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Biomedical subjects

Meenu Singh

Publications and source records attributed to Meenu Singh.

At least 19 recordsLinked to original sources
PubMed2006

Perinatal tuberculosis a case series.

Perinatal tuberculosis is insufficiently understood and has been rarely reported even in areas endemic for the disease, and unless a high index of suspicion is maintained the diagnosis can be missed. Differentiation of congenital from early postnatally acquired tuberculosis is only of epidemiological importance. We hereby report one case of congenital tuberculosis and three cases of perinatal tuberculosis, and problems faced during investigation and management and emphasize need for improved screening of women at risk and sensitization of the medical community about this entity.

Female↗
PubMed2006

Treatment with 400 microg of inhaled budesonide vs 200 microg of inhaled budesonide and oral montelukast in children with moderate persistent asthma: randomized controlled trial.

BACKGROUND: Montelukast is reported to be beneficial in asthma as add-on therapy to inhaled corticosteroids and may reduce the need for the latter. OBJECTIVE: To evaluate whether a combination of oral montelukast and 200 microg of inhaled budesonide has comparable efficacy to 400 microg of inhaled budesonide alone in children with moderate persistent asthma. METHODS: In this prospective, blinded, hospital-based randomized controlled trial, 71 children with moderate persistent asthma were randomized to receive either montelukast, 5-mg chewable tablet, with 200 microg of inhaled budesonide or only 400 microg of inhaled budesonide daily for 12 weeks. Baseline and serial measurements of forced expiratory volume in 1 second, peak expiratory flow rate, and Asthma Symptom Score were performed; the frequency and severity of exacerbations were also recorded. RESULTS: Measurements of forced expiratory volume in 1 second, peak expiratory flow rate, and Asthma Symptom Score showed no significant differences between the 2 groups at baseline, during the serial follow-up visits, and at the end of the study. However, children who received montelukast had a greater frequency of exacerbations vs those who did not (33.3% vs 9.1%; P < .01). CONCLUSION: The overall control of asthma with 5 mg of oral montelukast and 200 microg of inhaled budesonide is inferior to that with 400 microg of inhaled budesonide in children with moderate persistent asthma.

Acetates↗
PubMed2006

Hypocalcaemia following therapy of thyrotoxicosis in an infant.

UNLABELLED: A 2-mo-old infant born to a mother with Graves' disease and having symptoms of thyrotoxicosis was started on antithyroid drugs. Life-threatening hypocalcaemia requiring high-dose calcium infusions developed 1 mo after starting therapy. Serum alkaline phosphatase and paratharmone levels were elevated. This communication may serve to alert treating physicians about this rare complication in infants with thyrotoxicosis after initiation of antithyroid therapy. CONCLUSION: Severe hypocalcaemia may follow initiation of antithyroid therapy in infants with thyrotoxicosis.

Antithyroid Agents↗
PubMed2006

Whooping cough: the current scene.

Pertussis, a highly contagious disease caused by Bordetella pertussis, is making a comeback globally despite good immunization coverage. The developed countries have also shown a shift in the epidemiology of the disease to the adolescent and the adult age group, leading to a revision of their vaccination policies. The disease epidemiology in the South East Asian region seems poised for a similar change. Outbreaks have been reported among children and adults in countries such as Afghanistan, Israel, and Taipei. The anticipation and early recognition of this change in the epidemiology is important because the affected adolescents and adults act as reservoirs of the disease to the vulnerable population of infants, for whom the disease can be life threatening. The clinical presentation can be atypical in the adolescent age group, and the disease is often misdiagnosed. With the availability of polymerase chain reaction and serology, the disease can be diagnosed even later in the course of the disease when culture results are often negative. The whole-cell pertussis vaccine dramatically reduced the incidence of the disease but fell into disrepute due to the rare serious neurologic side effects that led to the introduction of the acellular pertussis vaccine, which led to fewer adverse reactions and also proved to be safe and effective in the adolescent age group when used as a booster. However, the cost of the acellular vaccine is may be prohibitive for widespread use in the developing nations of the South East Asian region.

Adolescent↗
PubMed2006

Adherence issues in asthma.

In any chronic disease like asthma, the effectiveness of therapy depends on how good the treatment is and how well the patient takes it. Non-adherence maybe in form of omission of doses, incorrect medication, incorrect dosages or schedules, premature discontinuation of drugs, not following advice to avoid allergens and sub optimal inhalation technique. Unrecognized non-adherence decreases the effectiveness of asthma therapy. Non adherence can result in an increased rate of illness exacerbation, hospitalization, emergency department visits and asthma related deaths. One hundred sixty eight patients and their guardians on follow up in pediatric asthma clinic were administered a questionnaire regarding adherence to anti asthma therapy. Non adherence of different forms was seen in up to 68 percent of patients. The purpose of this communication is to report the frequency of non adherence in patients with asthma and suggest remedial measures.

Asthma↗
PubMed2005

The burden of asthma in children: an Asian perspective.

A worldwide increase in the prevalence of asthma has been reported in recent years. With an increase in prevalence comes an increased burden of disease in terms of morbidity, mortality and compromised quality of life. The economic burden in terms of utilisation of healthcare resources and limitation of the earning capacity of the individuals and families is an added problem. Various indicators such as disability-adjusted life years and healthy life years have been used to define the economic burden. The data from Asian countries regarding these parameters is scarce, underlining the need for systematic studies in these countries, especially those that are resource poor. The purpose of this review is to highlight the varying prevalence of asthma in Asia and to assess the likely economic burden for the future.

Asia↗
PubMed2005

Esophageal duplication cyst: an unusual cause of respiratory distress in infants.

Esophageal duplication cysts are rare congenital anomalies. These should be recognized as a cause of respiratory distress in infants and are usually associated with feeding difficulties. We report 2 such cases of esophageal duplication cyst in infants, causing acute respiratory distress. Excision was curative.

Esophageal Cyst↗
PubMed2005

Efficacy of an individualized written home-management plan in the control of moderate persistent asthma: a randomized, controlled trial.

BACKGROUND: The management of childhood asthma necessitates a comprehensive approach including pharmacological treatment as well as education about self-evaluation and home management of the condition. AIM: To evaluate the efficacy of adding an individualized written home-management plan in the control of moderate persistent asthma. METHODS: Children with moderate persistent asthma were randomized to receive either an individualized written home-management plan or no plan, in addition to standard asthma therapy including education. They were followed up with serial measurement of outcome variables. RESULTS: Children receiving an individualized written home-management plan had fewer acute asthma events, fewer lost school days, lower symptom score and less nocturnal awakening than those who did not receive a written plan. CONCLUSION: The addition of a written individualized home-management plan improves overall control in children with moderate persistent asthma.

Asthma↗
PubMed2005

Pneumonic presentation of brucellosis.

Brucellosis is a rare disease in children. Lung involvement is an uncommon presentation of brucellosis. The authors are presenting a child with brucellosis, who presented with predominant pulmonary involvement. It was an eight-year-old child who was referred to us a case of non-resolving pneumonia. Brucella agglutination test was suggestive of brucellosis. He responded to the combination of doxycycline and rifampicin.

Agglutination Tests↗
PubMed2004

Wheeze and urban variation in South Asia.

Typically, urban South Asia is characterised by narrow streets, heavy traffic, visible haze, unplanned city architecture and the use of kerosene or wood-burning stoves at home. However, some urban areas in South Asia are clean and modern, with concrete housing, vehicle emission regulations and use of smoke-free household fuel. The purpose of this study was to compare wheeze prevalence in 13-14-year-olds between two South Asian cities (Galle, Chandigarh), representing each of the above two archetypes. The validated one-page International Study on Asthma and Allergies in Childhood (ISAAC) questionnaire for 13-14-year-olds was used for the study. Of 1814 distributed questionnaires, 1737 (95.8%) were completed correctly and returned (Galle: n=1162; Chandigarh: n=575). Crude prevalence rates, and prevalence odds ratios (with 95% two-sided confidence intervals (CI) for comparison of prevalence rates), were calculated. The prevalence rate for wheezing in Galle (28.7%) was higher than in Chandigarh (12.5%). The prevalence odds ratios (Galle versus Chandigarh) for lifetime wheezing (2.3; 1.8-2.9), wheezing in the previous year (2.1; 1.6-2.7), exercise-related wheeze (4.8; 3.5-6.7) and physician-diagnosed wheeze (1.7; 1.2-2.3) demonstrated significant differences in wheeze prevalence between the two cities ( P<0.05). The numbers of 13-14-year-olds experiencing less than 12 wheezing episodes per year or sleep disturbance due to wheeze of less than 1 night per week were also significantly higher for Galle than Chandigarh. There is a higher prevalence of wheeze in 13-14-year-old children living in an old-fashioned, congested city than in a clean and modern city in South Asia.

Adolescent↗
PubMed2004

Newer drugs for asthma.

Several new drugs have resulted from innovative pharmacological and immunomodulatory approaches towards treatment of asthma. Diverse therapeutic targets have provided new agents. The new classes of drugs available are newer "on site activated inhaled corticisteroids" and soft steroids, anti IgE compounds, leukotriene inhibitors and single isomer agents which are available for clinical use. Anti interleukin agents and phosphodiesterase inhibitors are in the stage of clinical trials. Antisense therapy and pharmacogenetics are the on horizon for treatment of asthma.

Asthma↗
PubMed2004

Multilocular cystic renal cell carcinoma in a child.

Multilocular cystic renal cell carcinoma is an extremely rare condition in adults with no previous case reports in the pediatric age group. The authors report on an 8-year-old girl who underwent nephrectomy for a right-sided renal cystic disease because of extensive involvement of the kidney. Subsequent histopathologic examination findings showed presence of renal cell carcinoma in all the cysts. Awareness of this malignancy in a child is extremely important in the background of recent reports advocating conservative wait and watch management in unilateral renal cystic disease, which has similar clinical and imaging findings.

Carcinoma, Renal Cell↗
PubMed2004

Comparison of improvement in quality of life score with objective parameters of pulmonary function in Indian asthmatic children receiving inhaled corticosteroid therapy.

This prospective, hospital based, descriptive study was designed to compare improvement in quality of life (QOL) score with objective measures of pulmonary function in children with persistent bronchial asthma receiving inhaled corticosteroid (ICS) therapy. QOL score (measured by an indigenous tool), forced expiratory volume in first second (FEV1), forced vital capacity (FVC), peak expiratory flow rate (PEFR) and asthma symptom score were measured in 20 newly diagnosed children with persistent asthma- before, during and eight weeks after ICS therapy. There was a significant improvement in all parameters compared at each follow up visit and at termination of the study (p less than 0.05). The magnitude of improvement in QOL was similar to improvement in objective measures of pulmonary function; although these changes were not similar to changes in asthma symptom score. Improvement in QOL score is likely to be a sensitive measurement of functional improvement in asthmatic children on treatment; however subjective sensation of improvement lags behind objective measures.

Administration, Inhalation↗
PubMed2002

Cystic fibrosis in North Indian children.

Cystic fibrosis is the most common life threatening, inherited disease of the Caucasians. Ever since the gene for this disease was delineated in 1989, there are about 900 mutations discovered so far. This disease is being reported with increasing frequency from North India now. We present our experience with the diagnosis and management of cystic fibrosis in children seen at Post-Graduate Institute of Medical Education and Research, Chandigarh.

Combined Modality Therapy↗
PubMed2002

Respiratory allergy.

Allergic rhinitis (AR) and asthma are common respiratory allergic disorders which are increasing globally more in developed countries. Although much has been written about childhood asthma and guidelines published by various international and national fora, not much information is available on AR. This is most common in children, is a significant risk factor for developing asthma, is a common comorbidity with asthma and affects quality of life. This paper highlights the risk factors for developing respiratory allergy asthma and AR, linkages between them and the management issues, particularly in relation to the allergic or allergological aspects as they have important bearing on management of children suffering from respiratory allergy. Specific immunotherapy (SIT) is re-emerging as useful therapy which alone has the potential to modify the natural history of disease and prevent the 'allergic march'. Timely diagnosis, correct management including timely referrals can ensure good quality life for those suffering from respiratory allergies.

Child↗