PubMed Health⌕ Search

Biomedical subjects

A Sibal

Publications and source records attributed to A Sibal.

14 recordsLinked to original sources
PubMed2002

Immunonutrition.

Nutrition and immunology are interrelated. Several nutrients like arginine, glutamine, omega-3-fatty acids and nucleotides enhance cellular immunity, modulate tumor cell metabolism and improve clinical outcome in stress situations. Glutamine supplementation has been shown to decrease incidence of sepsis and to reduce length of hospital stay in bone marrow transplant patients, low birth weight infants, surgical and multiple trauma patients. Studies with arginine have shown a reduction in infectious complications and lower mortality, however a better understanding of the biology of arginine is needed. Omega-3-fatty acid supplimentation as in fish oil stimulates the immune system. The beneficial effects of immunonutrition in surgical patients has been demonstrated in several studies. It significantly reduces infectious complications and length of hospital stay. In critically ill patients immunonutrition may decrease infectious complications but it is not associated with a mortality advantage. Pediatric experience is limited, but the future is promising.

Amino Acids↗
PubMed2002

Hepatitis C in childhood.

The prevalence of hepatitis C virus (HCV) infection is relatively low in childhood. Blood transfusion has been the principal route of acquisition in children but vertical transmission is gradually occupying primacy in the developed world. The risk of vertical transmission increases with higher maternal viraemia and human immuno-deficiency virus (HIV) co-infection but current international guidelines do not suggest avoidance of vaginal delivery and breastfeeding to minimise the risk of vertical transmission. The diagnosis of perinatal transmission is different from that in older child or adult and detection of HCV-RNA is essential. Although the natural history of HCV infection in children is not well characterised, almost 50-80% will progress to chronic hepatitis among vertically infected and blood transfusion acquired hepatitis C cases. Children have a lower viral load, lower ALT values and milder histological derangement as compared to adults with chronic hepatitis C cases. Experience of treatment of chronic hepatitis C in children is limited and still evolving. Few patients achieve spontaneous remission and progression to a more severe liver disease might occur in adult life. Here, the natural history, diagnosis and management of HCV infection in children are discussed with special emphasis on features which are different from adults.

Antiviral Agents↗
PubMed1999

Liver transplantation in the developing world.

Liver transplantation is an accepted therapy for acute and chronic liver failure. Advances in preoperative and postoperative management and surgical techniques have extended the indications and improved results. Most international centres report one year actual survival rates of between 58-90% and 5-8 years survival of 75-80%. These developments, however, have been limited largely to the West. While the need for liver transplantation is well recognised in the developing world, liver transplantation has only recently been performed successfully in India. This article examines the challenges of liver transplantation in the developing world.

Adolescent↗
PubMed1999

Helicobacter pylori in children.

Helicobacter pylori (Hp) infection is one of the most frequently encountered bacterial infections worldwide. Although strong epidemiological association exists between Hp infection and duodenal and gastric ulcers and gastric cancer in adults, the clinical spectrum of Hp infection in children is yet to be established. The increasing use of endoscopy as a diagnostic modality in gastroduodenal diseases in children has raised some questions regarding the role of Hp in causing symptoms in children and need for eradication therapy. Despite a variety of protocols, the standard therapy of Hp in children is still undecided. This article discusses the epidemiological and clinical spectrum of Hp infection in children and includes a review of various diagnostic modalities and treatment protocols for this infection.

Child↗
PubMed1996

Associated infections in persistent diarrhoea--another perspective.

Seventy-eight children diagnosed as cases of persistent diarrhoea (PD) from 1 month to 5 years of age (mean age 8.92 months) hospitalized during a 2-year study period were screened for the presence of non-gastrointestinal infections. Clinical screening suggested acute respiratory infection (ARI) in 30 per cent cases, urinary tract infection (UTI) in 19 per cent and acute suppurative otitis media (ASOM) in 10 per cent of cases. Investigations revealed pneumonia on chest X-ray (39 per cent), positive urine culture (32 per cent), leucocytosis (31 per cent) and positive blood culture (22 per cent). Seven cases (9 per cent) of pneumonia and 10 cases (13 per cent) diagnosed to have UTI were not identified on clinical screening and could be detected only after investigations. E. coli was the commonest organism isolated from urine culture (23 per cent) and blood culture (14 per cent); 54 per cent of cases had one or the other associated infection and 28 per cent were suffering from more than one infection. Bacterial pathogens were more frequently isolated from blood in children < 6 months (P < 0.01), with vomiting (P < 0.001), and severe malnutrition (P < 0.05); from urine in association with fever (P < 0.001), duration of diarrhoea > 4 weeks (P < 0.05), and vomiting (P < 0.001). Pneumonia was detected on chest radiograph more frequently in children with severe malnutrition (P < 0.001). Sixty eight per cent of cases were successfully treated with dietary management and appropriate treatment of associated infections and 18 per cent of cases died. Mortality was highest in association with sever oral thrush, severe malnutrition, septicaemia, and ARI. Our results suggest that majority of cases of PD are associated with one or the other non-gastrointestinal infections particularly UTI and ARI which may be missed on clinical examination unless efforts are made to investigate these children. Early detection and appropriate management of these infections can considerably modify hospital course and outcome.

Age Distribution↗