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Biomedical subjects

Shishir Kumar Bhatnagar

Publications and source records attributed to Shishir Kumar Bhatnagar.

5 recordsLinked to original sources
PubMed2005

Pancytopenia in children: etiological profile.

Pancytopenia is a common occurrence in pediatric patients. Though acute leukemias and bone marrow failure syndromes are usual causes of pancytopenia, etiologies such as infections and megaloblastic anemia also contribute. The aim of this study was to evaluate the clinico-hematological profile of varying degrees of childhood cytopenias with special reference to the non-malignant presentations. This is a retrospective study carried out in a tertiary care children's hospital. We retrospectively analyzed 109 pediatric patients who presented with pancytopenia for different etiologies. Acute leukemia (including ALL, AML and myelodysplastic syndrome) and aplastic anemia accounted for 21 per cent and 20 per cent cases respectively. Megaloblastic anemia was found in 31 (28.4 per cent) patients and was single most common etiological factor. Severe thrombocytopenia (platelet < or = 20 x 10(9)/l) occurred in 25.2 per cent of these patients. Various skin and mucosal bleeding occurred in 45.1 per cent of patients with megaloblastic anemia. Infections accounted for 23 (21 per cent) patients who presented with pancytopenia. Amongst infections, enteric fever occurred in 30 per cent patients. Malaria, kala-azar and bacterial infections were other causes of pancytopenia at presentation. The study focuses on identifying easily treatable causes such as megaloblastic anemia and infections presenting with pancytopenia. These conditions though look ominous but respond rapidly to effective therapy.

Acute Disease↗
PubMed2002

Antipyretics in children.

Fever is an important symptom of underlying disease condition and in general is considered harmful in pediatric age group as it may lead to febrile seizures, stupor, dehydration increase work of breathing, discomfort and tachycardia. The increase metabolic demands stress the patient with marginal cardiac and cerebral vascular supply. The hypothalamus controls the body temperature. The fever results due to resetting of the hypothalamus that occur from the prostaglandins produced by the pyrogens. Fever is treated variedly by the pediatricians. The physical therapy offers a simple and cost effective way of lowering the body temperature. The drugs as paracetamol, nimesulide and ibuprofen lower the temperature by inhibiting the prostaglandin synthesis. Paracetamol is considered the safest of all the antipyretic drugs. It is recommended that a combination of physical therapy such as tepid sponging and paracetamol is best way of controlling temperature.

Acetaminophen↗
PubMed2002

Ocular scrofuloderma with unilateral proptosis.

Proptosis due to an extraconal orbital abscess of tubercular origin with lacrimal gland involvement, representing ocular scrofuloderma, is a rare entity. This association has not been reported earlier in the literature. We describe a 7-year-old boy who presented with nodulo-ulcerative lesions of tubercular etiology with discharging sinuses on right side of the face and a similar lesion on the right lower eyelid along with proptosis of 4 months duration. Computerized tomography (CT) scan of the head confirmed the extraconal, intraorbital, hyperdense, homogeneously enhancing mass separated from the lateral rectus muscle and further revealed involvement of lacrimal gland along with erosion of the temporal bone. The patient showed marked improvement of his dermatological and ophthalmological lesions with anti-tubercular treatment. Subsequent ultrasound examinations of the orbit revealed regression in the size of the abscess from 10.7 mm to 5.0 mm and then complete disappearance of the abscess obviating surgical intervention.

Abscess↗