new born with lamellar ichthyosis [collodion baby]

Ichthyosis is an infrequent clinical entity worldwide with an incidence of 1:600,000 births. It can be one of the two types: collodion baby and Harlequin fetus or malignant keratoma [most severe form]. The clinical manifestations in either form are thick and hard skin with deep splits. Affected babies are born in a collodion membrane, a shiny waxy outer layer to the skin that is shed 10 - 14 days after birth, revealing the main symptom of the disease. The reported case is of a neonate, born to primigravida mother at seven and a half month's gestation with a birth weight of 2160 grams and Apgar score of 6/10 and 8/10 at 1 and 5 minutes respectively. Conclusively, early diagnosis of this condition can help cope and prevent serious morbidity or even mortality at time. These newborns should be monitored carefully in intensive care units by a multi-disciplinary team

Plasma exchange in patients with the diagnosis of Guillain-Barre syndrome: an experience in intensive care unit

To assess the effectiveness of plasma exchange in patients with Guillain-Barre syndrome. This descriptive study was conducted at Intensive Care Unit Lady Reading Hospital Peshawar from March 2008 to July 2010. Twenty eight patients were included in study after fulfilling inclusion criteria. All the diagnosed cases of Guillain-Barre syndrome were admitted in Intensive care Unit Post Graduate Medical Institute Lady Reading Hospital Peshawar and 4 sessions of plasma exchange therapy was initiated in every patient after informed written consent. Out of 28 patients 19 were male [67.85%] and 9 were female [32.14%]. Mean age was 32.32 years and mean duration of stay in Intensive Care Unit was 6.32 days. Out of these 28 patients, 60.71% [17] recovered and 39.3% [11] expired despite treatment and 2 patients developed adverse events secondary to Plasma Exchange. In 25 [89.29%] patients breathlessness was reported as their major symptom beside motor weakness, while in 19 [67.85%] patients, pain was also reported. Early referral to Intensive Care Unit, management of complications, good nursing care and specific therapy with Plasma Exchange within seven days of onset of symptoms improve prognosis and Plasma Exchange has proved beneficial to supportive treatment alone in Guillain-Barre syndrome with minimal side effects