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Biomedical subjects

V G Ramachandran

Publications and source records attributed to V G Ramachandran.

At least 19 recordsLinked to original sources
PubMed2006

Cytomegalovirus infection in neonates following exchange transfusion.

OBJECTIVES: This study was undertaken to ascertain the acquisition of cytomegalovirus infection following exchange transfusion and factors affecting such transmission in newborn infants at a tertiary care hospital in India. METHODS: Neonates undergoing double volume exchange transfusion (for any indication) with whole blood in the Neonatal Intensive Care Unit were enrolled over a 8 month period. Serum samples from the infant were collected for CMV serology before exchange transfusion, and at 6 and 12 weeks following the exchange. CMV serology was also conducted on samples obtained from the respective maternal and donor blood. RESULTS: Of 47 neonates who received exchange transfusion during the study period; only 26 (55.3%) neonates were finally followed up till 12 weeks of age. Only 3 (11.5%) children demonstrated CMV seroconversion during follow-up; all were low birth weight and small for gestational age. None of them demonstrated any clinical, hematological, biochemical, or radiological signs suggestive of perinatal CMV infection either at birth or during the course of follow-up. CONCLUSION: Exchange transfusion in neonates can result in perinatal transmission of CMV infection in low birth weight neonates. Such transmission does not result in any immediate manifestations. Data are not sufficient to warrant routine CMV screening of donor blood for exchange transfusion in our setting.

Cytomegalovirus Infections↗
PubMed2005

Clinical significance of polymicrobial bacteremia in newborns.

OBJECTIVE: To identify whether polymicrobial bacteremia in newborns is associated with any predisposing factors, distinguishing clinical features, or higher mortality. METHODS: Results of blood cultures obtained over a period of 1 year from neonates admitted to the paediatric ward and Neonatal Intensive Care Unit of a tertiary care hospital were retrospectively analysed. The study group included all cases with polymicrobial bacteremia (isolation of two or more organisms). Controls (double the number of study cases) were randomly selected from the monomicrobial group. Case records of included cases were retrieved and scrutinized. RESULTS: Of 770 positive cultures during the study period, 52 (6.8%) cultures were positive for more than one organism. Complete case records were retrieved for 40 polymicrobial and 78 monomicrobial cases. The two groups were comparable for maternal and neonatal parameters including: maternal and obstetric complications; period of gestation; mode of delivery; birthweight and perinatal asphyxia; clinical symptomatology; invasive therapeutic interventions; and mortality. CONCLUSIONS: Isolation of more than one organism from the blood culture of a suspected septic newborn is not rare. It does not always represent a true invasion by multiple organisms. Polymicrobial isolation per se should not be the criterion for hastily changing the therapeutic decisions.

Bacteremia↗
PubMed2005

Risk taking behavior and Sexually Transmitted Diseases: a study among men.

Sexually Transmitted Diseases (STDs) among men not only jeopardize their own health but also increase sexual morbidities among their spouses. STDs are primarily attributed to high-risk sexual behavior. The study was carried out among male patients attending the OPD of a Government dispensary. Risk taking behavior was assessed using a structured, pre-tested questionnaire and STDs were diagnosed using syndromic approach supported by laboratory investigations. Three hundred two men were selected by systemic random sampling for inclusion in the study. 39% had pre-marital sexual relationship, 20% had sex with Commercial Sex Workers. 12% of the married men had extramarital sex mostly with CSWs. 27% had more than one sex partner ever. Only 3.6% used condoms consistently. Thirteen per cent respondents had history of symptoms suggestive of STDs. Prevalence of syphilis, gonorrhea and other STDs among study subjects were 3.6%, 0.7% and 0.7% respectively. High risk sexual behavior is widely prevalent and STDs are also common. Behavior change communication and early diagnosis and prompt treatment of STDs will reduce the burden significantly.

Adolescent↗
PubMed2004

Immunogenicity of low dose intradermal hepatitis B vaccine and its comparison with standard dose intramuscular vaccination.

OBJECTIVE: A prospective study was carried out in the well baby and immunization clinics of tertiary care hospital to compare the immunogenicity of low dose hepatitis B vaccine (HBV) given intradermally versus standard dose given intramuscularly. METHODS: One hundred ninety six term, healthy, Australia antigen negative and exclusively breast fed babies were allocated into two groups in a simple randomized manner. In group I, hepatitis B vaccine was given in low dose (2 mcg) by intradermal route whereas in group II it was administered in standard dose (10 mcg) by intramuscular route. Diphtheria, pertussis, tetanus (DPT) and oral polio vaccine (OPV) were co-administered with HBV in both the groups at 6, 10 and 14 weeks of age at different sites. One hundred seventy seven infants could be regularly followed up and tested for anti-HBs titres by third generation ELISA test using mono-ELISA anti-HBs 3.0 kits. Geometric mean titres of anti-HBs were estimated in each group and compared. Student's t-test was used for statistical analysis. RESULTS: Seroprotective anti-HBs titres (titre greater than 10 mIU/mL) were achieved in 87 of 88 (98.8 percent) children having received intramuscular doses as compared to 82 of 89 (92.1 percent) children in the intradermal group. The geometric mean titres of the intradermal group were 92.71 mIU/mL (95 percent C.I. 68.85-124.85), significantly lower than 331.66 mIU/mL (95 percent C.I. 245.12-448.78), noticed in the intramuscular group. There were no significant adverse reactions in both the groups. Hepatitis B vaccine is immunogenic when co-administered with DPT and OPV vaccine. The intradermal hepatitis B administration is less effective with lower immunogenicity than the intramuscular vaccination.

Antibody Formation↗
PubMed2002

Bacteriological analysis of blood culture isolates from neonates in a tertiary care hospital in India.

This study was undertaken to determine the profile and antibiotic sensitivity patterns of aerobic isolates from blood cultures of neonates in a tertiary care hospital in New Delhi, India. All blood culture reports (n = 1,828), obtained during August 1995-September 1996 from newborns admitted to the Department of Pediatrics and the Neonatal Intensive Care Unit at the University College of Medical Sciences and GTB Hospital, Delhi, were analyzed, and the sensitivity patterns were recorded. The positivity of blood culture was 42% (770/1,828). Most (93.2%) bactaeremic episodes were caused by a single organism, while polymicrobial aetiology was observed in 52 (6.8%) cases. Gram-negative organisms were isolated in 493 (60%) of 823 cases, with Klebsiella (33.8%), Enterobacter (7.5%), Alcaligenes faecalis (4.9%), and Escherichia coli (4.6%) being the common microbes. Staphylococcus aureus (24.4%), followed by coagulase-negative staphylococci (7.9%), were the major Gram-positive isolates. Most (80%) Gram-positive isolates were sensitive to vancomycin, and 50-75% of the Gram-negative isolates were sensitive to ciprofloxacin and amikacin. It is concluded that Klebsiella and Staphylococcus aureus remain the principal organisms responsible for neonatal sepsis in a tertiary care setting.

Anti-Bacterial Agents↗
PubMed2002

Seroprevalence of cytomegalovirus among voluntary blood donors in Delhi, India.

Cytomegalovirus (CMV) is known to be a significant cause of morbidity and mortality following blood transfusion in children and immunocompromised adults. In India, it is not mandatory to screen donated blood for CMV in blood banks. Very few studies have been conducted in India to estimate the seroprevalence of this infection in voluntary blood donors. This study was conducted to estimate the seroprevalence of CMV among voluntary blood donors in Delhi, India. In this study, none of 200 donors tested positive for CMV IgM antibody, but 95% were positive for CMV IgG antibody. There was no statistically significant difference in seropositivity of CMV based on distribution of age. Of the 200 donors, 3% tested positive for HBsAg, 1% for HIV, 2% for hepatitis C virus, and 4.5% for syphilis. Since about 95% of blood donors in India are seropositive for CMV, it would seem superfluous to screen blood donors for CMV, as very few seronegative blood units would be available for transfusion. Other preventive strategies, such as leukoreduction, etc., could be more appropriate and cost-effective for the prevention of transmission of CMV through infected blood to immunosuppressed individuals.

Adolescent↗
PubMed2001

Hematological observations as diagnostic markers in dengue hemorrhagic fever--a reappraisal.

OBJECTIVE: To determine the utility of certain clinical and hematological parameters as diagnostic markers of dengue hemorrhagic fever (DHF), namely, (i) tourniquet test, (ii) association of bleeding manifestations with the platelet count, and (iii) "cut off" value of hematocrit diagnostic of DHF in Indian population. DESIGN: Prospective study. SETTING: Tertiary care hospital. SUBJECT: 304 children of DHF presenting between September 1996 to December 1996. RESULTS: The tourniquet test had a low sensitivity and was positive only in 61/239 (25.5%) cases. There was no statistical difference in the incidence of bleeding manifestations between thrombocytopenic and non-thrombocytopenic individuals highlighting poor association of thrombocytopenia with bleeding manifestations. A "cut off" hematocrit value of 36.3% diagnostic of DHF was estimated by discriminant analysis in Indian population. CONCLUSION: The study highlights tourniquet test as a less sensitive diagnostic marker of DHF, poor association of thrombocytopenia with bleeding manifestations and also defines the hematocrit value diagnostic of DHF in Indian population.

Child↗
PubMed1999

Enterobacter aerogenes outbreak in a neonatal intensive care unit.

BACKGROUND: Enterobacter aerogenes, a Gram-negative bacterium, is an important, although infrequent, cause of nosocomial bacteremia in the hospitalized pediatric and neonatal population. Enterobacter aerogenes was isolated for the first time in our neonatal intensive care unit (NICU) from blood culture of a 5-day-old neonate; 12 more cases were discovered in the next 70 days. The present report summarizes the clinico-bacteriological spectrum and outcome of the affected neonates. Efforts made to find the source of infection and curb the outbreak are also presented. METHODS AND RESULTS: Thirteen newborns, including seven preterms, acquired E. aerogenes septicemia. Perinatal risk factors were present in all the neonates. The mean birthweight of affected infants was 1880 +/- 540 g. Symptoms appeared at a mean age of 3.5 +/- 1.5 days (range 3-8 days). The clinical presentation was indistinguishable from septicemia caused by other Gram-negative organisms. Complications encountered included sclerema, bleeding diathesis, meningitis and shock. The organism, isolated from blood in all and from the cerebrospinal fluid in two cases, was found to be resistant to all antibiotics in the first five cases, but turned sensitive to gentamicin, cefotaxime and amikacin during the latter half of the epidemic. The bacterium in the last case (no. 13) was again found to be resistant to all the antibiotics. Overall mortality was 46.2%; the mean interval between onset of symptoms and death being 2.3 +/- 1.8 days. The organism was traced to the rubber pipe attached to a foot-operated suction machine in the NICU. The neonatal unit was temporarily closed, fumigated and reopened with strict instructions to follow proper hand washing protocol and ensure cohort nursing of infected infants. CONCLUSIONS: Enterobacter aerogenes is capable of causing nosocomial outbreaks of septicemia in NICU. Low birthweight infants with associated perinatal risk factors appear to be predisposed. The sensitivity patterns of the isolates highlight the capability of E. aerogenes to acquire or lose resistance to antibiotics rapidly during treatment. A high mortality rate coupled with a short interval between onset of symptoms and death, suggested high virulence of the strain.

Cross Infection↗