PubMed Health⌕ Search

Biomedical subjects

Ghanshyam D Kumhar

Publications and source records attributed to Ghanshyam D Kumhar.

5 recordsLinked to original sources
PubMed2005

Clinical significance of polymicrobial bacteremia in newborns.

OBJECTIVE: To identify whether polymicrobial bacteremia in newborns is associated with any predisposing factors, distinguishing clinical features, or higher mortality. METHODS: Results of blood cultures obtained over a period of 1 year from neonates admitted to the paediatric ward and Neonatal Intensive Care Unit of a tertiary care hospital were retrospectively analysed. The study group included all cases with polymicrobial bacteremia (isolation of two or more organisms). Controls (double the number of study cases) were randomly selected from the monomicrobial group. Case records of included cases were retrieved and scrutinized. RESULTS: Of 770 positive cultures during the study period, 52 (6.8%) cultures were positive for more than one organism. Complete case records were retrieved for 40 polymicrobial and 78 monomicrobial cases. The two groups were comparable for maternal and neonatal parameters including: maternal and obstetric complications; period of gestation; mode of delivery; birthweight and perinatal asphyxia; clinical symptomatology; invasive therapeutic interventions; and mortality. CONCLUSIONS: Isolation of more than one organism from the blood culture of a suspected septic newborn is not rare. It does not always represent a true invasion by multiple organisms. Polymicrobial isolation per se should not be the criterion for hastily changing the therapeutic decisions.

Bacteremia↗
PubMed2003

Growing skull fractures.

Growing skull fractures or craniocerebral erosions are rare sequel to cranial fractures where progressively growing cranial defects follow lacerations involving the duramater. Their usual site is the parietal region. They present as a cystic, non-tender swelling with an underlying palpable bony defect. One such case is reported.

Child Development↗
PubMed2002

Plantar response in infancy.

The objective of the study was to characterize the plantar response at various ages in infancy in Indian children. The subjects were 1281 apparently healthy children born at term and without any history suggestive of neurological disease, enrolled between the ages of 1 and 12 months. The plantar response was elicited in both feet by thumbnail drag method and graded as flexor, extensor and equivocal. The percentage of extensor, flexor and equivocal responses was compared between right and left foot and the average of these two responses was compared between the age categories [1-3 months (n=389), 3.1-6 months (n=332), 6.1-9 months (n=354) and 9.1-12 months (n=206)]. Frequency (%) of various combinations of bilateral responses was also calculated for different age categories. Results showed that the extensor plantar response was the predominant response till 6 months of age. Bilateral extensor response was seen in 79.4%, 67.8%, 32.5% and 31.1% in the four age categories respectively; bilateral flexor response in the corresponding age groups was 0.3%, 5.1%, 26.6% and 39.3% respectively. The percentage of asymmetrical responses was 20.7%, 25.3%, 40.3%, and 28.7% in different age categories. We concluded that normal plantar response is predominantly extensor in early infancy; the transition to flexor response starts occurring after 6 months of age. A fairly high number of infants continue to have an extensor response even after 6 months; and the transition may be advanced in one foot leading to asymmetrical plantar response.

Humans↗
PubMed2002

Bacteriological analysis of blood culture isolates from neonates in a tertiary care hospital in India.

This study was undertaken to determine the profile and antibiotic sensitivity patterns of aerobic isolates from blood cultures of neonates in a tertiary care hospital in New Delhi, India. All blood culture reports (n = 1,828), obtained during August 1995-September 1996 from newborns admitted to the Department of Pediatrics and the Neonatal Intensive Care Unit at the University College of Medical Sciences and GTB Hospital, Delhi, were analyzed, and the sensitivity patterns were recorded. The positivity of blood culture was 42% (770/1,828). Most (93.2%) bactaeremic episodes were caused by a single organism, while polymicrobial aetiology was observed in 52 (6.8%) cases. Gram-negative organisms were isolated in 493 (60%) of 823 cases, with Klebsiella (33.8%), Enterobacter (7.5%), Alcaligenes faecalis (4.9%), and Escherichia coli (4.6%) being the common microbes. Staphylococcus aureus (24.4%), followed by coagulase-negative staphylococci (7.9%), were the major Gram-positive isolates. Most (80%) Gram-positive isolates were sensitive to vancomycin, and 50-75% of the Gram-negative isolates were sensitive to ciprofloxacin and amikacin. It is concluded that Klebsiella and Staphylococcus aureus remain the principal organisms responsible for neonatal sepsis in a tertiary care setting.

Anti-Bacterial Agents↗