Kandamaran Krishnamurthy

Recognition of Pediatric Sepsis

The PICU at the Queen Elizabeth Hospital (QEH) caters to the entire pediatric population of this country. The study population included all children (age < 16 years) who were admitted to the PICU for severe acute asthma. Those who died on arrival or died within two hours of admission were excluded.. Data were extracted from the patients case record...

Monitoring and weaning from NIV

Introduction This research investigated the capabilities of ChatGPT-4 compared to medical students in answering MCQs using the revised Bloom’s Taxonomy as a benchmark. Methods A cross-sectional study was conducted at The University of the West Indies, Barbados. ChatGPT-4 and medical students were assessed on MCQs from various medical courses using...

Studies focusing on the safety and common side effects of vaccines play a crucial role in enhancing public acceptance of vaccination. Research is scarce regarding the usage of COVID-19 vaccines and the side effects experienced by health professions students in India and other countries.

Background: Nurses are essential members of the healthcare workforce and were among the first-line carers for patients in community and hospital settings during the COVID-19 pandemic. As a result, they were at a heightened risk of infection, resulting in several reported deaths among nursing staff. Several preventive measures were adopted to contai...

SCCM Critical Care Workforce Update 2023

OBJECTIVES: Numerous studies from around the world have documented disruption as well as a decrease in child health services. In this study, we look at the impact of the pandemic from a different perspective. We compare the spectrum of non-COVID-19 illnesses which necessitated hospitalisation among children during this pandemic and the pre-pandemic...

Oral and dental health examination policy refers to screening of dental and oral cavities on an annual basis as part of their progression during the school period. The oral and dental health examination helps to identify the status of dentition, oral hygiene care, dietary risk, dental anomalies, malocclusion, signs of deleterious habits such as smo...

Citation: Jeevan Divakaran, et al. "Recent Update in Diagnostic Evaluation of Hereditary Hemochromatosis". EC Paediatrics 12.7 (2023): 72-81. Abstract Hereditary hemochromatosis (also called bronze diabetes) is a common autosomal recessive disorder in the Caucasian population characterized by high levels of iron accumulation due to increased dietar...

OBJECTIVES: In the absence of freely and timely availability of the serological test for definitive diagnosis of dengue, clinicians are often called to rely on the blood counts for making an early diagnosis of this disease. This study analyses the blood cell counts in children hospitalised in Barbados with dengue in comparison with other febrile il...

Primary outcome is prevalence of acute critical illness, defined as: death within 48 hours, including ED mortality; OR admission/transfer to an HDU or ICU; OR transfer to another institution with a higher level of care; OR receiving critical care-level interventions (vasopressor infusion, invasive mechanical ventilation, non-invasive mechanical ven...

Background Efficacy and safety are fundamental for the development of successful COVID-19 vaccines. Vaccine-associated side effects influence vaccine hesitancy. This study investigated the prevalence, severity, and onset of side effects following the first dose of COVID-19 vaccines among physicians and dentists working in various healthcare setting...

We report the first documented paediatric case of Wolf-Hirschhorn syndrome, a rare genetic chromosomal abnormality, in a small island developing country in the Eastern Caribbean, Barbados. Although there are documented case reports on Wolf-Hirschhorn syndrome worldwide, few studies have described the condition in patients of Afro-Caribbean descent...

Background: Most universities around the world use the multiple-choice question (MCQ) examination format to evaluate medical education. However, the suitability and advantages of traditional MCQs and extended matching questions (EMQs) continue to be debated. Objectives: This study mainly aimed to perform a comprehensive comparative analysis of the...

An innovative, blended, and supplementary clerkship to minimize clinical training gaps identified during the COVID-19 pandemic

Objective: The objective of this study was a comprehensive comparative analysis of the performance of EMQ and traditional MCQ formats in the written medicine and therapeutics component of final MBBS examination. Methods: We conducted an item analysis of 80 EMQs and 200 MCQs administered to 532 examinees across four campuses/site in different Caribb...

It is a study of correlation between GPA and scores in the final MBBS examination

Background: The use of personal protective equipment (PPE) reduces the risk of transmission of infectious agents significantly among healthcare workers (HCWs). The study aimed to investigate the prevalence and characteristics of PPE-related adverse skin reactions among HCWs working at the main COVID-19 isolation center in Barbados. Methods: A cros...

Autoresuscitation, also referred to as Lazarus phenomenon, is a rare occurrence whereby a patient may experience restoration of spontaneous circulation and signs of life after a diagnosis of “death” following unsuccessful cardiopulmonary resuscitation. “Found alive after declared dead” has often appeared as sensational news on print, electronic, an...

The aim of this study was to determine the prevalence and characteristics of PPE-related adverse skin reactions among HCWs working at Harrison's Point, the main COVID-19 isolation centre in Barbados. A cross-sectional web-based online survey among HCWs was carried out from 1 April 2021 to 21 June 2021. The questionnaire recorded self-reported demog...

An innovative, blended, and supplementary clerkship to minimize clinical training gaps identified during the COVID-19 pandemic K Connell, K Krishnamurthy, MH Campbell, H Harewood, N Graves, A Kumar, D Springer, M O'Shea, A Harvey PM Lashley, OP Adams, MAA Majumder Faculty of Medical Sciences, The University of the West Indies, Cave Hill Campus,...

Introduction and Objectives: One of the vital nutrients, vitamin D, has a role in fat metabolism and other metabolic processes in addition to its direct impact on calcium and bone metabolism. This study intends to look at how vitamin D intake affects the levels of lipids, glucose, and insulin in rats with experimentally induced diabetes mellitus. M...

Medical education is changing at a fast pace. Students attend medical school with a high degree of technological literacy and a desire for a diverse educational experience. As a result, a growing number of medical schools are incorporating technology‐enhanced active learning and multimedia education tools into their curriculum. Gamified training pl...

Medical education is changing at a fast pace. Students attend medical school with a high degree of technological literacy and a desire for a diverse educational experience. As a result, a growing number of medical schools are incorporating technology-enhanced active learning and multimedia education tools into their curriculum. Gamified training pl...

Introduction and objective: With the advent of social media and widespread use of the internet, the learning routine of students has significantly changed over the last two decades. The use of smartphones and on-line educational applications has exponentially risen. Among medical students, readily accessible on-line tools in medical education have...

Management of pediatric covid infection

Objectives to evaluate the correlation between the grades from their final exit examination of the MBBS program and their GPA from the assessment during the five-year course. Methods This was a retrospective observational study on three cohorts of students. Study setting were the Faculty of Medical Sciences at three campuses of a single university....

Metabolomics is the study of metabolites, targeted or untargeted. They can be analyzed from body fluids like urine, blood and saliva. They are of low molecular weight (<1KD). These reflect the process involved in the metabolism. The targeted one is restricted to the known metabolites. The untargeted identifies unknown metabolites, known as Metabolo...

Introduction Due to increased exposure risk and the potential impact of COVID-19 infection, health care professionals (HCP) are a target group for COVID-19 vaccination. This study aimed to examine the acceptability of COVID-19 vaccines among HCP at the Queen Elizabeth Hospital, Barbados. Design and Methods A cross-sectional survey of HCP was condu...

Intervertebral disc disease (IVDD) is a common musculoskeletal disease affecting about 5% of all individuals. It is characterized by lumbar disc herniation, which causes nerve root irritation, either mechanically or via inflammatory mediators, and results in radiating pain, known as sciatica. Numerous studies have been conducted to identify the cau...

Abstract Background Barbados like other countries in the English-speaking Caribbean introduced the 7-valent pneumococcal conjugate vaccine (PCV7) in late 2007, replaced by the 13-valent vaccine (PCV13) in 2013, using a 3+ 0 dosing schedule. We investigated the prevalence and serotype pattern of nasopharyngeal (NP) carriage of Streptococcus pneumoni...

Background Barbados like other countries in the English-speaking Caribbean introduced the 7-valent pneumococcal conjugate vaccine (PCV7) in late 2007, replaced by the 13-valent vaccine (PCV13) in 2013, using a 3+ 0 dosing schedule. We investigated the prevalence and serotype pattern of nasopharyngeal (NP) carriage of Streptococcus pneumoniae (SP) a...

Objective To determine the threshold of the inotropic score (IS) and vasoactive–inotropic score (VIS) for predicting mortality in pediatric septic shock.Method This retrospective cohort study included children aged 1 mo to 13 y with septic shock, requiring vasoactive medication. The area under curve receiver operating characteristic (AUROC) was cal...

Commentary:“Fungal Infections of Oral Cavity:Diagnosis, Management, and Association with COVID-19”Ambadasu Bharatha &Latha Kandamaran &Kandamaran Krishnamurthy Accepted: 3 July 2021#The Author(s), under exclusive licence to Springer Nature Switzerland AG 2021The recently published article by Rajendra Santosh et al.[2021] elegantly addressed on diag...

Objective: This study aimed to examine the acceptability of COVID-19 vaccines among the healthcare professionals (HCP) of Queen Elizabeth Hospital, Barbados. Design and Methods: A cross-sectional survey of HCP between February 14 to 27, 2021 was conducted using an online questionnaire. Results: 350 respondents completed the questionnaire; the major...

Objective: To describe the impact of the COVID-19 pandemic on the burden and pattern of hospitalization from COVID-19-unrelated illnesses among children in Barbados. Methods: This was a population-based prospective clinical audit. It included children (aged < 16 years) admitted for COVID-19-unrelated illnesses to the only tertiary care hospital in...

Objective To study the association of cumulative fluid balance and clinical outcomes in a pediatric intensive care unit (PICU) practicing restrictive fluid protocol.Methods In this prospective cohort study, children aged less than 13 y admitted for more than 48 h were screened. Children with unstable hemodynamics throughout the stay were excluded....

Inaccurate penicillin allergy labels (PALs) are a major public health problem in high-income countries and has been linked to antimicrobial resistance (AMR) and huge healthcare costs. Data regarding epidemiology of PALs and its potential association with AMR is sparse in low-income countries (LICs), low-middle-income countries (LMICs) and upper-mid...

Early Childhood Caries (ECC) is one of the most common chronic infectious diseases of childhood. It represents a significant disease burden with long-term consequences for a child's health and well-being. Primary health care providers (pediatricians, family physicians, pediatric nurses) are the first point of contact for parents for any child healt...

Kawasaki disease (KD) is an acute, self-limiting febrile illness of childhood associated with vasculitis, mainly of the medium-sized arteries. The clinical significance and impact of this condition arise from its predilection for the coronary arteries. The criteria for classic Kawasaki disease are clearly defined, but many children present with aty...

A Correction to this paper has been published: https://doi.org/10.1007/s42399-021-00812-8

Whole Brain Death Project (WBDP)

The incidence of rheumatic heart disease has been steadily declining throughout the developed world, with the incidence in the United States and other developed now < 2 cases per 100,000 school-aged children [1]. Despite this, worldwide rheumatic heart disease and its complications result in about 233,000 deaths annually with the majority of cases...

Complementary feeding, also known as weaning in common terms, is the introduction of foods other than milk in the infants’ diet. It is a critical time in terms of the nutritional needs of these young and rapidly growing infants. There are many questions that arise in the minds of parents as well as the pediatricians who advise these parents on such...

Reporting a case of hypopituitarism presenting with micropenis in the newborn period, followed by a discussion on neonatal hypopituitarism.

The entire world is reeling under the effects of the novel corona virus pandemic. As it is a new infection, our knowledge is evolving constantly. There is limited information about impact of corona virus on neonatal care in relation to newborns with confirmed or suspected COVID-19. In this article, we summarize the current approach to this infectio...

In this issue of JAMA, contributors to the World Brain Death Project present an international consensus report on criteria for the diagnosis of brain death, or determination of death by neurologic criteria (BD/DNC).¹ The report addresses inconsistencies in clinical guidelines across different countries and focuses attention on the need for better e...

The world has begun adapting to “new normal” as a response to continued unsolved pandemic situations following to post‐lock down. The most complex aspect in medical and dental practice during this pandemic environment is identifying asymptomatic COVID‐19 individuals.

Coronavirus disease 2019 (COVID-19) is a pandemic and rapidly progressing infectious disease that represents a global health care emergency due to severe acute respiratory syndrome. Rapid tests detect antigen or antibody presence, which is useful for patient care and for assisting in disease surveillance and epidemiological research. The complicati...

Background: Barbados is one of the English speaking Caribbean countries with a population of 277,821 (2010). The whole population is served by a single tertiary care hospital the Queen Elizabeth Hospital (QEH). In this audit we report on the burden of hospitalization from acute severe asthma and other acute respiratory illnesses in children in this...

Burden of hospitalizations and mortality from acute severe asthma among children in Barbados, 2013-2016. - report form a population based longitudinal audit

Objectives: To identify currently carried prevalent serotypes of Streptococcus pneumoniae among Caribbean children; to determine whether there any differences in serotype prevalence among children of varying geographic and socioeconomic backgrounds; and to determine the antimicrobial susceptibility of isolates, overall and by serotype. Design and M...

Objectives: In this operational research study we critically examine the available resources in the public and the private primary health facilities, describe the utilization of the public and the private facilities by the children of this country including the demographics as well as the profile of the presenting illnesses. Methods: This report is...

Background: The objective structured clinical examination (OSCE) is the gold standard and universal format to assess the clinical competence of medical students in a comprehensive, reliable and valid manner. The clinical competence is assessed by a team of many examiners on various stations of the examination. Therefore, it is found to be a more co...

Road traffic crashes are one of the major causes of death, injuries and disabilities in all over the world and the after effects are very severe in developing countries like India. It adversely affects the national economy and worsens the social status as well. All road crash cases in India are tried at the Motor Accident Claims Tribunal (MACT), co...

Background: The major objectives of this study were to evaluate the existing primary health care service provisions in the public and private sector and utilization of the services, and to assess the existing manpower and material resources. Methods: Data were collected through interviews with the primary health care providers. Data were also co...

Emerging picture of hantavirus infection in the South America is characterized by greater proportion of childhood infection and wider spectrum of disease from mild asymptomatic to lethal cardiopulmonary disease. Barbados is endemic for dengue and leptospirosis, both of which share clinical features with hantavirus infection and in many cases neithe...

Objectives: To describe the seroprevalence of dengue antibodies in febrile suspected persons and investigated for dengue in this country. Design and Methods: It is a retrospective population based study of all febrile children and adults with probable dengue from 2006 to 2013. Persons with probable dengue were investigated for dengue IgM and IgG an...

Although dengue is endemic in all English-speaking Caribbean countries, there are no published studies on the clinical presentations and outcomes of children hospitalized with dengue from this region. This study aims to assess the clinical charcteristics and the outcome in children hospitalized with dengue. This was a population-based prospective s...

Objectives: The primary aim of this study was to determine the prevalence of selected bacterial and viral enteropathogens in children hospitalized with acute gastroenteritis and the secondary aim was to characterize the clinical course and the outcome. Methodology: A retrospective audit of children (<15 years) admitted with acute gastroenteritis du...

Background and aims: Presently, there is little or no documentation of the cost of pediatric ICU in Barbados hospital and hence, its impact of this aspect of the healthcare process on the population needs evaluation in the economical climate existing. Aim:Our study sought to determine the cost of providing ICU care for children in a public hospital...

Objectives. To study the prevalence and the pattern of major congenital malformations and its contribution to the overall perinatal morbidity and mortality. Methods. It is a retrospective population based study. It includes all major congenital malformations in newborns during 1993-2012. The data was collected from the birth register, the neonatal...

Spontaneous oesophageal rupture (Boerhaave's syndrome) is extremely rare in children. Presentation is usually in middle aged men as a result of vomiting following heavy food or alcohol consumption. We describe an unusual case of a 12-year old boy without significant past medical history presenting with acute chest pain following gastroenteritis.

Objectives: In this study we determine the burden and describe the epidemiology of hospitalization from asthma and other acute respiratory diseases in this population Methods: This study is a prospective clinical audit of children (Age <16 years) admitted to the QEH with ARD including those where the primary discharge diagnosis was AEA and those wh...

Recruitment of leukocytes circulating in our blood to the sites of infection or tissue damage is the key phenomenon in the acute inflammatory response(s). Among the leukocytes, neutrophils are primarily recruited into the areas of acute inflammation. When neutrophils interact with activated endothelium of the blood vessels, they become migratory an...

This study evaluated the outcome of patients in a pediatric intensive care unit (ICU) of a developing country applying Pediatric Index of Mortality (PIM) version-2 scoring system. A total of 163 consecutive patients were prospectively studied. Data included demographics, diagnoses at admission, PIM-2 score, the duration of ICU stay and hospital out...