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Biomedical subjects

P Nalini

Publications and source records attributed to P Nalini.

At least 19 recordsLinked to original sources
PubMed1997

Poliomyelitis trends in Pondicherry, south India, 1989-91.

STUDY OBJECTIVES: To assess the poliomyelitis trend, including study of the epidemiological features, and to correlate this with the immunisation coverage of infants. DESIGN: Three annual lameness surveys in children aged 0-60 months employing cluster sampling methods and a series of five cross sectional surveys of immunisation coverage in children aged 12-23 months of age were undertaken. SETTING: Pondicherry, India, 1988-92. SUBJECTS: More than 10,000 children in the age group of 0-60 months took part in the three annual lameness surveys and samples of 210 children aged 12-23 months were covered each year in immunisation coverage surveys. MEASUREMENTS AND MAIN RESULTS: Altogether 50 of 11,461, 24 of 10,093, and 17 of 11,218 children surveyed during 1989, 1990, and 1991 respectively had become lame as a result of poliomyelitis, giving prevalences of 4.4, 2.4, and 1.5 per 1000 children for the three surveys. The corrected prevalences of poliomyelitis were 5.9, 3.2, and 2.0 per 1000 children during 1989, 1990, and 1991 respectively. The proportion of cases aged up to 36 months fell from 48% in 1989 to 12.5% in 1990 and 6% in 1991. The age at onset was less than 1 year in most. The median age at onset was 10.7 months. About 54% of the affected children had received three doses of oral poliomyelitis vaccine (OPV) before the onset of paralysis. In 1988 immunisation coverage for the third dose of OPV was 91% and in 1992 it was 97.6%. The drop out rate for the first versus the third dose of OPV fell from 6.3 in 1988 to 1.9% in 1992. CONCLUSION: Three successive annual lameness surveys showed that poliomyelitis was declining between 1989 and 1991. Five immunisation coverage surveys conducted from 1988 to 1992 showed high initial coverage followed by an improvement in the form of almost universal coverage for OPV.

Age Factors↗
PubMed1995

Cardiac involvement and scorpion envenomation in children.

Cardiac complications of 32 children with scorpion envenomation, during a 1-year period from August 1990 to August 1991 were studied. Sixteen children (50 per cent) were diagnosed as having myocarditis; of these in four children the presentation was subclinical. ECG changes were seen in 63 per cent of children envenomed and was a sensitive indicator of myocarditis. Sixty-nine per cent of children with myocarditis had left ventricular dysfunction as shown by echocardiography. Though statistically not significant, there was a correlation between prolonged QTc and LV dysfunction, which needs to be studied further. In those children who came for follow-up, the left ventricular function reversed to normal.

Animals↗
PubMed1995

Scorpion envenomation in children in southern India.

The clinical presentation of 32 children with scorpion envenomation was analysed. The most common presentation was cold, clammy extremities with normal blood pressure. Myocarditis was present in 16 children (50%) and encephalopathy in four (12.5%). Two children died. ECG was a sensitive indicator of myocarditis which was subclinical in four children. Left ventricular dysfunction was a transient phenomenon. Myocarditis and encephalopathy were the two lethal complications observed. Serum free fatty acid levels were elevated two to three-fold in all symptomatic patients. Blood glucose levels were only mildly elevated and serum amylase levels and electrolytes were normal in all the children. No specific antivenom was given. In the absence of specific antivenom, early and active supportive treatment reduces the morbidity and mortality due to scorpion envenomation.

Animals↗
PubMed1995

Use of serum bactericidal activity in assessing previous antibiotic therapy in acute lower respiratory tract infection in children.

Bactericidal activity in sera of children with acute lower respiratory tract infection was assayed to determine its effect on the outcome of blood culture. Parental reporting of prior antibiotic therapy was also determined. 14.4% of samples without serum bactericidal activity yielded pathogens from blood culture, whereas only 2.4% of samples with serum bactericidal activity yielded pathogens. A statistically significant correlation was found between isolation of pathogens by blood culture and serum bactericidal activity. Parental reporting could not be relied upon as there was no positive correlation.

Acute Disease↗
PubMed1994

Enteric fever: a changing perspective.

All the cases of enteric fever admitted between 1988-1992 were studied. There was a gradual rise in the number of admitted cases. Central nervous system (CNS) complications like encephalopathy (14.9%), meningitis (8.8%), seizures (8.5%) and cerebellitis (3.4%) were noted more during 1991 and 1992. Other complications like myocarditis (4.6%), hepatitis (9.5%) and gastrointestinal bleeding were noted in increasing numbers during 1991-1992. Multidrug resistant (MDRT) cases were 46.3% in 1991 and 33.5% in 1992. There was a significant difference in the time taken for defervescence (a gradual rise) between the years but between the individual drugs there was no such significant difference. Deaths were noted only in 1991 and 1992 in cases of MDRT with complications. There has been an increase in resistance of S. typhi to commonly used drugs like ampicillin, chloramphenicol and cotrimoxazole. S. typhi resistant to ciprofloxacin was cultured in 2 cases each from 1990-1992. Further, the time taken for defervescence with ciprofloxacin also showed a gradual rise from 3.5 days in 1990 to 6.2 days in 1992. Nevertheless, ciprofloxacin is still the drug of choice for treatment of complicated cases of MDRT.

Anti-Bacterial Agents↗
PubMed1993

Short course chemotherapy for tuberculosis in children.

In order to determine the efficacy of short course chemotherapy (SCC) for tuberculosis in children, 83 newly diagnosed cases in children < 12 years old were given SCC and were prospectively followed for 1-3 years. Seventy-one cases were treated for 6-9 months as they had mild to moderate involvement. Twelve cases were treated for 12 months as they had meningitis (7), disseminated tuberculosis (2), or miliary tuberculosis (3). The results showed that none of the children, at the end of follow up, showed evidence of active tuberculosis. All children tolerated the drugs well, with side effects noticed being mild, namely transient hepatitis (4), vomiting (1), and skin rash (1). It is suggested that SCC for 6-9 months using isoniazid (INH) and rifampicin along with other drugs when necessary is highly effective in most cases of tuberculosis in children and has several advantages over conventional chemotherapy of 18 months or longer duration.

Adolescent↗
PubMed1993

Congenital malformations, reproductive wastage and consanguineous mating.

A study was undertaken in Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, South India, to understand the relation between congenital developmental disorders and consanguinity and also reproductive wastage and consanguinity. Four hundred children with existing congenital developmental disorders were studied with regard to their consanguineous parentage and compared with 1,000 randomly selected patients attending the paediatric outpatient department. There was a significantly higher prevalence of consanguinity in the study group (p < 0.001) and greater frequency in rural areas. The common types of consanguineous marriages were between first cousins (50.6%) and uncle and niece (42.4%). Frequency of consanguinity was not significantly related to religion and caste. The mean coefficient of inbreeding was 0.056. Consanguinity had no significant effect on average pregnancy rate and reproductive wastage. The frequency of consanguinity was significantly higher especially with autosomal recessive disorders (p < 0.001), congenital heart diseases (p < 0.001), multiple malformations (p < 0.001), neurological malformations (p < 0.005), chromosomal disorders (p < 0.01), genitourinary disorders (p < 0.02) and mental retardation-developmental disorders (p < 0.02). These observations stress the need for communicating the deleterious effects of inbreeding to the public through regular health education.

Abortion, Spontaneous↗
PubMed1992

Typhoid fever and nephrotic syndrome--an unusual association.

We report a case of nephrotic syndrome seen in a 9-year-old boy having a significant temporal relationship with culture proven multidrug resistant Salmonella typhi infection. Such an association is quite unusual and probably has not been reported before.

Child↗
PubMed1992

Multidrug resistant enteric fever.

Multidrug resistant typhoid fever (MDRT) is becoming an alarming public health problem in and around Pondicherry, South India. A retrospective review of the multidrug resistant typhoid fever cases admitted to the paediatrics ward of JIPMER Hospital, Pondicherry (India) during 1990 is presented. Prolonged pyrexia, chills and rigors, toxaemia, and tender hepatomegaly often more than 3 cm below the costal margin (often without splenomegaly) were striking features of MDRT cases. The incidence of complications was also greater. Positive blood cultures were observed even after weeks of antibiotic therapy, indicating persistent bacteraemia; resistance was almost always observed for multiple drugs (two or more). The fluoroquinolone group of drugs such as ciprofloxacin have been found to be the best for MDRT in terms of rapid response and cost effectiveness. Cefotaxime has moderate efficacy.

Anti-Bacterial Agents↗
PubMed1991

A profile of pyogenic meningitis in children.

Clinical profile of pyogenic meningitis was studied in 256 cases over a period of 8 years. The male to female ratio was 1.46: 1 and 83.6% of the patients were less than 3 years of age. Fever, altered sensorium, refusal to feed, convulsions and vomiting were the common presenting symptoms. Six (2.3%) of them had subnormal temperature and the sensorium was normal in 12.5% of cases. Cerebrospinal fluid was clear in 9.4%, cell count was less than 100/cmm in 8.2%, sugar was more than 40 mg% in 24.2% and protein was less than 50 mg% in 12.5% of cases. Diplococcus pneumoniae was the commonest causative agent. The overall mortality was 30.5%. It is concluded that young children suffering from this disease may not have the typical features and one should have the highest suspicion to make an early diagnosis so that the morbidity and mortality from this condition can be reduced.

Child, Preschool↗
PubMed1990

Empyema in infancy and childhood.

A study of 108 cases of empyema during 18 months period showed the incidence of empyema to be 2.17%. Staph. aureus (17.6%) was the common causative organism. Response to a combination of cloxacillin and gentamicin was better than that of crystalline penicillin and gentamicin. Only 30.3% cases needed intercostal drainage for more than 2 weeks. Almost 43% cases could be discharged by 3-4 weeks after hospitalisation and 38.1% by 30-57 days. The mortality rate was 12.1%. Among the survivors, excluding 8 children who left against medical advice, all had complete recovery excepting one child in whom AFB was isolated and who developed bronchiectasis and recurrent hemoptysis, inspite of antituberculous treatment. Age of the child, antibiotic combination given and nutritional status appear to be the main factors influencing the recovery and prognosis.

Anti-Bacterial Agents↗
PubMed1990

Typhoid fever below five years.

During a seven year period (1981-87), 53 cases of typhoid fever in children below five years were seen. This accounted for 13.5% of all typhoid admission in pediatrics during the above period. Predominant symptoms were fever (100%), vomiting (52.8%), diarrhea (30.2%) and anorexia (24.5%). Chills and rigor associated with fever was noticed in 38% of the children. Salmonella typhi was isolated from blood in 22 of 53 (41.7%) cases. A significant finding on peripheral smear was eosinopenia (86.8%). Complications like endotoxic shock, enteric encephalopathy and gastrointestinal hemorrhage were noticed in only few cases (7.6%). There were no deaths.

Child, Preschool↗
PubMed1989

Poliomyelitis: 20 years--the Pondicherry experience.

During a 20-year period, 12,830 cases of acute poliomyelitis in children (aged 1 month-12 years) were seen in a South Indian teaching hospital (Pondicherry). Almost three-quarters (72.4%) of children were below the age of 2 years. The median age at onset of poliomyelitis shifted from 19.5 months (in the period 1968-1977) to 11 months (in the years 1978-1987). After 1981, epidemic peaks were noted every third year. 66.3% of cases had not received even a single dose of oral polio vaccine and 14.7% cases were vaccine failures (in the years 1983-1987). Provocation of poliomyelitis occurred in 66% of children and usually followed intragluteal injections associated with treatment of non-specific fevers. The overall mortality was 2.13%, the major cause of death being respiratory failure (60%). Polio virus type 1 was the major isolate among selected cases studied during 1983-1987. The risk factors identified in our study are lack of immunization and administration of intramuscular injections during the pre-paralytic phase. Ensuring early administration of multiple doses of oral polio vaccine to infants and avoiding intramuscular injections in young febrile children are important measures for the control of poliomyelitis--a continuing problem in Southern India.

Age Factors↗
PubMed1982

Biosynthesis of hexamannophosphoinositides in Mycobacterium smegmatis ATCC 607.

The biosynthesis of hexamannophosphoinositides in Mycobacterium smegmatis ATCC 607 was examined using labelled tri- and tetraacylated dimannophosphoinositides (PIM2(-3)F and PIM2(-4)F) as precursors, by in vivo and in vitro incorporation. Tetraacylated dimannoside was metabolically more active as compared to triacylated dimannoside and seems to be the precursor for the synthesis of hexamannophosphoinositides.

Mycobacterium↗