Papers by Rabindran Chandran
International Journal of Medical Research and Review, 2016
Zika Virus is emerging as global emergency. We are presenting here a brief epidemiological profil... more Zika Virus is emerging as global emergency. We are presenting here a brief epidemiological profile, brief clinical features and preventive aspects of Zika virus fever globally.
International Journal of Medical Research and Review, 2016
Biomedical waste management system is poor in most of the hospital. There is urgent need to incre... more Biomedical waste management system is poor in most of the hospital. There is urgent need to increase awareness related with this issue in all the hospital staff.
International Journal of Medical Research and Review, 2015
Vitamin D Deficiency has become prevalent entity know. It is associated with various morbidities ... more Vitamin D Deficiency has become prevalent entity know. It is associated with various morbidities like osteoporosis, hip fracture, femur fracture. Early manifestation include pain in weight-bearing joints, back, thighs and/or calves, difficulty in walking and/or climbing stairs, or running and muscle cramps.
International Journal of Medical Research and Review, 2017
International Journal of Medical Research and Review, 2017
Trauma is a major cause of mortality worldwide. Majority of trauma deaths occurs within 24 hours ... more Trauma is a major cause of mortality worldwide. Majority of trauma deaths occurs within 24 hours of injury. Survival depends on timely resuscitation. Initial evaluation uses primary survey involving Airway maintenance, Breathing, Circulation, Disability and Exposure. In secondary survey, thorough head to toe examination is done. Initial resuscitation begins with 2 intravenous access and restricted volume replacement strategy. Controlling active bleeding, treating coagulopathy and transfusion of appropriate fluids is mandatory. Hypothermia should be treated with passive/ active peripheral warming and core warming. Ventilation strategy should be focussed to avoid hypoxaemia, hyperventilation and hypocapnia. Colloids (albumin, hydroxyethyl starches, dextrans, gelatins) and crystalloids (normal saline, ringer's lactate) are both used in resuscitation. For major blood volume loss, blood transfusion is recommended to maintain tissue oxygenation. Damage Control Resuscitation is the strategy for hemorrhagic shock management which requires large-volumes of blood product transfusion. Vasopressors maintain target arterial pressure in presence of myocardial dysfunction. For patients with expected massive haemorrhage, Plasma or Fibrinogen concentrate and RBC may be used.Head trauma severity is age specific. Sedation, analgesia and fluids should be started. Secondary injury from hypoxia, hypotension, hyperthermia or raised intracranial pressure should be avoided. After structured approach of airway, breathing, circulation and disability, definitive treatment of primary intracranial injury should be done. CT scan is done for moderate/ severe head trauma or if signs of basal skull fracture. Management of trauma patients is challenging and requires a multidisciplinary approach.
International Journal of Medical Research and Review, 2016
Alcohol withdrawal syndrome is a cluster of symptoms occurring when someone detoxes from alcohol.... more Alcohol withdrawal syndrome is a cluster of symptoms occurring when someone detoxes from alcohol. Alcohol dependence is one of the commonest psychiatric disorders, second only to major depression.
Handbook of Alcoholism, 2000
Sri Ramachandra Journal of Health Sciences
Objectives: Early establishment of human milk (HM) feeding significantly decreases neonatal morbi... more Objectives: Early establishment of human milk (HM) feeding significantly decreases neonatal morbidity. There are barriers in establishing and maintaining lactation in mothers of hospitalized extreme preterm and very low birth weight (VLBW) infants, particularly during the first 2 weeks of life. Infant feeding policy modification was done to improve lactation as a quality initiative project and the effect of this modification was studied. Material and Methods: This study was done at SRIHER by analyzing retrospective data from the period before infant feeding policy modification (April 1, 2017–June 30, 2017) and prospective data from post-policy modification (July 1, 2017–December 31, 2017). All extreme preterm babies and VLBW babies both inborn and outborn were included in the study. The policy was approved by the institutional quality control cell. Fishbone analysis and “why” question pattern were implemented to identify pitfalls in establishing and maintaining lactation in mothers ...
The Journal of medical research, 2016
Alcohol withdrawal syndrome is a cluster of symptoms occurring when someone detoxes from alcohol.... more Alcohol withdrawal syndrome is a cluster of symptoms occurring when someone detoxes from alcohol. Alcohol dependence is one of the commonest psychiatric disorders, second only to major depression.
International Journal of Medical Research and Review
In India, various surveys showed that over 70 % of preschool children, pregnant women and adolesc... more In India, various surveys showed that over 70 % of preschool children, pregnant women and adolescent girls are anaemic. Inspite of various government run nutritional supplements programe we are having very high prevalence of Anemia.
International Journal of Medical Research and Review
Today dengue ranks as the most important mosquito-borne viral disease in the world & its incidenc... more Today dengue ranks as the most important mosquito-borne viral disease in the world & its incidence has increased 30fold over the last 50 years. In India there is recent increase in cases of Dengue in last few years.
International Journal of Medical Research and Review
Introduction: Pathogens causing blood stream infections and their antibiotic susceptibility patte... more Introduction: Pathogens causing blood stream infections and their antibiotic susceptibility patterns constantly change over time & it is essential to monitor the epidemiology of infections to design appropriate antibiotic policy. Methodology: Blood culture reports of Children below 3 months of age admitted to our hospital over a period of 4 years were analysed to find the causative agents of sepsis & their antibiotic susceptibilities. All data were collected in validated preformatted proforma sheet & analysed using appropriate statistical methods. Results: Among 1401 blood cultures, culture positive growth was observed in 226 cases (16.1 %). In our study, Klebsiella pneumoniae was the commonest isolated in 23.4 % of blood cultures. Acinetobacter baumanii was the next commonest organism isolated in 13.7 % followed by MRSA growth in 11.9 %, MSSA in 4.8 %, E.coli in 8.8 %, Enterococcus faecalis in 7.5 %, B.cepacia in 6.6 %, P. aeruginosa in 5.3% & Enterobacter in 4.4 % of blood cultures. About 49% of K. pneumoniae were susceptible to Carbapenam & 60% of E.coli were susceptible to Amikacin & Tobramycin. All Enterobacter were sensitive to Imipenam, Meropenam, Ertapenam & Amikacin & 77% of A.baumanii were sensitive to Carbapenam. Yeasts were isolated in 8.4 %, the commonest being Candida tropicalis. Conclusion: It is essential to closely monitor the bacterial flora and their antibiotic sensitivity pattern to evolve rational antibiotic policy which is suitable for each unit. Guidelines on the reduction of emergence of drug resistance must be provided and instituted within the units.
The Journal of medical research, 2015
Vitamin D Deficiency has become prevalent entity know. It is associated with various morbidities ... more Vitamin D Deficiency has become prevalent entity know. It is associated with various morbidities like osteoporosis, hip fracture, femur fracture. Early manifestation include pain in weight-bearing joints, back, thighs and/or calves, difficulty in walking and/or climbing stairs, or running and muscle cramps.
Obsgyne Review: Journal of Obstetric and Gynecology, Jun 30, 2015
Cervical cancer is the second most common cancer among women worldwide. First priority to reduce ... more Cervical cancer is the second most common cancer among women worldwide. First priority to reduce deaths from cervical cancers is to implement high quality, fully organised screening programmes without delay. Knowledge about cervical cancer and Pap testing influences uptake of cervical cancer screening services. Screening and treatment for precancerous lesions is a more cost-effective intervention compared to management of invasive cervical cancer. Human papillomavirus is the etiologic agent of virtually all cases of cervical cancer worldwide. All women 30 years and older should be routinely screened &screening should continue until the age of 65 years. By reducing the smear interval from 5 to 3 years in the age group < 50 years, the risk reduction for cervical cancer could be improved. About 16% of the world′s total cases occur in india. At current incidence rates, the annual burden of new cases in India is projected to increase to 225,000 by 2025. However,the screening coverage in india is low upto 2.6-5 percent.Of all the screening tests available, the three main screening procedures commonly employed arePapanicolaou smears (Pap smears), visual inspection with acetic acid (VIA) and HPV testing. It has also been worked out that 'once in a lifetime' screening would result in reduction of 20-30% of the lifetime risk of cervical cancer. Health education is the most cost-effective approach in reducing the incidence of cervical carcinoma in developing countries like India.
Pediatric Review: International Journal of Pediatric Research, Feb 29, 2016
PICU stay is largely associated with hospital acquired infection. Preventive stratigies are impor... more PICU stay is largely associated with hospital acquired infection. Preventive stratigies are important to decrease morbidity and mortality associated with nosocomial infections.
Pediatric Review: International Journal of Pediatric Research, Jun 30, 2016
Stress hyperglycemia is common in pediatric critical illness. It is associated with poor outcome ... more Stress hyperglycemia is common in pediatric critical illness. It is associated with poor outcome in large number of patients.
Pediatric Review: International Journal of Pediatric Research, Feb 29, 2016
Therapeutic hypothermia for infants with perinatal asphyxia has been studied in several randomise... more Therapeutic hypothermia for infants with perinatal asphyxia has been studied in several randomised controlled trials. There is convincing evidence that moderate therapeutic hypothermia (33-34°C for 72 h), when initiated within 6 h after birth among term & near-term infants (≥35 weeks) with moderate to severe HIE reduces the risk of death or major disability & increases the rate of disability-free survival at 6-7 years of age
Pediatric Review: International Journal of Pediatric Research, May 31, 2016
Introduction: Hyperbilirubinemia is a common problem among term newborns. Cord bilirubin level ha... more Introduction: Hyperbilirubinemia is a common problem among term newborns. Cord bilirubin level has been found to correlate well with day 3 bilirubin level. We studied whether cord bilirubin could predict risk of development of significant hyperbilirubinemia among term neonates. Methodology: Prospective study from October 2009-July 2010. All newborns between 37 weeks-42weeks, birth weight > 2500 gram, Apgar score > 7 at 1 st & 5 th minute of life were included in the study. Cord blood, day 3 & day 5 bilirubin was collected. Maternal data & bilirubin values were collected & analyzed using SPSS software. Results: About 115 babies were studied. There was no significant difference in cord bilirubin & day 3 bilirubin between babies born to mothers < 30 years &> 30 years. There was no significant difference in bilirubin values bassed on mode of delivery. About 29.6% babies developed clinical jaundice & received phototherapy. Cord bilirubin levels had significant association with need of phototherapy. Cord bilirubin >/= 2.1 mg/dl predicted need for phototherapy with PPV of 90.3%. Maternal age, sex of baby, birth weight & gestational age had no significant effect on cord bilirubin levels. Cord bilirubin >/= 2.1 mg/dl predicted day 3 serum bilirubin > 15 mg/dl with sensitivity of 88 % & PPV of 77.49 %. The likelihood ratio with cord bilirubin > 2.1 mg/dl & day 3 serum bilirubin > 15 mg/dl was 9.316. Conclusion: Cord bilirubin is predictive of need of phototherapy & correlated well with day 3 bilirubin levels which would facilitate early management of neonatal hyperbilirubinemia.
Obsgyne Review: Journal of Obstetric and Gynecology, Sep 30, 2017
Abdominal Pain is very common reason for Out Patients Department and ward visit. In Pediatric pop... more Abdominal Pain is very common reason for Out Patients Department and ward visit. In Pediatric population almost more than half cases are not having anyu specific reason for that. These are classified as Functional Abdominal pain. Many times patients insist for radiographic evaluation. It is worthy to check if there is any gyenecological issues in these cases.
Obsgyne Review: Journal of Obstetric and Gynecology, Jun 30, 2016
IUGR is pathologic inhibition of intrauterine fetal growth. Risk factors for IUGR comprise matern... more IUGR is pathologic inhibition of intrauterine fetal growth. Risk factors for IUGR comprise maternal factors, fetal factors, adnexal factors & Placental or umbilical cord factors. For predicting IUGR a combined approach using clinical data, serum markers, biophysical parameters has higher predictive value. Maternal BMI, Symphysis-fundal height have been used to predict IUGR. Biochemical markers are recently being evaluated for predicting IUGR including angiogenesis-related biomarkers, endothelial function/oxidative stress-related biomarkers, placental proteins/ hormone-related biomarkers metabolomics & genetic biomarkers. Sonography is a noninvasive technique for predicting IUGR early. Sonographically measured fetal femur length-abdominal circumference ratio, Foetal Ponderal Index, Umbilical artery systolic/ diastolic (S/D) ratio, resistance index, pulsatility index, MCA-PSV,TCD/AC ratio, Placental Quotient , increased pulsatility index in uterine artery are used in predicting IUGR. Biometry & amniotic fluid volume also show promising value in predicting IUGR early.
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Papers by Rabindran Chandran