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Biomedical subjects

S Karande

Publications and source records attributed to S Karande.

15 recordsLinked to original sources
PubMed2005

Attention deficit hyperactivity disorder--a review for family physicians.

Attention deficit hyperactivity disorder (ADHD) is a chronic behavioral disorder characterized by persistent hyperactivity, impulsivity, and inattention that impairs educational achievement and/or social functioning. Its diagnosis is made by ascertaining whether the child's specific behaviors meet the diagnostic and statistical manual of mental disorders-IV-revised criteria. Its etiology is still unclear but recent studies suggest that genetics plays a major role in conferring susceptibility. Comorbidity with psychiatric disorders such as anxiety disorder, depression, oppositional defiant disorder and conduct disorder; and with specific learning disability is not uncommon. Although medication works well in most cases of ADHD, optimal treatment requires integrated medical and behavioral treatment. Methylphenidate (MPH) and atomoxetine are the two drugs being currently prescribed and their efficacy in decreasing the symptoms of ADHD is well documented. Pyschoeducational interventions in school can help increase the successful functioning of affected children and improve their academic performance. Almost half of affected children continue to show significant symptoms of the disorder into adolescence and young adulthood. The family physician can play an important role in detecting this condition early, coordinating its assessment and treatment, counseling the parents and classroom teacher, and monitoring the child's academic and psychosocial progress on a long-term basis.

Atomoxetine Hydrochloride↗
PubMed2003

An observational study to detect leptospirosis in Mumbai, India, 2000.

BACKGROUND: Leptospirosis is relatively uncommon in children. Following torrential rains and flooding an outbreak of leptospirosis was suspected in Mumbai. AIMS: To investigate the possibility of an outbreak of leptospirosis and describe the clinical illness. METHODS: From 24 July to 14 September 2000, children with a history of abrupt onset of high fever (>39 degrees C), who presented to our hospital, were admitted and tested serologically for anti-Leptospira antibodies by a quantitative enzyme linked immunosorbent assay (ELISA) test. An IgM titre of more than 20U/ml confirmed the diagnosis of leptospirosis. Clinical features in the confirmed leptospirosis and leptospirosis negative groups were analysed. RESULTS: Of 53 children screened, 18 (34%) had leptospirosis. In all 18, the disease was anicteric and responded well to intravenous penicillin. Four clinical features present at the time of admission were significantly associated with leptospirosis: a history of contact with flood water (18/18 v 16/35), conjunctival suffusion (5/18 v 1/35), abdominal pain (9/18 v 5/35), and skin rash (5/18 v 1/35). As the number of these four features concomitantly present increased, the chances of the child having leptospirosis also increased significantly. A history of contact with flood water had a sensitivity of 100%, and the presence of conjunctival suffusion, abdominal pain, and skin rash had a specificity of 97%, 86%, and 97%, respectively, for identifying children with leptospirosis. CONCLUSION: Leptospirosis should be suspected in febrile children with contact with flood water.

Age Distribution↗
PubMed2003

Multiple giant congenital melanocytic nevi with central nervous system melanosis.

A case of multiple giant congenital melanocytic naevi in whom central nervous system melanosis was detected at 6 weeks of age is described. The infant was asymptomatic, but presence of risk factors such as multiple naevi, giant naevi and naevi on scalp and posterior axial location prompted a magnetic resonance imaging study of the brain. To our knowledge, neurocutaneous melanosis at such a young age has not been reported in Indian literature.

Humans↗
PubMed2002

An unusual presentation of scurvy following head injury.

We report an unusual clinical presentation of scurvy in a one and half year old child. The child presented with abrupt onset of peri-orbital ecchymoses and scalp hemorrhage following head injury. The child also had a history of temper tantrums and head banging. Our case did not have any of the typical clinical features of scurvy. The diagnosis was eventually confirmed radiologically and by observing a dramatic response to vitamin C therapy. It is important to remember that scurvy can present atypically i.e. without bleeding gums, painful limbs, pseudo-paralysis or scorbutic rosary. Scurvy should be kept as a differential diagnosis in a young child presenting with bleeding manifestations. Taking a detailed dietary history is of utmost importance in pediatric practice.

Craniocerebral Trauma↗
PubMed2001

Approach to learning disability.

Learning disabilities (LD) is one of the important causes of poor academic performance in school going children. Learning disabilities are developmental disorders that usually manifest during the period of normal education. These disabilities create a significant gap between the true potential and day to day performance of an individual. Dyslexia, dysgraphia and dyscalculia denote the problem related to reading, writing and mathematics. Perinatal problems are certain neurological conditions, known to be associated with LD; however, genetic predisposition seems to be the most probable etiological factors. Evaluation of a child suspected to be having LD consists of medical examination, vision and hearing test analysis of school performance. The psycho-behaviour assessment and education testing are essential in the process of diagnosis. The experienced persons in the field of LD should interpret the results of such tests. With Individualized Remedial Education Plan (IEP) most children learn to cope up with disability and may get integrated in a regular steam.

Adolescent↗
PubMed1996

Ciprofloxacin use: acute arthropathy and long-term follow up.

OBJECTIVE: To assess whether children treated with ciprofloxacin in 1990 had developed any permanent joint damage. DESIGN: Retrospective questionnaire-based follow-up study. SETTING: Adverse Drug Reaction (ADR) Monitoring Center in Mumbai. SUBJECTS: 3341 children treated with ciprofloxacin in 1990, including 7 who had developed a ciprofloxacin-related acute arthropathy. METHODS: A questionnaire was sent in January 1995 to 147 pediatricians who had reported to us children in whom ciprofloxacin was prescribed in 1990. The information sought for included the number of children who had followed-up beyond 2 years and details of any joint-related complaints noted in them on long-term follow-up. RESULTS: Long-term follow-up was reported in 582 of these 3341 children. No joint-related complaints had developed in 581 children, either as an acute ADR in 1990 or as a delayed ADR during a minimum follow-up period of 2 years. Long-term follow-up was available in only 1 of the 7 children in whom a ciprofloxacin-related acute arthropathy had developed in 1990, and this child was now asymptomatic. New information was received about 13 children treated with ciprofloxacin during 1991-1994 who had developed a ciprofloxacin-related acute arthropathy. In the total 20 children, aged 2-12 years, reported to us for acute ADR, the arthropathy (joint pains, restriction of joint movements and/or swelling of joint) had developed on day 1 to 8 of ciprofloxacin therapy, and in 18 the acute arthropathy had resolved within 1 day to 4 weeks of either discontinuing or completing ciprofloxacin therapy. Outcome in the remaining 2 children was not available. CONCLUSIONS: Ciprofloxacin use can cause an acute reversible arthropathy, but in this study there is no evidence that its use can cause a delayed arthropathy or any permanent joint damage.

Acute Disease↗
PubMedDate not supplied

Cerebellar atrophy in an epileptic child: is it due to phenytoin?

A four and half year old epileptic child on phenytoin therapy since one year presented with signs of cerebellar dysfunction. Serum phenytoin level was high (33 mcg/ml) and computerised tomographic scan of the brain showed severe generalised cerebellar atrophy. The cerebellar signs represented drug over dosage and toxicity and persisted long after omission of phenytoin.

Anticonvulsants↗
PubMedDate not supplied

Hepatic hydatid cyst rupturing into sub-diaphragmatic space and pericardial cavity.

A ten-year-old male child presented with a large hepatic hydatid cyst which ruptured into the sub-diaphragmatic space and pericardial cavity, giving rise to a pericardial effusion. This communication between the hydatid cyst and the pericardium was documented on computerised tomographic scan of the chest and abdomen. The cyst was aspirated carefully and then enucleated. There was an associated right-sided reactionary pleural effusion. The pericardial effusion and pleural effusion resolved on albendazole therapy and did not require surgical intervention.

Albendazole↗