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Biomedical subjects

H P Sachdev

Publications and source records attributed to H P Sachdev.

At least 55 records · Page 3Linked to original sources
PubMed1991

Does breastfeeding influence mortality in children hospitalized with diarrhoea?

The association between breastfeeding and mortality in children hospitalized for diarrhoea was investigated in a prospective manner in 309 subjects below 18 months of age. In multivariate logistic regression analysis, 36 cases who died were compared with 273 controls who were discharged in a satisfactory condition. Breastfeeding had a strong protective effect against mortality even after allowance was made for confounding variables (including nutritional status, chronicity of illness, associated non-enteral infections) and a possible bias of interruption of breastfeeding as an early consequence of the terminal illness. The adjusted odd's ratio (OR) and 95 per cent confidence intervals (95 per cent CI) for the protective effect were 2.7 and 2.1-3.6, respectively. The adjusted OR's (95 per cent CI's) were 6.0 (3.6-10.2), 2.6 (2.0-3.4), and 1.8 (1.4-2.5) for the age intervals 0-6, 7-12, and 13-18 months, respectively (P less than 0.001, less than 0.01, and less than 0.05, respectively). Further stratified analyses suggested a greater benefit in children with severe wasting, severe stunting, protracted illness, and diarrhoea as the sole illness. It is concluded that in children up to 18 months of age, breastfeeding offers substantial protection against death in children hospitalized with diarrhoea.

Breast Feeding↗
PubMed1991

Risk factors for fatal diarrhea in hospitalized children in India.

There is scant information on the risk factors for diarrheal deaths in developing countries. A prospective evaluation was therefore conducted on 382 consecutive children (less than 5 years of age), who were hospitalized with diarrhea. A complete profile, including outcome, was available for 357 patients, 37 of whom died (10.4%). In the univariate analysis, four factors were significantly associated (p less than 0.02) with death: associated major infection (pneumonia, septicemia, or meningitis), severe wasting (less than or equal to 50% weight for age), severe stunting (less than or equal to 85% height for age), and protraction of illness (greater than 14 days). In the multivariate analysis, all four factors retained their significance. The adjusted odds ratios (95% confidence interval) were 4.7 (3.9, 5.6), 3.3 (2.7, 4.0), 1.9 (1.6, 2.3), and 1.5 (1.3, 1.8), respectively. In addition, in children less than 19 months of age (n = 241; 29 deaths) breast-feeding had a significant (p less than 0.001) protective effect (adjusted OR--2.3, 95% CI-1.9-2.8). It is concluded that even in a setting with high diarrheal fatality rates, high-risk children can be identified and targeted for intensive intervention.

Body Height↗
PubMed1990

Oral zinc supplementation in persistent diarrhoea in infants.

A controlled randomized trial was conducted in 40 infants (6-18 months old) with persistent diarrhoea (greater than 2 weeks' duration) to evaluate the effect of oral zinc supplementation. After completion of rehydration, 20 infants in group A received oral zinc sulphate (20 mg elemental zinc twice daily) and an equal number in group B were given a placebo (glucose). Each child was given oral nalidixic acid and a similar milk-free feeding schedule. Both the groups were comparable with respect to various initial characteristics including nutrition, diarrhoeal disease, serum alkaline phosphatase and serum and rectal mucosal zinc content. During therapy, all the assessed parameters of zinc status (serum alkaline phosphatase and serum and rectal zinc) recorded significant elevation and reduction in groups A and B, respectively. At recovery, the zinc status of group A was significantly higher than that of group B. The diarrhoeal duration and frequency in the zinc-supplemented group were lower but the differences were not statistically significant (p = 0.078 and p = 0.076, respectively). Weight gain in both groups was comparable. It is concluded that in persistent diarrhoea there is depletion of zinc with the progression of disease and oral zinc administration can improve the zinc status. The possible anti-diarrhoeal effect of zinc, however, merits further study.

Administration, Oral↗
PubMed1990

Serum and rectal mucosal magnesium status in acute and chronic diarrhoea.

Serum and rectal mucosal magnesium content was estimated in children (6-18 months old) with acute diarrhoea (Group I: n = 50), chronic diarrhoea (Group II: n = 25), extra-intestinal infections (Group III: n = 15) and healthy controls (Group IV: n = 20). The sex and nutritional status of the different groups were comparable. The mean serum magnesium levels in acute and chronic diarrhoea were comparable to healthy and infected controls. The tissue magnesium content of infants with chronic diarrhoea was significantly (P less than 0.001) lower than other groups. Repeat estimation at discharge in 38 patients (25 in Group I, 13 in Group II) revealed a significant reduction in serum levels in both groups (P less than 0.05 and P less than 0.01, respectively) and in tissue levels in acute diarrhoea (P less than 0.05). A total of 23 infants (16 in Group I) were evaluated 2-3 weeks after discharge. There was an increase in tissue magnesium content at recovery in acute (P less than 0.02) and chronic (P greater than 0.05) diarrhoea groups. It is concluded that infants with chronic, but not acute diarrhoea, are magnesium depleted at presentation; with the continuation of diarrhoea there is a progressive depletion of magnesium; and there is a tendency to regain the magnesium status during the convalescent period.

Acute Disease↗
PubMed1990

Serum and rectal mucosal zinc levels in acute and chronic diarrhea.

Serum and rectal mucosal zinc content was estimated in children (6-18 months old) with acute diarrhea (Group I: n = 50), chronic diarrhea (Group II: n = 25), extraintestinal infections (Group III: n = 15) and apparently healthy controls (Group IV: n = 20). The sex and nutritional status of various groups was comparable. The mean serum and tissue zinc levels in acute (p less than 0.001) and chronic (p less than 0.05 for serum; p less than 0.001 for tissue) diarrhea groups were significantly lower than healthy and infected controls. Group II had significantly lower (p less than 0.001) serum and rectal zinc content in comparison to Group I. There was a significant negative correlation between serum zinc and diarrheal duration (r = 0.5676; p less than 0.001). Repeat estimation at discharge in 38 patients (25 in Group I, 13 in Group II) revealed a significant reduction in both tissue and serum zinc and only tissue zinc in acute and chronic diarrhea, respectively. A total of 23 patients (16 in Group I, and 7 in Group II) were evaluated 2 weeks after discharge. After discharge, at recovery there was no alteration in serum zinc, but tissue zinc was marginally higher (p greater than 0.05). It is concluded that zinc depletion occurs in diarrhea, more so in the chronic state; with the continuation of diarrhea, depletion progresses; and there is a tendency for repletion during convalescence.

Acute Disease↗
PubMed1989

Serum and rectal mucosal copper status in acute and chronic diarrhea.

Serum and rectal mucosal copper content was estimated in children (6-18 months old) with acute diarrhea (group I: n = 50), chronic diarrhea (group II: n = 25), extraintestinal infections (group III: n = 15), and apparently healthy controls (group IV: n = 20). The sex and nutritional status of various groups was comparable. The mean serum copper levels in acute diarrhea and infected control groups were comparable, but significantly (p less than 0.001) greater in comparison to chronic diarrhea and healthy control groups. The tissue copper in group II was significantly (p less than 0.001) lower than other groups, which were comparable. There was a significant negative correlation between serum copper and diarrheal duration (r = -0.615; p less than 0.001). Repeat estimation at discharge in 38 patients (25 in group I and 13 in group II) revealed a significant (p less than 0.05) reduction in the serum and tissue copper content during this period. Among the 23 infants (16 in group I and 7 in group II) evaluated 2-3 weeks after discharge, there was an increase in copper values of tissue alone (p less than 0.05) in group I and both serum and tissue (p less than 0.05) in group II. It is concluded that elevation of serum copper in acute diarrhea is a nonspecific response to infection; infants with chronic but not acute diarrhea are copper depleted at presentation; and with the continuation of diarrhea, there is a progressive depletion of copper.

Acute Disease↗
PubMed1989

Electrophysiological studies of the eye, peripheral nerves and muscles in epidemic dropsy.

The involvement of the neurological system in epidemic dropsy is controversial. During two outbreaks of epidemic dropsy, detailed neurological and ocular examinations and electrophysiological studies of peripheral nerves and muscles (motor nerve conduction velocities, sensory nerve latencies and electromyography) and eye (electroretinogram and visually evoked cortical responses) were therefore undertaken. Amongst the 239 subjects examined, burning sensation and tingling paraesthesias of feet were reported by 42.3 and 35.6%, respectively; but none had any objective evidence of central or peripheral nervous system involvement. Electrophysiological studies of peripheral nerves and muscles (10 cases with subjective manifestations) and eyes (24 eyes of 12 patients hospitalized for control of glaucoma) were essentially normal. It is concluded that Argemone mexicana or its toxins do not have any significant effect on the nervous system.

Adolescent↗
PubMed1989

Sonographic evaluation of gall bladder in acute viral hepatitis.

Twenty children of acute viral hepatitis were subjected to ultrasound of gall bladder in acute and recovery phase. Increased wall thickness, reduced volume and abnormal echo-texture of gall bladder contents were the findings in the acute phase. A normal ultrasound of gall bladder was restored in most of the patients within 2-4 weeks.

Child↗
PubMed1989

Domperidone.

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Child↗
PubMed1988

Nalidixic acid.

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Female↗