Browsing by Author "Mondal, Rakesh"
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Item Authors’ Reply: Primary Neonatal Psoas Abscess.(2013-09) Mondal, Rakesh; Sarkar, SumantraItem Avascular Necrosis of Hip Following Combined Protein C and Protein S Deficiency.(2011-12) Nandi, Madhumita; Mondal, RakeshItem Childhood lupus: Experience from eastern India.(2010-08) Mondal, Rakesh; Nandi, Madhumita; Ganguli, Suhas; Ghosh, Alokendu; Hazra, AvijitObjective. To delineate the clinical behavior of SLE in children from Eastern India and to the differences in disease pattern. Methods. In the present study, all 44 patients of pediatric SLE who were diagnosed over a period of 5 years in our pediatric rheumatology clinic were followed prospectively. The resultant database was analyzed using standard statistical methods. Results. About 3.9% of all rheumatology cases dealt with in the clinic in the last five yrs (n=1063) were SLE. The number of children in 5-8 yrs and 8-12 yrs age groups were 13 and 27, respectively. The overall female (n=35) to male (n=9) ratio in this study was 3.8:1. Renal, hematological and Neuropsychiatric features were most common major organ manifestations(54%,54% and 25% respectively). Joints and skin were the most common minor organs involved. Two case were ANA negative SLE. Among the typical features of ANA negative disease, only nephritis was found in these patients. Anti dsDNA was positive in 50 % cases (n=21). C3 levels were studied in all cases with nephritis (n=22) and 68 % (n=15) had hypocomplementemia. Anti Ro and anti La antibodies were positive in two cases of neonatal lupus. APLA, Anti Sm antibody and anti U1RNP were negative in the cases where testing was done. Conclusions. This study has tried to delineate the disease trends of childhood lupus from Eastern India. Certain important trends have emerged which are different from other contemporary Indian and International observations.Item Childhood ‘Rhupus’ Syndrome.(2015-04) Mitra, Sonali; Mondal, RakeshItem Clinico-serological profile of juvenile idiopathic arthritis.(2009-07) Nandi, Madhumita; Ganguli, Suhas K; Mondal, Rakesh; Ghosh, AlokenduWe report clinico-serological profile of 210 children with Juvenile idiopathic arthritis (JIA), diagnosed as per ILAR classification criteria. Polyarticular, oligoarticular, and systemic onset disease was observed in 72, 69, and 40 children, respectively. The knee joint was the most frequently involved joint. Antinuclear factor and Rheumatoid factor were positive in 10 and 8, 6 and 20, and 7 and 7 percent children with polyarticular, oligoarticular, and systemic disease, respectively.Item Clitoral Length and Anogenital Ratio in Indian Newborn Girls.(2016-04) Mondal, Rakesh; Chatterjee, Kaushani; Samanta, Moumita; Hazra, Avijit; Ray, Somosri; Sabui, apas Kumar; Banerjee, Basanta; Das, Suman; Roychowdhury, Dibyendu; Biswas, RupaObjective: To generate normative data on clitoris length, anogenital distance and anogenital ratio in Indian newborns. Design: Cross-sectional study. Setting: Neonatal unit of a tertiary care teaching hospital in Kolkata. Participants: 378 female neonates, who were hemo-dynamically stable without critical illness or chromosomal anomaly, and without any vulval hematoma or genital abnormalities. Interventions: Measurements were recorded using a digital vernier caliper between 24-72 hours. Infant was held in position by an assistant, while the investigator measured clitoral length by gently retracting the labia majora. Anogenital distance (centre of the anus to posterior convergence of the fourchette) and anogenital ratio (anogenital distance divided by the distance from centre of the anus to base of the clitoris) was also measured. Main outcome measures: Gestational age- and birthweight-wise normative values of clitoral length, anogenital distance and anogenital ratios. Results: Mean clitoral length was 3.1 (1.54) mm for the whole cohort while anogenital distance and anogenital ratio were 10.2 (2.78) mm and 0.34 (0.07) mm, respectively. The gestation age-wise percentile charts of clitoral length, anogenital distance and anogenital ratio have been generated. There was no correlation between clitoral length and gestational age, body length, head circumference and birth weight. Correlations were also weak for anogenital distance. Conclusions: The normative values generated can serve as reference standard in the assessment of clitoromegaly, ambiguous genitalia, virilizing effects and suspected in utero androgen exposure.Item Consequences of Telemedicine.(2010-12) Nandi, Madhumita; Sarkar, Sumantra; Mondal, RakeshItem Diabetic Ketoacidosis With L-asparaginase Therapy.(2011-09) Mondal, Rakesh; Nandi, Madhumita; Tiwari, Astha; Chakravorti, SwatiDiabetic ketoacidosisis as a complication of L-asparaginase therapy in children with acute leukemia is rare. Hyperglycemia may occur in about 10% of cases receiving L-asp, which may present as mild glucose intolerance to severe hyperglycemia. We report two children with acute lymphoblastic leukemia who developed diabetic ketoacidosis after treatment with L-asparaginase.Item Electrocardiographic Parameters in Indian Newborns(Indian Academy of Pediatrics, 2019-11) Habibulla, SK Md; Bhowmik, Arijit; Saha, Jayanta; Hazra, Avijit; Halder, Sanjay K; Mondal, RakeshObjective: To generate data of electrocardiogram (ECG) parameters according to gestationalage in Indian newborns. Methods: An observational study was carried out over 7 months inneonatology unit of a tertiary care teaching hospital. Following auscultation, ECG parameterswere recorded simultaneously in 12 leads, on third day of life, in hemodynamically stableneonates. Data from 364 babies were analyzed, keeping at least 30 records for eachgestational age between 30 to 42 weeks. Results: There was no difference in mean heart raterecorded through auscultation and ECG traces. The mean (SD) values recorded were: Pwave duration 0.04 (0.01) s, P wave amplitude 1.3 (0.4) mm, T wave duration 0.07 (0.02) s, Twave amplitude 1.1 (0.6) mm, PR interval 0.09 (0.02) s, QRS duration 0.04 (0.01) s, QTinterval 0.26 (0.02) s, QTc 0.4 (0.03) s and QRS axis 127 (22) degree. Gestation age-wisepercentile charts of different ECG parameters were generated. Conclusion: Thesegestational age-wise percentile charts of different ECG parameters for Indian newborns canbe used as reference for neonatal ECGItem Extended Sick Neonate Score (ESNS) for Clinical Assessment and Mortality Prediction in Sick Newborns referred to Tertiary Care(Indian Academy of Pediatrics, 2019-02) Ray, Somosri; Mondal, Rakesh; Chatterjee, Kaushani; Samanta, Moumita; Hazra, Avijit; Sabui, Tapas KumarObjective:To evaluate utility of a new Extended Sick Neonate Score (ESNS). to predict ‘in-hospital mortality’ and compare with Score for Neonatal Acute Physiology – PerinatalExtension II (SNAPPE II) and Sick Neonate Score (SNS). Design:Prospective observationalstudy. Methods:All extramural sick newborns transported to the neonatology unit of a tertiarycare teaching hospitalover a period of one year.Correlation between ESNS, SNAPPE-II andSNS scoring, and sensitivity/specificity of each score to predict mortality were determined.Results:961 newborns were enrolled in the study. ESNS, SNAPPE II and SNS were stronglycorrelated, even when stratified by gestation. ESNS of ≤11 had the best sensitivity (85.9%)and specificity (89.8%). For preterms, ESNS ≤12 had the best sensitivity (92.3%) andspecificity (76.7%). Conclusion:ESNS can predict ‘in-hospital mortality’ outcome withsatisfactory sensitivity and specificityItem Growth of Children with Juvenile Idiopathic Arthritis.(2014-03) Mondal, Rakesh; Sarkar, Sumantra; Das, Niloy Kumar; Chakravorti, Swati; Hazra, Avijit; Sabui, Tapas; Nandi, Madhumita; Ray, Biman; Das, Anjan; Ganguli, SushasObjective: To evaluate the growth pattern in children with juvenile idiopathic arthritis and its subtypes in comparison with age, sex and temporally matched controls. Study design: Prospective study. Setting: Pediatric rheumatology clinic of a tertiary care hospital in Eastern part of India. Participants: Seventy-five children (2-12 years) diagnosed as juvenile idiopathic erthritis by International League of Associations for Rheumatology criteria and 75 age- and sex- matched controls. Intervention: Weight, height and body mass index were recorded at six monthly interval in both groups over a period of 3 years. Main outcome measures: weight, height and body mass index. Results: Subtype distribution of juvenile idiopathic arthritis was: oligoarthritis (49%, n=37), rheumatoid factor negative polyarthritis (27%, n=20), rheumatoid factor positive polyarthritis (8%, n=6), systemic onset (15%, n=11) and enthesitis related arthritis (1.3%, n=1). Anthropometric parameters in children with juvenile idiopathic arthritis were not significant different from controls. Comparison between the subtypes showed significant differences in height (P=0.011), weight (P=0.005), and growth velocity (P=0.005), but not in body mass index. Systemic onset disease led to significant restriction in height (P=0.018; 95% CI 2.13-33.77) and weight (P=0.008; 95% CI 1.47-14.43) compared to controls. Growth velocity was significantly affected in rheumatoid factor positive polyarthritis (P=0.003; 95% CIO. 46-3.14). Conclusions: Children with juvenile idiopathic arthritis do not have significantly lower values of anthropometric parameters compared to controls. Significant restriction in height and weight is seen in systemic onset disease, and growth velocity is significantly reduced in rheumatoid factor positive subjects.Item Hansen’s Chronic Polyarthritis in a Child.(2016-08) Das, Ananya; Mondal, Rakesh; Chatterjee, Kaushani; Banerjee, DonaBackground: Musculoskeletal manifestations of leprosy are often underdiagnosed and under-reported. Case characteristics: An 11-year old girl with leprosy presented with deforming symmetric polyarthritis with raised inflammatory parameters and erosion on imaging. Observation: The patient was diagnosed to have Hansen’s chronic polyarthritis and treatment started with non-steroidal anti-inflammatory drugs and methotrexate. Message: Hansen’s chronic polyarthritis is a rare differential of juvenile chronic arthritis in children.Item Hemothorax--a rare presentation of congenital strangulated diaphragmatic hernia.(2008-12-08) Mondal, Rakesh; Nandi, Madhumita; Gupta, Dipankar; Chatterjee, Anirban; Patra, Risavdeb; Roy, A KWe report the case of a 7 years old previously asymptomatic child who initially presented with respiratory distress because of massive left-sided hemothorax but was subsequently diagnosed to be having strangulated small intestine through a diaphragmatic rent on laparotomy. The case is being discussed in detail and the possible causes of hemothorax in such a scenario discussed.Item Isolated Congenital Absence of Sternum in a Newborn.(2015-10) Mondal, Rakesh; Sil, Archan; Ray, SomosriItem Nephrotic Syndrome with Atherosclerosis.(2011-11) Nandi, Madhumita; Mondal, RakeshItem Neurofibromatosis, Pathological Fracture and Hypervitaminosis-D.(2010-10) Mondal, Rakesh; Nandi, Madhumita; Chandra, P KPathologic fractures in children may be due to various causes. Rarely, it may be the presenting symptom of neurofibromatosis. A misdiagnosis of Rickets and Vitamin D supplementation in such a case may wreak havoc in the form of iatrogenic hypervitaminosis D. We report one such case.Item Normative Blood Pressure Data for Indian Neonates.(2015-08) Samanta, Moumita; Mondal, Rakesh; Ray, Somosri; Sabui, Tapas; Hazra, Avijit; Kundu, Chanchal; Sarkar, Debolina; Roychowdhury, DibyenduObjective: To establish the normative blood pressure (BP) values in healthy Indian neonates using oscillometric method, and to develop BP percentile charts. Design: Prospective observational study. Setting: Neonatal unit of a teaching hospital in Eastern India. Participants: 1617 hemodynamically stable inborn neonates without birth asphyxia, major congenital anomaly, maternal complications (e.g. preeclampsia, hypertension, diabetes) or critical neonatal illness. Procedure: Quite state measurements of systolic BP (SBP), diastolic BP (DBP) and mean arterial pressure (MAP) were recorded by oscillometric method on day 4, 7 and 14 of postnatal life. The averages of three readings at 2-minute intervals were used. Results: Percentile charts (providing 5th, 10th, 25th, 50th, 75th, 95th, and 99th percentile values) have been developed. SBP, DBP and MAP showed a steady rise from day 4 to day 14, and were comparable between males and females, but were significantly lower in preterms than in term neonates Conclusions: Normative neonatal BP data along with gestational age-wise percentile charts shall be of help for decision-making and planning for sick newborns.Item Parotid Gland Enlargement as a Presenting Manifestation of Acute Lymphoblastic Leukemia(2005-07) Agarwal, Vikas; Mondal, Rakesh; Krishnani, Narendra; Nityanand, SoniyaA young female presented with symmetric polyarthritis, generalized lymphadenopathy, hepatosplenomegaly and bilateral parotid gland enlargement without sicca symptoms. A second case of 15 months old child presented with short duration pyrexia with generalized lymphadenopathy, hepatosplenomegaly and bilateral parotid gland enlargement. Both the patients had out of proportion anemia on examination. Investigations confirmed CD 10+ B-cell acute lymphoblastic leukemia (ALL) in both the cases. Fine needle aspiration cytology of parotid glands in both the cases showed infiltration by lymphoblasts.We propose that ALL should be included in the differential diagnosis of bilateral parotid gland enlargement especially if associated with lymphadenopathy and hepato-splenomegaly.Item Protein C and Protein S Deficiency Presenting as Deep Venous Thrombosis.(2010-02) Mondal, Rakesh; Nandi, Madhumita; TapanWe report a 7 year old girl with deep vein thrombosis due to combined protein C and protein S deficiency, who presented with swollen left thigh and restriction of movement of left hip joint.Item Spirometric Assessment in Juvenile Idiopathic Arthritis.(2015-04) Alam, Md Mahboob; Ray, Biman; Sarkar, Sumantra; Mandal, Oona; Mondal, RakeshObjective : To estimate the prevalence of abnormal spirometry in Juvenile idiopathic arthritis (JIA) patients and to evaluate its relation with subtype, gender, disease activity and methotrexate therapy. Methods : A cross-sectional study was carried out involving 5-12 years old JIA patients. Forced vital capacity (FVC), Forced expiratory volume in 1 second (FEV1), FEV1/FVC ratio, Forced expiratory flow between 25-75% of vital capacity (FEF25-75%) and peak expiratory flow rate (PEFR) were measured. Result : Out of 33 patients, 18 were male. Six patients had oligoarthritis, 16 had polyarthritis and 11 had systemic JIA. Seventeen patients had clinically inactive disease and 16 received methotrexate. None had respiratory symptoms. Thirteen patients had decreased FVC with normal FEV1/FVC. One had decreased FEV1 and FEV1/FVC with normal FVC. Decreased FEF25-75% was found in 4 and decreased PEFR in 8 patients. JIA subtypes differed significantly with regard to prevalence of decreased FVC and FEV1. Conclusion : Abnormal spirometry was present in 13 patients and affected all subsets in terms of subtypes, gender, disease activity and methotrexate therapy.