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Biomedical subjects

A Narang

Publications and source records attributed to A Narang.

At least 73 records · Page 4Linked to original sources
PubMed1996

Fluconazole in the management of neonatal systemic candidiasis.

OBJECTIVE: To evaluate the role of Fluconazole in the management of neonatal systemic candidiasis. DESIGN: Descriptive, retrospective analysis. SUBJECTS: 23 neonates diagnosed as systemic candidiasis based on clinical suspicion with blood and/or urine culture positive for candida were treated with Fluconazole (5 mg/kg/day) for > 7 days. RESULTS: Babies had mean birth weight 1590 + 533 g, mean gestation 32.3 + 3.1 wks and fungal sepsis was diagnosed at a mean age of 14.3 + 7.9 days. Candida albicans (43.5%), C. tropicalis (21.7%), C. guillermondii (13%), C. parapsillosis (13%) and C. krusei (8.7%) were the species isolated. Fluconazole was effective in 82.3% cases with no side effects. Four resistant cases were C. parapsillosis (n = 2), C. albicans (n = 1) and C. guillermondii (n = 1) and there were three deaths, all in resistant cases though one death was unrelated to candidemia. CONCLUSION: Fluconazole is a safe and effective drug for neonatal systemic candidiasis.

Antifungal Agents↗
PubMed1996

A prospective study of delta infection in fulminant hepatic failure.

Thirty one patients of HBV related Fulminant Hepatic Failure (FHF) were studied for the presence of delta infection and subsequently the clinical features, course and outcome of the delta infected cases was compared with those of delta uninfected cases. Out of 31 patients studied, 11 patients (35.8%) were reactive for anti-delta antibodies. There was no significant difference in age in delta reactive and non-reactive group. Hepatic encephalopathy was seen in all of the patients. The mean SGOT and SGPT were 378 +/- 88.74 U and 454 +/- 70.44 U respectively in anti-delta reactive group as compared to 239 +/- 74.94 U and 274.1 +/- 100.34 U respectively in anti-delta non reactive group (p < 0.05). During follow up, 10/11 patients (91%) died in anti-delta reactive group as compared to 13/20 patients (65%) in anti-delta non reactive group. So this study suggests that delta virus infection is quite common in India and it lead to excerbation of illness and carries a relatively poor prognosis for FHF.

Adult↗
PubMed1995

Role of routine lumbar puncture in neonatal sepsis.

OBJECTIVE: To evaluate the utility of lumbar puncture done routinely as part of complete workup in neonatal sepsis. METHODOLOGY: Two hundred and nine consecutive lumbar punctures performed in 169 neonates were prospectively evaluated for the diagnosis of meningitis over a 6 month period in a tertiary care referral neonatal unit. RESULTS: Among babies with 'suspected clinical sepsis', five (3.3%) were diagnosed to have meningitis. None of the clinically normal babies with high risk obstetric factors alone had meningitis. The lumbar puncture was traumatic in 22.9%, and in 26.3% the fluid obtained was inadequate for complete analysis. The results were inconclusive in 37% of the cases. CONCLUSION: Based on this study, routine lumbar puncture may not be required in clinically normal newborns with adverse obstetric factors. In babies with clinical sepsis, though the yield is not very high; there are no reliable clinical or laboratory markers to predict which babies will have meningitis and hence these babies would warrant a lumbar puncture.

Birth Weight↗
PubMed1995

Neurotoxicity among pesticide applicators exposed to organophosphates.

OBJECTIVES: An epidemiological study of 90 male pesticide applicators licensed in New York was conducted to investigate the effect of exposure to organophosphate pesticides on the peripheral nervous system. METHODS: A cohort of farmers and pesticide applicators from New York State were questioned off season (November 1988-February 1989) and again during the spraying season (April 1989-August 1989) about the presence of several acute signs and symptoms. Short term exposure was validated by measuring the concentration of dimethylthiophosphate (DMTP), a metabolite of guthion, in urine. Chronic signs of subtle peripheral nerve damage were determined by vibration threshold sensitivity of the farmers and applicators tested during November 1988-February 1989 and compared with controls drawn from the general population who were tested during the same time period the next year (November 1989-February 1990). Vibration threshold sensitivity was determined for both the hands and feet. Long term exposure to pesticides was determined by questionnaire. RESULTS: Paired t tests show that mean vibration threshold scores were significantly higher for the dominant (P < 0.00) and non-dominant (P < 0.04) hands among pesticide applicators when compared with scores for population based controls individually matched on age, sex, and county of residence. CONCLUSIONS: A significant increase in mean vibration threshold sensitivity for the dominant and non-dominant hand suggests previous organophosphate exposure among pesticide applicators was associated with a loss of peripheral nerve function.

Adult↗
PubMed1995

Effect of oral water soluble vitamin K on PIVKA-II levels in newborns.

Intramuscular administration of vitamin K for prophylaxis against hemorrhagic disease of the newborn has the disadvantage of increased cost, pain, anxiety to parents and risk of transmission of infection. Oral route is a better alternative. Oral absorption of vitamin K has been shown to be equally good using special oral preparations. However, this preparation is not available in India. A prospective study was carried out on 51 full term, healthy breastfed newborns to evaluate if the injectable water soluble preparation of vitamin K (menadione sodium bisulphite) could be as effective. Fourteen babies received 1 mg vitamin K intramuscularly, 24 received 2 mg vitamin K orally while 13 controls did not receive vitamin K at birth. PIVKA-II levels were measured in cord blood and at 72-78 hours of age in all babies as a marker of vitamin K deficiency. The overall PIVKA-II prevalence in cord blood was 64.7%. At 72-78 hours, PIVKA-II was present in 50% of babies in IM group, 58.3% of babies in oral group and in 76.9% of babies in 'no vitamin K' group (p > 0.05). The PIVKA-II levels decreased or did not change at 72-78 hours in 91.6% of babies in oral group versus 92.8% of babies in IM group (p > 0.05). On the other hand, PIVKA-II levels increased in 30.7% of babies who did not receive vitamin K as against in 7.8% of babies receiving vitamin K in either form (p < 0.05). Hence, vitamin K prophylaxis is required for all newborns at birth and injectable vitamin K (menadione sodium bisulphite) given orally to term healthy babies is effective in preventing vitamin K deficiency state.

Administration, Oral↗
PubMed1995

The incidence of retinopathy of prematurity in a neonatal care unit.

In India, with advancement in neonatal care units, a large number of low-birth weight premature babies are now surviving and are at risk of developing retinopathy of prematurity (ROP). However, there are not enough reports on the incidence of ROP in this country. To determine the incidence of ROP in a prospective manner, 165 babies weighing < or = 1700 gm over a period of one year were examined. An incidence of 47.27% of ROP at the mean age of 7.21 +/- 0.3 weeks of life was detected. The maximum stage reached was stage 1 in 28 (16.97%), stage 2 in 29 (17.58%), stage 3 in 19 (11.52%) and stage 4b in 2 (1.21%) babies. Plus disease was present in 17 (10.3%) babies. Babies with lower birth weights and lower gestation age at birth had a significantly higher (p = < 0.05) incidence of ROP. However, the difference in mean birth weight and gestation age at birth for various stages of ROP was not significant (p = > 0.05). Thus, we recommend screening for all babies weighing < or = 1700 gm.

Female↗
PubMed1994

Preterm breech delivery in a developing country.

OBJECTIVES: To determine if cesarean section offers any advantage over vaginal delivery for a preterm breech fetus in a developing country. METHODS: A retrospective analysis from hospital records was done at a tertiary care center in North India. Two hundred and twenty-four preterm breech deliveries (28-36 completed weeks) between January 1988 and December 1991 from a total of 13,149 deliveries at the hospital during this period formed the study group. Fetal death and lethal congenital malformations diagnosed antepartum were excluded. Intrapartum and neonatal morbidity and mortality in vaginal versus cesarean deliveries were the main outcome measures. RESULTS: Although the combined intrapartum and neonatal mortality was significantly higher for vaginal delivery (35.9% vs. 17.7%), there was no significant difference when the data was correlated with birthweight or gestational age. The neonatal morbidity was also similar in both these groups. In women with a poor obstetric history, the neonatal survival was better in the cesarean group (93% vs. 43%; P = 0.0004). CONCLUSION: Even with optimum neonatal care facilities, cesarean section does not offer any advantage over vaginal delivery for a preterm breech fetus in a developing country. The present study does not advocate the routine use of cesarean section for this group of fetuses. However, it is the preferred route of delivery for women with a poor obstetric history.

Adult↗
PubMed1994

Predictive perinatal score in the diagnosis of neonatal sepsis.

A scoring system for prediction of neonatal sepsis was evolved after determining the interdependence of perinatal risk factors for infection. Records of 100 babies with a history of one or more perinatal risk factors were analysed for incidence of infection within 4 hours of birth and followed for 1 week thereafter for appearance of any clinical or laboratory signs of infection. The incidence of sepsis was compared amongst various risk factors. Since majority of perinatal risk factors occur in combinations interdependence of factors was determined using actuarial analysis and score assignment was done whether the factor was dependent or independent. No definite infection was seen in the control group of 100 babies having no history of high risk factors. The scoring system thus elucidated is recommended as a screening procedure for selecting of neonates for laboratory evaluation.

Actuarial Analysis↗