Tuesday, April 9, 2019

Procedure room Temperature for infants

Procedure room Temperature for infants

Some infants (birth to 12 months of age) develop complication soon after surgeries or CT Scan/ USG etc.

Therefore, Infants if kept in AC room below 25° C without (less) clothes can develop life- threatening Hypothermia complications including shock, Respiratory distress- bronchospasm, Grunting, Convulsion etc.
           
     When infants are to be Procedured upon pl. keep temp of the room of OT, USG room, CT area, MRI area, audiometry etc between 28-30° C and thereafter only receive the infant for procedure.

Inj. Paracetamol (Acetaminophen) in Children


Inj. Paracetamol in Children

In Serious cases it is used as injection 5mg/kg/dose.
However, it is best avoided; as severe hypothermia reaction (cold skin and perspiration leading to hypovolemia, hyponatremia), shock and death has been associated within 3 hours of using inj. PCM in seriously ill children.
The death is presumed to be because of serious illness of the child; however paracetamol can be a contributing factor.
In children it should be used always as diluted by infusion or preferably not to be used at all.
It seems that in some cases high grade fever is not as harmful as inj. Paracetamol.

Sunday, April 8, 2018

PEDIATRICS Dept PUBLICATIONS Bhavnagar

Since 2015




2] https://shar.es/a39TNP Ratna Bhojak, Jayendra Gohil  Efficacy of Once a Month Single Dose Intravenous (Deferoxamine) versus Daily Oral (Deferasirox) Iron Chelator in Thalassemia Major: An Open Label Randomized Parallel Group Active Control Interventional Trial


New added in May 2019

# Gohil JR. Adrenaline before Unconventional Therapy for Status Asthamaticus. Indian J Crit Care Med 2019;23(10):492.      doi.org/10.5005/jp-journals-10071-23273


Refractory Status Asthmaticus: A Case for Unconventional Therapies, article by Vohra R has mentioned survival of a child after using ECMO and isoflurane when other treatments were not effective.1  
History of food ingestion prior to onset of status is not mentioned as there are foods like dairy, nuts, seafood, eggs, and pollution and color, that may precipitate an acute episode.
In the treatment however, inj. adrenaline and inj. hydrocortisone were not used; although intravenous methylprednisolone (2 mg/kg) was used. Intramuscular adrenaline is having better absorption and quicker effects than subcutaneous route.2
Ipratropium is an atropine like drug and leads to thickening of secretions and mucus plugging and have to be removed by bronchoscopy lavage. 
Injections of adrenaline and hydrocortisone should be administered before resorting to ECMO and isoflurane.
Re f erenc es
1. Vohra R, Sachdev A, Gupta D, Gupta N, Gupta S. Refractory status asthmaticus: A case for unconventional therapies. Indian J Crit Care Med 2018;22(10):749–752.
2. Gohil J, Agarwal TS. Anaphylaxis and Angioedema: A of ABC means Adrenaline First: Airway comes Later. J Asso Physicians India. 2018;66(10):76.

Saturday, April 7, 2018

Friday, April 6, 2018

PAPERS published 2018


Screening of school children for Attention Deficit Hyperactivity Disorder using Vanderbilt ADHD Diagnostic Teacher Rating Scale
Jayendra R Gohil, Mrigank N Gupta*, Shruti U Patel, Shreya A Patel. Pediatr Education Res.2018;6(2 MayAug):116-119. Rcvd May 29, 2018. Accepted Jun 22, 2018 http://rfppl.co.in/current_issue.php?jid=22

Kangaroo Mother Care in Preterm Baby Receiving Assisted Respiratory Support (CPAP): A Case-Control Trial. Pranav H Punasanvala, Alpa N Parekh, Jayendra R Gohil, Shridhar Pujari. Int J Contemp Pediatr. 2018;May(3):1008-12. 
http://www.ijpediatrics.com/index.php/ijcp/article/view/1473 
http://dx.doi.org/10.18203/2349-3291.ijcp20181531


Anaphylaxis and Angioedema: A of ABC means Adrenaline First: Airway comes Later. Gohil JR, Agarwal TS.  J Assoc Physicians India. 2018 Oct;66:97..

Levetiracetam Adverse reaction : Pancytopenia. Gohil JR, Agarwal TS. J Pediatr Neurosci 2018;13(1):116-7. http://www.pediatricneurosciences.com/article.asp?issn=1817-1745;year=2018;volume=13;issue=1;spage=116;epage=117;aulast=Gohil

Cardio-toxicity associated with Midazolam in a patient with Diphtheria. Gohil J R, Jindal Sonal V. Current Drug Safety. 2019;14(1):57-59.  doi.org/10.2174/1574886313666181105122154



Cord Blood Albumin as A Predictor of Neonatal Hyperbilirubinemia: A Prospective Open Label Study.  HR Chauhan, AN Parekh, JR Gohil. National J Integrated Research in Medicine 2018;8 (5):41-43. http://www.nicpdjournals.com/?mno=284690

Pediatrics dept Bhavnagar Dissertation List

Thursday, July 13, 2017

Papers 2017

Intrathechal vs. Intramuscular Human Tetanus Immunoglobulin in Pediatric Tetanus: A Retrospective Study


Objective          To evaluate the effect of intrathecal vs. intramuscular tetanus immunoglobulin therapy on hospital stay and mortality in pediatric tetanus patients admitted to a tertiary care hospital.
Methods             Retrospective analysis of hospital records of tetanus cases to the pediatric ward during two year period from  march  2012 to february  2014 was done. All patients were managed as per pre-existing unit protocol. Group A received Human tetanus immunoglobulin (TIG) 250 unit via the Intrathecal route preceded by IV ketamine (1 mg/kg) for proper relaxation to ease the procedure and the group B was given TIG 750 unit via intramuscular route. Whether to give TIG by Intrathecal or intramuscular route was decided according to the treating unit’s protocol. Information regarding– sex, age, immunization status, mode of infection, grade of tetanus, outcome and hospital stay was recorded in the two groups.
Results              After excluding Neonatal tetanus cases there were 40 patients aged between 1 to 12 years during the two year study period. Out of 40, group A had 15 patients (intrathecal route) and group B had 25 (intramuscular route). Mortality and hospital stay was found to be numerically less, but statistically not significant, in group A (26.67%; 12.4 ±2.25days) as compared to group B (28%:15.4 ± 1.69 days).
Conclusion       We found no significant difference between intrathecal immunoglobulin and intramuscular immunoglobulin therapy in management of pediatric tetanus in terms of mortality and hospital stay. An unintended result was that ketamine can be safely used as a sedative in tetanus patients for lumbar puncture to give intrathecal antitetanus immunoglobulin.  

http://rfppl.co.in/online_first.php?jid=22
Pediatric Education Research 2017:5(2):57-60.

Friday, January 6, 2017

My Clock


timeanddate.com

Tuesday, September 13, 2016

Papers Published 2016

The effects of Music Therapy on Vital signs, Weight, and Well being ofPremature infants
Mehta Rajeshri R, Gohil Jayendra R, Patel Rhushita M, Agarwal Tushar

Indian Journal of Maternal fetal Neonatal Medicine. 2016(2,07-12);3:73-9.

Redflower publication PLtd


http://dx.doi.org/10.21088/ijmfnm.2347.999X.3216.32016/12 



Hassan Heena R, Gohil Jayendra R, Desai Rihan, Mehta Rajeshri R, Chaudhary Varunashree P.
2016/9 Journal of Clinical Neonatology Vol 5;3:193-8.
Saudi Neonatology Society



Headband Sign on MRI: An unusual finding of Scurvy in a 5y child described first time