Biomedical subjects
Publications and source records attributed to Prakash Manikoth.
A permanent bipolar cardiac pacemaker was inserted in the abdomen of a child with Down's syndrome, due to complete heart block following repair of atrioventricular septal defect. This report describes an unusual and unreported complication of the pacemaker getting extruded through the rectum without dysfunction. Implications for early diagnosis and appropriate management and steps to prevent such episodes in future are discussed.
Meconium peritonitis is a sterile chemical peritonitis caused by peritoneal seeding of meconium from an antenatal gastrointestinal perforation. We report a 32-week preterm female neonate who developed meconium peritonitis due to bowel perforation, secondary to a twisted left fallopian tube mass, which was excised and confirmed by histopathology. This association has not been reported earlier. The infant also developed transient central diabetes insipidus, a very rare condition in a preterm neonate.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
OBJECTIVE: Nasal intermittent positive pressure ventilation (NIPPV) has widely been used in neonates to prevent extubation failure and apnea. This pilot study was carried out to look at the early use of NIPPV to avoid intubation. METHODS: The study was carried out over a period of 3 months from August 2003 to October 2003 at the Royal Hospital, Muscat, Sultanate of Oman. The neonates with clinical signs of moderate to severe respiratory distress were given a trial of early NIPPV based on the avoid-intubation protocol. Inclusion, exclusion and failure criteria with general procedure were made clear to all medical and nursing staff and the protocol was posted in the unit for further time to time referral. RESULTS: A total of 16 neonates met the inclusion criteria for early NIPPV trial. Out of these, 13 (81%) had a successful NIPPV. The mean age of entry was 0.95 hours; however, the mean duration of NIPPV was 23 hours. No NIPPV related complications were noted in the study group. CONCLUSION: We concluded that NIPPV is an appropriate mode of ventilation in neonates requiring respiratory support. The major advantage of NIPPV is the non-invasive mechanics. It is also less expensive and less labor intensive. Further randomized controlled trials with larger sample size are warranted to confirm our findings.
Coarctation of aorta is the most common cardiovascular cause of secondary hypertension. The condition is correctable although early diagnosis is often not made. We report the case of a 9-year-old child who was admitted with severe intractable abdominal pain as the presenting symptom of post-subclavian coarctation of aorta with hypertension. His pain resolved after control of hypertension with parenteral antihypertensives and the narcotic analgesics. He subsequently underwent transcatheter balloon dilation of the coarctation of aorta and remains well with normal blood pressure on follow-up.