Browsing by Author "Utpal Kant Singh"

Now showing 1 - 20 of 24

Amphotericin B therapy in children with visceral leishmaniasis: Daily vs. alternate day, a randomized trial
(Oxford University Press, 2010) Utpal Kant Singh; Rajniti Prasad; Bir Prakash Jaiswal; Prabhat Kumar Singh; C.P. Thakur
A randomized study was carried out to compare the efficacy and adverse reactions of daily vs. alternate day regimens of amphotericin B in children with visceral leishmaniasis (VL). Six hundred and five children of VL below 14 years of age were randomized into two groups; Group A (302), who received amphotericin B at a dose of 1 mg kg. -1 day. -1 for 15 days and Group B (303); same doses but on alternate days. All patients in both groups were cured, who had completed course of amphotericin B therapy. None had relapsed at 1 and 6 months of follow-up. Adverse reactions in both groups were non-significant. The duration of stay and cost of therapy was significantly lower in Group A children who left the hospital against medical advice, which was also significantly more in Group B. Thus, daily regimen of amphotericin B is equally effective, well tolerated, not more toxic and cost-effective than alternate day regimen, which is currently practiced. © The Author [2010]. Published by Oxford University Press. All rights reserved.
Arteriovenous malformation of brain with stroke in Down syndrome: A case report
(2009) Rajniti Prasad; Utpal Kant Singh; Om Prakash Mishra
Down syndrome is a common chromosomal aberration in children. A variety of associated malformations have been reported in the literature, including vascular malformations of pelvic organs. The vascular malformations of brain with Down syndrome have not been reported in the literature. Therefore, we report a child with Down syndrome, with associated arteriovenous malformation in the brain, who developed stroke and was treated successfully.
Association of possible osteopetrosis with acute myeloid leukaemia in a child
(2013) Rajniti Prasad; B.P. Jaiswal; O.P. Mishra; Utpal Kant Singh
Osteopetrosis is a rare disease characterised by an increase in bone mass, skeletal malformations and bone marrow failure due to defective bone resorption. We report a 3-month-old male child presented with chest infections, failure to thrive and hepatosplenomegaly and diagnosed with osteopetrosis associated with acute myeloid leukaemia M3 type (AML-M3). The patient died on day 7 of admission due to respiratory failure. To our knowledge, this is the first case where both osteopetrosis and AML is diagnosed in a patient.
Cerebrospinal fluid Gene XPERT (CBNAAT) in children with tuberculous meningitis
(Elsevier Ltd, 2021) Annapurna Rai; Rajniti Prasad; B.K. Das; Shampa Anupurba; Utpal Kant Singh
Objectives: To observe the role of CSF Gene XPERT (CBNAAT) in diagnosis of tuberculous meningitis (TBM) and determine its sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV). Methods: A prospective study was done from October 2017 to March 2020. CSF samples of 55 children diagnosed as tuberculous meningitis as per defined clinical and imaging criteria, were subjected to routine CSF analysis, MGIT culture and CBNAAT. Children on prior anti-tuberculous therapy for more than one month were excluded from study. Results: Of 55 children, meningeal signs were present in 54.5% children. Neurological deficits were present in 47.3%. Common CT brain findings were communicating hydrocephalus followed by infarct and basal exudates. CSF Gene XPERT (CBNAAT) were positive in 9 (16.4%), of which 6 was also culture positive and 3; negative. Two children were rifampicin resistant. Fifteen (27.3%) children had positive CSF culture. Gene XPERT showed sensitivity, specificity, PPV, NPV and diagnostic accuracy of 40%, 92.5%, 66.7%, 80.4% and 78.2% respectively as compared to culture. Conclusion: Although sensitivity of CSF CBNAAT is low i.e. 40% but positive result not only confirm bacteriological diagnosis of tuberculous meningitis but also reveal about rifampicin sensitivity and resistance for plan of therapy. © 2021
Chronic abdominal pain in children
(Springer, 2013) Utpal Kant Singh; Rajniti Prasad; Nishant Verma
Chronic abdominal pain in children is usually not caused by organic disease. Diagnostic triage focuses on the assessment of alarm symptoms by means of history and physical examination. Additional diagnostic evaluation is not required in children without alarm symptoms. Family characteristics have an important influence on the chronicity of abdominal pain. A specific intervention is not recommended owing to lack of evidence of a beneficial effect. The greatest challenge is to identify children at risk of a prolonged course of pain and its correlated functional disability. The evaluation of family for coping strategies, psychosocial factors and appropriate follow-up can prevent ineffective use of healthcare resources. © 2012 Dr. K C Chaudhuri Foundation.
Cognitive and behaviour dysfunction of children with neurocysticercosis: A cross-sectional study
(Oxford University Press, 2014) Rajniti Prasad; Shambhavi; Om P. Mishra; Shashi K. Upadhyay; Tej B. Singh; Utpal Kant Singh
Eighty-three confirmed cases of neurocysticercosis diagnosed as per modified delBrutto criteria were enrolled in the study (Group-I) to observe cognitive and behavioural changes. Controls consisted of two groups: children with idiopathic generalized tonic-clonic seizure (Group-II) and normal children with non-specific cough (Group-III). Cases and controls were subjected to cognitive and behaviour assessment. There was significant difference in the intelligence quotient (IQ) of cases in domains of visual perception, immediate recall, analysis synthesis and reasoning, verbal ability, memory and spatial ability. In the age group of 6-18 years, cases had significantly more behaviour problems than control without seizure, in domains of anxious depressed, withdrawn depressed, somatic problems, social problems and rule-breaking behaviour. Neurocysticercosis causes decline in cognitive function and behaviours in older children, which should be recognized early for appropriate management and to avoid undue parental anxiety. © The Author [2014].
Current concept in the management of cerebral palsy
(Indian Medical Association, 2005) Rajniti Prasad; S.B.P. Singh; B.P. Jaiswal; Utpal Kant Singh
The authors have described, in depth, the current concept along with the management of cerebral palsy in the present article.
Cysticercal encephalitis with cortical blindness
(BMJ Publishing Group, 2010) Rajniti Prasad; Neha Thakur; C. Mohanty; M.K. Singh; O.P. Mishra; Utpal Kant Singh
The authors report a 6-year-old boy, who had presented with low-grade fever, altered sensorium, headache and seizure for 5 days. On examination, he had features of raised intracranial pressure with left VI cranial-nerve palsy and bilateral extensor plantar response. CT scan showed multiple calcifications in cerebral cortex. MRI cranium showed multiple cysts involving whole of the brain. He was diagnosed as having cysticercal encephalitis, based on immunological and imaging study. He was managed with 20% mannitol, phenytoin and albendazole, and regained consciousness 7 days later, but had residual neurological deficit as left-lower-limb monoparesis and visual acuity of just projection of rays (PR+) and perception of light (PL+).
Disseminated cysticercosis with a right common femoral vein thrombosis
(2013) Utpal Kant Singh; Rajniti Prasad; Prashant Bhushan; Om P Mishra
Disseminated cysticercosis is an uncommon presentation of cysticercosis. Less than 10 cases of disseminated cysticercosis have been reported worldwide in children. We report the case of an 8-year-old boy with disseminated cysticercosis, who had presented with a swelling of the body for 1 month and proptosis of the eyeballs for 14 days. On examination, he had bilateral proptosis, subcutaneous nodules and hypertrophy of muscles of the limbs, neck and face. The CT cranium was normal, but the orbit showed bilateral bulky extraocular muscles heterogeneous in their whole length. The MRI cranium and whole body showed multiple nonenhancing vesicular cysts involving the brain, extraocular muscle, heart, trunk and muscles of the extremities and subcutaneous tissues. A Doppler study of the femoral vein showed thrombosis of the right common femoral vein. He was managed with corticosteroid, albendazole, phenytoin sodium, low-molecular-weight heparin followed by warfarin for 6 months and recovered completely. Copyright 2013 BMJ Publishing Group. All rights reserved.
Echocardiography versus cardiac biomarkers for myocardial dysfunction in children with scorpion envenomation: An observational study from tertiary care center in northern India.
(Elsevier B.V., 2020) Rajniti Prasad; Anil Kumar; Dharmendra Jain; B.K. Das; Utpal Kant Singh; T.B. Singh
Objective: This study was done to evaluate myocardial function by 2D Echocardiography and Cardiac biomarkers (cTnI, CK-MB, BNP) changes in patients of scorpion envenomation of grade II-IV and correlate mortality of envenomed children with myocardial dysfunction. Methods: A total of 40 patients admitted consecutively with grade II and more scorpion envenomation from October 2015 to July2018 were enrolled in the study. The data included demographics, the time of presentation, clinical features, echocardiographic findings, electrocardiographic findings, cardiac biomarker levels at admission and discharge, use of inotropic medication, oral prazosin, time of discharge, and their outcome. Results: The most common ECG abnormality was sinus tachycardia 28 (70%) followed by low voltage complex 13 (32.5%) which got normalized at the time of discharge in majority. Cardiac troponin I (cTnI) levels were more than 0.1 ng/mL, suggesting myocarditis was present in 25 (62.5%) and got normalized at discharge. CK-MB levels were increased in 26 (65%) patients suggesting myocardial involvement. BNP levels were also increased in 24 (60%) patients suggesting heart failure and its value got normalized at discharge. Abnormal 2D Echo findings as reduced left ventricular ejection fraction (LVEF) was present in 18 (45%) cases suggesting myocardial dysfunction and became normal at discharge. The sensitivity, specificity, positive predictive value and negative predictive value of Cardiac troponin I (cTnI) considering ECHO cardiograph as gold standard were 100, 68.1, 72 and 100% respectively. One patient had died whose Ejection fraction was less than 30%. Conclusion: Echocardiography and cTnI can identify subgroup of patients, who require early aggressive therapy. Echocardiography, if not available, cardiac troponin I level can guide early therapy and indicates the prognosis. © 2020 Cardiological Society of India
Hydrocarbon and related compounds poisoning
(2009) Utpal Kant Singh; R. Prasad; A. Gaurav
In Indian children hydrocarbon (kerosene) is the commonest poison consumed. The clinical manifestations depend on the viscosity and amount of hydrocarbon consumed. Pulmonary toxicity represents the most common complication of hydrocarbon ingestion and accounts for the majority of fatalities. Management is principally conservative but few children require mechanical ventilation.
Immunosuppressive therapy in children
(Indian Medical Association, 2011) Rajniti Prasad; Utpal Kant Singh; Roopali Mittal; O.P. Mishra
The treatment of auto-immune diseases is evolving and newer agents become available. This review will outline treatment options in children with auto-immune disorders. Treatment with current corticosteroids and azathioprine works in majority but issues of intolerance and incomplete response arise, which led to window of newer immunosuppressants including mycophenolate mofetil, cyclosporine, tacrolimus, sirolimus, and various antibodies of human and animal origin. The newer agents have been studied in fewer numbers of children, so they are not first-line treatment yet but do have a clear role in patients with intolerance or incomplete response to standard therapy.
Miltefosine in children with visceral leishmaniasis
(2006) Utpal Kant Singh; Rajniti Prasad; Ranjeet Kumar; Bir Prasad Jaiswal
Sixty four children (38 boys and 26 girls), aged 1 yr to 14 yr, presenting with fever, splenomegaly and positive LD body in splenic smear examination, admitted to pediatric ward of Nalanda Medical college and Child care center between 1st July 03 to 30th June 04 were taken for study. Patients were categorized into two groups: 44 were in Group I (Patients who had not received prior anti-leishmanial drug) and 20 in Group II (Patients who had received 30 days course of SAG; 20 mg/kg/day). All patients were given Miltefosine in dose of 2.5 mg/kg /day od or bid per orally to a maximum of 100 mg and were followed at completion of therapy, 1 month and 6 months for clinical response, splenic size and parasite density. 63 patients had parasitological cure with relapse in one patient of Group I during follow up. One patient in Group II had no response with first course but became parasitologically negative with 2nd course of Miltefosine. In Group I, one patient had persistent splenomegaly and found to have associated portal hypertension. GI side effects i.e. diarrhea and vomiting were observed in 26 and 23 patients respectively. Majority of patients had pancytopenia. Elevated ALT (>3 times of normal) were seen in 28 and 11 patients of Group I and Group II respectively which returned to normal in subsequent follow up. The final cure rates were 93.2% and 95% in Groups I and II respectively.
Miltefosine: An Oral Drug for Visceral Leishmaniasis
(The Indian Journal of Pediatrics, 2004) Rajniti Prasad; Ranjeet Kumar; B.P. Jaiswal; Utpal Kant Singh
Miltefosine, a phosphocholine analogue originally developed as antimalignant drug, has been found to be highly active against leishmania in vitro and animal model. 1,2 Based on these experiences this drug was tried against human visceral leishmaniasis and found to be highly effective and achieved 97% and 94% cure in phase 2 and phase 3 trial in children.
Multiple Cerebral Sinus Thrombosis in a Child
(Springer India, 2016) Rajniti Prasad; Utpal Kant Singh
[No abstract available]
Oral atropine sulfate for infantile hypertrophic pyloric stenosis
(Springer, 2005) Utpal Kant Singh; Ranjeet Kumar; Rajniti Prasad
This study aimed to evaluate the effectiveness of oral atropine in the management of IHPS. Cases were diagnosed clinically and confirmed sonographically. Atropine was given orally from the outset at a dose of 0.18mg/kg/day in eight divided doses, increased daily by 1/4th of the commencing dose till vomiting ceased. Ultrasonographic evaluation of pyloric muscle thickness and length was done at the commencement of treatment, after completion of treatment and at 3,6,9,12 and 15 months follow up. Oral atropine was effective in 11/12 (91.06%) cases. Vomiting ceased in 14 to 21 days in all cases. One case required initial 7 days of I.V. treatment followed by 18 days oral treatment to stop vomiting. USG evidence of normalization of pylorus was observed in all these cases, 3-15 months after completion of treatment. We conclude that oral atropine proved to be a simple, effective, safe, very cheap and acceptable treatment option for IHPS.
Osteogenesis imperfecta with partial trisomy 15
(2009) Rajniti Prasad; Biswanath Basu; Utpal Kant Singh; Om Prakash Mishra
Osteogenesis imperfecta (OI) is the most common genetic cause of osteoporosis, which presents as multiple fractures of bone. Mutations in the loci COL1A1 on band 17q21 and COL1A2 on band 7q22 have been reported as the cause in most cases of OI, but partial trisomy 15 has not been reported previously as a possible cause. A 3-month-old child with OI with an unusual association of partial trisomy 15 is reported.
Portal hypertension with visceral leishmaniasis
(2010) Rajniti Prasad; Utpal Kant Singh; O.P. Mishra; B.P. Jaiswal; Sunil Muthusami
We conducted this study to observe evidence of portal hypertension in children with visceral leishmaniasis (VL). Eighty-eight consecutive cases (50 male) of VL were subjected to ultrasonography. Those with evidence of portal hypertension also underwent upper gastrointestinal endoscopy and liver biopsy. Eight patients had portal hypertension as evidenced by dilated caliber of portal and splenic veins. Two patients had periportal, splenic and peripancreatic collaterals and one patient had cavernous transformation of portal vein. Out of eight patients, four patients had esophageal and gastric varices. Liver biopsy was done in four patients and revealed hepatic sinusoidal dilations without any evidence of fibrosis. Portal hypertension may be an independent manifestation of VL and remain undiagnosed unless a physician maintains a high index of suspicion.
Serum procalcitonin in septic meningitis
(2013) Rajniti Prasad; Rishi Kapoor; Om Prakash Mishra; Ragini Srivastava; Utpal Kant Singh
Objective: To evaluate the role of serum procalcitonin (PCT) in diagnosis of septic meningitis in children and its efficacy in differential diagnosis. Methods: The study included 40 children of septic meningitis admitted in pediatric ward with fever, headache, vomiting and seizure, up to 14 y of age. The diagnosis of septic meningitis was based on clinical features; physical examination, blood and cerebrospinal fluid (CSF) cytochemical findings, gram's stain and bacterial culture. Fifteen cases of aseptic meningitis admitted during same period were also included in the study, and 15 children with normal CSF were taken as control. Serum PCT was measured by ELISA Kit. Results: Serum PCT level was significantly higher in children with septic meningitis than those with aseptic meningitis or in controls (p < 0.001). In culture and gram's stain positive 7 cases, serum procalcitonin was significantly elevated (24,768.21 ± 6,567.45 pg/mL) than aseptic meningitis(14,451.24 ± 4,266.15 pg/mL) (p < 0.001). Further its level was found significantly elevated in partially treated septic meningitis as compared to aseptic meningitis cases (p < 0.001). At optimum cut off value of ≥ 5,000 pg/mL, based on area under ROC curve, PCT showed sensitivity, specificity, positive predictive value and negative predictive value of 98.5 %, 93.5 %, 98.6 % and 93.3 % respectively. Serum PCT with cut off level of 15,000 pg/ml showed sensitivity, specificity, PPV and NPV of 92 %, 67 %, 91.4 % and 71.4 % respectively for the differentiation of septic from aseptic meningitis. Conclusions: Serum PCT may be used as diagnostic marker for septic meningitis and its differentiation from aseptic meningitis. © 2013 Dr. K C Chaudhuri Foundation.
Serum Retinol, Vitamin D and Zinc Levels in Under Five Children with Acute Lower Respiratory Tract Infections
(Springer, 2019) Rajniti Prasad; Anil Sharma; B.K. Das; S.P. Mishra; Utpal Kant Singh
[No abstract available]