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Biomedical subjects

N Thilothammal

Publications and source records attributed to N Thilothammal.

14 recordsLinked to original sources
PubMed2002

Dengue fever epidemic in Chennai--a study of clinical profile and outcome.

Children with dengue fever presenting to the Institute of Social Pediatrics, Government Stanley Hospital, during the months of October to December 2001, were prospectively followed up for clinical profile and outcome. Commonest clinical features were fever, vomiting, bleeding, body pain and hepatomegaly. Elevated liver enzymes and low platelet counts were common laboratory findings in dengue. Hepatomegaly, positive tourniquet test, elevated haematocrit and thrombocytopenia were more common in DHF and DSS group. Retro-orbital pain was slightly more in DHF and DSS groups and there was a tendency for DSS to present at an earlier age. There was no correlation between platelet counts and bleeding in classical dengue cases.

Child↗
PubMed1996

Does BCG vaccine prevent tuberculous meningitis?

The reported efficacy of BCG vaccine in preventing pulmonary tuberculosis varies from 0-80%; however, its efficacy in preventing tuberculous meningitis ranges from 52%-84%. A case-control study was conducted to assess the efficacy of BCG in preventing tuberculous meningitis in children. New cases of tuberculous meningitis, confirmed bacteriologically, were registered as cases. Controls were children suffering from febrile convulsions attending the same hospital. A total of 107 cases and 321 controls, block matched for age, were registered. Vaccination status was determined from the history reported by the mother and by BCG scar reading. Data regarding socioeconomic status, crowding, and nutritional status were collected. Using multiple logistic regression analysis the odds ratio obtained for the presence of BCG scar was 0.23 (95% confidence interval (CI) 0.14 to 0.37) and the protective efficacy of BCG vaccine in preventing tuberculous meningitis in children was found to be 77% (95% CI 71 to 83%).

Age Factors↗
PubMed1996

Isolation of Mycobacterium tuberculosis from cerebrospinal fluid by the centrifugation & filtration methods.

Cerebrospinal fluid (CSF) samples were collected in 2 bottles each, from 112 children, examined clinically for tuberculous meningitis (TBM) One was processed by the centrifugation method and the other by the filtration method for the isolation of M. tuberculosis. Of these specimens, 11 and 13 yielded M. tuberculosis by the centrifugation method and the filtration method, respectively. In 7 specimens M. tuberculosis was isolated by both the methods; in 4, only by the centrifugation method, and in 6, only by the filtration method. Using both the methods, 17 (15.2%) of 112 specimens were culture positive for M. tuberculosis. The improvement in the rate of isolation, thus obtained, assumes importance as the confirmation of the diagnosis of TBM in all the clinically suspected cases is always desired. Moreover, the filtration method is simple and inexpensive and it can be carried out even in remote hospitals and the membranes, after filtration, can be transported to central mycobacteriology laboratory for culture of tubercle bacilli.

Bacteriological Techniques↗
PubMed1996

Comparison of phenobarbitone, phenytoin with sodium valproate: randomized, double-blind study.

OBJECTIVE: To compare the efficacy and side effects of phenobarbitone (PB), phenytoin (PHT) and sodium valproate (SVP) in controlling generalized tonic-clonic convulsions (GTC). DESIGN: Randomized, double blind clinical trial. SETTING: Out-Patients in a tertiary care hospital. PATIENTS: 151 children with GTC, aged 4-12 yrs, from Madras city were enrolled. At the end of 2 yrs, 127 children remained in the study. INTERVENTION: Each child was given one active drug and 2 placebo tablets. Clinical, hematological and biochemical evaluations were done every month. Serum drug levels were assessed periodically. MAIN OUTCOME MEASURES: Recurrence of convulsion and side effects. RESULTS: The proportion of children with recurrence did not differ among the 3 groups. More than one side effect was observed in 16 (32%) children on PB, 20 (40%) children on PHT and 9 (19%) children on SVP and this difference was statistically significant (p < 0.05). Hyperactivity was the major side effect of PB, observed in 22% of children. CONCLUSION: All 3 drugs were equally effective in controlling seizures. Side effects were minimal with SVP followed by PB. Though side effects were more frequent with PHT, most of them disappeared on adjusting drug dosage. Least expensive phenobarbitone may be preferred as the first drug of choice but, only for pre-school children. SVP is advised for school going children.

Child↗
PubMed1995

Testing compliance of drug taking--a simple bed side method.

Assessment of compliance in drug taking is a problem in a crowded Outpatient Department. Using riboflavin as a urinary marker is a simple and rational method. Identifying riboflavin in the urine by fluorescence on exposure to ultraviolet (UV) rays or torch light is being used in medical practice but not extensively. In this study, the validity and reliability of these methods were assessed. The sensitivity and specificity of this test by UV method was 86% and 82% for Reader I (medical person) and 82% and 94% for Reader II (paramedical person). For Reader I, the accuracy of reading by UV lamp was the same as torch light (85%) whereas for Reader II the accuracy was better with UV lamp (87%) than with torch (79%). In reading the fluorescence by UV lamp the crude agreement between the 2 readers was 82% and chance corrected agreement was 64%. UV lamp method appears to be a reliable way of assessing compliance both by medical and paramedical persons whereas torch method appears to be more reliable when used by a medical person than by a paramedical person.

Biomarkers↗
PubMed1995

Tuberculous meningitis in children--clinical profile, mortality and morbidity of bacteriologically confirmed cases.

One hundred and seven cases of tuberculous meningitis were registered as a part of a case-control study during the period 1990-1992. The CSF of all cases was positive for culture and/or smear for acid fast bacilli. Children were examined at the time of admission and at the time of discharge and they were contacted at the end of 1 year. Clinical picture, mortality and morbidity were analyzed. Mortality of children during the first month of illness was 22%. Some of the cases presented as acute neurological illness. We also came across CSF picture with minimal cytological and biochemical changes but with positive culture results.

Age Factors↗
PubMed1994

Migraine in children.

A descriptive study was carried out to find out the clinical profile, and electroencephalographic (EEG) changes in children with migraine. Screening for urinary excretion of 5-hydroxy indole acetic acid (5-HIAA) was carried out. Fifty children suffering from migraine as per Prensky's criteria were recruited over a period of 1 year. Forty six children were suffering from common migraine and 4 had classic migraine. The most common precipitating factors were physical strain and psychological stress like examination fear, fear of teacher and fights with friends. Abnormal EEG recordings were seen in 35 out of 50 patients. Urine samples taken during the headache free period were negative for 5 HIAA. Among the samples taken during the episode of headache, only 1 was positive for 5-HIAA. It is concluded that common migraine is more prevalent than classic migraine. Clinical criteria is the only way of diagnosing migraine. Since EEG changes are non-specific, this cannot be used as a diagnostic test. Biochemical analysis is expensive and less sensitive.

Child↗
PubMed1993

Role of phenobarbitone in preventing recurrence of febrile convulsions.

A randomized double blind placebo controlled trial was carried out to study the effect of phenobarbitone (PB) in preventing recurrences of simple and atypical febrile convulsions among children in the age group 6 months to 6 years. Children with simple febrile convulsions were randomly allocated to receive either phenobarbitone or placebo. Children with atypical convulsions were treated with phenobarbitone, as a third group. Thirty children were admitted in each group. All the children were followed up for a period of twelve months. Recurrence of convulsions and side effects of PB were recorded. Recurrence occurred in only 7% (95% confidence interval: 1-22) of children on Phenobarbitone, suffering from either simple or atypical febrile convulsions, compared to 53% (95% confidence interval: 34-72) of children on placebo, suffering from simple febrile convulsions. With Phenobarbitone, 5% of children had intolerable side effects. These results suggest that long term prophylaxis with phenobarbitone, even in simple febrile convulsions will be useful.

Child↗
PubMed1993

Suicide pacts.

Suicide pacts in an Indian population were studied through police records of the state of Tamul Nadu. A total of 148 suicide pacts, involving 324 persons, were identified. More women died in them than might be expected from general population figures. Social stressors like financial problems and marriage-related issues were the principal causes. The results and their implications are discussed and compared with those obtained in Western and other Eastern countries.

Adolescent↗
PubMedDate not supplied

Influence of maternal nutritional status on mode of delivery and asphyxia neonatorum.

To assess the influence of maternal malnutrition on the mode of delivery and asphyxia neonatorum, a cross sectional survey of 615 women in the age group of 20-28 yrs at the time of delivery was done. Women with chronic ailments and complicated pregnancies were excluded. The mothers were then classified into three groups based on Weight Height Product Index (WHPI) namely well nourished (WN), moderately malnourished (MMN) and severely malnourished (SMN). The proportion of asphyxiated babies among the three groups did not differ (P greater than 0.05). Abnormal deliveries like caesarean section were more common among SMN group compared to WN group ((P less than 0.01). No such difference was made out between MMN and WN groups (P greater than 0.05).

Asphyxia Neonatorum↗
PubMedDate not supplied

Risk factors for recurrence of febrile convulsions.

A cohort of hundred children with febrile convulsions, in the age group of 3 months to 5 years were followed up prospectively for one year to study the natural course of the illness, and to determine if specific factors would increase the risk of recurrence of febrile convulsions. The risk factors studied were age of onset under one year, long duration of convulsion (more than 15 minutes), family history of febrile convulsion or epilepsy and combination of two or all of the above factors. Four groups of children with different risk factors were followed up for recurrence of convulsion, after the first attack. A group of children without any risk factor was considered as control and they were also followed up for recurrence of convulsions. Though all the groups with the risk factors, showed a trend towards a higher recurrence rate when compared to controls, the difference observed clinically was not significant statistically. This could be due to the small sample size of each group. A larger study could throw light on the predictive value of these risk factors and narrow down the use of long term anticonvulsant prophylaxis.

Age Factors↗