Browsing by Author "Mittal, S K"
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Item Acute diarrhea in malnourished children. Clinical, biochemical and bacteriological profile.(1980-03-01) Mittal, S K; Saxena, S; Mundkur, N; Srivastava, G; Gupta, SItem Acute respiratory infections.(1990-09-01) Mittal, S K; Aggarwal, VItem Aetiology of chronic diarrhoea in tropical children.(1999-01-28) Rastogi, A; Malhotra, V; Uppal, B; Aggarwal, V; Kalra, K K; Mittal, S KAIM: We studied the causes and presentations of chronic diarrhoea in post-weaned children. METHODS: Forty seven children (6 months to 12 years) with diarrhoea of more than 2 weeks duration were recruited and subjected to detailed clinical examination and investigations. RESULTS: Primarily on the basis of history, clinical examination and duodenal biopsy, children could be classified into 5 groups namely tropical enteropathy (46.8%), irritable bowel syndrome (10.6%), giardiasis (14.8%), celiac disease (6.8%) and non specific diarrhoea (21.8%). Children with tropical enteropathy improved with broad spectrum antimicrobial therapy, those with irritable bowel syndrome and non specific chronic diarrhoea with dietary interventions while children with celiac disease required definite withdrawal of gluten from diet.Item Antibiotic resistance of gram negative rectal flora.(1984-09-01) Kanwar, A; Mittal, S K; Ramachandran, V G; Varghese, AItem Assessment of the immune and nutritional status of the host in childhood diarrhoea due to cryptosporidium.(1994-12-01) Jaggi, N; Rajeshwari, S; Mittal, S K; Mathur, M D; Baveja, U KCryptosporidium oocysts were detected microscopically in the concentrated faecal smears (stained by modified kinyoun's acid fast stain) in 13 out of 100 (13 per cent) cases of acute diarrhoea (AD < 2 weeks duration), 7 out of 50 (14 per cent) cases of chronic diarrhoea (CD > 2 weeks duration) and none in 50 age matched controls. The grades of malnutrition of the cases and controls were calculated by the weight for age criteria and the immune status assessed by the levels of serum immunoglobulins and SIgA in duodenal fluids. Malnutrition was observed in 6 out of 13 cases (46.1 per cent) in acute and 6 out of 7 cases (85.71 per cent) in chronic cryptosporidial diarrhoeas. There was no significant statistical difference (P > 0.05) in serum immunoglobulins and SIgA levels in chronic cryptosporidiosis. SIgA was significantly reduced (P > 0.05) in cases of acute cryptosporidiosis. Cryptosporidium is an important cause of symptomatic infection in apparently immunocompetent children not having been detected in a single non-diarrhoeal control. Further a low SIgA could contribute to acute symptomatic cryptosporidiosis by favouring colonization with the parasite.Item Asymmetry in the bony epiphyses of the knee joint in normal and malnourished children.(1988-10-01) Gupta, A; Garg, K; Mathur, R; Mittal, S KItem Autoimmune hemolytic anemia in infancy and childhood.(1970-07-01) Verma, I C; Mittal, S K; Ghai, O PItem Bacterial infections among home delivered neonates. Clinical picture and bacteriological profile.(1980-01-01) Saxena, S; Anand, N K; Saini, L; Mittal, S KItem Benign oesophageal strictures in children of north India.(2000-01-03) Mittal, S K; Kalra, K K; Khanijo, C M; Rajeshwari, KItem Bowel pattern and weight gain in breast fed infants.(1988-02-01) Mittal, S KItem Cellular and humoral factors of human milk in relation to nutritional status in lactating mothers.(1982-09-01) Narula, P; Mittal, S K; Gupta, S; Saha, KItem Cerebellar disorders in childhood. A review.(1969-08-01) Mittal, S KItem The challenge of infant mortality--need for a national commitment.(1982-04-01) Bhargava, S K; Mittal, S KItem Child health and manpower: 2000 AD.(1990-06-01) Mittal, S K; Ramji, SItem Chloramphenicol kinetics in malnutrition.(1981-11-01) Saini, G; Mittal, S K; Tayal, G; Saini, LItem Chronic diarrhea in children of tropics.(1994-11-01) Mittal, S K; Aggarwal, V; Kalra, K KSyndrome of prolonged diarrhea is quite frequent in tropical children. Careful clinical appraisal can help in separating these children into distinct clinical entities which have different underlying etiological factors. In most cases diagnosis is possible on clinical grounds supplemented by simple investigations. A step by step approach as outlined is extremely helpful in planning a rational management.Item Chronic diarrhea in tropics.(1999-11-02) Mittal, S KDiarrheal diseases continue to be very frequent in the tropics. Upto 40% of mortality associated with diarrheal diseases is associated with prolonged episodes of diarrhea and accompanying malnutrition. Prolonged diarrheal episodes can basically be divided into three main types: a) acute onset prolonged diarrhea or persistent diarrhea; b) insidious onset chronic diarrhea and c) recurrent diarrhea. Epidemiology, risk factors, etiological factors, gut pathophysiology and management of persistent diarrhea has been extensively reviewed in the article. Chronic diarrhea in tropics has entirely different etiological considerations than those observed in Western countries. Most of these factors are associated with poor sanitary and living conditions and gastrointestinal infections. Celiac disease is also identified as an important cause of chronic diarrhea in Indian settings. Chronic diarrhea needs to be differentiated from chronic non specific diarrhea wherein no adverse nutritional effects are seen in the patient.Item Clinical spectrum of chronic liver disease in north Indian children.(1997-10-05) Dangwal, T R; Aggarwal, V; Malhotra, V; Baveja, U; Mittal, S KRecent advances in serodiagnosis of hepatotropic viruses have revolutionized the approach to diagnosis and understanding of chronic liver disease (CLD). There are few studies on CLD in children from India. The present study was planned to define the clinical spectrum of CLD in children, its histopathology and seroepidemiology. Forty children with clinical features satisfying the criteria for diagnosing chronic liver disease were studied. All underwent routine laboratory investigations, liver function tests and ultrasound scan of the abdomen. Liver biopsy, upper GI endoscopy and other special investigations were done wherever indicated. The most common presenting features were jaundice (70%), fever (67%), and abdominal distention (60%). On examination hepatomegaly and icterus (80% each) and splenomegaly (67%) were the commonest findings. Serum transaminases were raised in 62.5% of children while prothrombin time was prolonged in 75% patients. Oesophageal and/or gastric varices were seen in 13 out of 29 patients subjected to upper GI endoscopy. Hepatitis B surface antigen (HbsAg) was positive in 5 children (12.5%) while 3 (7.5%) tested positive for anti HCV antibody. The commonest histopathological diagnosis was infantile cholangiopathy (20%) followed by cryptogenic cirrhosis and idiopathic chronic active hepatitis (17.5% each). The study suggests that the incidence of chronic hepatitis B and C is rather low in childhood. However larger and longer studies are required to delineate the exact incidence of these conditions in childhood and their progression in adolescence and early adulthood.Item Communication disabilities: emerging problems of childhood.(1977-10-01) Mittal, S K; Zaidi, I; Puri, N; Duggal, S; Rath, B; Bhargava, S KItem A comparative study of double contrast barium enema and colonoscopy for evaluation of rectal bleeding in children.(1995-04-01) Aggarwal, V; Mittal, S K; Kumar, N; Chowdhury, VIn pediatric age group, rectal bleeding is both common and distressing. Unlike in adults, very few studies comparing diagnostic efficacy of double contrast barium enema (DCBE) and Colonoscopy are available in children. A prospective study was performed to compare the diagnostic accuracy of high quality DCBE against colonoscopy in children with overt rectal bleeding. Fourty four children underwent flexible colonoscopy and DCBE independently. The final diagnosis was made after considering all investigations. Against this gold standard, the sensitivity and specificity of DCBE were 66.66% and 100% while that of colonoscopy 74.35% and 100% respectively. When assessing polypoidal lesions of colon, diagnostic yield of enema study was 86.20% as compared to 72.41% with colonoscopy. In colitis cases, the similar figures for enema and endoscopy were 53.84% and 76.92% respectively. The observed differences were statistically insignificant. No significant preparation, premedication or procedure related complications were encountered. The study thus highlights the utility and complementary role of DCBE and colonoscopy for evaluation of children with rectal bleeding.