatric illnesses has been established. Hence, psychological factors govern its management. Objective: The objective of the study was to assess the self-esteem and behavior of asthmatic children. Materials and Methods: The cross-sectional study was conducted at the Department of Pediatrics of a Tertiary Hospital of South India. Asthmatic children between 6 and 16 years of age, diagnosed as mild to moderate, visiting the asthma clinic were included in the study. The respondents could either answer the questionnaire or point out their choices or indicate them verbally. Culture-Free Self-Esteem Inventory (CFSEI) by Battle (1981) was used for the study. Child Behavior Checklist by Achenback and Ederirock (1983) is designed to record in a standardized format the behavioral problems and social competencies of children, as reported by parents/guardians. Results: A total of 70 children were enrolled in the study. There were 30 children each in the case and control group, with regular follow-ups to the clinic. The majority of the children belonged to the age group of 10–13 years (63.3%) in the case and 10–14 years (63.03%) in the control group. Among the cases, about 50% had at least 3 wheezing episodes. Among the number of inpatient admissions, 14 were admitted once, four were admitted twice, and one child had three admissions. The school absenteeism in case varied from 1 to 6 weeks per academic year. Mean self-esteem scales for boys were 10.36 in case and 13.05 in control (p<0.05) and the results were statistically significant. Parental self-esteem showed significant differences between the two groups. Mean self-esteem scales for girls were 2.273 in general self-esteem and 0.132 in social self-esteem. These results had a highly significant correlation. Conclusion: Asthmatic children were found to have low self-esteem and those with chronic diseases had both higher depression score and low self-esteem. The treating physicians should identify the associated psychological issues in asthmatic cases and address them as needed
Neck circumference and waist circumference as a tool for evaluating obesity
No full textBackground: Obesity has acquired an epidemic proportion, leading to increased morbidity and mortality. Early identification and timely intervention in children are the need of the hour. Objective: The objective of the study was to measure and compare the neck circumference (NC) and waist circumference (WC) in normal, overweight, and obese children followed by their correlation with body mass index (BMI). Materials and Methods: This cross-sectional study was conducted in 1000 school-going children of 6–14 years age group. Their BMI, NC, and WC were measured, compared, and correlated by appropriate statistical analysis. Results: The difference between NC and WC of overweight and obese children and that of normal children was statistically significant and the measurements correlated with the BMI. The age-wise cutoff values of NC and WC in male and female children were calculated along with their sensitivity and specificity for detecting obesity. Conclusion: NC and WC are practical, efficient, and cost-effective tools to identify obesity amongst school-going children
Gastrointestinal mucormycosis: Rare presentation and review of literature
No full textMucormycosis is an emerging life-threatening opportunistic infection. It is commonly seen in immunocompromised patients. Gastrointestinal mucormycosis is rare and only 25% of cases of gastrointestinal mucormycosis are reported antemortem. The stomach is the common site of gastrointestinal mucormycosis. In this study, three cases of gastrointestinal mucormycosis were diagnosed in 1 year. One was a gastric endoscopic biopsy. Two cases were diagnosed in the small intestine, one in the jejunum and one in the ileum. The diagnosis was made on hematoxylin and eosin stains. Gomori Methenamine Silver staining was done to confirm the morphology in all the cases. Mucormycosis shows broad non-septate filamentous hyphae with irregular branching. It is associated with angioinvasion with necrosis and acute inflammation. Cultures were not done as the diagnosis was not suspected
Carotid intimal thickness and response to gluten-free diet: A prospective study in children with celiac disease
No full textBackground: Carotid intimal-medial thickness (CIMT) has recently emerged as one of the early markers of atherosclerosis and is helpful in providing direct evidence in comparison to traditional biochemical screening parameters. Objective: The objective of the study was to determine the change in the CIMT in children with celiac disease (CD) aged 1–14 years after 6 months of gluten-free diet (GFD). Materials and Methods: A total of 31 consecutive children with newly diagnosed CD (anti-tissue transglutaminase antibody titer of >10 U/L and intestinal biopsy histology of either Marsh Grade 3B or 3C) were enrolled in the study. CIMT was measured at the time of diagnosis and after 6 months follow-up on GFD by a single experienced radiologist who was blinded to the participant’s casestatus and risk factors. Results: The mean age of enrolled cases in our study was 7.58±3.38 years. The mean CIMT among enrolled children before GFD (0.0523±0.0069 cm) and after 6 months of GFD (0.0537±0.0063 cm) was greater than that of expected CIMT for this age (0.0411±0.5 cm). After 6 months of GFD, mean values on the right side (anterior wall, posterior wall, and mean; p=0.27, 0.794, and 0.557, respectively) or the left side (anterior wall, posterior wall, and mean; p=0.122, 0.063, and 0.078, respectively) were not statistically significantly. Conclusion: CIMT among children with CD was increased at enrolment but did not decrease significantly after 6 months of GFD. Further, studies are needed to be conducted with longer duration of follow-up for more insight into the subject
Efficacy of acupuncture for the treatment of sciatica: A case report
No full textSciatica is a common type of pain affecting the sciatic nerve, a large nerve extending from the lower back down the back of each leg. Depending on where the sciatic nerve is affected, the pain may also extend to the foot or toes. We report the case of a 53-years-old male patient with sciatica pain for 1 year that started after lifting heavy weight. This case study was done to investigate the effectiveness of acupuncture for relieving sciatic pain. The treatment was given for 10 days. Gall bladder 30, urinary bladder (UB) 40 and UB 60 acupuncture points were used in this treatment. According to the findings of the visual analog scale, the pain symptom score changed from 8 to 2 after 10 days of treatment. This result has been proven the efficacy of acupuncture treatment for sciatic pain relief in this case. Under this case study, we can conclude that acupuncture techniques are beneficial to enhance the recovery stage of pain related to sciatica
Awake craniotomy in Intraoperative magnetic resonance suite (IMRIS) setting: Our institutional experience
No full textNeurosurgery of the lesions within or near eloquent areas of the brain is challenging due to the risk of causing permanent neurological deficits during resection. Awake craniotomy allows intraoperative monitoring of the brain functions and guides the neurosurgeon continuously in maximum safe resection of lesions near the eloquent cortex with minimum neurological deficit. Intraoperative magnetic resonance imaging (iMRI) helps the neurosurgeon in improving the safety and efficacy during resection of the lesions. The combination of awake craniotomy and iMRI increases the overall challenges for both neurosurgeons and neuroanesthesiologists and requires close communication between all the teams involved. We present a series of ten cases of awake craniotomy done in the iMRI suite for the resection of gliomas located in close proximity to functionally eloquent areas of the brain
Ectopic non functional pituitary adenoma – A case report
No full textEctopic pituitary adenoma comprises 1–2% of all pituitary adenomas with a slight female predominance. Cases have been reported in the sphenoid sinus, cavernous sinus, parasellar region, nasal cavity, clivus, nasopharynx, and third ventricle. Here, we report the case of a 48-year-old female patient who presented with a 2 years history of nasal obstruction, epistaxis, and headache. The patient underwent necessary hematological, biochemical, and radiological investigations. Magnetic resonance imaging brain with angiography study showed a large soft-tissue mass in nasopharynx eroding the clivus and extending to involve bilateral sphenoid sinuses and parasellar region. The airway was also compromised. The pituitary gland appeared normal. All hematological and biochemical investigations were within normal limits. An endoscopic biopsy was also done. Tissue was submitted for histopathological examination and a diagnosis of pituitary adenoma was given. The patient had uneventful post-operative recovery and regularly came for follow-up
High-resolution computed tomography thorax evaluation of sputum positive/CBNAAT positive pulmonary tuberculosis in diabetic and non-diabetic patients
No full textBackground: Diabetes mellitus (DM) and pulmonary tuberculosis (TB) are major health problems in India. Diabetes being an immunosuppressive state is thought to be a risk factor for acquisition of TB. However, very few researches provide evidence demonstrating whether DM affects radiological diagnostic findings of pulmonary TB. Hence, this novel cross-sectional study was undertaken to find the difference between the high-resolution computed tomography (HRCT) findings of TB patients with diabetes to that from non-diabetics. Material and Methods: HRCT thorax scans were performed in patients diagnosed as pulmonary TB on the basis of sputum positivity or CBNAAT positivity. Patients were divided into diabetic and non-diabetic group. Patient details and clinical history were recorded and HRCT thorax findings were then compared in both groups. Results: Compared to non-diabetic patients (26.5%), the diabetic patients (53.1%) showed a higher detection rate of lesions at the lower lung lobe (p < 0.05), non-segmental consolidation was also higher in diabetic group (28%) compared to non-diabetic group (2%) p < 0.01), cavitary lesion was noted in 37.5% of diabetic group compared to 8.1% of non-diabetic group (p < 0.01). Conclusion: CT findings of TB in diabetic patients are different from those in non-diabetic patients, with a higher occurrence of non-segmental distribution, cavitary lesion and lower lobes are more commonly affected in TB patients with diabetes
Clinical profile and complication of nephrotic syndrome in a tertiary health care center in central India
Full text linkBackground: Nephrotic syndrome (NS) is a common renal disease that is characterized by episodes of relapses and remissions, with variations in the outcome. It is an important cause of chronic renal disease. Objective: The objective of the study was to access the clinical presentation, investigation profile, associated complication, and therapeutic response in children with NS. Materials and Methods: This prospective observational study was conducted from March 2017 to June 2018 in the department of pediatrics of a tertiary care institution of Central India. A total of 107 children diagnosed with NS were included in the study. Detailed information on age, sex, age at first episode, presenting complaint, history of presenting illness, social, and family history was taken. Detailed general physical examination, systemic examination, investigation profile, and response to management were recorded on a pro forma and correlated statistically. Results: of 107 cases of NS, the most common age group was 5–7 years (54.2%). There were 73 (68.2%) males and 34 (31.7%) females with a male-to-female ratio of 2.1:1. It was found that 39 (36.4%) subjects were newly diagnosed and 68 (63.6%) were relapse cases. A total of 95 (88.8%) patients were steroid-sensitive while 12 (11.2%) had initial steroid resistance NS. Conclusion: In our study, clinical presentation and response to treatment in cases with NS did not differ significantly from other studies