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Banjara Hills, India

Sundaram V.,Post Graduate Institute of Medical Education and Research | Chirla D.,Intensive Care Service | Panigrahy N.,Rainbow Childrens Hospital | Kumar P.,Post Graduate Institute of Medical Education and Research
Indian Journal of Pediatrics | Year: 2014

The number of Neonatal Intensive Care Units (NICUs) and Special Care Newborn Units (SCNUs) in the country has increased exponentially. However, their current status of functioning is not known. A structured questionnaire survey of 70 NICUs spread across the country was conducted to assess their infrastructure, staffing, equipment, patient profile and their involvement in research and training. Majority of the units were well staffed and led by neonatologists trained in India and abroad. All had facilities for mechanical ventilation and were equipped with sophisticated imported equipment. Yet, availability of in-house blood gas and X-ray, microbiology facility, invasive blood pressure monitoring and support of ophthalmologist was not universal. More than half had published papers in scientific journals and were having recognized training programs in neonatology. Though tremendous progress is visible since the last surveys, the number of NICUs is still grossly insufficient. The current and future gap in trained manpower is however daunting, and intensive efforts for expanding the in-service training programs and innovative approaches to training are required. There is an urgent need to improve the quality of care by launching collaborative quality improvement programsand mandatory periodicaccreditation managed by independent empowered organizations. The focus has to move forward from simply ‘survival till discharge’ to ‘intact complete life survival’. Simultaneously, the NICU care has to stay available and affordable for the masses. © 2014, Dr. K C Chaudhuri Foundation. Source

Naushad S.M.,SASTRA University | Jain J.M.N.,DNA Diagnostics Center | Prasad C.K.,DNA Diagnostics Center | Naik U.,Institute of Child Health | Akella R.R.D.,Rainbow Childrens Hospital
Indian Journal of Biochemistry and Biophysics | Year: 2013

In order to ascertain whether autistic children display characteristic metabolic signatures that are of diagnostic value, plasma amino acid analyses were carried out on a cohort of 138 autistic children and 138 normal controls using reverse-phase HPLC. Pre-column derivatization of amino acids with phenyl isothiocyanate forms phenyl thio-carbamate derivates that have a λmax of 254 nm, enabling their detection using photodiode array. Autistic children showed elevated levels of glutamic acid (120 ± 89 vs. 83 ± 35 μmol/L) and asparagine (85 ± 37 vs. 47±19 μ,mol/L); lower levels of phenylalanine (45 ± 20 vs. 59 ± 18 μ,mol/L), tryptophan (24 ± 11 vs. 41 ± 16 μmol/L), methionine (22 ± 9 vs. 28 ± 9 μ,mol/L) and histidine (45 ± 21 vs. 58 ± 15 μ,mol/L). A low molar ratio of (tryptophan/large neutral amino acids) × 100 was observed in autism (5.4 vs 9.2), indicating lesser availability of tryptophan for neurotransmitter serotonin synthesis. To conclude, elevated levels of excitatory amino acids (glutamate and asparagine), decreased essential amino acids (phenylalanine, tryptophan and methionine) and decreased precursors of neurotransmitters (tyro sine and tryptophan) are the distinct characteristics of plasma amino acid profile of autistic children. Thus, such metabolic signatures might be useful tools for early diagnosis of autism. Source

Adio A.,L V Prasad Eye Institute | Kekunnaya R.,L V Prasad Eye Institute | Lingappa L.,Rainbow Childrens Hospital
Indian Journal of Ophthalmology | Year: 2014

A 2-year 7-month-old girl born out of a consanguineous marriage, presented at our facility with clinical features characterized by the eyelid triad of blepharophimosis, blepharoptosis and epicanthus inversus in association with hypertelorism, cleft palate and craniosynostosis. This constellation of features is suggestive of Michels syndrome. At the time of writing this report, there were only ten reported cases worldwide and to the best of our knowledge, there have been no published reports from India. Source

Sonnappa S.,Rainbow Childrens Hospital
Indian Journal of Pediatrics | Year: 2015

Pulmonary function assessment plays an integral part in the clinical management of school-aged children with respiratory disease. Pulmonary function tests (PFTs) are being increasingly applied in infants and preschool children too, albeit only in specialised centres. PFTs, when performed and interpreted accurately, provide objective outcome measures which can be used clinically to guide management, for prognostic purposes and in epidemiological research studies. They can be used to determine the nature and severity of lung disease, to ascertain response to treatment and to monitor disease progression. PFTs are rarely diagnostic in their own right with the exception of asthma, but are valuable adjuncts and before clinicians select a PFT they must know what the results are likely to be in the disease being considered. Spirometry and tests of airway calibre and function are the most widely used PFTs, as diseases in children commonly affect airway function. As such, spirometry should be a standard part of the assessment of school-age children who present to the pediatrician with chronic respiratory symptoms. This review will provide a bird’s eye view of currently available PFTs in children to assist in the diagnosis and management of respiratory disorders. © 2015, Dr. K C Chaudhuri Foundation. Source

Kumar C.M.,Jamia Hamdard University | Prasad S.V.N.,Rainbow Childrens Hospital
Indian Journal of Critical Care Medicine | Year: 2015

Introduction and Objective : Scorpion stings are a common emergency in India and many other tropical countries. In India, the red scorpions are more prevalent, and their venom is more likely to cause myocardial dysfunctions. There are very few studies conducted on this problem. The following study was done in Andhra Pradesh and aimed to identify cardiovascular complications of scorpion stings in children with a follow-up of 6 months Study Design: Prospective observational study. Setting: Children admitted with scorpion sting in a tertiary care hospital between December 2009 and November 2010 and followed-up till May 2011. Results: Scorpion stings account for 1 in every 36 admissions. Maximum cases were in 0-3 years age group. Electrocardiogram changes were seen in 76% cases and myocarditis in 42% cases. Echocardiography revealed decreased ejection fraction (EF), transient mitral regurgitation and wall motion abnormalities were observed. Average EF improved from 16% on day 1 to 47.94% and 59% on day 5 and 14 respectively, which was highly statistically significant. By the end of 1 month, all the survivors had normal EF and no residual cardiac dysfunction was observed at 6 months. Conclusion: Scorpion stings, a common and fatal medical emergency in India, produce echocardiographic changes without any long term residual damage on myocardial activity. Source

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