Browsing by Author "Baldev Bhatia"

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Antithymocyte globulin and cyclosporin in children with acquired aplastic aneamia
(Springer, 2009) Vineeta Gupta; Baldev Bhatia
[No abstract available]
Clinical profile of somatoform disorders in children
(2011) Vineeta Gupta; Aparna Singh; Shashi Upadhyay; Baldev Bhatia
Objective: To study the clinical profile, socio-demographic features, psychosocial stressors and outcome of somatoform disorders in children Methods: Children up to the age of 18 year presenting with unexplained physical symptoms over a period of 6 months were evaluated. A detailed history and physical examination was carried out. Appropriate investigations were undertaken to exclude organic causes. Diagnosis was made according to DSM-IV-TR criteria. Results: Forty-five children were diagnosed with somatoform disorders during the study period. The prevalence was 0.5% and 0.9% among outdoor and indoor patients, respectively. Conversion disorder (48.9%) was the commonest followed by other somatoform disorders (26.7%). Pseudoseizures and fainting attacks in conversion disorder and pain abdomen and general body pain in somatoform disorder were the commonest symptoms. Male to female ratio was 2.2:1. Urban children (25) were represented more than rural children (20). Stress factors were identified in 71.1% patients, which included fear of school or examinations. Thirty-three patients (73.3%) remained asymptomatic after counseling whereas, 8 patients (17.6%) had relapse requiring further counseling. Four patients (8.8%) showed no improvement and needed psychiatric evaluation. Conclusions: Early referral to mental health professional is required to avoid unnecessary investigations and delay in diagnosis of somatoform disorders in children. © 2010 Dr. K C Chaudhuri Foundation.
Determinants of capillary refill time in healthy neonates
(Journal of Clinical and Diagnostic Research, 2015) Shweta Singh; Ashok Kumar; Sriparna Basu; Baldev Bhatia
Objectives: Traditionally Capillary refilling time (CRT) has been used as a widely accepted method to assess cardiac output and peripheral circulation in neonates. There are only few studies describing normal values and the correct method of recording CRT. The value of CRT is affected by various factors like ambient or skin temperature, age, site of measurement, duration as well as amount of pressure and inter observer variation. However, none of these have been standardized. Hence, we conducted this study to establish the normal value and factors affecting Capillary Refilling Time (CRT) in healthy neonates in Varanasi. Design: Prospective observational study done over a period of 2 years. Setting: Maternity wards and Neonatal intensive care unit of Sir Sunderlal Hospital, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India. Participants: Healthy neonates between 35-42 weeks of gestation staying with their mothers and admitted in neonatal intensive care unit. Materials and Methods: CRT was measured by standard technique four times during first week of life on day 1, 3, 5 and 7. Statistics Analysis: Student t-test was used for analysis. A p-value less than 0.05 was taken as statistically significant. Results: The mean capillary refilling time (CRT) was 2.23 ± 0.37 seconds in healthy neonates during first week of life. We studied each neonate four times in first week of life. Significantly lower values of CRT were noted in low birth weight babies throughout first week in healthy neonates. Babies under phototherapy and radiant warmer had also shorter CRT values. Values were not affected by age, sex and gestation. Conclusion: The normal value of capillary refilling time (CRT) in healthy neonate is less than three seconds. The major determinants of CRT in healthy neonate are birth weight, radiant warmer and phototherapy. CRT alone in neonatal age is less informative haemodynamic parameter; it should be evaluated along with either blood pressure or oxygen saturation with pulse oxymeter. Further studies are needed to assess the reliability and validity of CRT as a clinical tool to measure perfusion in neonates. © 2015, Journal of Clinical and Diagnostic Research. All rights reserved.
Hodgkin disease with spinal cord compression
(2009) Vineeta Gupta; Arvind Srivastava; Baldev Bhatia
Hodgkin disease is a nodal disease. Spinal cord or root compression is a rare complication and usually seen in the setting of progressive, advanced disease. We report 2 cases of Hodgkin disease in pediatric patients who presented with neurologic signs. One patient had paravertebral masses and involvement of thoracic vertebrae, which was initially misdiagnosed as spinal tuberculosis. The second patient who presented with paraplegia and bladder and bowel involvement had an epidural mass with collapse of thoracic vertebra. Lymph node biopsy revealed Hodgkin disease, mixed cellularity in both the cases. Both were treated with chemotherapy followed by radiotherapy. © 2009 by Lippincott Williams & Wilkins.
Immunosuppressive therapy in aplastic anemia
(2012) Vineeta Gupta; Akash Kumar; Vijai Tilak; Isha Saini; Baldev Bhatia
Objective: To assess the response to antithymocyte globulin based immunosuppressive therapy (IST) in pediatric patients with idiopathic aplastic anemia. Methods: Thirty patients (19 boys and 11 girls) with aplastic anemia received antithymocyte globulin and cyclosporine. Twenty-two patients had severe and 8 had very severe aplastic anemia. Results: Mean age of the patients was 9.19 ± 2.56 y. Three patients died within 1 mo of therapy, two due to sepsis and one due to intracranial hemorrhage. Twenty-seven patients were analyzed for response to therapy. Eight patients (29.7%) responded at 3 mo: 3 complete response (CR) and 5 partial response (PR). Six mo after the therapy, overall response (OR) was seen in 9/27 (33.3%), with one more patient in no response group achieving partial response. At 1 year, patients in CR maintained their status and 1 patient in PR group relapsed. He again achieved partial response with repeat course of ATG. Responders had significantly shorter duration of illness and higher absolute neutrophil count as compared to non responders to IST. None of the patients developed acute leukemia in the follow up. Conclusions: The treatment of aplastic anemia in pediatric patients is a challenging task. One third of the patients achieved overall response which included both complete and partial response. © 2012 Dr. K C Chaudhuri Foundation.
Spectrum of hemoglobinopathies in Eastern Uttar Pradesh
(2009) Vineeta Gupta; Jyoti Shukla; Vijai Tilak; Baldev Bhatia
[No abstract available]
Superior vena cava syndrome in children
(2008) Vineeta Gupta; Srikanth R. Ambati; P. Pant; Baldev Bhatia
Superior vena cava syndrome (SVCS) is rare in childhood. 18 cases of SVCS were seen in children ranging from 3-14 years with a mean age of 8.8 years. There were 15 males and 3 female children. Diagnosis could be confirmed in 17 cases as one child succumbed to severe respiratory distress without a definitive diagnosis. The commonest cause of SVCS was lymphoma. Non-Hodgkin's lymphoma (NHL) was more common than Hodgkin's disease. In two cases the final diagnosis was tuberculosis of mediastinal lymph nodes. The diagnosis was confirmed by cervical lymph node biopsy in 6 cases, mediastinal biopsy in 6 cases and bone marrow aspiration in the remaining 5 cases. Intravenous Dexamethasone provided relief of symptoms in 13 patients. None of the children received emergency radiotherapy. Anti-tubercular treatment produced complete cure in the two patients with tubercular mediastinal lymphadenopathy. © Indian Society of Haematology & Transfusion Medicine 2008.
Transformation of myelodysplastic syndrome to acute lymphoblastic leukemia in a child
(2010) Vineeta Gupta; Baldev Bhatia
Childhood myelodysplastic syndrome (MDS) is an uncommon condition. Unlike adult MDS, pediatric patients have a more progressive course and rapidly transform to acute myeloid leukemia. Evolution to acute lymphoblastic leukemia is extremely rare. We report a 5 year old female child who presented with refractory anemia with excess blasts and transformed into acute lymphoblastic leukemia 4 months after initial diagnosis. © 2010 Indian Society of Haematology & Transfusion Medicine.