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Biomedical subjects

Y K Amdekar

Publications and source records attributed to Y K Amdekar.

At least 19 recordsLinked to original sources

Cough in children.

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Anti-Bacterial Agents↗

Cough and asthma.

Cough is a common symptom in office practice. Though troublesome, it serves to maintain normal function of respiratory tract. Chronic or recurrent cough may be caused by variety of diseases, asthma being the most common amongst them. Cough, wheeze and breathlessness are classical features of asthma syndrome. Many diseases may lead to this syndrome. Asthmatic children present with cough of variable intensities and patterns. At times, wheeze and breathlessness may not be clinically apparent. It was well known that all that wheezes is not asthma but now it is well understood that every asthmatic child does not wheeze. In an acute attack of asthma, cough often starts at the end of wheezing episode. It leads to expulsion of thick, stringy mucus often in the form of casts. Though cough is a minor symptom during acute attack, it ensures removal of secretions and avoid complications. Cough is a prominent symptom in persistent asthma especially between acute exacerbations. Episodic nocturnal cough may be the only symptom of chronic asthma. Children with cough variant asthma do not wheeze. It is postulated that they have milder degree of airway hyperresponsiveness and higher wheezing threshold. However, they show all the characteristics of asthma on laboratory tests. Cough represents bronchial hyperresponsiveness and is not a measure of asthma. Hence it may be caused by many diverse etiologies such as gastroesophageal reflux, enlarged adenoids, sinusitis or tropical eosinophilia. Cough in such conditions mimicks asthma and relevant tests may be necessary for proper diagnosis.

Asthma↗

Natural history of asthma in children.

Asthma is a syndrome of reversible bronchial obstruction in hyperresponsive airways mediated by allergy or other trigger factors. Allergic disease represents true asthma while transient wheezing may be caused by factors such as viral infection, aspiration, prematurity and neonatal lung damage and is likely to outgrow within few years. Personal or family history of atopy, increased serum IgE and positive skin tests may suggest allergic asthma, which persists throughout life irrespective of presence or absence of symptoms. Onset of age beyond 2 years, severity, persistence or recurrence of symptoms beyond 6 years of age, airway hyperresponsiveness and abnormal lung function even in absence of symptoms, strong family history especially in the mother, exposure to allergens, parental smoking and delay in starting appropriate therapy are some of high risk factors in persistence of asthma in adult life. As outcome of asthma depend upon multiple variable factors, it is difficult to predict natural history of asthma in an individual child.

Anti-Asthmatic Agents↗

Epidemiology of streptococcal infection with reference to rheumatic fever.

Antistreptolysin antibodies were estimated in 787 normal children and young adults by latex test. This test detects titres of 200 IU/ml and above, which is the western cut off point, for diagnosis. Children below one year showed no antibodies. Unlike western studies where no antibodies are detected below the age of 3 years, our study revealed that 7.9% children between 1-3 years had significantly elevated antibodies. This epidemiological pattern is well reflected in the different clinical profile of younger children developing rheumatic heart disease in our country. Antibodies progressively increased with age--11.8% in 4-8 years group to 15.8% in 9-12 years age group. All these were from the lower socio-economic group. ASO was positive in 16.7% of young adults from lower socio-economic status while it was positive only in 9.2% in the upper socio-economic status. A total of 522 patients of rheumatic carditis were studied. Only 23.4% had no antibodies or less than 200 IU/ml, and 77% were positive (26.9% had greater than 400 IU/ml and 49.7% had 200 IU/ml). Throat swab culture and ASO antibodies were done simultaneously in 76 outdoor patients, clinically diagnosed as acute bacterial pharyngitis. Group A beta hemolytic streptococci were isolated in 64% and significant antistreptolysin antibodies were seen in 62%. School health records were scanned in more than 50,000 school children. Point prevalence of rheumatic heart disease was estimated to be 0.17% in lower and 0.05% in upper socio-economic groups. Age and socio-economic factors are important variables in epidemiology of streptococcal infection.(ABSTRACT TRUNCATED AT 250 WORDS)

Antibodies, Bacterial↗