PubMed Health⌕ Search

Biomedical subjects

J L Mathew

Publications and source records attributed to J L Mathew.

12 recordsLinked to original sources

Prevalence and risk factors for transmission of infection among children in household contact with adults having pulmonary tuberculosis.

AIMS: To study the prevalence of tuberculosis infection among children in household contact with adults having pulmonary tuberculosis, and identify the possible risk factors. METHODS: Children under the age of 5 years who were in household contact with 200 consecutive adults with pulmonary tuberculosis underwent tuberculin skin testing. Transverse induration of greater than 10 mm was defined as positive tuberculin test suggestive of tubercular infection. Infected children underwent chest radiography and analysis of gastric lavage fluid or induced sputum for detection of acid fast bacilli. RESULTS: Tuberculin test was positive in 95 of 281 contacts (33.8%), of which 65 were contacts of sputum positive patients, while 30 were contacts of sputum negative patients. Nine of these children were diagnosed as having tuberculosis based on clinical features and/or recovery of acid fast bacilli; seven were in contact with sputum positive adults. The important risk factors for transmission of infection were younger age, severe malnutrition, absence of BCG vaccination, contact with an adult who was sputum positive, and exposure to environmental tobacco smoke. CONCLUSION: The prevalence of tuberculosis infection and clinical disease among children in household contact with adult patients is higher than in the general population, and risk is significantly increased by contact with sputum positive adults.

Adult↗

Evaluation of quality of life in indian children with bronchial asthma using a disease-specific and locally appropriate questionnaire.

AIM: To evaluate quality of life (QOL) in Indian children with bronchial asthma. METHODS: A disease-specific, locally appropriate QOL questionnaire was administered in asthmatic children and compared with FEV1, FVC, PEFR and asthma symptom score, on three occasions. RESULTS: QOL score had strong negative correlation with symptom score and weaker positive correlation with pulmonary function tests. CONCLUSION: Disease-specific QOL score correlates inversely with symptom score in children with bronchial asthma.

Asthma↗

Randomized controlled trial of intrapleural streptokinase in empyema thoracis in children.

AIM: To compare intrapleural streptokinase and placebo in paediatric empyema. METHODS: Children with empyema greater than stage 5 received intrapleural streptokinase (n = 19) or normal saline (n = 21) along with intercostal drainage. Clinical and serial sonographic outcomes were compared. RESULTS: Although there was no difference in clinical and sonographic outcome, none of the children with stage 7 empyema (multi-loculated empyema) who received streptokinase developed pleural thickening 30 d later. CONCLUSION: There is no short-term clinical benefit of intrapleural streptokinase in paediatric empyema; this therapy may be reserved for those with stage 7 empyema to prevent pleural thickening in the long term.

Anti-Bacterial Agents↗

Effect of maternal antibiotics on breast feeding infants.

Antibiotic usage is fairly common among breastfeeding mothers and there is potential for transfer to infants through breast milk. While most medicines taken by lactating women cause no harm to their babies, at times it can result in serious consequences. This article reviews the principles governing transfer of maternal antibiotics to breast milk, its clinical significance, and ways to minimise inadvertent infant exposure.

Anti-Bacterial Agents↗

Gastro-oesophageal reflux and bronchial asthma: current status and future directions.

In recent years there have been several reports suggesting an association between bronchial asthma and gastro-oesophageal reflux; however a cause and effect relationship has not been proven yet. Confirmation of such a relationship is likely to have far reaching implications on the management of asthma. Reliable assessment of this issue is hampered by the presence of various lacunae in most of the published studies. Hence it is essential to carefully examine the strength of data suggesting a link between asthma and reflux. This article critically analyses currently available literature on the subject (including published reviews, meta-analyses, and randomised clinical trials in the English language) and summarises valid conclusions that can be drawn; it also proposes a framework for future studies to resolve the issue.

Asthma↗

Assessment and management of pain in infants.

Infants, including newborn babies, experience pain similarly and probably more intensely than older children and adults. They are also at risk of adverse long term effects on behaviour and development, through inadequate attention towards pain relief in early life. However, the issue of analgesia in young babies has been largely neglected in most clinical settings, despite subjecting them to painful diagnostic and therapeutic procedures. Several therapeutic and preventive strategies, including systemic and local pharmacological and non-pharmacological interventions, are reported to be effective in relieving pain in infants. A judicious application of these interventions, backed by awareness and sensitivity to pain perception, on the part of the caregivers is likely to yield the best results. This article is a review of the mechanisms of pain perception, objective assessment, and management strategies of pain in infants.

Analgesics↗

Comparison of induction and recovery characteristics of intravenous midazolam and thiopentone in paediatric halothane general anaesthesia.

UNLABELLED: Fifty children were randomized for induction with 0.3 mg kg(-1) midazolam or 5 mg kg(-1) thiopentone. Efficacy, safety, recovery time, amnesic effect, tolerability and recovery characteristics were compared. Midazolam required longer for induction and recovery from anaesthesia. The safety profile was similar with both drugs. CONCLUSION: Midazolam is efficacious and safe for the induction of anaesthesia in children. Its action is comparable with thiopentone and may be an alternative to it.

Anesthesia Recovery Period↗

Anti-oxidant vitamins and steroid responsive nephrotic syndrome in Indian children.

OBJECTIVE: In recent years, it has been proposed that nephrotic syndrome is a consequence of an imbalance between oxidant and anti-oxidant activity. In the present study, the levels of micronutrient anti-oxidant vitamins (vitamin E, vitamin C, carotene and riboflavin) in Indian children with steroid responsive nephrotic syndrome were investigated. Their levels were measured during the acute proteinuric phase of the disease, as well as during clinical recovery (remission), in order to understand the possible role of nutritionally modifiable anti-oxidants in the aetiopathogenesis of the disease. METHODS: The study was a hospital based, prospective cohort study. Serum and erythrocyte vitamin E, leucocyte vitamin C, serum carotene, erythrocyte riboflavin activity and serum malonyldialdehyde (MDA) levels were measured in 30 consecutive cases of children with nephrotic syndrome (International Study of Kidney Diseases in Children (ISKDC) criteria) during the proteinuric phase of the disease and at 4 weeks after remission was induced by steroid therapy. The same biochemical parameters were measured in healthy siblings (controls) of the 30 patients. RESULTS: Mean vitamin E (serum and erythrocyte), vitamin C and carotene were significantly lower during the proteinuric phase of the disease, and there was decreased erythrocyte riboflavin activity. There was significant elevation in the serum level of MDA during this phase. In addition, all these parameters tended to improve during remission, although complete normalization did not occur. CONCLUSION: These vitamins were active in performing their anti-oxidant function, as indicated by significant depression in their levels during the acute (proteinuric) phase, followed by partial recovery during remission. It may be concluded that steroid responsive nephrotic syndrome in children is associated with oxidative stress.

Ascorbic Acid Deficiency↗

Tracheal agenesis.

Explore the source record for details and available documents.

Anus, Imperforate↗

Clinical profile of children with nephrotic syndrome not on glucorticoid therapy, but presenting with infection.

OBJECTIVE: This is a prospective, hospital based study over a period of one year, to examine the clinical profile of nephrotic children not on glucocorticoid therapy, but presenting with infection. METHODS: Sixty-eight children with 76 episodes of nephrotic syndrome were enrolled during the study year. They were examined for evidence of infection using clinical and investigative criteria. The children were monitored daily for proteinuria and improvement of infection. After the infection was controlled, prednisolone therapy was started in those who were not already in remission. RESULTS: Of the 76 episodes, eight were excluded from analysis as they had developed infection while they were on glucocorticoid therapy. Of the remaining 68 nephrotic episodes in 60 children, there was evidence of infection in 57 episodes (83.8%). Upper respiratory infection was the most common (28.0%) followed by urinary tract infection (22.8%), peritonitis (15.8%), pneumonia (14.0%), acute invasive diarrhoea (10.5%) and empyema (5.3%). Children with infection had significantly lower serum albumin and higher serum cholesterol compared to non-infected children. Of the 57 episodes with infection, remission occurred with control of infection alone in nine episodes (15.8%) and glucocorticoid therapy was not required. CONCLUSION: Infection is widely prevalent among Indian children presenting with episodes of nephrotic syndrome, even when they are not on glucocorticoid therapy. Some children may go into remission by control of infection alone. Among the infections, upper respiratory and urinary tract infections are the most common.

Albumins↗