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Biomedical subjects

P P Maiya

Publications and source records attributed to P P Maiya.

At least 19 recordsLinked to original sources
PubMed2005

Spontaneous spinal epidural hematoma in a toddler--a case report.

OBJECTS: Spontaneous spinal epidural hematoma (SSEDH) is rare in children below the age of 2 years. It can produce rapidly progressive neurological deficits. METHODS: The authors report a case of SSEDH in a 15-month-old boy diagnosed by MRI. Suspension laminotomy and evacuation of the clot were done 48 h after the onset of symptoms. The patient made excellent neurological recovery. Computed tomography (CT) and MRI scanning carried out 6 months after surgery revealed good fusion of the laminotomy. A brief review of relevant literature is presented. CONCLUSION: Although rare SSEDH requires immediate surgical decompression to avoid any permanent neurological deficit. Reconstructive surgical procedures like laminotomy are preferred in children where the incidence of spinal deformity is high following laminectomy.

Hematoma, Epidural, Spinal↗
PubMed2004

Possible role of neonatal infection with the asymptomatic reassortant rotavirus (RV) strain I321 in the decrease in hospital admissions for RV diarrhea, Bangalore, India, 1988-1999.

We sought to determine the proportion of rotavirus (RV) infections among children with severe diarrhea in Bangalore, India, and to determine the role of neonatal infection with the asymptomatic RV strain I321 in protection against subsequent RV diarrhea. At 2 major hospitals, there was a >42% decrease in diarrhea-specific admissions during the study period. At 6 hospitals, asymptomatic infections were found in 25%-50% of neonates, when screening was performed randomly, and in >58% of neonates, when screening was performed daily, with the majority of infections occurring within the first 7 days of life. All the RVs found in asymptomatic neonates were strain I321. A 24-month follow-up of a cohort of 44 children who had been neonatally infected with strain I321 and 28 children who had not (control group) revealed comparable rates of RV detection but a marked decrease in the number of RV diarrhea episodes in the strain I321-infected group (2.3%), compared with the control group (39.3%) (P<.0001). This preliminary study suggests a possible association between neonatal infection with strain I321 and protection against subsequent RV illness.

Age Factors↗
PubMed2004

Appendicitis with perforartion in a neonate.

Appendicitis is a very rare clinical entity in neonates. Preterm and male neonates are commonly affected. It is often seen in association with surgical conditions like Hirschsprung's disease and necrotizing enterocolitis. Non-specific clinical features result in delay in the diagnosis and predisposes to perforation. The risk of perforation is very high (85%) in neonatal appendicitis. Management includes pre-operative stabilization, appendicectomy and peritoneal drainage in cases of perforation with peritonitis. Prognosis is uniformly poor with mortality rate as high as 70%. Herewith reporting a neonate with multiple perforations who was successfully managed.

Appendectomy↗
PubMed2003

Accidental dextropropoxyphene poisoning.

Dextropropoxyphene poisoning is an uncommon accidental poisoning in children. Presentation is similar to narcotic over dosage or poisoning. Convulsions, conduction disturbances, arrhythmias and hypoglycemia are common. Naloxone is the antidote. As it is uncommon and not documented in children in Indian literature we are reporting this case.

Accidents, Home↗
PubMed2001

Role of score for neonatal acute physiology (SNAP) in predicting neonatal mortality.

OBJECTIVES: To assess the validity of SNAP in predicting the outcome in terms of mortality and duration of hospital stay. The study was also undertaken to evolve the best cut-off SNAP scores for predicting mortality in different individual neonatal conditions. METHODS: 295 consecutive newborn admitted to NICU during an eleven month period were evaluated with the investigations required as per the specifications of SNAP. Neonates who succumbed within 24 hours of admission and those who were shifted to the NICU for observation purposes were excluded. RESULTS: In general, SNAP correlated well with mortality; the sensitivity and specificity of SNAP score > 15 in predicting mortality were 63% and 95% respectively. The positive and negative predictive values were 72% and 92.5% respectively. Very low birth weight babies and ventilated preterm neonates had higher mortality and the best cut-off SNAP score for predicting mortality in these groups was 10. In all the other groups, SNAP score > 15 correlated well with higher mortality. By using multiple regression analysis on three variables including birth weight, gestational age and SNAP, SNAP was found to show the best correlation with mortality. On correlating SNAP with duration of hospital stay, 76.8% of the surviving neonates with SNAP < 16 stayed for < 15 days, whereas the rest stayed longer despite low SNAP. All the 9 babies with SNAP > 15 who survived stayed for > 15 days. CONCLUSIONS: SNAP is a measure of illness severity and correlates well with neonatal mortality. SNAP may assist the clinician in explaining the probable outcome and therapeutic intervention needed and the cost of treatment to the parents. SNAP scores > 10 in VLBW babies and > 15 in others are associated with higher mortality.

Female↗
PubMed1999

Multicenter randomized placebo controlled trial of therapy with intravenous immunoglobulin in decreasing mortality due to neonatal sepsis.

OBJECTIVE: To determine whether therapy with intravenous immunoglobulin G (IVIG) would decrease mortality in neonatal sepsis. SETTING: Three tertiary care neonatal intensive care units in the city of Bangalore. METHODS: All neonates admitted to the Neonatal Intensive Care Units with the clinical diagnosis of sepsis and having at least C-reactive protein and one other rapid diagnostic criteria positive were enrolled. Neonates with a birth weight of less than 1000 g and those with any major congenital malformation were excluded. The neonates were randomized to receive 1 g/kg of IVIG on three consecutive days or an equivalent amount of placebo. The rest of the treatment including antibiotics and supportive care was as per the treating physician's decision. The main outcome variable was survival. RESULTS: The trial was carried out over a period of 8 months and recruited 58 neonates. Seven neonates who qualified but did not receive either IVIG or placebo were taken into a separate control group, and one baby who received only one dose of IVIG was excluded from the analysis. Twenty-five neonates were enrolled into the IVIG arm and 25 in the placebo arm. The neonates in the therapy and placebo groups were comparable in terms of birth weight (2144+/-675 g vs. 2072+/-682 g), gestation (37.0+/-3.56 vs. 35.8+/-3.52 weeks), sex distribution, duration of stay, and number requiring ventilation. The placebo group had a significantly higher number of babies with positive blood culture. Seven babies in each group died (p>0.05). There was no significant benefit in using IVIG (OR 1.0; 95% CI 0.25-4.07) (p = 0.74). CONCLUSION: In the sample studied therapy with IVIG did not reduce mortality in neonatal sepsis

Female↗
PubMed1996

Epidemiology of symptomatic human rotaviruses in Bangalore and Mysore, India, from 1988 to 1994 as determined by electropherotype, subgroup and serotype analysis.

Epidemiology of symptomatic rotaviruses from Bangalore and Mysore in Southern India was investigated. While serotype G3 predominated throughout the 7-year study period from 1988 to 1994 in Bangalore, serotype G1 was more predominant than serotype G3 in Mysore during 1993 and 1994. Serotype G2 strains were either not detected or infrequently observed in both the cities. However, several strains with subgroup I and 'short' RNA pattern that exhibited high reactivity with typing MAbs specific for serotype 2 as well as other serotypes were detected throughout the period. Among the nonserotypeable strains from both cities, several exhibited dual subgroup (SGI + II) or subgroup I specificity and 'long' RNA pattern indicating their probable animal origin. Notably, a gradual, yet highly significant reduction in rotavirus gastroenteritis, from 45.3% in 1988 to 1.8% during 1994, was observed in Bangalore in stark contrast to the consistently high (about 34%) incidence of asymptomatic infections among neonates by I321-like G10P11 type strains during the same period. Moreover, I321-like asymptomatic strains were not detected in children with diarrhea.

Antibodies, Monoclonal↗
PubMed1995

Mechanical ventilation of newborns: experience from a level II NICU.

OBJECTIVES: To analyse the indications, clinical profile, complications and outcome of the babies requiring mechanical ventilation. DESIGN: Retrospective study. SETTING: NICU of a teaching hospital. SUBJECTS: One hundred and twenty one neonates requiring assisted ventilation during three years. RESULTS: Of 121 babies 59(48.76%) survived. Hyaline membrane disease (HMD) was the commonest indication for ventilation followed by birth asphyxia, apnea of prematurity, meconium aspiration syndrome (MAS) and septicemia. Infants with HMD whose birth weight was more than 1.5 kg and those who required ventilation after 24 hours of birth had better outcome. Survival rates increased with increasing birth weight and gestational age. Prolonged ventilatory support was needed for HMD (mean 117.3 hr) and MAS (mean 82.6 hr). Pneumonia was the commonest complication, followed by sepsis, air leak syndromes and intracranial and pulmonary hemorrhage. CONCLUSIONS: Ventilatory facilities must be focussed for neonates weighing > 1000 g. Assisted ventilation may not be cost-effective in patients weighing < or = 1000 g and those with complex heart diseases and other congenital anomalies.

Cost-Benefit Analysis↗
PubMed1992

Exclusive asymptomatic neonatal infections by human rotavirus strains having subgroup I specificity and "long" RNA electropherotype.

A large number of stool specimens, of healthy newborn infants, collected from various hospitals and clinics in Bangalore City, India, have been examined for the presence of asymptomatic rotaviral excretion. Out of 370 samples analysed during a three year period from 1988 to 1991, 133 specimens (36%) were positive for rotavirus RNA. All these asymptomatic neonatal strains, without exception, showed "long" RNA pattern, but subgroup I specificity. Serotype analysis by ELISA or by hybridization with serotype-specific probes indicated that these strains probably represent a new serotype in newborn children. We find an exclusive association of human rotaviruses having "long" RNA pattern and subgroup I specificity with asymptomatic neonatal infections in contrast to the earlier observations of association of such unusual strains with acute gastroenteritis in young children.

Antigens, Viral↗
PubMed1985

Transitional diarrhoea in newborn infants.

A self-limited acute fluid diarrhoea was seen in 80 of 3550 (2.2%) live-born infants not kept in a nursery in this hospital. Rotavirus and enteropathogenic serotypes of E. coli were detected with equal frequency with and without diarrhoea. It is suggested that this self-limited episode of diarrhoea occurring soon after birth is not necessarily due to rotavirus infection but could also be due to failure of adaptation to enteral feeding and microbial colonization during this transitional period.

Breast Feeding↗