Biomedical subjects

Sunil Gomber

Publications and source records attributed to Sunil Gomber.

10 recordsLinked to original sources

PubMed2006

Physical growth patterns and dental caries in thalassemia.

This study was conducted to assess the effect of age, ferritin level, hemoglobin level and chelating agents on the physical growth in thalassemic children and to determine the prevalence of dental caries in thalassemic children. Weight, standing height, sitting height and subischial leg length were measured in 65 children attending the Thalassemia day care center at a tertiary hospital in Delhi. Their mean pre transfusion hemoglobin and ferritin levels over the previous two years were calculated. Dental caries indices, DMFT and DMFS were measured and compared with age matched controls. Weight, standing height, sitting height and subischial leg length expressed as percentage for age in children >or=10 y were significantly lower than those of children < 6 y, and those 6 to 10 y. Mean hemoglobin and ferritin did not affect growth significantly. Sitting height for age in children receiving Desferrioxamine alone or Desferrioxamine with Deferiprone was significantly lower than that of children receiving Deferiprone alone or no chelating agent. Dental caries were significantly higher in thalassemics.

Adolescent↗

PubMed2005

Cardiac syncope from occult transposition masquerading as convulsive epilepsy.

A four-year-old boy on Valproate therapy for a presumed diagnosis of epilepsy presented with a recurrence of tonic spasms. A history of precipitation of these episodes with exercise prompted a search for an underlying cardiac disorder. The child was ultimately diagnosed to have corrected transposition of great arteries with 2:1 atrioventricular block. This case illustrates that cardiac syncope due to underlying congenital heart disease can masquerade as epilepsy in children.

Anticonvulsants↗

PubMed2004

Tuberculous osteomyelitis of the mandible: a case report in a 4-year-old child.

The incidence of tuberculosis is increasing worldwide. The disease has a variable mode of presentation and therefore diagnosis is not easy. Although a rare occurrence, the differential diagnosis of tuberculous osteomyelitis must always lurk in the deepest recesses of the dental clinician's mind when routine therapy fails to bring about an improvement in lesions of the jaw. We present an unusual case of tuberculous osteomyelitis in a 4-year-old boy in whom pulmonary tuberculosis was detected only subsequently and emphasize the role of history taking, diagnostic techniques, and management.

Antitubercular Agents↗

PubMed2004

Comparative efficacy of desferrioxamine, deferiprone and in combination on iron chelation in thalassemic children.

OBJECTIVE: Ascertainment of an appropriate strategy of iron chelation for multi-transfused thalassemic children in developing countries. DESIGN: Prospective study from May 2000 to April 2001. SETTING: Urban tertiary care center. METHODS: Thirty thalassemic children having received more than 20 blood transfusions and a serum ferritin greater than 1500 ng/ml were enrolled and randomized into three groups. Group I received desferrioxamine (DFX) at a dose of 40 mg/kg subcutaneously, 5 days/week. Children in group II received oral deferiprone (L1) at a dose of 75 mg/kg/day daily and group III received a combination of daily L1 at a dose of 75 mg/kg/day and DFX at a dose of 40 mg/kg/day two times per week. The assessment of chelation was done by 24-hr urinary iron excretion (UIE) and measurement of serum ferritin levels at start and after 6 months of follow up. Statistical difference of serum ferritin levels between the three groups was assessed by applying analysis of variance. Analysis of covariance was applied to find out the urinary iron excretion keeping serum ferritin values same in each groups. RESULTS: Ferritin levels after 6 months of intervention were maximally decreased in group I. There was a significant difference between groups I and II however, no difference was noted between groups I and group III. There was no statistically significant difference in mean urinary iron excretion by keeping the initial serum ferritin levels equal though it was found to be more in group III as compared to other groups. CONCLUSIONS: DFX is the most effective chelating drug in iron overloaded multi-transfused thalassemic patients. In view of cost and unacceptability of daily DFX injections, combination therapy is an effective method of chelation thus increasing the compliance and cost effectiveness. Deferiprone (L1) alone is not an effective mode of chelation when used for a short period.

Blood Transfusion↗

PubMed2004

Immunogenicity of low dose intradermal hepatitis B vaccine and its comparison with standard dose intramuscular vaccination.

OBJECTIVE: A prospective study was carried out in the well baby and immunization clinics of tertiary care hospital to compare the immunogenicity of low dose hepatitis B vaccine (HBV) given intradermally versus standard dose given intramuscularly. METHODS: One hundred ninety six term, healthy, Australia antigen negative and exclusively breast fed babies were allocated into two groups in a simple randomized manner. In group I, hepatitis B vaccine was given in low dose (2 mcg) by intradermal route whereas in group II it was administered in standard dose (10 mcg) by intramuscular route. Diphtheria, pertussis, tetanus (DPT) and oral polio vaccine (OPV) were co-administered with HBV in both the groups at 6, 10 and 14 weeks of age at different sites. One hundred seventy seven infants could be regularly followed up and tested for anti-HBs titres by third generation ELISA test using mono-ELISA anti-HBs 3.0 kits. Geometric mean titres of anti-HBs were estimated in each group and compared. Student's t-test was used for statistical analysis. RESULTS: Seroprotective anti-HBs titres (titre greater than 10 mIU/mL) were achieved in 87 of 88 (98.8 percent) children having received intramuscular doses as compared to 82 of 89 (92.1 percent) children in the intradermal group. The geometric mean titres of the intradermal group were 92.71 mIU/mL (95 percent C.I. 68.85-124.85), significantly lower than 331.66 mIU/mL (95 percent C.I. 245.12-448.78), noticed in the intramuscular group. There were no significant adverse reactions in both the groups. Hepatitis B vaccine is immunogenic when co-administered with DPT and OPV vaccine. The intradermal hepatitis B administration is less effective with lower immunogenicity than the intramuscular vaccination.

Antibody Formation↗

PubMed2004

Homocystinuria: a rare cause of megaloblastic anemia.

We present an eight-year-old boy who initially presented to us with megaloblastic anemia and subsequently developed dislocation of lens. The child had a positive sodium nitroprusside test and homocystinuria. He was diagnosed to have homocystinuria type 1. His anemia improved on oral pyridoxine and folic acid therapy. Homocystinuria should be remembered as a cause of megaloblastic anemia.

Anemia, Megaloblastic↗

PubMed2004

Linezolid.

Linezolid is an oxazolidinone antibacterial agent that acts by inhibiting the initiation of bacterial protein synthesis. Linezolid has a wide spectrum of activity against gram-positive organisms including methicillin resistant staphylococci, penicillin resistant pneumococci and vancomycin resistant enterococcus faecalis and E. faecium. Linezolid has a good bio-availability orally and could be switched from parenteral to oral therapy while treating serious infections. Linezolid is well tolerated in children.

Acetamides↗

PubMed2003

Prevalence & etiology of nutritional anaemia among school children of urban slums.

BACKGROUND & OBJECTIVES: The prevalence of anaemia has been well studied particularly on etiology of nutritional anaemia in children of age group 5-10.9 yr in India. The present study was carried out to find out the prevalence and etiology of nutritional anaemia among 5 to 10.9 yr old corporation school children from urban slums. METHODS: Urban Delhi slums were divided into four areas and one corporation school from each area was randomly selected. A total of 406 children from 4 each school were randomly selected over a period of one yr and prevalence of anaemia was estimated. Another subset of 95 anaemic children admitted to the hospital during the same period were evaluated for the etiology of nutritional anaemia. RESULTS: Prevalence of anaemia as judged by WHO recommended cut-off values of haemoglobin among these children was 41.8 per cent. Pure or mixed iron deficiency anaemia was the commonest type of anaemia noted in 68.42 per cent (65 of 95) children followed by pure or mixed B12 deficiency noticed in 28.42 per cent (27 of 95) anaemic children. Of the pure variety, iron deficiency was the commonest cause occurring in 41.05 per cent (39 of 95) children. INTERPRETATION & CONCLUSION: Childhood anaemia continues to be a significant public health problem in school children aged 5 to 10.9 yr and iron deficiency either alone or in combination is the commonest nutritional cause of anaemia. Pure or mixed vitamin B12 deficiency is an important but yet not commonly recognized cause of anaemia among these children.

Anemia↗

PubMed2002

Typhoidal focal suppurative lymphatic abscess.

We describe a submandibular suppurative lymphatic abscess caused by Salmonella typhi in an 8-year-old child. The diagnosis was confirmed by repeated isolation of S. typhi from the abscess. A literature search found no previous report of a similar nature and this therefore seems to be the first case report of focal suppurative typhoidal lymphatic abscess. The child responded to cephalexin and surgical drainage.

Abscess↗

PubMed2002

Impact of daily versus weekly hematinic supplementation on anemia in pregnant women.

OBJECTIVE: To compare the effectivity of weekly versus daily iron therapy in reducing maternal anemia and to evaluate the association of maternal hemoglobin and fetal growth. DESIGN: Prospective. SETTING: Tertiary care teaching hospital in an urban metropolis. METHOD: 40 pregnant women received daily and 40 pregnant women received weekly oral therapy (335 mg of ferrous sulphate and 500 g folic acid) for a period of 14 weeks. The age of each pregnant woman and their baseline anthropometric data (weight, height and body mass index) were estimated. Hemoglobin and hematocrit estimations were carried out during follow period at 4 wks, 8 wks and 14 weeks. Serum ferritin values as a marker of iron status were also calculated in both the groups initially, at 14 weeks and at the time of delivery. Fetal anthropometric indices of 137 full term neonates delivered to mothers included in either of the supplementation groups or admitted to the hospital were also studied in relation to maternal hemoglobin concentration. RESULTS: Forty subjects each were initially randomized into groups I and II. The age of pregnant women along with their baseline anthropometric data were similar in both groups. A total of 29 pregnant women in group I and 27 pregnant women in group II could be regularly followed up. The increase in hemoglobin and hematocrit values were similar in daily and weekly supplemented mothers. An intention to treat analysis also showed similar results. The ferritin values were similar at the start of supplementation and after 14 wks of weekly or daily iron therapy. Birth weight, crown heel length, head circumference of the neonate and placental weight increased significantly with rise in maternal hemoglobin levels. CONCLUSION: Weekly iron supplementation is an effective mode of treating anemia among pregnant women and maternal anemia during pregnancy is adversely associated with fetal growth.

Anemia↗