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Background: Neonatal mastitis may occur de novo due to infection by various organisms, most notably Staphylococcus aureus. This condition usually responds well to treatment, but may sometimes progress to breast abscess formation.Methods: This was a retrospective study. All the patients who were admitted in hospital with admission diagnosis of neonatal mastitis or breast abscess were included in this study. Various demographic, clinical and lab data were recorded and analyzed.Results: Total 11 patients fulfilled the inclusion criteria and were included in the study. (7 females: 4 males). Swollen and red breast area was the most common presenting complaint, seen in 10 patients. One patient came with complaint of pus draining from the swollen breast. 2 patients were febrile. The age at presentation varied from 7 days to 30 days (median age 14 days). 7 patients had undergone breast massage at hands of their family members to express the witch's milk. Pus culture from the 6 cases of breast abscesses grew Staphylococcus aureus in 3 cases and Coagulase negative staph (CONS) in 1 patient. Blood culture was sterile in 8 cases, grew CONS in two cases and MRSA in 1 patient. In all the cases where blood culture grew an organism, a lumbar puncture was also done but CSF analysis was normal in all the cases. Drainage of abscess and IV antibiotics led to resolution of disease in all patients and none of the patients developed any complications.Conclusions: Neonatal mastitis and breast abscess is not an uncommon condition. Complications are very rare and the condition responds well to IV antibiotics. People should be made aware about the ill effects of cultural practice of breast massage to express witch's milk in neonates. Early treatment of mastitis leads to better outcome and lesser chances of abscess formation.
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Background:Asthma is a chronic inflammatory condition of lung airways resulting in episodic airflow obstruction. Aims: The main objective of this study is tofind the effect of antiasthma medication on serum IgE levels and blood eosinophil count.Study Design:Thisrandomizedcontrolled trial studywas performed in children aged 6-15 years of age, with clinically stable and moderate persistent asthma.Results:The findings of this study indicate both group(Budesonide/formoterol group and budesonide group) patients experienced a significant decrease in serum IgE levels and blood eosinophil counts over the study period.However, the difference in two groups was not statistically significant.Conclusions:Inhaled steroids are effective in controlling systemic inflammation in asthma as evidenced by a decrease in IgE levels and eosinophil counts. However addition of LABA doesn’t have any additive effect.
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Introduction: Hypernatremic dehydration in neonates is themost dangerous form of dehydration due to complicationsassociated with it as well as its management. This study wasplanned to study the impact of the significant physiologicchanges in body water content on serum sodium concentrationin the immediate postnatal period and try to identify riskfactors for hypernatremic dehydration.Material and Methods: Only healthy term/near-term babieswere included. They were examined on day four of life in thewell baby clinic. These neonates were again examined on daysseven and ten of life. Blood samples were collected on daysfour and ten of life, serum was separated and stored at -20°C.These serum samples were processed subsequently and serumsodium and potassium were estimated and compared withweight lost by the neonates.Results: 184 neonates were included in the study. Mean serumsodium level was 149 ± 6.0 mEq/l (range 135-172 mEq/l).Hypernatremia of varying severity was detected in 137neonates. By day 10 of life sodium levels had normalized inall hypernatremic neonates except one, who was hospitalizedon day 5 of life with hypernatremic dehydration. Perceptionof decreased milk production by mother, higher birth order,delivery by cesarean section and decreased urination in theneonate bore significant association with hypernatremia. Signsof dehydration were clinically discernible in nine patients andall of them had hypernatremia, however, most of the babiesdidn’t have obvious dehydration signs and weight loss wascomparable between two groups.Conclusion: Mild to moderate degree of hypernatremia isquite common during physiological dehydration in earlyneonatal period and adequate breastfeeding appears to bean effective and safe intervention for mild to moderatehypernatremic dehydration.
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Background:This study was conducted to find out the pattern of poisoning cases among the pediatric population in Srinagar and its Northwestern suburbs and compare it with what occurs elsewhere in India. Thereby we aimed to provide practical knowledge in dealing with these pediatric patients.Methods:The hospital records of children between the ages of 0-19 years admitted to the pediatric emergency ward of SKIMS Medical College Hospital Srinagar with poisoning from July 2016 to June 2018 were evaluated.Results:A total of 154 cases of poisoning were admitted in the study period, of which 89(57%) were males and 69(43%) were females. In the 0-12 year age group the poisonings were mostly in boys(68.26%) and were accidental whereas in the 13-19 year agegroup poisonings were mostly in girls(64%) and due to suicidal attempts. Organophoshorus poisoning was the most commonly ingested poison across all age groups(44.8%) followed by rodenticides(16.23%), kerosene(13.63%) and medications(11.68%). Interventions mostly commonly done were gastric lavage, induced vomiting. Mortaliy was seen in 2 cases over 2 years(1.29%). Conclusion:Knowledge on epidemiological and clinical features ofpoisoning in children according to age groups, establishing safety standards for sale and storage of harmful chemicals, and parental education can help to decrease the burden of childhood poisoning
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Parkinson’s disease is seen in adults in their late middle or old age. It has four cardinal signs - resting tremor, bradykinesia, akinesia, and postural instability. Patient’s gait is often slow, shuffling with a stooped posture and they tend to walk faster with shorter steps. The affected patients have uncontrolled movements of the body along with stiffness of muscles. Tremors in orofacial musculature caused by Parkinson’s disease can make dental treatments, a challenge. The psychological component like depression, cognitive problems, and apathy further jeopardise the successful fabrication and utilisation of complete denture. This case series presents completely edentulous patients with Parkinson’s disease successfully treated with complete dentures in a sympathetic and caring approach. Some modification of techniques and materials were adopted to suit the special situations.
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Objective: To test whether blood pressure-to-height ratio (BPHR) can be used to screen for hypertension in children. Methods: Data regarding blood pressure and other variables was recorded for 2702 school children between the ages of 10-16 years as a part of a nutritional survey. Results: The optimal thresholds for defining hypertension in boys were 0.76 for systolic BPHR and 0.50 for diastolic BPHR; the respective threshold in girls were 0.80 and 0.52. Conclusion: BPHR can be used as an effective screening test for diagnosing both hypertension and prehypertension in children aged 10-16 years.
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Objective: To study the relation between maternal overt hypothyroidism and neurodevelopmental outcome of neonates in iodine-deficient region of Northern India (Kashmir Valley). Design: Prospective cohort study. Setting: Endocrinology department of a tertiary-care hospital. Participants: 82 hypothyroid pregnant women were enrolled and followed up till delivery. The neonates born to this group represented the case neonates. 51 euthyroid healthy pregnant women were selected as control group. The neonates born to these mothers served as controls. Main outcome measures: Early neonatal behavioral assessment at 3-4 weeks of age. Results: The mean TSH and free T4 in neonates of mothers with well controlled hypothyroidism was significantly different from those born to mothers with poorly controlled hypothyroidism and controls in 1st trimester, but the difference was statistically insignificant for 2nd and 3rd trimester values. Conclusion: Overt maternal hypothyroidism in iodine-deficient area constitutes a risk factor for an abnormal neurobehavioral development of affected child.
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A survey was undertaken to assess the knowledge, attitude and practice of medical ethics among surgical residents and interns in three teaching hospitals of Karachi, Pakistan. 101 out of 120 completed responses were included in the study. Fifty-one respondents had heard about the Code of Ethics formulated by the Pakistan Medical and Dental Council. Forty-four had read the code. Seven had no knowledge about it. Forty-seven reported taking consent for procedures. Forty-two respondents gave correct answers on questions of confidentiality and knowledge of law pertaining to trauma victims. Only 11 reported having been taught ethics as students. Four did not feel the need of its teaching at an undergraduate level. Doctors graduating within the last 10 years gave fewer correct answers than those graduating earlier. Knowledge of medical ethics and its application on the surgical floors is extremely poor. The survey results support the view that medical ethics should be part of the undergraduate medical curriculum.