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11.
Dinesh Raj Rakesh Lodha Aparna Mukherjee Tavpritesh Sethi Anurag Agrawal Sushil Kumar Kabra 《Indian pediatrics》2014,51(2):105-111
Objective
To determine whether fractional exhaled nitric oxide (FENO) has a utility as a diagnostic or predictive maker in acute exacerbations of asthma in children.Design
Analysis of data collected in a pediatric asthma cohort.Setting
Pediatric Chest Clinic of a tertiary care hospitalMethods
A cohort of children with asthma was followed up every 3 months in addition to any acute exacerbation visits. Pulmonary function tests (PFT) and FENO were obtained at all visits. We compared the FENO values during acute exacerbations with those at baseline and those during the follow up.Results
243 asthmatic children were enrolled from August 2009 to December 2011 [mean (SD) follow up — 434 (227) days]. FENO during acute exacerbations was not different from FENO during follow up; however, FENO was significantly higher than personal best FENO during follow up (P < 0.0001). FENO during acute exacerbation did not correlate with the severity of acute exacerbation (P=0.29). The receiver operating characteristics curve for FENO as a marker for acute exacerbation had an area under the curve of 0.59. Cut-off of 20 ppb had a poor sensitivity (44%) and specificity (68.7%) for acute exacerbation.Conclusions
FENO levels during acute exacerbation increase from their personal best levels. However, no particular cut off could be identified that could help in either diagnosing acute exacerbation or predicting its severity. 相似文献12.
Graham SM Ahmed T Amanullah F Browning R Cardenas V Casenghi M Cuevas LE Gale M Gie RP Grzemska M Handelsman E Hatherill M Hesseling AC Jean-Philippe P Kampmann B Kabra SK Lienhardt C Lighter-Fisher J Madhi S Makhene M Marais BJ McNeeley DF Menzies H Mitchell C Modi S Mofenson L Musoke P Nachman S Powell C Rigaud M Rouzier V Starke JR Swaminathan S Wingfield C 《The Journal of infectious diseases》2012,205(Z2):S199-S208
There is a critical need for improved diagnosis of tuberculosis in children, particularly in young children with intrathoracic disease as this represents the most common type of tuberculosis in children and the greatest diagnostic challenge. There is also a need for standardized clinical case definitions for the evaluation of diagnostics in prospective clinical research studies that include children in whom tuberculosis is suspected but not confirmed by culture of Mycobacterium tuberculosis. A panel representing a wide range of expertise and child tuberculosis research experience aimed to develop standardized clinical research case definitions for intrathoracic tuberculosis in children to enable harmonized evaluation of new tuberculosis diagnostic technologies in pediatric populations. Draft definitions and statements were proposed and circulated widely for feedback. An expert panel then considered each of the proposed definitions and statements relating to clinical definitions. Formal group consensus rules were established and consensus was reached for each statement. The definitions presented in this article are intended for use in clinical research to evaluate diagnostic assays and not for individual patient diagnosis or treatment decisions. A complementary article addresses methodological issues to consider for research of diagnostics in children with suspected tuberculosis. 相似文献
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Effect of oropharyngeal colostrum therapy in the prevention of necrotising enterocolitis among very low birthweight neonates: A meta‐analysis of randomised controlled trials 下载免费PDF全文
B. D. Garg H. Balasubramanian N. S. Kabra A. Bansal 《Journal of human nutrition and dietetics》2018,31(5):612-624
Background
Necrotising enterocolitis (NEC ) is one of the most common life‐threatening emergencies of the gastrointestinal tract in preterm neonates. The present study aimed to determine the efficacy of oropharyngeal colostrum with respect to reducing NEC in preterm neonates.Methods
A literature search was conducted for various randomised control trials by searching the Cochrane Central Register of Controlled Trials, PubMed, EMBASE and ongoing clinical trials. Randomised or quasi‐randomised trials comparing oropharyngeal colostrum versus placebo in neonates (birthweight ≤ 1500 g or gestational age ≤ 32 weeks) were included in the review. The methodological quality of each trial was independently reviewed by the authors. For categorical and continuous variables, typical estimates for relative risk and typical estimates for weighted mean difference were calculated, respectively. A random effect model was assumed for meta‐analysis.Results
In total, four eligible trials were included in the review. Oropharyngeal colostrum therapy was not associated with a statistically significant reduction in the incidence of NEC stage ≥2 [typical relative risk (RR ) = 0.64; 95% confidence interval (CI ) = 0.27–1.49], mortality from any cause (typical RR = 0.86; 95% CI = 0.15–4.80) and time to reach full feed [typical weighted mean difference (WMD) = ?3.26; 95% CI = ?8.87 to 2.35]. Duration of hospital stay was significantly less in the control group (typical WMD = 9.77; 95% CI = 3.96–15.59).Conclusions
The current evidence is insufficient for recommending oropharyngeal colostrum as a routine clinical practice in the prevention of NEC . We emphasise the need for large randomised controlled trials with an adequate sample size and validated clinical outcomes in preterm neonates.19.
20.
Correa Alec Reginald Errol Mishra Puneeta Kabra Madhulika Gupta Neerja 《Indian journal of pediatrics》2020,87(3):175-178
Indian Journal of Pediatrics - To report a phenotypic series of eight patients of Beckwith-Wiedemann Syndrome (BWS) with abnormalities of 11p15.5 region to highlight the spectrum of phenotypic... 相似文献