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Article ; Online: Mass Deworming: Does it Impact Nutritional Outcomes in Children?

Mishra, Kirtisudha

2023 Volume 60, Issue 8, Page(s) 672–674

Language	English
Publishing date	2023-08-07
Publishing country	India
Document type	Journal Article
ZDB-ID	402594-5
ISSN	0974-7559 ; 0019-6061
ISSN (online)	0974-7559
ISSN	0019-6061
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Article ; Online: Evaluation of Children With Hematuria: Deveil Lies in the Details!: Authorsp Reply.

Mishra, Kirtisudha

Indian pediatrics

2022 Volume 59, Issue 3, Page(s) 258

MeSH term(s)	Child ; Female ; Hematuria/diagnosis ; Hematuria/etiology ; Humans ; Male
Language	English
Publishing date	2022-03-03
Publishing country	India
Document type	Journal Article ; Comment
ZDB-ID	402594-5
ISSN	0974-7559 ; 0019-6061
ISSN (online)	0974-7559
ISSN	0019-6061
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Article ; Online: Identification of Probable Urinary Tract Infection in Children Using Low Bacterial Count Thresholds in Urine Culture.

Nyayadhish, Rutuja / Mishra, Kirtisudha / Kumar, Manish / Saigal, Karnika

Indian pediatrics

2023 Volume 60, Issue 5, Page(s) 369–372

Abstract: Objective: To assess the proportion of children, symptomatic for urinary tract infection (UTI), with urine culture showing single bacterial species >104 CFU/mL, and to compare patient and disease characteristics between children having low counts (from > ...

Abstract	Objective: To assess the proportion of children, symptomatic for urinary tract infection (UTI), with urine culture showing single bacterial species >104 CFU/mL, and to compare patient and disease characteristics between children having low counts (from >104-105 CFU/mL) and those with counts >105 CFU/mL. Methods: Prospective observational study, enrolling symptomatic children aged 1 month to 12 years. Mid-stream clean-void or catheter collected urine were cultured. Children with single species >104 CFU/mL were scheduled for imaging studies, following age criteria of Indian Society of Pediatric Nephrology guidelines. The main outcome was proportion with single bacterial species >104 CFU/mL in urine culture. Results: Of 216 children (132 males) with median (IQR) age of 24 (12, 48) months, 38 (17.6%) showed single species growth >104 CFU/mL. Of these, 29 (13.4%) were diagnosed as UTI at cutoff >105 CFU/mL, and an additional 9 (4.2%) were found to have 'probable low-count UTI' (from >104 to 105 CFU/mL). One child in the latter group had bilateral hydroureteronephrosis, vesico-ureteral reflux and renal scarring. There was largely no difference in parameters between children with low counts and those with counts >105 CFU/mL. Conclusions: An additional proportion of symptomatic children with probable urinary tract infection and possible underlying urological abnormalities may be identified by lowering bacterial colony count cutoff to >104 CFU/mL, in clean-voided and catheter-based urine samples.
MeSH term(s)	Male ; Child ; Humans ; Infant ; Bacterial Load ; Urinary Tract Infections/diagnosis ; Bacteria ; Prospective Studies ; Vesico-Ureteral Reflux/diagnosis
Language	English
Publishing date	2023-02-09
Publishing country	India
Document type	Observational Study ; Journal Article
ZDB-ID	402594-5
ISSN	0974-7559 ; 0019-6061
ISSN (online)	0974-7559
ISSN	0019-6061
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Etiology and Outcome of Community-Acquired Acute Kidney Injury in Pediatric Inpatients.

Ashish, Ashna / Kumar, Manish / Mishra, Kirtisudha

Indian pediatrics

2023 Volume 60, Issue 6, Page(s) 459–462

Abstract: Objective: To estimate the etiology, outcome, and risk factors for mortality in children with community-acquired acute kidney injury (CA-AKI).: Methods: Between October, 2020 and December, 2021, consecutive hospitalized children aged 2 mo-12 years ... ...

Abstract	Objective: To estimate the etiology, outcome, and risk factors for mortality in children with community-acquired acute kidney injury (CA-AKI). Methods: Between October, 2020 and December, 2021, consecutive hospitalized children aged 2 mo-12 years with a minimum 24 hours of stay, and at least one serum creatinine level measured at or within 24 hours of hospitalization were prospectively enrolled. CA-AKI was labelled in children with an elevated serum creatinine level at admission and subsequent fall during hospitalization. Results: Of 2780 children, 215 were diagnosed as CA-AKI (7.7%, 95% CI 6.7-8.6). Diarrhea with dehydration (39%) and sepsis (28%) were the most common causes of CA-AKI. 24 children (11%) died during hospitalization. Requirement of inotropes was an independent predictor of mortality. Out of 191 children discharged, 168 (88%) had complete renal recovery. At 3 months, out of 22 children without complete renal recovery, 10 progressed to chronic kidney disease (CKD), with 3 becoming dialysis dependent. Conclusion: CA-AKI is common in hospitalized children, and is associated with increased risk of progression to CKD, especially in those with incomplete renal recovery.
MeSH term(s)	Humans ; Child ; Inpatients ; Creatinine ; Retrospective Studies ; Hospitalization ; Acute Kidney Injury/epidemiology ; Acute Kidney Injury/etiology ; Acute Kidney Injury/therapy ; Renal Insufficiency, Chronic ; Risk Factors
Chemical Substances	Creatinine (AYI8EX34EU)
Language	English
Publishing date	2023-03-20
Publishing country	India
Document type	Journal Article
ZDB-ID	402594-5
ISSN	0974-7559 ; 0019-6061
ISSN (online)	0974-7559
ISSN	0019-6061
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Article ; Online: Publication Ethics.

Mishra, Kirtisudha / Dabas, Aashima

Indian pediatrics

2021 Volume 58, Issue 8, Page(s) 781–785

Abstract: Publications in the field of medical literature are a matter of prestige and fame for doctors. While genuine research contributes to the existing scientific knowledge, fraudulent data make publication unreliable, demeans the credibility of the author and ...

Abstract	Publications in the field of medical literature are a matter of prestige and fame for doctors. While genuine research contributes to the existing scientific knowledge, fraudulent data make publication unreliable, demeans the credibility of the author and reduces faith in science. Research misconduct includes the three cardinal sins fabrication, falsification and plagiarism. To promote highest standards in publication ethics, Committee on Publication Ethics provides advice and guidance to journals and publishers. Investigators should abide by ethical norms during the conduct of the research. Journals also maintain editorial standards and have well-defined policies for responding to misconduct. With an increase in medical publications over the years, it is important for all stakeholders to abide by publication ethics, in order to uphold the sanctity of research and credence in science.
MeSH term(s)	Biomedical Research ; Humans ; Plagiarism ; Scientific Misconduct
Language	English
Publishing date	2021-04-20
Publishing country	India
Document type	Journal Article
ZDB-ID	402594-5
ISSN	0974-7559 ; 0019-6061
ISSN (online)	0974-7559
ISSN	0019-6061
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Article ; Online: Abbreviated protocol of plasma exchanges for patients with anti-factor H associated hemolytic uremic syndrome.

Thangaraju, Sharan / Khandelwal, Priyanka / Mishra, Kirtisudha / Kumar, Manish / Puraswani, Mamta / Saini, Rahul / Hari, Pankaj / Coshic, Poonam / Sinha, Aditi / Bagga, Arvind

Pediatric nephrology (Berlin, Germany)

2024

Abstract: Background: Plasma exchanges (PEX) and immunosuppression are the cornerstone of management of anti-factor H (FH) antibody-associated atypical hemolytic uremic syndrome (aHUS), particularly if access to eculizumab is limited. The duration of therapy with ...

Abstract	Background: Plasma exchanges (PEX) and immunosuppression are the cornerstone of management of anti-factor H (FH) antibody-associated atypical hemolytic uremic syndrome (aHUS), particularly if access to eculizumab is limited. The duration of therapy with PEX for anti-FH aHUS is empirical. Methods: We compared the efficacy of abbreviated PEX protocol (10-12 sessions) in a prospective cohort of patients diagnosed with anti-FH aHUS (2020-2022), to standard PEX protocol (20-22 sessions) in a historical cohort (2016-2019; n = 65). Efficacy was defined as 70% decline in anti-FH titers or fall to ≤ 1300 AU/ml at 4 weeks. Patients in both cohorts received similar immunosuppression with oral prednisolone, IV cyclophosphamide (5 doses) and mycophenolate mofetil. Outcomes included efficacy, rates of hematological remission and adverse kidney outcomes at 1, 3 and 6 months. Results: Of 23 patients, 8.2 ± 2.1 years old enrolled prospectively, two were excluded for significant protocol deviation. PEX was abbreviated in 18/21 (86%) patients to 11.5 ± 3.3 sessions. Abbreviation failed for lack of hematological remission by day 14 (n = 2) and persistent neurological manifestations (n = 1). All patients in whom PEX was abbreviated achieved > 70% reduction in anti-FH titers at day 28. The percentage fall in anti-FH titers was similar for the abbreviated vs. standard PEX protocols at 1, 3 and 6 months. At last follow-up, at median 50 months and 25 months for standard and abbreviated cohorts, the estimated GFR was similar at 104.8 ± 29.1 vs. 93.7 ± 53.4, respectively (P = 0.42). Conclusion: Abbreviation of the duration of PEX is feasible and efficacious in reducing anti-FH titers. Short-term outcomes were comparable in patients managed by abbreviated and standard PEX protocols.
Language	English
Publishing date	2024-01-25
Publishing country	Germany
Document type	Journal Article
ZDB-ID	631932-4
ISSN	1432-198X ; 0931-041X
ISSN (online)	1432-198X
ISSN	0931-041X
DOI	10.1007/s00467-024-06279-8
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Article ; Online: 50 Years Ago in The Journal of Pediatrics: Detection of Bacteriuria in Children.

Mishra, Kirtisudha / Gupta, Piyush

The Journal of pediatrics

2018 Volume 204, Page(s) 58

MeSH term(s)	Asymptomatic Infections ; Bacteriuria/diagnosis ; Bacteriuria/history ; Child ; Female ; History, 20th Century ; Humans ; Male ; Mass Screening/history ; Mass Screening/methods ; Pediatrics/history
Language	English
Publishing date	2018-12-19
Publishing country	United States
Document type	Historical Article ; Journal Article
ZDB-ID	3102-1
ISSN	1097-6833 ; 0022-3476
ISSN (online)	1097-6833
ISSN	0022-3476
DOI	10.1016/j.jpeds.2018.07.068
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Article ; Online: Low-dose versus conventional-dose prednisolone for nephrotic syndrome relapses: a randomized controlled non-inferiority trial.

Sheikh, Seenam / Mishra, Kirtisudha / Kumar, Manish

Pediatric nephrology (Berlin, Germany)

2021 Volume 36, Issue 10, Page(s) 3143–3150

Abstract: Background: Reduction of steroid exposure in relapses of steroid-sensitive nephrotic syndrome (SSNS) is under-researched.: Methods: In this randomized controlled non-inferiority trial, 1-12-year-old children with relapse of SSNS were randomized to ... ...

Abstract	Background: Reduction of steroid exposure in relapses of steroid-sensitive nephrotic syndrome (SSNS) is under-researched. Methods: In this randomized controlled non-inferiority trial, 1-12-year-old children with relapse of SSNS were randomized to receive prednisolone 1 mg/kg/day (low dose) or 2 mg/kg/day (standard dose) until disease remission or day 15, whichever was earlier. Therapy was switched to 2 mg/kg/day in children in low-dose group not in remission by day 15. Primary outcome was days to remission, and secondary outcome being pattern of subsequent relapse(s) over 1 year. Estimating time to remission of 8 ± 2.5 days with standard-dose therapy, non-inferiority margin of 2 days, 90% power, and α-0.05, 60 patients were randomized. Results: Of the 60 children (30 in each group) enrolled, 4 (one in low-dose group) failed remission by day 15. Time to remission was comparable between low-dose and standard-dose groups [9.0 ± 2.2 vs. 8.6 ± 2.2 days; mean difference (95% CI) 0.4 (- 0.79 to 1.59) days; p = 0.49], thus establishing non-inferiority of low dose. Median time to subsequent relapse was 86 (IQR 74.8, 97.2) and 150 (IQR 59.0, 240.9) days, in low- versus standard-dose groups, respectively (log rank p = 0.39). In follow-up, proportion of children having relapses, frequency of relapses, proportion with frequent relapse/steroid dependent (FR/SD), and cumulative corticosteroid dose taken were comparable between groups. Conclusions: This study shows that time to achieve remission after treatment of a relapse with low-dose prednisolone is non-inferior to that after treatment with conventional dose in children with SSNS. The proportion of children achieving remission, further course, and pattern of relapses was comparable between both groups.
MeSH term(s)	Child ; Child, Preschool ; Chronic Disease ; Humans ; Infant ; Nephrotic Syndrome/drug therapy ; Prednisolone ; Recurrence ; Steroids ; Treatment Outcome
Chemical Substances	Steroids ; Prednisolone (9PHQ9Y1OLM)
Language	English
Publishing date	2021-04-16
Publishing country	Germany
Document type	Journal Article ; Randomized Controlled Trial
ZDB-ID	631932-4
ISSN	1432-198X ; 0931-041X
ISSN (online)	1432-198X
ISSN	0931-041X
DOI	10.1007/s00467-021-05048-1
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Article ; Online: Clinico-Etiologic Profile of Macroscopic Hematuria in Children: A Single Center Experience.

Mishra, Kirtisudha / Kumar, Manish / Patel, Ankita / Singh, Lavleen / Zanak, Komal Dattatrya

Indian pediatrics

2021 Volume 59, Issue 1, Page(s) 25–27

Abstract: Objective: To study the demographic, clinical and etiological profile of macroscopic hematuria in children presenting to a tertiary care hospital.: Methods: This prospective observational study, conducted between January, 2018 and December, 2019, ... ...

Abstract	Objective: To study the demographic, clinical and etiological profile of macroscopic hematuria in children presenting to a tertiary care hospital. Methods: This prospective observational study, conducted between January, 2018 and December, 2019, enrolled children aged 3 months to 12 years, presenting with gross hematuria. Results: Of the 62 children (44 males) enrolled, (mean (SD) age of 7.3 (2.6) years), glomerular hematuria was seen in 59.7%. Post-infectious glomerulonephritis was the commonest etiology of glomerular hematuria; hypercalciuria and renal calculi predominated among non-glomerular hematuria. After a median (IQR) follow up of 8 (6,14.2) months, microscopic hematuria persisted in 10 (7, glomerular hematuria) children. The median time to resolution of gross as well as microscopic hematuria tended to be longer in glomerular etiologies. Conclusion: Majority of children with gross hematuria had glomerular etiologies, thus requiring monitoring and follow-up.
MeSH term(s)	Child ; Hematuria/diagnosis ; Hematuria/epidemiology ; Hematuria/etiology ; Humans ; Kidney Diseases/complications ; Kidney Glomerulus ; Male ; Prospective Studies
Language	English
Publishing date	2021-01-28
Publishing country	India
Document type	Journal Article ; Observational Study
ZDB-ID	402594-5
ISSN	0974-7559 ; 0019-6061
ISSN (online)	0974-7559
ISSN	0019-6061
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Reliable cerebrospinal fluid cytology reporting over an extended period: Is it possible by adding formol saline and ethylenediaminetetraacetic acid as cell preservative?

Rastogi, Kanika / Singh, Lavleen / Khatri, Arti / Mishra, Kirtisudha / Gupta, Ranjan

Diagnostic cytopathology

2020 Volume 48, Issue 8, Page(s) 745–751

Abstract: Background: Reporting cerebrospinal fluid (CSF) cytology within a narrow time frame is crucial as it is often indicated in critically ill patients and moreover, the cells in CSF are highly labile and tend to decline rapidly on standing. However, due to ... ...

Abstract	Background: Reporting cerebrospinal fluid (CSF) cytology within a narrow time frame is crucial as it is often indicated in critically ill patients and moreover, the cells in CSF are highly labile and tend to decline rapidly on standing. However, due to various logistic issues, delay in reporting is inevitable at times, especially if ancillary tools are required. In this study, we examine the effect of using formol saline and ethylenediaminetetraacetic acid (EDTA) as a preservative on the cellular composition of CSF at 18, 24, and 48 hours of preservation. Methods: Thirty CSF specimens were examined within 2 hours of collection and this reading was recorded as time zero reading. The CSF specimens were then divided in three tubes with: (a) preservative:CSF ratio of 1:1; (b) preservative:CSF ratio of 1:5; and (c) no preservative. Total and differential leucocyte counts and immunocytochemistry were performed on the three specimens at 18, 24, and 48 hours and were compared with the readings at 0 hour. Results: Preserved CSF (in the ratio of 1:5) showed no significant decrease in the number of cells at 18 hours (P = .4), 24 hours (P = .3), and 48 hours (P = .1). Cellularity decreased by 8.5%, 22%, and 40% at 18, 24, and 48 hours, respectively. Cell morphology and antigenicity were well preserved at all the three time intervals. Conclusion: Formol saline and EDTA, when mixed with the CSF in the ratio of 1:5, can preserve significant cellularity for up to 24 hours.
MeSH term(s)	Cerebrospinal Fluid/cytology ; Child ; Child, Preschool ; Cytodiagnosis/methods ; Edetic Acid ; Female ; Fixatives ; Formaldehyde ; Humans ; Infant ; Infant, Newborn ; Male ; Saline Solution ; Specimen Handling ; Tissue Preservation/methods
Chemical Substances	Fixatives ; Saline Solution ; Formaldehyde (1HG84L3525) ; Edetic Acid (9G34HU7RV0)
Language	English
Publishing date	2020-05-13
Publishing country	United States
Document type	Journal Article
ZDB-ID	632710-2
ISSN	1097-0339 ; 8755-1039
ISSN (online)	1097-0339
ISSN	8755-1039
DOI	10.1002/dc.24471
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