Biomedical subjects
Publications and source records attributed to A P Dubey.
Peripheral gangrene as a manifestation of tuberculosis is very uncommon. An 8 year old male child presented with non-healing ulcer over the sole of left foot, left inguinal tubercular lymphadenopathy with scrofloderma, tubercular pleural effusion and gangrene of the right fore foot. The child improved on antitubercular treatment.
OBJECTIVE: To evaluate the short-term effect of frequency of complementary feeding on total ad libitum consumption in breast fed infants. METHODS: Twenty infants between 6 to 10 months of age were studied in a tertiary hospital in New Delhi for 48 hours. A traditional gruel made of rice and pulses (mean (SD) caloric density 54.22 (7.08) kcal/100 g) was offered in a randomized manner three (n = 10) or four (n = 10) times per day to the subjects over the first 24 hours with the subjects crossing over in the next 24 hours. They were allowed ad libitum breast feeding with no other food or fluid during the study period. Total caloric intake from breast milk and semisolids was computed for each day. RESULTS: There was no difference in the total caloric consumption with a semisolid feeding frequency of three or four times per day. The frequency of breast feeding and the breast feeding duration were also comparable (P > 0.05). However, breast milk intake was lower with a semisolid feeding frequency of 4 times/day (mean difference -61.2 g/d [95% confidence interval (CI) -122.2-0.32]; P = 0.051). The time required for feeding was higher (mean difference 14.75 min; P < 0.001), whereas the per meal intake of semisolids was lower with four semisolid feeds per day (mean difference -5.5 kcal/meal; [95% CI -10.19 to -0.81]; P = 0.024). CONCLUSION: In the short term, a change in semisolid feeding frequency from three to four times per day does not result in enhanced energy consumption because of lower breast milk intake.
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OBJECTIVES: To evaluate the short term effect of oil supplementation of complementary food on total ad libitum consumption in breastfed infants. METHODS: Twenty infants between 6 to 10 months of age were studied in a tertiary hospital in New Delhi for 48 hours. They were given three semi-solid complementary feeds per day and ad libitum breastfeeding. No other food or fluid was allowed during the study period. A traditional gruel made of rice and pulses with high energy density (oil added; caloric density = 35 kcal/100 g) or low energy density (without oil; caloric density = 20 kcal/100 g) was offered in a randomized manner on consecutive days to all infants. Total caloric intake from breast milk and semi-solids was computed for each day. RESULTS: Infants consumed an equivalent amount of semi-solid (mean difference, 10.75 g/day; 95% confidence interval, 10.56 to 32.06; P = 0.304) and a lower amount of breast milk (mean difference, 121.1 g/day; 95% confidence interval, 35.13 to 207.16; P = 0.008) when high energy density feeds were offered. Although the caloric intake from semi-solids increased significantly (18.9 kcal/day; 95% confidence interval, 12.9 to 24.8; P < 0.001) with the high density diet, the total caloric intake (breast milk and study feeds) decreased (mean difference = 59.6 kcal/day; 95% confidence interval, 5.95 to 113.34; P = 0.031). An inverse relationship was found between caloric density of semi-solids and breast milk intake (r = 0.34, r = 0.12, P = 0.032). CONCLUSION: In the short term, oil supplementation of complementary food in breastfed infants does not translate into enhanced total caloric intake, primarily as a result of breast milk displacement.
Hepatitis C virus is considered to be the main aetiological agent responsible for the occurrence of post-transfusion hepatitis. Patients with thalassaemia acquire hepatitis most often from viruses contracted through blood transfusions. The present study was undertaken to evaluate the prevalence of hepatitis C virus (HCV) in thalassaemic patients with multiple blood transfusions. The association of HCV seropositivity with number of blood transfusions and liver enzyme profile was also analysed. The study group consisted of fifty patients (40 males and 10 females) attending the thalassaemic unit of Lok Nayak Hospital, a tertiary care hospital at Delhi, within the age group of 1-25 years. Thirty patients (60%) were found to be seropositive for HCV antibodies while one patient (2%) was co-infected with HCV antibodies and hepatitis B surface antigen. Study of liver enzyme profile showed aspartate aminotransferase levels to be significantly higher, although the level of serum alanine aminotransferase, alkaline phosphatase, total protein, bilirubin and albumin were not significantly altered in these patients. It is inferred from this study that 60% of the thalassaemics were infected with HCV and this was directly related to the number of blood transfusions received by them. The regularised national blood policy followed by blood banks for providing safe blood along with better screening method of donated blood in blood banks would bring down the incidence of hepatitis C in such high risk group.
A case of idiopathic hypereosinophilic syndrome who had an unusual presentation in the form of pericardial effusion is being presented here. The child initially responded to corticosteroids but could not maintain normal eosinophil counts on tapering of steroids. Therefore he was put on hydroxyurea and low dose of steroids with regular monitoring of absolute eosinophil counts.
MMR is a live attenuated vaccine. Indian children show almost 90% seroconversion against measles and rubella and 90% against mumps. Several adverse effects have been reported. Epidemiological studies do not support a causative link between MMR and autism, IBD or GBS. There is an association between the Urabe strain of mumps vaccine and viral meningitis. Vaccine associated thrombocytopenia has been reported. Severe hypersensitivity reactions occur, mainly due to the gelatin component. Outbreaks of measles occur in areas of high measles vaccine coverage, when susceptible individuals accumulate. A second dose is given mainly to vaccinate those who missed the first dose or had primary vaccine failure, rather than to boost waning antibody levels. The possibility or eradication of mumps with a second dose of mumps vaccine is being considered.
Nutritional status of 44 children with newly diagnosed malignancy was evaluated by anthropometric, hematological and biochemical parameters before initiating therapy and response to therapy was assessed during follow up. Malnutrition was seen in 56.8% children by weight for age criteria (WFA <-2 z). Low hemoglobin was found in 82% children, 25% had low total proteins (<5.7 g/dL), 20.5% low serum albumin (<3.2 g/dL), 27.3% low serum transferrin (<210 mg/dL) and 16.3% low serum iron (<60 ug/dL). Mean anthropometric and biochemical parameters were higher among the survivors compared to non-survivors. Significant difference between the well nourished and the malnourished group was detected in the achievement of remission/response (69.5% vs 38.1%), delays in therapy (8. 7% vs 38.1%) and mortality (30.5% vs 61.9%). Complications like febrile neutropenia and bleeding were more in the malnourished group. A statistically significant higher incidence of infection was seen in children with serum iron<60 ug/dL than those with higher values of serum iron (42.8% vs 8%). Malnutrition is a major determining factor in treatment planning, complication rates, response to therapy and survival.
The objectives of the present report were to study the site of infections and pathogenic organisms during febrile episodes in different childhood malignant conditions, to correlate febrile episode with Absolute Neutrophil Count (ANC) and to know the sensitivity pattern of bacteria to different antibiotics so as to know the most appropriate antibiotic regimen in these children. The study material comprised of forty two febrile episodes occurring in children aged lt 12 years with various malignancies. All the episodes were worked up in detail including complete history, physical examination and relevant hematological, microbiological and radiological investigations. Out of the 42 episodes, 15 (36%) occurred in children with acute leukemias, 20 (48%) in children with lymphomas and 7(17%) in children with solid tumors. 26 (62%) episodes were seen in children during chemotherapy, while 12% each in freshly diagnosed and remission and 14% in relapse cases. 12 (28%) episodes occurred in children with ANC < 500/mm3. 36% were microbiologically confirmed. Klebsiella species was the commonest organism isolated followed by E. coli. Maximum sensitivity (75%) was seen with ciprofloxacin against both Klebsiella species and E.coli.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.