Chromhidrosis – Colored Sweat in a Toddler.

Background: Chromhidrosis means production of coloured sweat. Case characteristics: A toddler who presented with colored sweat was diagnosed to have chromhidrosis based on skin biopsy. No treatment was attempted considering the young age. Outcome: Parents were counselled about the benign nature of this disorder. Message: Identification of causes of colored sweat requires appropriate investigations.

Vitamin D Deficiency in Childhood – A Review of Current Guidelines on Diagnosis and Management.

Vitamin D deficiency has emerged as a significant public health problem throughout the world. Even in the Indian context,it has been reported to be present in majority of children in spite of wide availability of sunlight. Recent guidelines have defined vitamin D status as severe deficiency, deficiency, sufficiency and risk for toxicity as 25(OH)D levels <5, <15, >20 and >50ng/mL, respectively.The manifestations of deficiency may vary from hypocalcemic seizures, tetany in infancy and adolescence to florid rickets in toddlers. Treatment is necessary for all individuals with deficiency whether symptomatic or not and consists of vitamin D supplementation as Stoss therapy or daily or weekly oral regimens with equal efficacy and safety, combined with calcium supplements. Routine supplementation starting from newborn period is being increasingly endorsed by various international organizations. Prevention by sensible sunlight exposure, food fortification and routine supplementation are the currently available options for tackling this nutritional deficiency.

Factors Associated With Delay in Diagnosis of Kawasaki Disease in India.

A retrospective analysis was carried out to identify factors associated with delay in diagnosis of Kawasaki disease in a tertiary care pediatric hospital setting in Chennai, India. Over a period of 2 years, a total of 37 cases were studied. The cases were divided into Early Diagnosis Group (EDG) and Delayed Diagnosis Group (DDG) with the cut-off for early diagnosis being ten days. A greater proportion of cases in the EDG presented primarily to our institution (P=0.004). In the DDG group greater number of cases had received medical attention from practicing pediatricians prior to referral. There was greater interval in onset of individual symptoms in the DDG group. There was no difference between the two groups with regard to age, gender, total blood counts, CRP, liver enzymes, urine analysis or serum albumin values. Platelet counts were higher in the DDG compared to the EDG (P=0.004).Coronary abnormalities were more common in the DDG (P=0.05). Our findings suggest that children presenting primarily to a tertiary care centre with symptoms of Kawasaki disease are more likely to be associated with early diagnosis and delay in onset of neck swelling or oral lesions may be associated with delayed diagnosis. There is a need for creating more awareness about Kawasaki disease among practicing pediatricians in India.

Correlation of Nasal Smear Eosinophilia with Class of Allergic Rhinitis.

We correlated the grade of nasal smear eosinophilia with severity of allergic rhinitis, in 50 children in a cross sectional study conducted at a tertiary care referral hospital, between August 2007 to July 2009. The grade of nasal smear eosinophilia correlated well with increasing severity of allergic rhinitis (P<0.001)(r=0.83).