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Biomedical subjects

A N Pandit

Publications and source records attributed to A N Pandit.

At least 37 records · Page 2Linked to original sources
PubMed1991

Reduction in parenteral nutrition related complications in the newborn.

A comparison of total parenteral nutrition (TPN) related complication in newborns was made between two study periods, namely, 1986 (Study A) and 1989-90 (Study B). A significant reduction was seen in all complications in Study B. Local complications (thrombophlebitis, gangrene, abscess) reduced from 80.0 to 29.4%, septicemia from 52.0 to 11.7% and metabolic complications from a computed mean of 1.6 episode per baby to 0.88 episode per baby. The reduction in these complications has been attributed to the following additional inputs in the recent study (i) Additional staff (research officers, nurses, biochemist); (ii) Better training of resident staff; (iii) Use of a laminar flow system for mixing solutions; (iv) Specially designed locally manufactured intravenous sets and accessories; and (v) Use of well balanced nutrient solutions. Outstanding problems perceived are--high incidence of TPN-related cholestasis (14.7%), azotemia (26.4%), central catheter-related sepsis (75.0%) and the falling, but yet high cost of the technique (Rs. 650 per day).

Humans↗
PubMed1991

Neonatal septicemia: a reappraisal with special reference to the use of cefotaxime.

In a study period of one year, 381 babies (38.7% of all nursery admissions) were clinically diagnosed to have sepsis. Of these, 156 (40.9%) had positive blood cultures. Klebsiella was by far the commonest organism isolated (41%) followed by other Gram negative organisms. Gram positive organisms were uncommon (8%). Sensitivity of Gram negative organisms was poor to penicillin (11%) and ampicillin (18%); significantly better to kanamycin (65%), gentamicin (74%) and best to cefotaxime (79%). Only 8% isolates were resistant to all antibiotics. Combination of cefotaxime and gentamicin was effective against 90% of the isolates (in vitro) as compared to 74% for gentamicin and ampicillin. In vivo, mortality in the cefotaxime treated group was significantly lower (24.3%) than control group (47%) although both groups were clinically and bacteriologically comparable (p less than 0.05).

Bacteremia↗
PubMed1991

A study of Baroda Development Screening Test for infants.

Baroda Development Screening Test for Infants based on Baroda Norms on BSID-Research Form 1961 were studied at the Child Development Unit of the Department of Pediatrics in the K.E.M. Hospital, Pune. Screening validity, sensitivity, specificity, over-referrals and under-referrals were calculated in three samples--(i) 730 records of 130 babies evaluated on BSID-Baroda Norms during 1979 and December 1984; (ii) 101 records of babies tested at six months out of the first sample; and (iii) 50 babies screened by interviewing the mothers and tested on the full scales by the experts. Screening validity, sensitivity and specificity were more than 76, 66 and 77%, respectively. Over-referrals were highest (35%) in the sample screened by interview. Suggestions are made to improve the screening by interview. Baroda Development Screening Test for Infants is recommended for use in the field for further evaluation.

Child, Preschool↗
PubMed1991

A longitudinal follow up of development of preterm infants.

A prospective study was undertaken to determine the development of preterm (PT) babies (gestation less than 37 weeks). One hundred and seventy two preterm babies and 36 control babies were followed up for a period of 18-24 months. Psychomotor development was assessed using the Bayley Scales of Infant Development at 3, 6, 9, 12, 18, 24 months, using the corrected or post conceptional age. Preterm babies, as a group, caught up with normal babies between 18-24 months, both on the motor and mental scale. Higher the birth weight, better was the mean motor development quotient at 18 months. Uncomplicated preterm babies showed higher mean development quotients at 18 months than preterm babies with additional complications and they also caught up earlier (12-18 months) than the latter group who caught up between 18-24 months. Similarly, PT appropriate for gestational age (AGA) babies showed, earlier 'catch up' than PT small for gestational age (SGA) babies. The incidence of cerebral palsy was low (4%).

Birth Weight↗
PubMed1988

Copper in urine and hair in Indian childhood cirrhosis.

In advanced Indian childhood cirrhosis (ICC) urine copper concentration was higher (range 416-103,448 mg/g creatinine) than in other hepatic diseases (range 67-10,303 mg/g creatinine). In early ICC urine copper concentration was more modestly raised (1188-9470 mg/g creatinine), but rose to high values (2222-42,819 mg/g creatinine) after a single dose of penicillamine 20 mg/kg. A post-penicillamine urinary copper:creatinine ratio greater than 10,000 mg/g supports a diagnosis of ICC. The concentration of copper in the hair, while increased in advanced ICC, is of no diagnostic value in early cases.

Child, Preschool↗
PubMed1987

Clinical trials of penicillamine in Indian childhood cirrhosis.

The outcome in 15 children with advanced Indian childhood cirrhosis (ICC) treated with penicillamine 20 mg/kg/day was not significantly different from that in untreated children. Among children admitted to a further double blind trial who had ICC but who had not yet developed jaundice or ascites 10 treated with penicillamine and 10 treated with penicillamine plus prednisolone had a significantly improved survival. Fourteen of 29 treated cases made a clinical recovery and were alive 489 to 1460 days from the start of treatment. Biopsy specimens in survivors showed a return to normal liver histology in three, residual fibrosis in six, and inactive micronodular cirrhosis in five. Thus penicillamine, while not shown to be beneficial in advanced ICC, lowered mortality from 93% to 52% in preicteric cases of ICC.

Clinical Trials as Topic↗
PubMed1983

Early introduction of copper-contaminated animal milk feeds as a possible cause of Indian childhood cirrhosis.

Brass and copper household utensils are a possible source of the gross hepatic copper accumulation characteristic of Indian childhood cirrhosis (ICC). In 107 families with a child with ICC, the use of copper or brass for water storage (97%) and of brass for milk storage (90%) or milk boiling (67%) resembled that of neighbouring village control families. However, the feeding history of 132 children with ICC differed from that of 70 children with other hepatic disorders and 311 children in 2 rural control groups. No child with ICC was exclusively breast-fed whereas 10%, 32%, and 25% of the control children were. Duration of breast-feeding was shorter in children with ICC and animal milk was introduced earlier. 57% were started on animal milk before 3 months of age. The age at introduction of animal milk correlated with the age at presentation with ICC. 66 urban Pune children had a feeding history similar to those with ICC, but in these families brass vessels were not used for milk. Experimentally, milk took up copper from utensils more avidly than water did. The copper concentration in milk samples obtained from ICC households, and those obtained experimentally, would supply a copper intake 6 to 20 times greater than that of the breast-fed infant, and similar to that producing copper toxicosis in the lamb. The hypothesis that early introduction of copper contaminated animal milk is of aetiological importance explains many of the epidemiological features of ICC.

Alloys↗
PubMed1982

Liver disease in India.

One hundred and twenty-five children with chronic liver disease were seen in Pune in 13 months. Fifty-nine of them, aged 8-39 months, had Indian childhood cirrhosis histologically diagnosed. Their characteristics included an insidious onset of symptoms, a geographical clustering of cases in rural areas north-east of Pune, a high rate of parental consanguinity and affected siblings, and a very high hepatic copper concentration (790-6654 micrograms/g dry weight). Only 8 survived for 6 months, adverse prognostic features being jaundice, ascites, enlargement of the gall bladder, and severe anaemia at presentation. Clinical differentiation from other liver disorders in the same age group was clear in advanced cases but unreliable in earlier cases. Four asymptomatic siblings with hepatomegaly had a benign course. The need for non-invasive methods to diagnose early cases in the community is demonstrated. The other major diagnostic categories were: unresolved hepatitis (12); chronic active hepatitis (7); cryptogenic cirrhosis (6); neonatal hepatitis and biliary atresia (8).

Adolescent↗