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91.
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Karande S Gandhi D Kulkarni M Bharadwaj R Pol S Thakare J De A 《Journal of tropical pediatrics》2005,51(3):174-181
This prospective study was undertaken to investigate the possibility of a concurrent outbreak of leptospirosis and dengue and to describe the clinical illnesses. From 20 June to 14 November 2002, children who presented to our hospital with a suspected diagnosis of leptospirosis or dengue were admitted. In every child with suspected leptospirosis, a screening latex agglutination test was carried out to detect anti-Leptospira antibodies. The diagnosis of leptospirosis was confirmed by a positive enzyme-linked immunosorbent assay (ELISA) test or microagglutination test. The diagnosis of dengue was confirmed by a positive IgM antibody capture ELISA test. Clinical features in the leptospirosis and leptospirosis-negative groups, and dengue and dengue-negative groups were analysed. Of 90 children screened, 15 (16.7 per cent) had leptospirosis. Two children with Weil's disease died and the remaining 13 responded well to intravenous penicillin. Five clinical features were significantly associated with leptospirosis, namely conjunctival suffusion (p=0.007), haemorrhage (p=0.020), abdominal pain (p=0.011), hepatosplenomegaly (p=0.044), and oedema (p=0.007). As the number of these five features concomitantly present increased, the chances of the child having leptospirosis also increased significantly (p<0.0001). Of 90 children screened, 16 (17.8 per cent) had dengue. All responded well to the treatment and went home. Two clinical features were significantly associated with dengue, namely arthralgia (p=0.020) and thrombocytopenia (p=0.001). If both these features were present, the chances of the child having dengue increased significantly (p=0.001). Our study shows that a concurrent outbreak of leptospirosis and dengue had occurred in the slums of Mumbai city. 相似文献
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Pathak P Kapil U Kapoor SK Saxena R Kumar A Gupta N Dwivedi SN Singh R Singh P 《Indian journal of pediatrics》2004,71(11):1007-1014
Deficiencies of micronutrients (zinc, iron, folic acid and iodine) during pregnancy are known causes of Low Birth Weight (LBW).
Studies have documented status of one or two micronutrients amongst pregnant women (PW). However, no attempt has been made
to concurrently assess the prevalence of multiple micronutrient deficiencies and the factors associated with them amongst
PW.Objective: The present study was undertaken to assess the prevalence of multiple micronutrient deficiencies amongst PW in a rural area.Methods: A community based cross sectional survey was conducted in six villages of a rural area of district Faridabad in Haryana
state, India during November 2000 and October 2001. All PW aged 18 years or more, with pregnancy duration of more than 28
weeks were enrolled. Data were collected on socio-economic status and other demographic parameters. Serum zinc, copper and
magnesium levels were estimated by utilizing the Atomic absorption spectrophotometry (AAS); serum ferritin and folate was
estimated by Enzyme Linked Immuno Sorbent Assay (ELISA) method and the Radio-lmmuno Assay (RIA) method, respectively and serum
thyroid stimulating hormone (TSH) level was estimated by the Abbot AxSYM System. Serum zinc, copper, magnesium, ferritin,
and folate levels less than 70.0 μg/dl, 80.0 μg/dl, 1.80 mg/dl, 15 ng/ml, and 3 ng/ml, respectively were considered as indicative
of deficiency for respective micronutrients. The TSH levels of 4.670 and more indicated iodine deficiency status. Dietary
intake of micronutrients was assessed utilizing 1-day 24-hour dietary recall methodology. Food consumption pattern was assessed
utilizing the food frequency questionnaire methodology.Results: Nearly 73.5, 2.7, 43.6, 73.4, 26.3, and 6.4 percent PW were deficient in zinc, copper, magnesium, iron, folic acid and iodine,
respectively. The highest concurrent prevalence of two, three, four and five micronutrient deficiency was of zinc and iron
(54.9%); zinc, magnesium and iron (25.6%); zinc, magnesium, iron and folic acid (9.3%) and zinc, magnesium, iron, folic acid
and iodine (0.8%), respectively. No pregnant woman was found to have concomitant deficiencies of all the six micronutrients.
Dietary intake data revealed an inadequate nutrient intake. Over 19% PW were consuming less than 50% of the recommended calories.
Similarly, 99, 86.2, 75.4, 23.6, 3.9 percent of the PW were consuming less than 50% of the recommended folic acid, zinc, iron,
copper, and magnesium. The consumption of food groups rich in micronutrients (pulses, vegetables, fruits, nuts and oil seeds,
animal foods) was infrequent. Univariate and Multivariate logistic regression analysis revealed that low dietary intake of
nutrients, low frequency of consumption of food groups rich in micronutrients and increased reproductive cycles with short
interpregnancy intervals were important factors leading to micronutrient deficiencies.Conclusion: There was a high prevalence of micronutrient deficiencies amongst the PW of the area, possibly due to the poor dietary intake
of food and low frequency of consumption of food groups rich in micronutrients. The concurrent prevalence of two, three, four
and five micronutrient deficiencies were common. 相似文献
96.
Spectrum of holoprosencephaly 总被引:1,自引:0,他引:1
Objective : To conduct a clinical study of holoprosencephaly (HPE).Method : Thirteen cases of HPE were studied regarding their clinical features, family history, and prenatal and imaging studies.
Chromosomal analysis was done whenever fresh sample was available.Results : Six cases were antenatally detected by ultrasound; four cases were stillborn. Three cases were identified by neuroimaging
done a part of evaluation of developmental delay or cleft lip. Eleven of them had facial anomalies characteristics of HPE.
Two of these had subtle facial features and microcephaly. Karyotype was abnormal in 2 of 7 cases studied.Conclusion : Most of the cases of HPE present antenatally or at birth. Milder forms like lobar and semilobar can present as developmental
delay during infancy. Facial anomalies are usually associated with HPE. Chromosomal study of the case and clinical examination
of the parents is essential for providing information regarding risk of recurrence to the family. 相似文献
97.
MRI follow-up and natural history of avascular necrosis of the femoral head in Kuwaiti children with sickle cell disease 总被引:2,自引:0,他引:2
PURPOSE:: To document the MRI progression and the natural history of avascular necrosis of the femoral head (AVNFH) in Arab children with sickle cell disease. PATIENTS AND METHODS: Twenty-three SS and 7 SbetaThal patients (aged 6-17 years) were screened for AVNFH between 1998 and 1999. Eight (26.7%) were identified with varying degrees of AVNFH. Seventeen of the original 30 patients have now been followed for 1 to 4 (mean 2.0 +/- 1.2) years, with repeat MRI of the hips. Spin-echo T1-and T2-weighted images and T2 fat-saturation sequences were obtained using a 1.5-Tesla GE unit with superconductors. AVNFH was graded I (mild), II (moderate), or III (severe). RESULTS: Eleven (64.7%) of the 17 patients had significant progression of their lesions; at the initial study, 9 were normal, 7 were grade I, 1 was grade II, and none was grade III. At the end of the follow-up period, two were normal, seven were grade I, one was grade II, and seven were grade III. Of the nine who were initially normal, two still had no lesions, while four were grade I and three were grade III on follow-up. Of the seven who were classified as grade I initially, four remained at grade I, one moved to grade II, and two became grade III. The one patient who was initially grade II progressed to III. CONCLUSIONS: AVNFH is a common, chronic, and unrelenting complication in children with sickle cell disease, and it is usually progressive. 相似文献
98.
Daily versus intermittent iron supplementation in pregnant women: hematological and pregnancy outcome 总被引:3,自引:0,他引:3
Mukhopadhyay A Bhatla N Kriplani A Pandey RM Saxena R 《The journal of obstetrics and gynaecology research》2004,30(6):409-417
AIM: To compare the hematological parameters and pregnancy outcome in women receiving daily versus weekly iron supplements during pregnancy. METHODS: A prospective randomized controlled study was carried out at the Department of Obstetrics and Gynaecology of the All India Institute of Medical Sciences, New Delhi, India, during which 111 women were randomized to receive either 100 mg elemental iron daily (n=55) or 200 mg elemental iron weekly (n=56). Hemogram and serum ferritin level estimation were carried out at the beginning of pregnancy and within the 32-34-week period of gestation. Side-effects, compliance and the number of tablets consumed were noted for each group. The mean birth weight, period of gestation at delivery and mode of delivery were also compared between the two intervention groups. RESULTS: There was no significant difference in the mean hemoglobin levels between the two intervention groups at the end of an average 17 weeks of iron supplementation. However, among anemic women who received daily supplementation, there was a greater rise in hemoglobin compared with those receiving supplementation weekly. The serum ferritin level was lower in the weekly supplemented group compared with that in the daily. There was no difference in the mean birth weight, period of gestation and mode of delivery between the two groups. Side-effects and non-compliance were significantly higher (P<0.001) in the daily supplemented group. CONCLUSIONS: Weekly iron supplementation is an effective option for prophylaxis in non-anemic pregnant women, but has less than optimal benefit in anemic women. 相似文献
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