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Biomedical subjects

S Singhi

Publications and source records attributed to S Singhi.

At least 19 recordsLinked to original sources
PubMed1992

Multi-drug-resistant Salmonella typhi--a need for therapeutic reappraisal.

Enteric fever caused by Salmonella typhi resistant to all the standard first-line antibiotics is emerging as a major problem in developing countries. Fifteen such culture-proven cases were treated with ceftriaxone (6), cefotaxime (5) or ciprofloxacin (4). The earliest defervescence occurred with ceftriaxone (mean 3.3 days). Clinical cures were obtained with all three drugs with only one child having a relapse. Ciprofloxacin, by virtue of its cost and an oral route of administration, is the ideal choice in a developing country.

Cefotaxime↗
PubMed1992

Hyponatraemia and the inappropriate ADH syndrome in pneumonia.

We studied serum sodium, plasma osmolality and urinary sodium and osmolality on days 1, 3 and 5 of hospitalization of 100 children aged from 1 month to 12 years admitted with a diagnosis of pneumonia. Hyponatraemia (serum sodium concentration < or = 130 mmol/l) was found in 31 patients at the time of admission. The probable cause of hyponatraemia in 94% of cases was the syndrome of inappropriate antidiuretic hormone secretion (SIADH). Symptoms and signs indicative of severe pneumonia were two to three times more frequent and the mean duration of tachypnoea, chest-wall retraction and hospital stay about one and a half times longer in children with hyponatraemia. Four children died (two on day 1, one on day 5 and one on day 8); all four had a serum sodium concentration < or = 125 mmol/l which persisted until death. Of the remaining 27 hyponatraemic children, serum sodium concentrations returned to normal on day 3 in 26, while in one hyponatraemia persisted until day 7. The recovery from hyponatraemia showed a good correlation with improvement in clinical signs of respiratory distress. The SIADH occurred in about one-third of the children hospitalized for pneumonia, and was associated with a more severe disease and a poorer outcome. Perhaps fluid restriction in these cases may improve the outcome.

Child↗
PubMed1992

Bacteremia and bacterial infections in highly febrile children without apparent focus.

To find the incidence of bacteremia and serious bacterial infections in febrile children without an apparent focus of infection, we prospectively studied 100 febrile children aged 1 month-3 years with a rectal temperature > or = 39 degrees C. Ten children had a blood culture positive bacteremia and nine had serology positive for bacteremia; 6 had urinary tract infection, 5 otitis media and 8 meningitis. A diagnosis of non bacterial illness was made in 62 patients. Staphylococcus aureus was the most common bacteriologic isolate on blood culture (five) and by serology (eight). TLC > or = 15,000/cu mm m-ESR > or = 25 mm and temperature > or = 39 degrees C had high specificity (95-100%) but low sensitivity for diagnosis of bacteremia.

Bacteremia↗
PubMed1992

Frequency and significance of electrolyte abnormalities in pneumonia.

To determine the frequency of electrolyte disturbance in pneumonia, we studied 264 hospitalized children with pneumonia for serum sodium and potassium concentration, and plasma osmolality (Posm) on the day of admission. Urine osmalality (Uosm) and urine spot sodium concentration were measured in those who had a serum sodium less than or equal to 130 mEq/L. Hyponatremia was found in 27%, hypernatremia in 3.7%. Hypokalemia (serum potassium less than or equal to 3.5 mEq/L) in 19 and 2% had hyperkalemia (serum potassium greater than or equal to 6.5 mEq/L). Of all the hyponatremia, 68% were secondary to syndrome of inappropriate ADH secretion (SIADH) as suggested by a concomitant lowering of Posm less than or equal to 280 mosm/kg and increased urinary osmolality and sodium excretion. Hyponatremia was associated with 60% longer hospital stay, two fold increase in complications and the 3.5 times higher mortality compared to that of normonatremia. The above variables were affected further, if hypokalemia coexisted with hyponatremia.

Child↗
PubMed1992

Fever without focus.

Explore the source record for details and available documents.

Bacterial Infections↗
PubMed1991

Urban parents' understanding of fever in children: its dangers, and treatment practices.

One hundred urban parents were interviewed for their knowledge, attitude and treatment practices towards fever in children. Only 55% parents were aware of the normal body temperature and 23% of the febrile temperature. A total of 58% considered fever as a disease, 91% felt that fever could go on rising if unchecked, and 60% believed that if it is brought down the child would be cured. As home treatment, paracetamol was used by 57% parents, and cold sponging by 29%. Sixty three per cent were of the opinion that a doctor must be consulted for any fever. The understanding of fever and home treatment practices were significantly better in highly educated parents. Above points must be considered while counselling parent of a febrile child, and for formulating health education package for the parents.

Adult↗
PubMed1990

Psychosocial problems in families of disabled children.

Psychosocial problems faced by parents and other family members were studied in 50 families with a physically disabled child (PD group), 50 with a mentally retarded child (MR group) and 50 with a healthy child (control group). A semi-structured questionnaire assisted interview and standardized scales were used to measure social burden, marital adjustment and maternal neuroticism. Families with disabled children perceived greater financial stress, frequent disruption of family routine and leisure, poor social interaction, and ill effects on their physical and mental health as compared to families of control children. The overall social burden scores were significantly higher in both the groups with disabled children as compared to controls (mean scores PD 17.8, MR 14.6, C 0.72, p less than .001), and showed a significant inverse correlation with the socio-economic and educational status of parents. The neuroticism scores were also significantly higher (PD 23.7, MR 19.0, C 9.6, p less than .01), and the marital adjustment scores lower (PD 75, MR 79, C 86, p less than .01) in families with disabled children. Appropriate management of these problems should be part of rehabilitation programmes.

Adolescent↗
PubMed1990

Reliability of subjective assessment of fever by mothers.

To evaluate reliability of mother's subjective assessment of fever, we measured actual body temperature of 301 children and correlated these with assessment of fever (presence or absence) by the mother. Mothers could identify 88.9% (104/117) of febrile children and 88.6% (163/184) afebrile children correctly (positive and negative predictive values 83.2 and 87.6%, respectively). Palpation of more than one anatomical site for subjective assessment had a sensitivity of 100% and a specificity of 92.2%. The accuracy of the assessment was maximum in infants, and was not influenced by sex of the child, mother's educational status and the use of thermometer at home. In the situation where accurate measurement of temperature by thermometer is not available, mother's assessment about presence or absence of fever in her child can be relied upon by health-workers and physicians.

Body Temperature↗
PubMed1990

Evaluation of steam therapy in acute lower respiratory tract infections: a pilot study.

In a prospective controlled evaluation of steam therapy, in severe acute lower respiratory tract infection (ALRI) requiring hospitalization, 16 cases of bronchiolitis and 20 cases of pneumonia were assigned alternately to receive steam therapy in a cloth tent (Study Group); others served as controls. Respiratory status was assessed at the time of admission and subsequently at 6 hourly interval for 48 hours. No advantage of steam therapy could be identified in children with pneumonia. Bronchiolitis patients on steam therapy, as compared to the controls, showed a significant decrease in respiratory distress within first 24 hours after hospitalization and took significantly shorter time for recovery from the distress. The study patients also showed a tendency for rapid improvement in hypoxemia. Further critically controlled studies with a larger sample size are warranted.

Acute Disease↗