Care Institute In South India Research Articles

Cord Blood TSH Level Variations in Newborn - Experience from A Rural Centre in Southern India.

Universal screening of all neonates has for long been recognized as the most effective method to detect congenital hypothyroidism. However, various maternal as well as perinatal factors can influence the cord blood TSH levels. To evaluate the effect of perinatal factors on cord blood TSH level variations in neonates born in a rural tertiary care institution in South India. A cross-sectional study was done in 430 term neonates at birth to analyse the cord blood TSH levels and a repeat TSH estimation was done on 3rd postnatal day for those having abnormal values. The values were statistically analysed with respect to maternal, paternal and perinatal parameters. The mean value of CBTSH was 12.88 mIU/mL. One hundred twenty five of the 430 neonates (29.06%) were found to have elevated CBTSH levels. Two babies (0.46%) had CBTSH levels below 2.3 mIU/mL. Repeat TSH estimation done on third postnatal day in the 127 babies who had abnormal CBTSH levels revealed only 5 (3.94%) babies had abnormal levels. Serum T4 levels done on the same sample showed abnormal values in 3 (2.67%) babies. CBTSH levels showed no gender varations but increased significantly with the gestational age of the baby (p=0.001). CBTSH levels increased with increasing maternal age (p<0.001) and were significantly higher in babies of mothers with history of hypothyroidism. The incidence of congenital hypothyroidism was 3 in 430 babies, which was high compared to national and international references, highlighting the urgent need of universal screening giving importance to maternal factors also.

Cerebral edema in children with Diabetic Keto acidosis From a pediatric tertiary care Institute in South India

Cerebral edema in children with Diabetic Keto acidosis –From a pediatric tertiary care Institute in South India Cerebral edema (CE) is the major cause for mortality in children with Diabetic keto acidosis (DKA). This study was conducted to estimate the prevalence, risk factors and outcome of cerebral edema in children with DKA. Among the study of 118 episodes of DKA, cerebral edema was encountered in 28 children (23.7%). 93% of cerebral edema was diagnosed either at admission or within 6 hours of therapy

How safe is Celecoxib for Asian-Indian patients with rheumatic diseases?

Cyclo-oxygenase (COX)-2 inhibitors have been the target of severe criticism, more so following the withdrawal of Rofecoxib. Post-marketing surveillance of Celecoxib in Asian Indians, who are predisposed to premature athero-thrombotic events, has not been studied. To study the adverse effects of Celecoxib and compare them with those of other non-steroidal anti-inflammatory drugs (NSAIDs) in an Asian Indian cohort. This is a retrospective chart review with convenience sampling of patients on NSAIDs (at least five tablets a week, for at least 3months prior to the study), attending the Rheumatology clinic of a tertiary care institution in south India between June 2004 and November 2004. Those with pre-existing heart disease, hypertension, thrombo-embolic disease, peptic ulcer and patients on corticosteroids were excluded. All the recorded adverse events were noted and compared between the Celecoxib and non-selective NSAID users. Univariate analysis using Chi-square test was performed. Of the 1387 patients included, 915 were on Celecoxib. In the NSAID group, 204 had used multiple NSAIDs in sequence. Of the Celecoxib users, 164 had switched over to an NSAID during the study period. New onset of hypertension was significantly higher in the Celecoxib users as compared to non-selective NSAID users (3.06% vs. 1.27%, P=0.04). However, those who had switched over to NSAIDs did not show this trend. NSAID users, on the other hand, had significant gastrointestinal (GI) toxicity (2.54% vs. 0.327%, P=0.001). A significant number of Celecoxib users who switched over to NSAIDs also developed GI toxicity (6.1% vs. 1.21%, P=0.018) over a shorter time span, as compared to the continuous NSAID users. Multiple NSAID users had higher adverse events (6.37% vs. 2.23%, P=0.023) as compared to single NSAID users. Celecoxib significantly increased the incidence of new onset hypertension in this cohort of Indian patients with rheumatic diseases. No thromboembolic events were documented.