Browsing by Author "Sriram, Gangina"
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Item Neuroimaging studies in children aged 6 months to 16 years with new onset afebrile seizures(Medip Academy, 2020-01) Satyanarayan, Akula; Sriram, Gangina; Bhavani, Ganga; Chandra, T. JayaBackground: Seizures are the most common pediatric neurological disorder. With this a study was conducted to determine the frequency of abnormal neuroimaging in children aged between 6 months to 16 years with new onset afebrile seizures.Methods: Study was conducted in the department of pediatrics, GSL Medical College. Children aged six months to sixteen years, presented with the symptoms of first episode of afebrile seizures were included in the study. After through clinical examinations, findings were recorded, and all the participants underwent imaging studies such as CT and MRI. And the findings were recorded. p<0.05 was considered statistically significant.Results: Total of 80 participants were included in the study; in this, 22.5% (18) had simple partial, 41.3% (33) had complex partial and 5% (4) had partial seizures with 20 generalization and 31.3% (25) had generalized seizures. Seizures were more common among non-vegetarians (p<0.05). Bain CT shows localization to the parietal lobe in 54% of these cases.Conclusions: Neurocysticercosis and tuberculoma are common causes of seizures. Although cysticercosis incidence is greater in pork eaters, but vegetarians shouldn't be excluded. Studies on large sample size for long time are recommended.Item Predictive value of serum bilirubin level for identifying term neonates at risk for subsequent hyperbilirubinemia(Medip Academy, 2019-09) Sriram, Gangina; Paramahamsa, R. Rama KrishnaBackground: Infants who are clinically jaundiced in the first few days are more likely to develop hyperbilirubinemia. The present study was made attempt to evaluate the predictive value of serum bilirubin level on day one postnatal age for identifying term neonates at risk for subsequent hyperbilirubinemia.Method: The present hospital based prospective study involving neonate's ?37 weeks of gestational age included 200 healthy term newborn babies (?37weeks GA) born at GSL medical college and hospital at Rajahmundry during study period. The purpose of this study was explained to the parents/ guardian and written consent was taken prior to the study. Data collected was kept securely. Permission was obtained from the Ethical Committee of GSL medical College before starting the study.Result: Newborns who developed significant hyperbilirubinemia male: female ratio was 1.07:1. 9(33%) newborns with significant hyperbilirubinemia had jaundice in previous siblings. In the present study, the value of 4.9 mg/dl was determined to have the best combination of sensitivity and specificity to predict neonates at risk of hyper birubinemia subsequently. At this value of 4.9 mg/dl there is high sensitivity and a very high negative predictive value, although a low positive predictive value for predicting neonates likely to develop significant hyperbilirubinemia.Conclusion: Early screening and appropriate management of hyperbilirubinemia is needed for prevention of complications in the newborn. This decreases the significant burden of untreated severe neonatal jaundice, causing potential neurological sequelae. Prediction of neonatal hyperbilirubinemia has widespread implication especially in our country where there are limited resources.Item Study on clinical profile and risk factors associated with pneumonia(Medip Academy, 2019-09) Sriram, Gangina; Satyanarayana, AkulaBackground: Modernization, industrialization and urbanization are now posed with the problem of increase in ARI morbidity and mortality. The epidemiological information regarding risk factors and management is scanty. A large gap exists in our knowledge about these factors, which needs to be fulfilled by systematic studies. The present study is designed to identify the risk factors of pneumonia in our area.Methods: This was a prospective clinical study of pneumonia conducted on 94 children who were admitted to Paediatric ward in GSL Medical College General Hospital, Rajahmundry in study duration. Epidemiological factors affecting the same were studied and bronchoscopy was done whenever it was needed. A detailed history of the relevant symptoms, such as fever, cough, rapid breathing, refusal of feeds, noisy breathing, bluish discolouration etc., was collected.Results: The most affected children belonged to the age group of 1 year to 3 years (64.9%). Bronchopneumonia (86.2%) was the most common clinical diagnosis made at admission. According to WHO ARI control programme, 28.7% had pneumonia, 54.3% had severe pneumonia and 17% very severe pneumonia. It was found that younger age group, malnutrition, kutcha house, crowding, poor sanitation facilities, cooking with fuel other than LPG (indoor pollution) and low socio economic status and high respiratory rate were significant risk factors for pneumonia in children.Conclusions: ARI, especially pneumonia is one of the major causes of morbidity and mortality in children. Bronchopneumonia is the predominant form of presentation in infants and preschool children.