Syed Ahmed Zaki

Lokmanya Tilak Municipal General Hospital and Lokmanya Tilak Municipal Medical College | LTMGH · Department of Pediatrics

Acute diarrhoeal illness remains a common medical problem in children with nearly 1.7 billion cases globally every year. We report five infants who, following severe diarrhoea, developed methaemoglobinemia. This is an altered state of haemoglobin presenting with cyanosis and can pose a diagnostic dilemma. It should be suspected in young infants wit...

Sepsis remains a major challenge that necessitates improved approaches to enhance patient outcomes. This study explored the potential of Machine Learning (ML) techniques to bridge the gap between clinical data and gene expression information to better predict and understand sepsis. We discuss the application of ML algorithms, including neural netwo...

This study investigated the temporal dynamics of childhood sepsis by analyzing gene expression (GE) changes associated with pro-inflammatory processes. Five datasets, including four meningococcal sepsis shock (MSS) datasets (two temporal and two longitudinal) and one polymicrobial sepsis dataset, were selected to track temporal changes in gene expr...

Plummer-Vinson Syndrome (PVS) or Paterson-Brown-Kelly syndrome is characterized by the classical triad of iron deficiency anemia, esophageal webs and dysphagia. PVS is commonly found in women of middle age especially in the fourth and fifth decade of life and is rarely reported in children. We report a case of a 4-year-old girl who had a classic pr...

Human immunodeficiency virus type 1 (HIV-1) causes various diseases in different age groups. Neurological manifestations of HIV are common and add to morbidity and mortality. It was previously thought that the central nervous system (CNS) was involved only in the advanced stages of the disease. However, recent evidence supports pathological involve...

Metabolic acidosis is characterised by a primary decrease in the serum bicarbonate concentration, a secondary decrease in the arterial partial pressure of CO­2, and a reduction in blood pH. Metabolic acidosis, acute or chronic, may have deleterious effects on cellular function and cause increased morbidity and mortality. A systematic review of the...

Background: Adverse drug reactions are an important cause of morbidity and mortality in all patients. Information regarding adverse drug reactions in the pediatric age group, especially with regard to the drugs involved and the clinical presentations is scanty. The aim of our study is to determine the incidence of adverse drug reactions and to stud...

Diabetic ketoacidosis (DKA) is a life-threatening complication of type 1 diabetes mellitus in children. Despite the presence of dehydration, hypertension occurs in a significant proportion of children with DKA. There is a lack of clarity in the literature regarding the management of hypertension in patients with paediatric DKA. Herein, we report th...

Sepsis remains a leading cause of in-hospital morbidity and mortality. In the acute phase sepsis is described as a dysregulated process. The objective was to track temporal transcriptomic changes in infants with meningococcal disease (MSS). Therefore, two datasets underwent secondary analysis using temporal transcriptomic data. Methods applied to a...

Sepsis remains a major global health issue in pediatric and adult populations, largely due to a lack of understanding of its complex pathophysiology. Despite its high mortality rate, there have been few advancements in sepsis-specific therapies over recent decades. The study aimed to investigate the potential benefits of a genome-wide transcriptomi...

Background and Aim An essential issue for Kawasaki Disease (KD) is the development of coronary artery disease. We decided to investigate (VEGF) subtype gene expression in KD due to the proangiogenic nature of Vasoactive Endothelial Growth Factor A (VEGF). VEGF-A is a known angiogenic molecule with pro-inflammatory effects, whereas the role of VEGFB...

Severe acute respiratory syndrome-coronavirus-2 (SARS-CoV2), also known as COVID-19, has rapidly spread resulting in a worldwide pandemic. Although COVID-19 infections in children are generally mild and nonfatal, there is increasing recognition of its association with the multisystem inflammatory syndrome in children (MIS-C), leading to serious ill...

Postoperative adhesions are commonly seen after most abdominal surgeries. The majority of patients with intra-abdominal adhesions remain asymptomatic; however, some patients may develop symptoms ranging from mild abdominal pain to sometimes life-threatening complications. The most severe complication seen in association with postoperative adhesions...

Background Otilonium bromide is a quaternary ammonium compound commonly used in the management of irritable bowel syndrome. There are no previously published cases of overdose of otilonium bromide in humans. Due to its poor systemic absorption, it acts locally and has an excellent safety profile. Data from safety and postmarketing observation showe...

Meningococcal Septic Shock (MSS) is a life-threatening condition, especially in Infants. Acutely, critical care support to physiologically impact disease progression is an imperative. Exploring the clinical relationship according to temporal microarray data could aid in tracking MSS pathogenesis during this critical period. For the first time, clin...

Background Meningococcal Septic Shock (MSS) is a life-threatening condition, especially in Infants. Therefore the ability to track MSS pathogenesis during using temporal microarray data was explored. Gene Modular association analysis of Meningococcal Septic Shock time series data in infants was explored using WGCNA. 5 infants with Meningococcal Sep...

Ortner's syndrome is a rare condition characterized by hoarseness of voice due to left recurrent laryngeal nerve (RLN) palsy in association with cardiovascular disease. We report two cases of congenital heart disease in infants presenting with Ortner's syndrome. We believe that the dilated pulmonary artery in the first case and the left atrial dila...

Background and Objective Octreotide is a somatostatin analogue and has been used off-label for a variety of conditions. There are no specific guidelines for the use of octreotide in neonates and its safety and efficacy have not been systematically evaluated. The objective of this study is to present our experience of using octreotide therapy in neo...

Acute poststreptococcal glomerulonephritis (PSGN) is the most common type of glomerulonephritis seen in children. It can affect multiple organs with heart being frequently involved. Yet, there are very few studies on cardiac status in children with PSGN and hence this study was conducted. All consecutive children from 1 month to 12 years of age, ad...

Acute poststreptococcal glomerulonephritis (PSGN) is the most common type of glomerulonephritis seen in children. It can affect multiple organs with heart being frequently involved. Yet, there are very few studies on cardiac status in children with PSGN and hence this study was conducted. All consecutive children from 1 month to 12 years of age, ad...

Panayiotopoulos syndrome (PS) is a benign childhood epilepsy with predominant autonomic symptoms. The syndrome can have varied presentations resulting in diagnostic dilemma. We herein describe a 3-year-old boy with PS, who had manifestations similar to septic shock. His investigations were normal and had a complete recovery. Through this case, we w...

An exemplary method includes an adaptive media content presentation system detecting an interaction of a user with a media content program, generating a playing pattern associated with the media content program based on the detected interaction of the user with the media content program, and applying the playing pattern to at least one of a present...

A method including receiving a request to start recording a sequence of navigational inputs to be received by a user device; storing each navigational input of the sequence when each navigational input is received; receiving a request to stop recording the sequence of navigational inputs; stopping the recording of the sequence of navigational input...

Caroli's syndrome (CS) is a rare congenital disorder characterized by multiple segmental cystic or saccular dilatations of the intrahepatic bile ducts and congenital hepatic fibrosis. We report a 9-year-old boy who was diagnosed with CS and autosomal recessive poly-cystic kidney disease. On screening, his 5-month-old asymptomatic sister had multipl...

Posterior reversible encephalopathy syndrome (PRES) is a rare clinicoradiologic condition manifesting with headache, seizures, altered sensorium, visual disturbances, and characteristic lesions on neuroimaging predominantly affecting the posterior regions of the brain. We report a case of an 8-year-old boy with poststreptococcal glomerulonephritis,...

Levetiracetam is well-tolerated and commonly used as a broad spectrum antiepileptic in both partial and generalized seizures. Few cases of levetiracetam-induced psychosis in children are reported in the literature. The present case of levetiracetam-induced acute psychosis highlights the adverse effect of this drug and also emphasizes the need for c...

Pseudomonas aeruginosa is usually considered a relatively rare pathogen of pyogenic liver abscess in healthy children. A 3-year-old girl presented with fever, abdominal pain, and vomiting. Ultrasonography of the abdomen showed multiple liver abscesses. During her stay in hospital, she developed portal vein thrombosis, hepatic encephalopathy, and mu...

Pseudotumor cerebri is a condition of elevated intracranial pressure in the absence of clinical, laboratory or radiological evidence of an intracranial space-occupying lesion. Various associations with pseudotumor cerebri have been made in literature. We report the case of a five-month-old female infant with vitamin D deficiency rickets, who presen...

Terlipressin, an analog of the natural hormone arginine-vasopressin, is a splanchnic constrictor that is used to control variceal bleeding in portal hypertension. It has a very good safety profile compared to vasopressin. Although rare, adverse effects such as hyponatremia and seizure can occur. We describe a 7-year-old male child who developed hyp...

Acute renal failure is one of the serious complications of malaria with untoward consequences including increased risk of mortality. This study was conducted to evaluate the incidence, clinical features, course, outcome, and predictors of mortality of acute renal failure (ARF) in children with malaria in the pediatric general wards and intensive ca...

Acute renal failure is one of the serious complications of malaria with untoward consequences including increased risk of mortality. This study was conducted to evaluate the incidence, clinical features, course, outcome, and predictors of mortality of acute renal failure (ARF) in children with malaria in the pediatric general wards and intensive ca...

A 4-year-old boy presented with alleged history of accidental consumption of the entire bottle of rifampicin syrup (30 ml bottle, 5 ml/100 mg) i.e. 600 mg. The syrup rifampicin was prescribed for his elder sister who had pulmonary tuberculosis. Immediately after consuming the syrup, he developed nausea and abdominal pain. After half an hour, fever,...

Tuberculosis (TB) of the hard palate is rare and usually secondary to pulmonary TB. We present a case of a 7-year-old boy who presented with difficulty in swallowing solid foods, low-grade fever and loss of weight. Oral cavity examination showed perforation of the hard palate with an irregular, undermined margin and a necrotic base. Chest X-ray sho...

Typhoid fever and viral hepatitis are endemic in many developing countries. Both are transmitted by the feco-oral route and are associated with poor sanitation. Co-existence of both the infection is possible posing a diagnostic dilemma for the treating physician. We report a 7-year-old boy, who had co-existent typhoid fever and hepatitis A infectio...

Renal damage in dengue haemorrhagic fever (DHF) has been reported in association with shock, haemolysis, rhabdomyolysis and sepsis. This report describes acute glomerulonephritis with DHF without the above-mentioned complications. A 3-year-old boy presented with fever, vomiting and oliguria. He had hypertension, deranged renal function and low seru...

Trimethoprim-sulfamethoxazole (TMP/SMX) is a widely prescribed antimicrobial for the management of several uncomplicated infections. It is commonly used for the treatment and prophylaxis of Pneumocystis jirovecii pneumonia (PCP) in the HIV-infected population. The adverse reaction to TMP/SMX is more frequent and severe in HIV-infected patients as c...

The middle aortic syndrome (MAS) is a rare condition characterized by diffuse narrowing of the descending thoracic aorta, abdominal aorta, or both. It can be congenital or acquired due to several conditions. We report an 8-year-old girl who developed middle aortic syndrome due to Takayasu arteritis.

Thyroid dysfunction causes remarkable cardiovascular derangements. Both systolic and diastolic dysfunction of the heart can occur in hypothyroidism leading to cardiac arrhythmia and congestive heart failure. Refractory cardiogenic shock and hypotension in congenital hypothyroidism is rare. We describe a 5-month-old female infant with congenital hyp...

In patients with central nervous system disease, life-threatening hyponatremia can result from either the syndrome of inappropriate secretion of antidiuretic hormone or cerebral salt wasting. Clinical manifestations of the two conditions may be similar, but their pathogeneses and management protocols are different. Cerebral salt wasting syndrome is...

Univentricular heart or single ventricle heart is a rare and complex congenital heart disease (CHD). We report the successful management of a parturient with a single ventricle, and pulmonary stenosis. The univentricular heart is discussed in detail and the maternal and fetal outcome in pregnant women with CHD is reviewed.

Gestational diabetes mellitus (GDM) is a metabolic disorder defined as glucose intolerance with the onset or first recognition during pregnancy. Women with GDM are at increased risk for adverse obstetric and perinatal outcome. The complications associated with GDM can be prevented by early recognition, intense monitoring and proper treatment. The p...

We report a 13-day-old exclusively breastfed neonate, admitted with a history of fever, poor feeding, lethargy and decreased urine output. The mother had history of lactation failure. The neonate had severe hypernatremia, acute renal failure and metabolic acidosis. Renal ultrasound was normal, but the sodium level in mother's milk was 96 mEq/L (nor...

Acute glomerulonephritis following varicella infection Sir, A seven-year-old female presented with puffiness of eyes, headache, and oliguria since two days. There was no fever, convulsion, altered sensorium, visual disturbances, recent sore throat infection, or pyoderma. She had varicella two weeks prior to admission. On admission, she was afebrile...

Tetrabenazine (TBZ) is widely used to treat hyperkinetic movement disorders in adults; however, published experience with the drug in children is limited. Common side effects of TBZ include drowsiness, sedation, weakness, Parkinsonism, depression, and acute akathisia, all of which are reversible with decreased doses. We report here a 7-year-old gir...

Enalapril is an angiotensin converting enzyme inhibitor widely used in children for treatment of hypertension and congestive cardiac failure. We report a 5-year-old boy who developed severe hyponatremia and altered sensorium on enalapril therapy. The serum sodium gradually became normal within 3 days. The patient's sensorium improved significantly...

Piperacillin/tazobactam is a commonly prescribed antibiotic and is generally considered safe. We report a case of a 2-year-old girl who developed hypokalemic metabolic alkalosis and bradycardia after receiving intravenous piperacillin-tazobactam for bronchopneumonia. Upon withdrawal of the drug, serum potassium normalized in 2 days. Hypokalemia is...

Sturge Weber syndrome is characterized by unilateral facial nevus with a tram track appearance on CT scan. However different variants have been described. We report one such variant in a 14 months old child with bilateral facial nevus and bilateral curvilinear calcification. There was also global development delay and early onset of seizures reflec...

Sodium artesunate is used in the treatment of malaria. We report a case of sodium artesunate induced diuresis and natriuresis in a patient with malaria. Following artesunate administration there was polyuria accompanied by natriuresis that was reversed after discontinuation of artesunate treatment. The diuretic effect of artesunate can modify the c...

Cryptococcus neoformans has a worldwide distribution. Meningoencephalitis is the most common manifestation of cryptococcosis. The outcome of a patient with cryptococcal infection depends on the immune status of the host. Patients with nephrotic syndrome are particularly susceptible to cryptococcal infection not only due to innate changes in their i...

Takayasu's arteritis is a chronic, idiopathic, inflammatory disease primarily affecting aorta and its branches. It mainly affects young females in the age group of 10-30 years. Various atypical presentations of Takayasu's arteritis have been described in children. These atypical presentations can cause delayed diagnosis resulting in increased morbi...

Multidrug-resistant typhoid fever (MDRTF) is defined as typhoid fever caused by Salmonella enterica serovar Typhi strains (S. Typhi), which are resistant to the first-line recommended drugs for treatment such as chloramphenicol, ampicillin and trimethoprim-sulfamethoxazole. Since the mid-1980s, MDRTF has caused outbreaks in several countries in the...

Long considered a benign infection, Plasmodium vivax is now increasingly recognised as a cause of severe and fatal malaria. Various atypical presentations of vivax malaria have been reported. This report highlights the occurrence of acute glomerulonephritis in a 7-year-old girl who presented with fever and vomiting. Peripheral smear examination dem...

We report a 5-year-old boy who developed optic neuritis as a paradoxical reaction to anti-tuberculous therapy. Steroids were re-started in the patient with gradual recovery of his vision. The case emphasizes the importance of recognizing paradoxical reactions in patients on anti-tuberculous therapy. Prompt recognition and treatment of such reaction...

A 40-year-old woman presented with a history of pain in the right lower chest, fever and cough with purulent sputum in the previous 20 days. She was treated for a presumed lower respiratory tract infection and her fever subsided, but she continued to produce 400-500 mL of purulent sputum daily, which was blood-tinged on two occasions. Her past medi...