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Biomedical subjects

M Nanda

Publications and source records attributed to M Nanda.

12 recordsLinked to original sources

Nosocomial infections in pediatric intensive care units.

Nosocomial infections are a significant problem in pediatric intensive care units. While Indian estimates are not available, western PICUs report incidence of 6-8%. The common nosocomial infections in PICU are bloodstream infections (20-30% of all infections), lower respiratory tract infections (20-35%), and urinary tract infections (15-20%); there may be some differences in their incidence in different PICUs. The risk of nosocomial infections depends on the host characteristics, the number of interventions, invasive procedures, asepsis of techniques, the duration of stay in the PICU and inappropriate use of antimicrobials. Most often the child had endogenous flora, which may be altered because of hospitalization, are responsible for the infections. The common pathogens involved are Staphylococcus aureus, coagulase negative staphylococci, E. coli Pseudomonas aeruginosa, Klebsiella, enterococci, and candida. Nosocomial pneumonias predominantly occur in mechanically ventilated children. There is no consensus on the optimal approach for their diagnosis. Bloodstream infections are usually attributable to the use of central venous lines; use of TPN and use of femoral site for insertion increase the risk. Urinary tract infections occur mostly after catheterization and can lead to secondary bacteremia. The diagnostic criteria have been discussed in the review. With proper preventive strategies, the nosocomial infection rates can be reduced by up to 50%; handwashing, judicious use of interventions, and proper asepsis during procedures remain the most important practices.

Adolescent↗

Progressive confluent circumpapillary multiple evanescent white-dot syndrome.

PURPOSE: To describe a morphologic variant of the multiple evanescent white-dot syndrome that can mimic other conditions. METHODS: We examined three patients with severe cases of unilateral multiple evanescent white-dot syndrome characterized by an atypical progressive circumpapillary discoloration of the fundus. RESULTS: The confluent circumpapillary lesion progressed toward or beyond the equator of the fundus, raising initial concern of a viral retinitis. However, pinpoint dots at the leading edge evolved into the typical wreath-like spots of multiple evanescent white-dot syndrome, which then coalesced into the advancing edge of a geographic retinitis or retinal pigment epitheliitis, before spontaneous resolution. CONCLUSION: Progressive geographic circumpapillary discoloration, appearing as a giant white spot, occurs rarely in severe cases of multiple evanescent white-dot syndrome. The distinctive appearance may suggest a disorder other than multiple evanescent white-dot syndrome, which can make initial diagnosis more difficult and lead to unnecessary or inappropriate testing and treatment.

Adult↗

Fine needle aspiration cytology (FNAC) in malignant bone tumours.

Patients with malignant bone tumours often come at a very late stage of disease to Medical Colleges. Because of their high mortality rate, accurate & quick diagnosis of these lesions become essential, inspite of clinical, radiological and histopathological assessments. A simple, inexpensive, safe & least traumatic technique-fine needle aspiration cytology (FNAC) in diagnosis of 55 malignant bone tumours was carried out. Specific tumour types metastatic tumour (12), Giant cell tumour (12), Ewing's sarcoma (10), Osteosarcoma (7), Multiple myeloma (7), Chordoma (3), Chondrosarcoma (3) and Fibrosarcoma (1) could be ascertained in 87.2% whereas malignant tumour was suggested in 94.5% (52 cases).

Adolescent↗

Fulminant pseudomonal keratitis and scleritis in human immunodeficiency virus-infected patients.

Patients with human immunodeficiency virus infection are predisposed to fungal, parasitic, and viral infections. Bacterial infection can also be seen, although ocular bacterial infections have not been reported in patients with acquired immunodeficiency syndrome until recently. We present two cases of Pseudomonas corneoscleritis and one case of Pseudomonas keratitis in patients with human immunodeficiency virus infection that failed to respond to antibiotic treatment. Predisposing factors included extended-wear soft contact lens use in one patient and exposure secondary to Bell's palsy in another patient. All three patients had neutropenia that may have contributed to their poor response to treatment. Enucleation was required to treat two patients with overwhelming infection. Enucleation has been rarely required for treatment of corneoscleritis in immunocompetent patients treated at our institution. Pseudomonas keratitis in human immunodeficiency virus-infected patients represents a serious ocular infection requiring early diagnosis and aggressive treatment.

Acquired Immunodeficiency Syndrome↗

The relationship of puberty to diabetic retinopathy.

The presence of background and preproliferative retinopathy in 70 patients with type I diabetes was correlated with their pubertal development. Pubertal status was assessed by pediatricians using the sexual maturity ratings of Tanner. In young diabetics with comparable disease duration (5 to 10 years), postpubertal children had a greater prevalence of retinopathy than those who were not sexually mature. After adjusting for duration of diabetes and sex, the relative odds of having retinopathy in the postpubescent group relative to the prepubescent or pubescent groups was 4.8 (95% confidence interval: 1.5 to 15.3). This study suggests that minimal retinopathy in children is not rare and that postpubescent children have a greater prevalence of diabetic retinopathy than do prepubescent children with similar diabetes duration.

Adolescent↗

Ocular histopathologic findings in a case of human herpes B virus infection.

A 37-year-old male laboratory technician who sustained a cutaneous penetrating wound from a rhesus monkey developed a progressive ascending encephalomyelitis due to culture-proven herpes B virus (Herpesvirus simiae) infection. He died 6 weeks after his injury despite acyclovir and ganciclovir treatment that was initiated after central nervous system symptoms developed. Histopathological examination of the patient's left eye revealed a multifocal necrotizing retinitis associated with a vitritis, optic neuritis, and prominent panuveitis. Herpes-type virus was identified in the involved retina by electron microscopy. Postmortem vitreous cultures taken from both eyes and retinal cultures taken from the right eye were positive for herpes B virus. Herpes B virus produces infection and destruction of retinal tissues similar to other herpesviruses. To our knowledge, this case represents the first histopathologic demonstration of herpes B virus infection in a human eye.

Adult↗

Colorectal trauma.

Surgical treatment of colon and rectal trauma continues to challenge physicians. Injuries to a colon or rectum filled with feces results in subsequent peritoneal contamination which will lead to severe septic complications unless dealt with promptly and correctly. The authors have reviewed the records of 242 patients with colon and rectal trauma operated on at the Cook County Trauma Unit from July 1, 1973 to December 31, 1983, to evaluate treatment results. The mechanism of trauma was penetrating in 233 of 242 patients. Most, if not all, colonic lesions were treated with either exteriorization, resection and no anastomosis, or closure and proximal colostomy. Mortality related to colonic injury was 2.5 percent. Morbidity related to colonic injury included wound infection, 6.3 percent; abscess, 2.5 percent; other, 3.3 percent. Despite the severity of the trauma, adherence to conservative principles of "no anastomosis" in the overwhelming majority of cases has resulted in low morbidity and mortality.

Adolescent↗

Intracorneal bacterial colonization in a crystalline pattern.

We report the case of a 78-year-old woman who developed an intrastromal bacterial colonization 22 months after penetrating keratoplasty. Slit-lamp examination revealed discrete, finely branched, fernlike stromal opacities, which were histopathologically found to be large intrastromal aggregates of gram-positive cocci with almost no inflammatory cell response.

Aged↗

Beliefs and practices of urban mothers regarding "hot" and "cold" foods in childhood illnesses.

Beliefs and practices of 100 urban mothers regarding "hot" and "cold" foods during four common childhood illnesses were determined by using a pretested, partly structured interview schedule. Egg, by 60% of mothers, mango by 52%, lentils by 49%, jaggery by 46% were considered "hot" properties. "Hot" foods were preferred and "cold" foods restricted in the treatment of cough and cold and illnesses with rash. In diarrhoea, "cold" foods were preferred and "hot" foods restricted. The knowledge that many food combinations and certain procedures are believed to change the properties of common food may be utilized in promoting the consumption of nutritionally balanced diets. Introduction of culturally acceptable education in nutrition which incorporates the above knowledge is likely to help in the prevention of protein-energy malnutrition and to increase parental co-operation during therapy.

Abdomen↗

Post-Fordist technology and the changing patterns of women's employment in the Third World.

Literate but unskilled--and largely female--labor has thus far fueled the tremendous increase in manufactured exports of garments and microelectronic products from the Third World to the industrially advanced economies of the North. The future growth of these sectors, however, may require literate and skilled workers--a category in which women are woefully under-represented, especially in the Third World. In the case of the garment industry, defensive innovation in the industrially advanced countries, including automation and flexible management, has initiated a relocation of jobs to these countries or to offshore locations geographically close to their markets. Automated garment production in these countries requires fewer but computer-literate workers. In the case of microelectronics, development policies of East Asian countries and the competitive pressures on start-up companies in the North have led to an increased demand for computer-literate, skilled technicians over the unskilled and overwhelmingly female workforce of manual-assembly workers. Women's continued employment and advancement in these industries globally will depend upon their acquisition of new technical skills. The ratification by the 1995 international women's conference at Beijing of the demand for better access to education and skills training for women, especially in the Third World, is a step in the right direction.

Developing Countries↗