Browsing by Author "Kumar, Sandeep"
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Publication A Five Year Profile of Clinical, Epidemiological and Radiological Characteristics of H1N1 Influenza in Children Admitted to Tertiary Care Center in South India(Nepal Paediatric Society (JNPS), 2023) Kumar, Sandeep; Athota, Mahesh Choudary; Kini, Pushpa; Aroor, Shrikiran; Mundkur, Suneel; Bhat Y, Ramesh; Moras, Karen JaniceAbstract: Introduction: Influenza viruses are common etiological agents of acute respiratory illness in children. Clinical presentation varies from flu like illness to severe respiratory and multi organ involvement. This study is done to describe the clinical profile and outcome of hospitalized children diagnosed with H1N1 influenza. Methods: A retrospective descriptive study was done at a tertiary care hospital in South India. It included children with swine flu diagnosed by RT-PCR assay of nasopharyngeal swab during the study period of five years. Data included clinical features, radiological findings, laboratory parameters, clinical course, complications and outcome. Results: There were 118 children with H1N1 Influenza. Median age was 4.35 years (IQR 0.8 - 10.7) with male:female ratio of 0.8:1. Fever was the commonest symptom present in 113 children (95.7%) followed by cough in 103 (87.2%) and nasal discharge (39.8%). Lower respiratory tract signs were present in 38 (27.9%) of the children. Co-morbid illness included malnutrition (33%), pre-existing wheeze (9.3%) and anaemia (6.8%). Anaemia was the common laboratory (36%) followed by thrombocytopenia (21.2%) and leucopenia (18.6%). Interstitial pattern was the commonest radiological finding (27.9%). Complications included secondary bacterial infection (27.1%), severe respiratory distress (16.2%), septic shock and MODS (5.9%), pleural effusion (3.4%), ARDS (2.5%), pneumothorax (1.7%) and PAH (1.7%). Mortality was observed in 5 (4.2%) children. Conclusion: The presence of co-morbid illness is a risk factor for severity of illness. Malnutrition and anaemia were risk factors for hospitalization and mortality.Publication Fibroscan as a Non-invasive Tool for Assessment of Hepatic Fibrosis in Children with Beta Thalassemia Major(Perinatal Society of Nepal (PESON), 2024) Chowdhury, Udita; Mundkur, Suneel; Kumar, Sandeep; Kini, Pushpa; Aroor, Shrikiran; Bhat Y, RameshAbstract: Introduction: Fibroscan is a noninvasive tool for measuring liver fibrosis. This study was done to assess liver fibrosis in thalassemic children and to correlate fibroscan findings with supportive markers of increased iron store such as serum ferritin. Methods: This prospective observational study was conducted in children between five and 18 years of age diagnosed with beta thalassemia major who were on regular blood transfusion. The fibroscan findings of liver were correlated with serum ferritin, liver enzymes, and blood transfusion requirements. Results: Among the 34 children who satisfied the inclusion criteria, 22 children (64%) had no fibrosis, 10 (30%) had mild fibrosis, and two (6%) had moderate fibrosis. Higher mean duration of blood transfusion and greater median ferritin levels (3420 vs 1997 µg / L; p-value 0.006) were observed in children with fibrosis. A greater number of transfusions were significantly associated with a greater degree of hepatic fibrosis which was statistically significant (p < 0.05). No association was observed between liver fibrosis and mean age of the study population, gender, and mean age at first transfusion, AST or ALT levels. Spearman’s correlation coefficient (rho) measured to estimate the degree and direction of the relationship between degrees of fibrosis with ferritin levels was 0.549, indicating a moderately positive relationship between serum ferritin levels and hepatic fibrosis (p-value - 0.0007). Conclusions: Fibroscan is an affordable, noninvasive, and faster alternative tool to estimate liver fibrosis in children with beta thalassemia major and is directly related to serum ferritin levels and transfusion requirements in children.