Papers by Muhammad Irshad
Indian Journal of Child Health, 2020
Background: The periventricular leukomalacia (PVL) is the most common white matter injury in pret... more Background: The periventricular leukomalacia (PVL) is the most common white matter injury in preterm very low birth weight (VLBW) neonates. It occurs due to ischemic injury to developing oligodendrocytes. It can be detected by cranial ultrasonography (CUS). Objective: The objective of the study was to find incidence of PVL in preterm VLBW babies and its correlation with gestational age, birth weight, and arterial blood PH. Materials and Methods: A total of 80 preterm low birth babies admitted in our neonatal intensive care unit over 1 year were included who met the inclusion criteria. All babies were subjected to CUS starting from the 1 st week of their life and repeated weekly by trained radiologist to find changes suggestive of PVL till clinically indicated or normal scan on the 14 th day of life. Results: Among 80 preterm low birth babies in our study, 54 (67.5%) were male and 26 (32.5%) were female. Three babies had gestational age of 30 weeks or less, 25 had gestational between 30 and 32 weeks, 35 had gestational age between 32 and 34 weeks, while 17 had gestational age more than 34 weeks. A total of 62 (77.5%) were born through normal vaginal delivery and 18 (22.5%) were born by cesarean section. The incidence of PVL was 2.5%. The most common change was periventricular flare. The incidence of PVL was more in extreme preterm and those with PH <7.2. The mortality was 50% in babies with PVL. Conclusion: The incidence of PVL in preterm low birth weight babies is 2.5% with a mortality of 50%. Prevention and early detection are the keys to mitigate the effects of this disastrous complication of prematurity.
Background: Infectious diseases like neurocysticercosis and neurotuberculosis are endemic in Indi... more Background: Infectious diseases like neurocysticercosis and neurotuberculosis are endemic in Indian subcontinent and are important causes of epilepsy. Epileptic children are prone to have poor school performance, higher levels of anxiety and depression apart from low self esteem. These treatable condition could be easily picked up on neuroimaging like cranial computed tomography (CT) scan and treated accordingly at an earliest. Objectives: To assess the role of cranial computed tomography scan in children having epilepsy. Material and Methods: Seventy two children between the age of 1 month and 14 years were prospectively enrolled, who had atleast two unprovoked seizures greater than 24 hours apart, and all those children where seizures result from acute central nervous system insult were meticulously excluded. Diagnosis of epilepsy was based on detailed history, thorough clinical examination, routine laboratory tests with additional specific tests like electroencephalogram (EEG) an...
Indian Journal of Child Health, 2020
Background: The periventricular leukomalacia (PVL) is the most common white matter injury in pret... more Background: The periventricular leukomalacia (PVL) is the most common white matter injury in preterm very low birth weight (VLBW) neonates. It occurs due to ischemic injury to developing oligodendrocytes. It can be detected by cranial ultrasonography (CUS). Objective: The objective of the study was to find incidence of PVL in preterm VLBW babies and its correlation with gestational age, birth weight, and arterial blood PH. Materials and Methods: A total of 80 preterm low birth babies admitted in our neonatal intensive care unit over 1 year were included who met the inclusion criteria. All babies were subjected to CUS starting from the 1 st week of their life and repeated weekly by trained radiologist to find changes suggestive of PVL till clinically indicated or normal scan on the 14 th day of life. Results: Among 80 preterm low birth babies in our study, 54 (67.5%) were male and 26 (32.5%) were female. Three babies had gestational age of 30 weeks or less, 25 had gestational between 30 and 32 weeks, 35 had gestational age between 32 and 34 weeks, while 17 had gestational age more than 34 weeks. A total of 62 (77.5%) were born through normal vaginal delivery and 18 (22.5%) were born by cesarean section. The incidence of PVL was 2.5%. The most common change was periventricular flare. The incidence of PVL was more in extreme preterm and those with PH <7.2. The mortality was 50% in babies with PVL. Conclusion: The incidence of PVL in preterm low birth weight babies is 2.5% with a mortality of 50%. Prevention and early detection are the keys to mitigate the effects of this disastrous complication of prematurity.
Clinical Hypertension, 2020
Globally hypertension in adults is among the leading preventable cause of premature death, where ... more Globally hypertension in adults is among the leading preventable cause of premature death, where a graded association from the childhood hypertension is well recognised. With the concurrent rise in obesity and pediatric hypertension (HTN) during the past decade in developed countries, a parallel trend is emerging in developing countries that has a potential for exponential rise in cardiovascular, cerebrovascular and renal tragedies. A cumulative incidence of pediatric HTN in China and India is 50–70 and 23% respectively, is quite disturbing. New guidelines for the detection, evaluation and management of hypertension in children and adolescents published in 2017, where a jump in prevalence of pediatric HTN is observed, rings a call to address this under-attended burning problem; for which a review in pediatric hypertension and its management is warranted.
Clinical Hypertension, 2020
Globally hypertension in adults is among the leading preventable cause of premature death, where ... more Globally hypertension in adults is among the leading preventable cause of premature death, where a graded association from the childhood hypertension is well recognised. With the concurrent rise in obesity and pediatric hypertension (HTN) during the past decade in developed countries, a parallel trend is emerging in developing countries that has a potential for exponential rise in cardiovascular, cerebrovascular and renal tragedies. A cumulative incidence of pediatric HTN in China and India is 50–70 and 23% respectively, is quite disturbing. New guidelines for the detection, evaluation and management of hypertension in children and adolescents published in 2017, where a jump in prevalence of pediatric HTN is observed, rings a call to address this under-attended burning problem; for which a review in pediatric hypertension and its management is warranted.
International Journal of Contemporary Pediatrics, 2019
Background: Neonatal sepsis refers to generalized bacterial blood stream infection in first 28 da... more Background: Neonatal sepsis refers to generalized bacterial blood stream infection in first 28 days of life documented by positive blood cultures. It is one of leading causes of neonatal mortality. Objectives was to study clinicobacteriological, antibiotic sensitivity patterns and mortality of neonatal sepsis.Methods: This prospective study was conducted in the Department of Pediatrics of Government Medical College Srinagar in collaboration with Department of Microbiology of same medical college after ethical clearance from ethical committee of Government Medical College Srinagar. One hundred (100) neonates out of 731 neonates admitted between octomber2007 and September 2008 with signs and symptoms of neonatal sepsis were included in our study by random sampling method. After history, examination and laboratory investigation blood culture results were analyzed by standard statistical methods.Results: The blood culture was positive in 40% of neonates. Fifty one (51) neonates were mal...
International Journal of Contemporary Medical Research [IJCMR], Jun 1, 2019
Introduction: Transient elevation of serum prolactin levels occurs in immediate postictal period ... more Introduction: Transient elevation of serum prolactin levels occurs in immediate postictal period in true epileptic events only. Current study was aimed to investigate the role of postictal serum prolactin levels in differentiation of true seizures from pseudo epileptic events. Material and methods: A total of 110 patients of either sex between ages of 6 months to 12 years out of 676 cases admitted for seizure evaluation were enrolled in our study and divided into four groups. Group 1 included 30 children having frank seizures, group 2 included 30 children with typical febrile seizures, group 3 included 25 children with seizure mimics and group 4 included 25 children without seizures.The serum prolactin levels were quantitatively determined by using Coat-A-Count Prolactin Immuno-radiometric assay (IRMA). All data was analyzed by standard statistical methods. Results: There were 64(58.2%) males and 46(41.8%) females with mean age of 60.8 and 61.3 months. The serum prolactin level was highest in group I with mean level of 25.5ng/ml ±10 SD(p value =0.00).The serum prolactin levels were raised in 30.3% (20/66) of patients in group I,II,and III when serum sample was obtained within 20 minutes and in none 0/19 (0.00%) when sample was taken after 20 minutes (p value =0.006).All patients with generalized tonic clonic seizures with abnormal EEG had abnormal prolactin levels while as only 83.3% with complex partial seizures and 20% with simple partial seizures had raised prolactin levels (p value =0.002). Conclusion: There was a significant rise in serum prolactin level in children with epileptic seizures as compared to febrile seizures and seizure like events.
International Journal of Contemporary Pediatrics, 2019
Background: Neonatal sepsis refers to generalized bacterial blood stream infection in first 28 da... more Background: Neonatal sepsis refers to generalized bacterial blood stream infection in first 28 days of life documented by positive blood cultures. It is one of leading causes of neonatal mortality. Objectives was to study clinicobacteriological, antibiotic sensitivity patterns and mortality of neonatal sepsis.Methods: This prospective study was conducted in the Department of Pediatrics of Government Medical College Srinagar in collaboration with Department of Microbiology of same medical college after ethical clearance from ethical committee of Government Medical College Srinagar. One hundred (100) neonates out of 731 neonates admitted between octomber2007 and September 2008 with signs and symptoms of neonatal sepsis were included in our study by random sampling method. After history, examination and laboratory investigation blood culture results were analyzed by standard statistical methods.Results: The blood culture was positive in 40% of neonates. Fifty one (51) neonates were mal...
Journal of Evolution of Medical and Dental Sciences, 2019
BACKGROUND Neonatal sepsis is one of the commonest causes of morbidity and mortality in neonates ... more BACKGROUND Neonatal sepsis is one of the commonest causes of morbidity and mortality in neonates in India compared to the developed countries. It is one of the four leading causes of morbidity and mortality in India among the neonates due to delivery and postnatal follow up in an unhealthy environment and low socioeconomic state leading to maternal infection and premature delivery. It is absolutely necessary to diagnose early neonatal sepsis and its cause using clinical signs and rapid diagnostic method so that no time is wasted in starting appropriate treatment. MATERIALS AND METHODS A hospital-based study carried out in the Department of Neonatology over the period from 15 June 2013 to 15 May 2014. Setting-A teaching, research and tertiary care hospital at Srinagar, Kashmir, North India. Participants-All the neonates, inborn or out-born with at least one of the following anamnestic or clinical criteria as developed by the French National Agency for Accreditation and Health, were included in study. Procedure: Variables recorded were-presenting risk factors, symptoms, clinical signs, baseline laboratory tests, blood, urine and CSF cultures and sensitivities. RESULTS 100 neonates were included in the study. The most common symptoms of neonatal sepsis were general (62%) followed by respiratory (54%). 32% neonates were having fever and 34% hypothermia. Klebsiella was most common gram-negative organism (36.84) grown and CONS most common gram-positive organism (13.5%) among culture positive sepsis. CONCLUSION Neonatal sepsis is a major cause of morbidity and mortality in neonates in Kashmir India despite recent improvements in the health care system. Clinical manifestations are nonspecific and varied and early diagnosis is must to prevent morbidity and mortality. Gram negative neonatal sepsis is most common.
Journal of Evolution of Medical and Dental Sciences, 2019
BACKGROUND Neonatal sepsis is one of the commonest causes of morbidity and mortality in neonates ... more BACKGROUND Neonatal sepsis is one of the commonest causes of morbidity and mortality in neonates in India compared to the developed countries. It is one of the four leading causes of morbidity and mortality in India among the neonates due to delivery and postnatal follow up in an unhealthy environment and low socioeconomic state leading to maternal infection and premature delivery. It is absolutely necessary to diagnose early neonatal sepsis and its cause using clinical signs and rapid diagnostic method so that no time is wasted in starting appropriate treatment. MATERIALS AND METHODS A hospital-based study carried out in the Department of Neonatology over the period from 15 June 2013 to 15 May 2014. Setting-A teaching, research and tertiary care hospital at Srinagar, Kashmir, North India. Participants-All the neonates, inborn or out-born with at least one of the following anamnestic or clinical criteria as developed by the French National Agency for Accreditation and Health, were included in study. Procedure: Variables recorded were-presenting risk factors, symptoms, clinical signs, baseline laboratory tests, blood, urine and CSF cultures and sensitivities. RESULTS 100 neonates were included in the study. The most common symptoms of neonatal sepsis were general (62%) followed by respiratory (54%). 32% neonates were having fever and 34% hypothermia. Klebsiella was most common gram-negative organism (36.84) grown and CONS most common gram-positive organism (13.5%) among culture positive sepsis. CONCLUSION Neonatal sepsis is a major cause of morbidity and mortality in neonates in Kashmir India despite recent improvements in the health care system. Clinical manifestations are nonspecific and varied and early diagnosis is must to prevent morbidity and mortality. Gram negative neonatal sepsis is most common.
International Journal of Contemporary Pediatrics, 2019
Background: Early detection of congenital heart disease is of paramount importance to improve the... more Background: Early detection of congenital heart disease is of paramount importance to improve the quality of life of children and prevent morbidity and mortality. Congenital heart disease (CHD) is one of the major causes of mortality and morbidity in the pediatric population of both the developing and developed countries. Present aim was to study the prevalence, age and sex wise distribution, and clinical spectrum of congenital heart disease (CHD) at Sopore, Kashmir, North India.Methods: Around 39829 children in the age group 0 months to 18 years were screened for Defects at birth, Diseases in children, Deficiency conditions and Developmental Delays including Disabilities over the period of 18 months under RBSK. Clinical examination, echocardiography and color Doppler were used as diagnostic tools.Results: A prevalence of 5.3 per 1000 population was observed. VSD (ventricular septal defect) was the commonest lesion (30.1%), followed by PDA (patent ductus arteriosus) in 21.6 % and AS...
International Journal of Contemporary Pediatrics, 2019
Background: Breastfeeding is a well-established and recommended intervention for the improvement ... more Background: Breastfeeding is a well-established and recommended intervention for the improvement of child nutrition. Formula feeding is a major public health problem. Objective of the current study was to know the significance of demography, socioeconomic, parental education and employment and mode of delivery on exclusive breast-feeding Kashmir, North India.Methods: A prospective hospital-based study, carried out in the Department of Pediatrics, G.B Pant Hospital Srinagar Kashmir India over the period from 2014 July to June 2015. A teaching, research and tertiary care hospital at Srinagar Kashmir North India. All the mothers who were having infants in the age group 0 to 6 months were included in study. Procedure of this variables recorded were modes of feeding, demographics, socioeconomic status, literacy level, mode of delivery, place of delivery etc.Results: A total of 600 mothers were included in study. Less than 35% of mothers were exclusively breast feeding their infants. Excl...
Indian Journal of Critical Care Medicine, 2014
The recent standardization and validation of defi nitions of pediatric acute kidney injury (pAKI)... more The recent standardization and validation of defi nitions of pediatric acute kidney injury (pAKI) has ignited new dimensions of pAKI epidemiology and its risk factors. pAKI causes increased morbidity and mortality in critically ill-children. Among the hospitalized patients incidence of pAKI ranges from 1% to 31%, while mortality ranges from 28% to 82%, presenting a broad range due to lack of uniformly acceptable pAKI defi nition. In addition, cumulative data regarding the progression of pAKI to chronic kidney disease in children is rising. Despite these alarming fi gures, treatment modalities have failed to deliver signifi cantly. In this review, we will summarize the latest developments of pAKI and highlight important aspects of pAKI management.
Journal of Medical Biochemistry, 2011
Analysis of Serum Proteins and Enzymes Level in Human Subjects with OsteoarthritisThe aim of the ... more Analysis of Serum Proteins and Enzymes Level in Human Subjects with OsteoarthritisThe aim of the present study was to assess the serum proteins and enzymes level using polyacrylamide gel electrophoretic (PAGE) profiles in human subjects with osteoarthritis (OA). Forty-one subjects with confirmed OA were selected for the present study. Sera were collected from these individuals and loaded in equal amounts on native and denaturing PAGE separately. Software analysis of these profiles was done using Scion Imaging (Beta release-4, Scion Corporation) and GelPro (Media Cybernetics, USA) programs. To visualize esterases (Est) and lactate dehydrogenase (LDH) isoenzymes in the sera of these patients substrate specific staining was performed. Differences in the values of control and OA subjects were tested statistically. Software analysis of native-PAGE profiles revealed the presence of nineteen peptides in control and twenty one in OA subjects respectively. Two extra peptides were present in ...
BMJ, 1960
An experiment in helping mentally handicapped men, women, and young people to lead normal working... more An experiment in helping mentally handicapped men, women, and young people to lead normal working lives is to begin shortly in Northern Ireland. Twelve women and girls, aged 18 and over, will be taken out of special institutions, jobs will be found for them, and they will live in the ordinary community surroundings in a small hostel. The hostel will be in charge of a warden, who will be available to discuss personal problems that arise. The women and girls going into the first hostel are being transferred from special-care centres, where they have received expert training, and they will go out to work each day in the normal way. Some of them will work in local hospitals in the kitchens and laundries, and others may be placed in jobs with outside firms. If this experiment succeeds there will later be separate hostels for men.
American Journal of Infection Control, 2005
ISSUE: Key guidelines for hand hygiene, prevention of intravascular infection, and prevention of ... more ISSUE: Key guidelines for hand hygiene, prevention of intravascular infection, and prevention of pneumonia have been released by HICPAC. The recommendations have been implemented with varying success. A survey was designed to assay the level of guideline compliance in Florida. PROJECT: Members of the state infection control organization (FPIC) were surveyed in September 2004. Questions were asked about the implementation of recommendations and performance measures from three HICPAC guidelines (hand hygiene, catheter-related infections, and prevention of pneumonia).
Indian Journal of Child Health, 2014
Osteopetrosis or marble bone disease is a heterogeneous group of hereditary disorders in which de... more Osteopetrosis or marble bone disease is a heterogeneous group of hereditary disorders in which deficient or altered function of osteoclasts results into defective resorption of bone with resultant sclerosis. We report a case of infantile osteopetrosis who presented to us as failure to thrive, severe anemia and developmental delay. This case report highlights the importance of this rare disease as a differential diagnosis in infants with failure to thrive, to avoid the potentially treatable entity.
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Papers by Muhammad Irshad