Publications by authors named "Saumil Desai"

17 Publications

  • Page 1 of 1

The Use of Postnatal Weight Gain Algorithms to Predict Severe or Type 1 Retinopathy of Prematurity: A Systematic Review and Meta-analysis.

JAMA Netw Open 2021 Nov 1;4(11):e2135879. Epub 2021 Nov 1.

Department of Ophthalmology, Perth Children's Hospital, Perth, Australia.

Importance: The currently recommended method for screening for retinopathy of prematurity (ROP) is binocular indirect ophthalmoscopy, which requires frequent eye examinations entailing a heavy clinical workload. Weight gain-based algorithms have the potential to minimize the need for binocular indirect ophthalmoscopy and have been evaluated in different setups with variable results to predict type 1 or severe ROP.

Objective: To synthesize evidence regarding the ability of postnatal weight gain-based algorithms to predict type 1 or severe ROP.

Data Sources: PubMed, MEDLINE, Embase, and the Cochrane Library databases were searched to identify studies published between January 2000 and August 2021.

Study Selection: Prospective and retrospective studies evaluating the ability of these algorithms to predict type 1 or severe ROP were included.

Data Extraction And Synthesis: Two reviewers independently extracted data. This meta-analysis was performed according to the Cochrane guidelines and reported according to the Preferred Reporting Items for Systematic Reviews and Meta-analysis of Diagnostic Test Accuracy Studies (PRISMA-DTA) guidelines.

Main Outcomes And Measures: Ability of algorithms to predict type 1 or sever ROP was measured using statistical indices (pooled sensitivity, specificity, and summary area under the receiver operating characteristic curves, as well as pooled negative likelihood ratios and positive likelihood ratios and diagnostic odds ratios).

Results: A total of 61 studies (>37 000 infants) were included in the meta-analysis. The pooled estimates for sensitivity and specificity, respectively, were 0.89 (95% CI, 0.85-0.92) and 0.57 (95% CI, 0.51-0.63) for WINROP (Weight, IGF-1 [insulinlike growth factor 1], Neonatal, ROP), 1.00 (95% CI, 0.88-1.00) and 0.60 (95% CI, 0.15-0.93) for G-ROP (Postnatal Growth and ROP), 0.95 (95% CI, 0.71-0.99) and 0.52 (95% CI, 0.36-0.68) for CHOP ROP (Children's Hospital of Philadelphia ROP), 0.99 (95% CI, 0.73-1.00) and 0.49 (95% CI, 0.03-0.74) for ROPScore, 0.98 (95% CI, 0.94-0.99) and 0.35 (95% CI, 0.22-0.51) for CO-ROP (Colorado ROP). The original PINT (Premature Infants in Need of Transfusion) ROP study reported a sensitivity of 0.98 (95% CI, 0.91-0.99) and a specificity of 0.36 (95% CI, 0.30-0.42). The pooled negative likelihood ratios were 0.19 (95% CI, 0.13-0.27) for WINROP, 0.0 (95% CI, 0.00-0.32) for G-ROP, 0.10 (95% CI, 0.02-0.53) for CHOP ROP, 0.03 (95% CI, 0.00-0.77) for ROPScore, and 0.07 (95% CI, 0.03-0.16) for CO-ROP. The pooled positive likelihood ratios were 2.1 (95% CI, 1.8-2.4) for WINROP, 2.5 (95% CI, 0.7-9.1) for G-ROP, 2.0 (95% CI, 1.5-2.6) for CHOP ROP, 1.9 (95% CI, 1.1-3.3) for ROPScore, and 1.5 (95% CI, 1.2-1.9) for CO-ROP.

Conclusions And Relevance: This study suggests that weight gain-based algorithms have adequate sensitivity and negative likelihood ratios to provide reasonable certainty in ruling out type 1 ROP or severe ROP. Given the implications of missing even a single case of severe ROP, algorithms with very high sensitivity (close to 100%) and low negative likelihood ratios (close to zero) need to be chosen to safely reduce the number of unnecessary examinations in infants at lower risk of severe ROP.
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http://dx.doi.org/10.1001/jamanetworkopen.2021.35879DOI Listing
November 2021

A Quality Improvement Initiative Study to Improve Breastfeeding Rates in Kangaroo Mother Care Position.

Breastfeed Med 2021 04 27;16(4):313-317. Epub 2021 Jan 27.

Neonatology Department, Seth GS Medical College and King Edward Memorial Hospital, Mumbai, India.

Exclusive breastfeeding is an integral component of Kangaroo Mother Care (KMC). However, the practice of breastfeeding in KMC position is often suboptimal. Hence, a Quality Improvement (QI) initiative study was conducted to improve breastfeeding rates while providing KMC. Fish bone analysis was used to identify the potential barriers, which were targeted to bring improvement through Plan-Do-Study-Action (PDSA) cycles. Eligible mother-infant (≥34 weeks) dyad who were admitted in Neonatal intensive care unit during the study period were enrolled in the study ( = 45). QI was implemented through two PDSA cycles. In the first PDSA cycle, training and sensitization of health care providers was done. In the second PDSA cycle, mothers were educated and trained for breastfeeding in the KMC position. Data were collected using bed side nursing charts and interviewing the mothers. Data were analyzed using run charts and SPSS software. A -value of <0.05 was considered to be significant. Percentage of mothers practicing breastfeeding in KMC position increased to 50% after first PDSA cycle and to 100% after the second PDSA cycle from the baseline of <10%. Average duration of KMC increased significantly from baseline 6.09 to 10.9 hours ( = 0.003) in first cycle and 15.6 hours in second cycle ( < 0.001). QI measures increased the rates of breastfeeding in KMC position. The total duration of KMC per day was also significantly increased.
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http://dx.doi.org/10.1089/bfm.2020.0329DOI Listing
April 2021

Validation of WINROP (online prediction model) to identify severe retinopathy of prematurity (ROP) in an Australian preterm population: a retrospective study.

Eye (Lond) 2021 May 17;35(5):1334-1339. Epub 2020 Jul 17.

Department of Ophthalmology, Perth Children's Hospital, Perth, WA, Australia.

Introduction: Retinopathy of prematurity (ROP) is the most common disease leading to blindness in extreme preterm infants. Current screening guidelines recommend frequent eye examinations. There is a dearth of trained ophthalmologists for these frequent screening procedures. The ANZNN neonatal network report (2013) found that only 6.4% of all screened infants had severe ROP and less than half received treatment. WINROP (online prediction model, Sweden) uses the postnatal weight gain (surrogate marker for low insulin-like growth factor IGF-1 and poor retinal vascular growth) to identify ROP requiring treatment and aims to reduce the number of examinations. Our objective was to validate the WINROP model in an Australian cohort of preterm infants.

Methods: Birth weight, gestational age, and weekly weight measurements were retrieved retrospectively along with the final ROP outcomes and plotted on the online WINROP software.

Results: The sensitivity, specificity, positive predictive value, and negative predictive value of WINROP were 85.7%, 59.0%, 6.98%, and 99.1% respectively for a cohort of 221 preterm infants (Median birth weight, 1040 g; Gestational age, 27.9 weeks). WINROP alarm was signaled in 42.6% of all infants. WINROP did not signal an alarm in one infant who needed treatment. This infant had intra ventricular hemorrhage grade 3-4 and temporary ventricular dilatation.

Conclusions: This is the first Australian study validating WINROP model. Our findings suggest that it lacked sensitivity to be used alone. However, adjusting the algorithm for the Australian population may improve the efficacy and reduce the number of examinations when used along with the current screening guidelines.
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http://dx.doi.org/10.1038/s41433-020-1094-7DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8182793PMC
May 2021

Diffuse excessive high signal intensity on term equivalent MRI does not predict disability: a systematic review and meta-analysis.

Arch Dis Child Fetal Neonatal Ed 2021 Jan 25;106(1):9-16. Epub 2020 May 25.

Neonatal Intensive Care Unit, King Edward Memorial Hospital for Women Perth, Subiaco, Western Australia, Australia.

Objective: To evaluate whether diffuse excessive high signal intensity (DEHSI) on term equivalent age MRI (TEA-MRI) predicts disability in preterm infants.

Design: This is a systematic review and meta-analysis. Medline, EMBASE, Cochrane Library, EMCARE, Google Scholar and MedNar databases were searched in July 2019. Studies comparing developmental outcomes of isolated DEHSI on TEA-MRI versus normal TEA-MRI were included. Two reviewers independently extracted data and assessed the risk of bias. Meta-analysis was undertaken where data were available in a format suitable for pooling.

Main Outcome Measures: Neurodevelopmental outcomes ≥1 year of corrected age based on validated tools.

Results: A total of 15 studies (n=1832) were included, of which data from 9 studies were available for meta-analysis. The pooled estimate (n=7) for sensitivity of DEHSI in predicting cognitive/mental disability was 0.58 (95% CI 0.34 to 0.79) and for specificity was 0.46 (95% CI 0.20 to 0.74). The summary area under the receiver operating characteristics (ROC) curve was low at 0.54 (CI 0.50 to 0.58). A pooled diagnostic OR (DOR) of 1 indicated that DEHSI does not discriminate preterm infants with and without mental disability. The pooled estimate (n=8) for sensitivity of DEHSI in predicting cerebral palsy (CP) was 0.57 (95% CI 0.37 to 0.75) and for specificity was 0.41 (95% CI 0.24 to 0.62). The summary area under the ROC curve was low at 0.51 (CI 0.46 to 0.55). A pooled DOR of 1 indicated that DEHSI does not discriminate between preterm infants with and without CP.

Conclusions: DEHSI on TEA-MRI did not predict future development of cognitive/mental disabilities or CP.

Prospero Registration Number: CRD42019130576.
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http://dx.doi.org/10.1136/archdischild-2019-318207DOI Listing
January 2021

Correlation of haematological parameters and C-reactive protein between cord blood and first post-natal blood sample in preterm neonates: A prospective observational study.

J Paediatr Child Health 2020 Jun 13;56(6):922-927. Epub 2020 Jan 13.

Pathology Department, Seth GS Medical College and King Edward Memorial Hospital, Mumbai, India.

Aim: There is some recent evidence on the utility of the cord blood as a reliable source for admission complete blood count in preterm neonates. However, there is a need to validate other laboratory parameters from the cord blood such as C-reactive protein (CRP) to rule out neonatal sepsis. The present study was carried out to evaluate the correlation between haematological parameters and CRP obtained from the cord blood to the first post-natal blood sample, for it to be considered as a reliable alternative.

Methods: A total of 89 paired cord blood and first post-natal blood samples were prospectively analysed to assess the haematological parameters (complete blood count) and CRP. Pearson's coefficient was calculated to assess the correlation between the cord blood and the first post-natal blood sample.

Results: When Pearson's correlation coefficient was calculated for various haematological parameters, it showed good correlation coefficient of 0.84 for total leukocyte count, 0.84 for absolute neutrophil count count, 0.87 for immature to total neutrophil ratio and 0.95 for CRP. The correlation coefficient was 0.64 for haemoglobin and 0.36 for platelet count.

Conclusion: There is a strong correlation between the majority of haematological parameters and CRP obtained from the cord blood with the first post-natal blood sample in preterm neonates, except the platelet count. Hence, umbilical cord blood is a feasible and reliable alternative source for assessment of haematological parameters and CRP for the first post-natal blood sample, thereby avoiding a painful prick in these fragile preterm neonates.
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http://dx.doi.org/10.1111/jpc.14776DOI Listing
June 2020

Children's Hospital of Philadelphia Score to predict severe retinopathy in Indian preterm infants.

Eye (Lond) 2019 09 8;33(9):1452-1458. Epub 2019 Apr 8.

National Institute of Immunohaematology, Indian Council of Medical Research, Mumbai, India.

Background: Retinopathy of Prematurity (ROP) screenings are expensive and entail heavy workload. Predictive models using postnatal weight gain reduces the number of ophthalmological examinations. The objective was to validate Children's Hospital of Philadelphia (CHOP) score to predict severe ROP in resource limited settings.

Methods: Prior to ophthalmic examination, the CHOP score was calculated to predict severe ROP (point estimate = 0.014) in 191 preterm infants. Cut-off point estimate, most suitable in resource limited settings was assessed.

Results: CHOP Score cutoff point (0.014) showed 67% sensitivity, 75% specificity. With CHOP score cut-off point (0.010), the corresponding values were 100% sensitivity, 51% specificity, PPV 12% and NPV 100%.

Conclusion: CHOP Score (0.014) is a poor tool to predict the onset of severe ROP. However, CHOP Score (0.010) is a promising tool to predict the onset of severe ROP and reduces the need for ophthalmological examinations by 50% in resource limited settings.
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http://dx.doi.org/10.1038/s41433-019-0431-1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7002559PMC
September 2019

Serum Albumin and C-Reactive Protein as Predictors of Adverse Outcomes in Critically Ill Children: A Prospective Observational Pilot Study.

Indian J Pediatr 2019 08 26;86(8):758-759. Epub 2019 Mar 26.

Department of Neonatology, Seth GS Medical College and KEM Hospital, Mumbai, India.

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http://dx.doi.org/10.1007/s12098-019-02934-3DOI Listing
August 2019

Innate immune gene polymorphisms and their association with neonatal sepsis.

Infect Genet Evol 2018 08 30;62:205-210. Epub 2018 Apr 30.

Department of Haematogenetics, National Institute of Immunohaematology (ICMR), KEM Hospital Campus, Parel, Mumbai, India. Electronic address:

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http://dx.doi.org/10.1016/j.meegid.2018.04.037DOI Listing
August 2018

Red Cell Distribution Width (RDW): Normative Data in Indian Neonates.

J Pediatr Hematol Oncol 2019 03;41(2):e119-e121

Department of Haematogenetics, National Institute of Immunohaematology (ICMR), KEM Hospital campus, Parel, Mumbai, India.

Red cell distribution width (RDW) is altered because of prematurity and fetal growth restriction (FGR). We conducted a prospective observational study to determine normal RDW values in Indian neonates (N=964) with significant FGR. Mean RDW values in preterm neonates were higher than term neonates (P<0.0004). The RDW values in Indian neonates (with significant FGR) were higher than their western counterparts (P<0.0001). The mean RDW values for different gestational ages in Indian neonates are higher than those observed in other studies. This could be attributable to the FGR component among Indian neonates.
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http://dx.doi.org/10.1097/MPH.0000000000001164DOI Listing
March 2019

Red cell distribution width and its association with mortality in neonatal sepsis.

J Matern Fetal Neonatal Med 2019 Jun 8;32(12):1925-1930. Epub 2018 Jan 8.

a Department of Haematogenetics , National Institute of Immunohaematology (ICMR), KEM Hospital campus , Mumbai , India.

Objective: Neonatal sepsis is a major cause of mortality in the developing countries. However, with current severity scores and laboratory parameters, predicting outcomes of neonatal sepsis is a serious challenge. Red cell distribution width (RDW) is a readily available pragmatic means to predict outcomes of various comorbidities in adults and children, without causing any additional blood loss. However, its utility in neonates remains unexplored. Hence, the objective of the present study was to evaluate the association of RDW with neonatal sepsis and its role as a predictive marker for mortality.

Methods: This Prospective observational study was carried out in a Level IIIB NICU for a period of 3 years. It involved comparison of RDW values of septic neonates with those of controls (matched for gestational age and birth weight) with an equal allocation ratio. A total of 251 septic neonates along with 251 controls >28 weeks of gestational age were enrolled. The RDW was derived from complete blood count done within first 6 hours of life. After arranging the RDW (median; interquartile range (IQR)), the values were categorized as those above the 50th percentile i.e. ≥20% and those below the 50th percentile i.e. <20%. The cumulative survival rates of the above two groups were assessed using the Kaplan-Meier curve and the log rank test.

Results: RDW levels were significantly higher among the neonatal sepsis cases (19.90%) as compared to the controls (18.90%) with a p value of < .001. RDW was significantly higher amongst the nonsurvivors than survivors (p < .003). Kaplan-Meier curve showed that septic neonates having RDW values ≥20% had significantly increased mortality (p < .02) with a hazard ratio of 0.5.

Conclusions: High RDW is associated with neonatal sepsis and is an independent outcome predictor for mortality associated with neonatal sepsis.
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http://dx.doi.org/10.1080/14767058.2017.1421932DOI Listing
June 2019

Effect of Expressed Breast Milk versus Swaddling versus Oral Sucrose Administration on Pain Associated with Suctioning in Preterm Neonates on Assisted Ventilation: A Randomized Controlled Trial.

Indian J Palliat Care 2017 Oct-Dec;23(4):372-378

Department of Neonatology, Seth GS Medical College and KEM Hospital, Mumbai, Maharashtra, India.

Objective: The objective of our study was to assess the pain associated with suctioning in preterm neonates on assisted ventilation and comparing the use of expressed breast milk (EBM), sucrose, and swaddling to alleviate pain.

Methods: Study design: A randomized controlled clinical trial.

Inclusion Criteria: Preterm neonates on assisted ventilation.

Exclusion Criteria: Major congenital anomalies and severe encephalopathy.

Study Duration And Site: 6 months in level III neonatal Intensive Care Unit. In the first phase, we used premature infant pain profile (PIPP) score to assess pain associated with suctioning in preterm neonates on assisted ventilation. In the second phase, the effect of EBM, swaddling, and sucrose on pain relief during suctioning in neonates on assisted ventilation was assessed.

Results: There was a significant increase in pain associated with suctioning in preterm neonates on assisted ventilation (preprocedure PIPP score 7.90 ± 2.50; procedural PIPP score 13.63 ± 2.57; < 0.05). The postintervention mean procedural PIPP score was not significantly different between the EBM, swaddling, and sucrose groups ( = 0.24).

Conclusions: Suctioning is painful for preterm neonates on assisted ventilation. There was no difference between EBM, swaddling, and sucrose in relieving pain associated with suctioning.
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http://dx.doi.org/10.4103/IJPC.IJPC_84_17DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5661337PMC
November 2017

Comparison of Neonatal Pain, Agitation, and Sedation Scale with Premature Infant Pain Profile for the Assessment of Acute Prolonged Pain in Neonates on Assisted Ventilation: A Prospective Observational Study.

Indian J Palliat Care 2017 Jul-Sep;23(3):287-292

Department of Neonatology, KEM Hospital, Seth G S Medical College, Mumbai, Maharashtra, India.

Aim: This study aimed to compare Neonatal Pain, Agitation, and Sedation Scale (N-PASS) with Premature Infant Pain Profile (PIPP) for the assessment of acute prolonged pain in ventilated neonates.

Methods: This study was conducted in two phases. In phase 1 of the study, we assessed whether neonates on assisted ventilation experienced acute prolonged pain. In phase 2, the aim was to compare N-PASS with PIPP for the assessment of acute prolonged pain in neonates on assisted ventilation..

Design: This is a prospective observational study.

Study Setting And Duration: This study was conducted at a tertiary care neonatal intensive care unit for 6 months.

Inclusion Criteria: Neonates on assisted ventilation for >48 h were selected for this study.

Exclusion Criteria: Neonates with lethal congenital anomalies and severe encephalopathy were excluded from the study. N-PASS and PIPP tools were used to assess acute prolonged pain in ventilated neonates. Taking PIPP as gold standard and N-PASS as a new test, the correlation coefficient was calculated. The sensitivity, specificity, positive predictive value, and negative predictive value were also computed. The time taken to administer the tools was also computed.

Results: The average PIPP score for ventilated neonates was 8.33. The correlation coefficient of N-PASS when compared to PIPP was 0.62. The average time taken to apply the N-PASS scale was 4.42 min as compared to 8.20 min for PIPP scale. In term neonates, the sensitivity, specificity, positive predictive value, and negative predictive value of N-PASS were 75%, 100%, 100%, and 60%, respectively. The corresponding values in preterm neonates were lesser.

Conclusions: The study proves that neonates on assisted ventilation experience acute prolonged pain. N-PASS is clinically reliable and valid to assess acute prolonged pain in ventilated term neonates. The N-PASS is quicker than PIPP in assessing acute prolonged pain in ventilated neonates.

Future Directions: The modified N-PASS tool (including the gestational age) should be developed.
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http://dx.doi.org/10.4103/IJPC.IJPC_42_17DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5545954PMC
August 2017

Labour room Continuous Positive Airway Pressure (LR CPAP) in preterm neonates <34 weeks: An Indian experience.

Sudan J Paediatr 2017 ;17(2):30-34

Department of Neonatology, Seth G S Medical College and KEM Hospital, Parel, Mumbai 400012, India.

Early continuous positive airway pressure (CPAP) has proven to be beneficial in reducing ventilator dependence and subsequent chronic lung disease in neonates suffering from Respiratory distress syndrome (RDS). However, the efficacy of initiating labour room (LR) CPAP has not been determined prospectively in resource limited settings like India. Hence the objective of the present study was to study the efficacy of LR CPAP in preterm neonates with RDS in resource limited Indian settings. This was a prospective observational study including preterm neonates (26-34 weeks with RDS) carried out over a period of 6 months (January to June 2016) when the CPAP was initiated in LR. The outcome was compared with a similar population during the corresponding period of the previous year when CPAP was initiated in NICU. The historical controls were retrieved from case records and matched for gestational age and birth weight with the study population. There was 36% absolute risk reduction in the need for surfactant and 56% for mechanical ventilation in the LR CPAP group respectively. LR CPAP reduces the need for mechanical ventilation and surfactant in preterm neonates with RDS in resource limited settings.
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http://dx.doi.org/10.24911/SJP.2017.2.3DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5845453PMC
January 2017

Efficacy of fixed low dose hydroxyurea in Indian children with sickle cell anemia: a single centre experience.

Indian Pediatr 2013 Oct 5;50(10):929-33. Epub 2013 Apr 5.

Department of Pediatrics, Government Medical College, Nagpur; and * National Institute of Immunohaematology, Mumbai, India. Correspondence to: Dr Dipti Jain,Professor, Department of Pediatrics, Governement Medical College, Nagpur, Maharashtra 440 003, India.

Introduction: Data on the efficacy of hydroxyurea (HU) in Indian children with sickle cell anaemia (SCA) is limited. Hence, we have evaluated the efficacy of fixed low dose HU in Indian children.

Methods: The study cohort consisted of 144 children (<18 years of age) with SCA having severe manifestations (≥ 3 episodes of vasocclusive crisis or blood transfusions, or having ≥ 1 episode of acute chest syndrome or cerebrovascular stroke or sequestration crisis) who were started on fixed low dose HU (10 mg/kg/day). They were followed up for two years and monitored for the hematological and clinical efficacy and safety.

Results: There was significant increase in the fetal hemoglobin level (HbF%), total hemoglobin and mean corpuscular volume. Vasoocclusive crises, blood transfusions, acute chest syndrome, sequestration crises and hospitalizations decreased significantly. Baseline HbF% had significant positive correlation with HbF% at 24 months. There was significant negative correlation between baseline HbF% and change in HbF% from baseline to 24 months. No significant correlation was found between HbF% at baseline and clinical event rates per year after HU. No major adverse events occurred during the study period.

Conclusions: Fixed low dose HU is effective and safe in Indian children with SCA.
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http://dx.doi.org/10.1007/s13312-013-0264-0DOI Listing
October 2013

A rare cause of neck swelling in a child.

BMJ Case Rep 2013 Apr 5;2013. Epub 2013 Apr 5.

Department of Pediatrics, Government Medical College, Nagpur, Maharashtra, India.

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http://dx.doi.org/10.1136/bcr-2012-008444DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3644932PMC
April 2013

Low fixed-dose hydroxyurea in severely affected Indian children with sickle cell disease.

Hemoglobin 2012 ;36(4):323-32

Department of Paediatrics, Government Medical College, Nagpur, Maharsashtra-440009, India.

There is limited data on the efficacy of hydroxyurea (HU) in Indian sickle cell anemia patients who have severe manifestations despite high fetal hemoglobin (Hb F). Sixty sickle cell anemia children (5-18 years) with more than three episodes of vasoocclusive crises or blood transfusions per year were randomized to receive HU (n = 30) or placebo (n = 30) therapy. Fixed dose (10 mg/kg/day) of HU was administered for 18 months and the patients were followed-up monthly with clinical assessment and laboratory monitoring. In the HU group, hemoglobin (Hb) and Hb F levels increased significantly along with a significant decrease in the number of painful crises, blood transfusion requirements and hospitalizations compared to the placebo group. No major adverse events were observed in this study. In conclusion, low-fixed dose HU therapy was effective for the treatment of Indian sickle cell anemia children. However, there is a need for long-term studies to evaluate the efficacy and toxicity in a larger number of Indian sickle cell anemia patients.
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http://dx.doi.org/10.3109/03630269.2012.697948DOI Listing
October 2012

Primary mucinous carcinoma of urachus--a case report.

Indian J Pathol Microbiol 2006 Jul;49(3):409-11

Department of Pathology, Gujarat Cancer & Research Institute, Asarwa, Ahmedabad.

The authors describe a case of primary mucinous carcinoma of urachus in 65 years old male. Patient presented with hematuria with suprapubic mass. The patient underwent total cystectomy with en bloc excision of the tumor mass and umbilicus. Histological examination showed features of mucinous carcinoma of urachus. A clinicopathological study and brief review of literature is presented.
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July 2006
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