Browsing by Author "Arora, Sunita"
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Publication Association of Vitamin D Deficiency with Acute Lower Respiratory Infection in Toddlers Authors(Nepal Paediatric Society (JNPS), 2016) Narang, Gursharan Singh; Arora, Sunita; Kukreja, Sahiba; Shifali, DrAbstract: Introduction: Pneumonia remains a significant health problem in India with significant morbidity and mortality. Objectives of this study were to identifying an effective nutritional agent that reduces the need for antibiotics, duration of pneumonia and length of hospitalization would be highly cost-beneficial. Material and Methods: This was a hospital-based case-control study: A total of 100 children including 50 cases and 50 controls, aged 2–60 months, were enrolled. Case definition of severe ALRI as given by the World Health Organization was used for cases. Controls were healthy children attending outpatients’ service for immunization or admitted for minor ailments other than ALRTI. Results: Mean 25(OH)D concentrations in children of the study group were lower than those of the control group (20.431 ng/mL vs. 27.67 ng/mL; p = 0.035). Factors significantly associated with decreased risk of ALRTI in univariate analysis were: exclusive breastfeeding in the first 6 months (cases 13/50 (26%), controls 42/50 (84%); p=0.000); adequate exposure to sunlight (cases 14/50 (28%), controls 42/50 (84%); P=0.000); and serum 25OHD3 <20 ng/ml (cases 28/50 (56%), controls 0/50 (0%); p=.000). Multivariate logistic model indicated that severe vitamin D deficiency (OR=NA), exclusive breast feeding (OR=.174); 95% CI (.061- .521; p=.002) and adequate sunlight exposure (OR=.179) ;95%CI (.062-.519); p=.002) were significant independent predictive risk factors for ALRTI among the children between 2 months – 5 years of age (all p<0.05). Conclusion: Severe vitamin D deficiency (<20ng/ml), nonexclusive breastfeeding in the first six months of life, inadequate sun exposure were significant risk factors for ALRTI in Indian children.Publication Chylolymphatic Cyst - Presenting as Acute Intestinal Obstruction – A Case Report(Nepal Paediatric Society (JNPS), 2022) Arora, Sunita; Kaur, Taranjeet; Rana, Harwinder SinghAbstract: Chylolymphatic cyst is one of the rare variants of mesenteric cysts. These cysts are present within mesentery and contain chylous or lymphatic fluid. Chylolymphatic cysts are rare in paediatric age group. We present a case of a four years old boy who presented with features of acute intestinal obstruction. CECT abdomen revealed a hypodense cystic mass in the peritoneal cavity. Exploratory laparotomy of the abdomen revealed a solitary cyst measuring 10.7 cm x 9.4 cm x 10.5 cm which was adherent to the loops of small intestine and right kidney. Complete excision of cyst along with resection of the adjacent gut and end to end anastomosis was done. Histopathology of the excised cyst was suggestive of chylolymphatic cyst. It has been highlighted that chylolymphatic cyst can be a rare cause of intestinal obstruction in children.Publication Congenital Chylothorax as a Cause of Non Immune Hydrops: A Case Report(Nepal Paediatric Society (JNPS), 2022) Arora, Sunita; Narang, Gursharn Singh; Kaur, Anmol; Kaur, TaranjeetAbstract: Chylothorax is a rare cause of non immune hydrops fetalis & presents with respiratory distress at birth. We present a late preterm diagnosed antenatally as hydrops with chylothorax with bilateral pleural effusion and respiratory distress at birth requiring mechanical ventilation. Baby was managed successfully with intercostal drainage, octreotide infusion & MCT milk formula.Publication Cord Serum Bilirubin Level in Predicting the Development of Significant Hyperbilirubinemia in Newborns with ABO Incompatibility(Nepal Paediatric Society (JNPS), 2015) Arora, Sunita; ShifaliAbstract: Introduction: Neonatal hyperbilirubinaemia is common problem which is benign in majority of neonates. Rh iso immune hemolytic disease as a cause of hyperbilirubinemia is becoming nearly nonexistent due to the use of prophylactic anti D. Hence Isoimmune hemolytic disease due to ABO incompatibility assumes significance as a cause of significant hyperbilirubinaemia. This study was conducted to determine the incidence of ABO incompatibility, ABO iso immune disease in new born, to determine critical cord serum bilirubin level to predict subsequent significant hyperbilirubinemia. Material and Methods: The study was done in neonatal ICU of a tertiary care hospital where 100 full term healthy newborns with B.W≥2500gm and gestational age ≥37 wk with blood group A, B, AB, born to mothers with O blood group without simultaneous Rh incompatibility at SGRDIMSR were included. Serum bilirubin was measured approximately at 12-24hrs, 36-48hrs, 60-72hrs. Results: Out 100 ABO incompatible newborns 33(33%) developed ABO isoimmune disease manifesting as significant hyperbilirubinaemia with any of the four total serum bilirubin levels exceeding threshold levels defined for phototherapy. TSB of ≥ 2.16mg/d1 from cord blood has a sensitivity of 100% specificity of 89.55%, NPV 100% and PPV of 82.50% to predict significant hyperbilirubinaemia. Conclusion: A critical cord S.bilirubin between 2.16 mg/d1 and 4.09mg/d1 will predict all newborns who will have significant hyperbilirubinaemia and can be used as a safe demarcator to decide time of discharge. Any therapeutic intervention if necessary can be started as early as possible.Publication Neurological Worsening in a Child of Miliary Tuberculosis with Neuro-Tuberculosis on Anti Tubercular Treatment(Nepal Paediatric Society (JNPS), 2015) Arora, Sunita; Narang, Gursharan Singh; Dhillon, Prabhjot KaurAbstract: A seven and half year old male child presenting with pyrexia of unknown origin was diagnosed to be a case of miliary tuberculosis. Neuroimaging revealed multiple discrete ring as well as nodular enhancing lesions indicative of tuberculomas. After the initial response to ATT along with systemic steroids the child again presented with severe headache along with vomiting towards the end of intensive phase. Repeat neuroimaging showed appearance of new lesions with perilesional edema. Child was started again on systemic steroids and Streptomycin was added to the anti tubercular regimen, to which the child responded well.