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Pankaj Garg

Publications and source records attributed to Pankaj Garg.

15 recordsLinked to original sources
PubMed2006

Do we need to use nitric oxide in preterm babies in developing countries?

Neonatal care in developing nations is advancing rapidly. There is an increasing tendency to include nitric oxide in the therapeutic armamentarium. But the opinion regarding its use remains divided among neonatologists even in the western world. Nitric oxide has an established role in the management of persistent pulmonary hypertension in term neonates. However, the use of nitric oxide in preterm neonates has been controversial and the Cochrane review updated in 2001 did not give conclusive answers. There have been adequately powered multi-centre trials recently on the issue, planned to resolve the controversy. The present communication highlights the salient features and conclusions drawn from these trials.

Developing Countries↗
PubMed2006

Evaluation of an algorithm for persistent/ chronic diarrhea in children at a community hospital adjoining slums in Agra, north India.

The objective of this study was to evaluate an algorithm for the management of children with persistent/chronic diarrhea at a community level hospital. The study was carried out in the pediatric OPD of a 150 bed trust hospital catering to children from poor, rural and urban slums. Fifty clinically stable children (6 months-5 years old, mean = 19.7 months) with persistent or chronic diarrhea refusing admission, being managed on an outpatient basis, were enrolled prospectively. A detailed history and physical examination were done for each child to ascertain the cause of diarrhea. They were managed using a pre-tested simplified algorithm and monitored for symptom improvement using a questionnaire 15 days, 1 month and 3 months after initiation of therapy. The average cost for treatment of each child was also calculated. Twenty-one (42%) children had persistent diarrhea. Seven (14%) infants with a typical history of lactose malabsorption responded to a trial of WHO feeding protocols or lactose/sucrose free milk. Four (8%) infants had chronic non-specific diarrhea. A total of 71.8% (28/39) of children were treated satisfactorily with albendazole or metronidazole and Cotrimaxazole along with hematinics and multivitamins. Three (6%) children were diagnosed with abdominal tuberculosis. Four (8%) had raised anti-tissue tranglutaminase antibodies (age 18-34 months). The algorithm used was successful in managing all the children with chronic diarrhea. The average cost per managed case was US$10. Further, multi-center evaluations of similar algorithms are needed to validate the observations in the present study.

Algorithms↗
PubMed2005

NICU in a community level hospital.

OBJECTIVE: To study the clinical profile and outcome of neonates in NICU of a community hospital and highlight the importance and problems in neonatal care at a community level hospital. METHODS: Retrospective analysis of case records during the period Jan. 2001- Dec. 2003. Data regarding antenatal care, maternal morbidity, place of birth, age at admission, birth weight, gestational age, diagnosis, relevant investigations, duration of stay and outcome were recorded on a preset proforma. A cost analysis for average expenses per newborn per day for different morbidities was also done. Neonatal data was analyzed among survivors and expired using appropriate statistical tests. Probability of less than 5% was taken significant. Factors found significant on univariate analysis were subjected to logistic regression model to study independent predictor of fatality. RESULTS: A total of 168 neonates were admitted during the study period. The overall survival rate was 65%. 42(25%) neonates expired and 5.4% were referred to higher centers. The commonest morbidity in survivors was hyperbilirubinemia. Prematurity with HMD and neonatal sepsis were the commonest cause of mortality. 36(24.3%) expired within 48 hr of admission (Mean 33.2 hr). 31(17.8%) could not be referred and none survived. The difference of birth weight, gestational age and duration of stay was statistically different in survivors & expired. These variables retained their significance on multivariate analysis and thus were independent predictors of fatality. An average expense of Rs 400-500/day/newborn was charged in the NICU. CONCLUSION: In a country of limited resources, 65 % neonates requiring NICU can be managed at community level hospitals.

Female↗
PubMed2005

Arthritis in HIV.

Explore the source record for details and available documents.

Arthritis↗
PubMed2005

Predictors of fatality in neonates requiring mechanical ventilation.

OBJECTIVE: To evaluate initial arterial blood gas, pulmonary pressures, pulmonary mechanics (compliance and resistance), pulmonary volumes, oxygenation indices and serum carotenoid levels as predictors of fatality in mechanically ventilated neonates. DESIGN: Cross Sectional. SETTING: Referral neonatal unit of a teaching hospital. SUBJECTS: 83 mechanically ventilated outborn neonates. METHODS: 83 neonates consecutively put on mechanical ventilator from March to December 2001 were enrolled in the study. The mechanical ventilator used was pressure limited time cycled ventilator with facility for online measurement of volumes and pulmonary mechanics. Arterial blood gas after half an hour of initiation of mechanical ventilation and initial pulmonary pressures, pulmonary compliance, resistance and duration of mechanical ventilation were recorded in a pre structured proforma. Initial serum carotenoid levels were also measured using spectrophotometric method. The neonates were regularly followed up for outcome. Multiple logistic regression analysis was done to find out the predictors of fatality for those variables that were significantly associated with outcome on univariate analysis. RESULTS: On univariate analysis weight ( < 2000 g), gestational age <34 weeks, pH <7.3, duration of mechanical ventilation <72 hours, a/A <0.25, compliance <1 mL/cmH2O, fraction of inspired oxygen (FiO2) >60%, oxygenation index >10, AaDO2 >250 and serum carotenoid levels < 100 microg/dL were significantly associated with fatality in neonates requiring mechanical ventilation. However, on multiple regression analysis only FiO2, gestational age and serum carotenoids < 100 microg/dL were found to be independent predictors of fatality. CONCLUSIONS: Initial FiO2 > 60%, gestational age <34 weeks and initial serum carotenoid levels < 100 microg/dL were independent predictors of fatality in neonatal mechanical ventilation. Even in a setting with high fatality rates, high risk of mortality in mechanically ventilated neonates can be identified.

Carotenoids↗
PubMed2004

Infantile colic--unfolded.

Infantile colic is a common complaint for which mothers bring their babies to pediatricians. Though the condition has been a cause of controversy and a subject of extensive research, no consensus is yet reached on its definition, etio-pathogenesis and management. This article reviews the existing literature on present subject.

Colic↗