ABSTRACT
Background: The most commonly used light sources in the conventional phototherapy units are compact fluorescent lamp (CFL), halogen spotlights and fiberoptic blankets. Recently light emitting diodes (LED) has emerged as better light source for phototherapy and almost replacing all the available conventional light sources. Comparative studies on the efficacy of LED versus conventional phototherapy are limited from India. That is why; this study was undertaken.Methods: 48 neonates of ≥35 weeks gestational age with hyperbilirubinemia were participated in this study. Among them, 24 neonates received conventional phototherapy and rest of them received LED phototherapy. The rate of fall of bilirubin levels at 6 hours and at completion along with total duration of phototherapy in both groups was measured. Results analysed by standard statistical methods.Results: LED phototherapy units showed higher rate of fall in bilirubin at six hrs (LED group: 0.38±0.05 mg/dl/hr versus conventional group: 0.30±0.04 mg/dl/hr, p<0.05) and after completion of therapy (LED group: 0.32±0.03 mg/dl/hr versus conventional group: 0.26±0.03 mg/dl/hr, p<0.05) compared to conventional group. Significant difference was documented in total duration of phototherapy in LED group (30.8±1.8 hours) when compared to conventional group (34.6±0.7 hours). None of the neonate showed phototherapy failure. Side effects were minimal and comparable in both the groups.Conclusions: The LED phototherapy units are more efficacious in terms of higher rate of fall of bilirubin levels and lesser duration of phototherapy compared to conventional phototherapy units.
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Background: Acute toxic leukoencephalopathy following intrathecal methotrexate administration is well documented but intracranial haemorrhage is extremely rare. Case Characteristics: A 2½-year-old girl with acute lymphoblastic leukemia developed sudden onset neurological deterioration following intrathecal methotrexate. Observations: Computed tomography scan of brain demonstrated intraventricular and subarachnoid hemorrhage. Outcome: Child improved gradually on conservative management. Follow-up neuroimaging showed resolution of hemorrhage. Message: Intracranial haemorrhage is a rare but serious complication of intrathecal methotrexate.
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Background: Association between Joubert Syndrome and Hirschsprung disease is rare. Case characteristics: A 9-month-old girl having developmental delay and chronic constipation. Observation: Molar tooth sign on MRI brain and absence of ganglion cells in rectal biopsy specimen. Outcome: Child underwent surgical repair for Hirschsprung disease. Message: Association of these two rare entities could be explained by ciliopathy.
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Background: Incidence of intracerebral hemorrhage in patients with tuberous sclerosis is rare, and in most of the cases it is associated with either underlying cerebrovascular malformation or hemorrhage into the subependymal giant cell astrocytoma. Case characteristics: A 2-year-old boy presented with a hemorrhagic stroke, and subsequently diagnosed as a case of tuberous sclerosis. Observation: Detailed work-up for stroke did not reveal any definite etiology. Outcome: Weakness gradually improved. Follow-up neuroimaging showed resolution of hemorrhage. Message: Clinician must be aware regarding this rare presentation of tuberous sclerosis.
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Hemophilic pseudotumors are rare but dangerous complications of Hemophilia. We hereby report a 3-year-old boy with Hemophilia B, presenting with nasal pseudotumor, showing favorable response to radiotherapy after unsuccessful treatment with factor IX replacement therapy. The diagnosis and treatment of this rare condition is also reviewed.
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Aim: To compare the efficacy and safety of ferrous ascorbate and colloidal iron in children with iron deficiency anemia. Study Design: An open, randomized, comparative, parallel-group study. Place and Duration of Study: Department of Pediatric Medicine of ‘Nilratan Sircar Medical College and Hospital’, Kolkata, India, between January 2009 and February 2010. Methodology: Children between the age group of 6 months to 12 years were included if they had anemia defined as hemoglobin <10 gm%. Children received treatment with either ferrous ascorbate or colloidal iron for 12 weeks. Each child received elemental iron 3 mg/kg body weight/day. Follow-up assessments were performed at the end of week 4, week 8 and week 12. Results: Out of the 137 children screened, 80 were included in the analysis. The mean rise in hemoglobin at the end of the 12 weeks was significantly higher in ferrous ascorbate group than colloidal iron group [3.24 ± 1.66 gm% vs. 1.42 ± 2.04 gm%; p <0.01]. Responder rate (hemoglobin ≥11.5 gm%) after 12 weeks of therapy was 53.57% in ferrous ascorbate group versus 10.34% in colloidal iron group; p<0.01. Conclusion: The study provides evidence for the role of ferrous ascorbate as an efficient oral iron supplement in the treatment of iron deficiency anemia in children.
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Aim: The primary aim of our study was to assess the effectiveness of beta blockers in non bleeding portal hypertensive children. The secondary objective was to evaluate whether the newer generation beta blockers were superior compared to conventional ones. Methods: Conventional propranolol and newer generation carvedilol were administered to 31 subjects each, after stratifying them into nearly equal subgroups according to etiology (sinusoidal or presinusoidal). Results: At the end of 2 years study period, 3 children (4.83%) had breakthrough bleeding. A decrease, increase and no alteration in grade of oesophageal varices was seen in 40, 9 and 13 cases respectively. Of the 9 children with associated gastroeosophageal varices (GOV), the severity of lesions was reduced in 8 of them. Both the drugs had efficacious outcome in sinusoidal as well as presinusoidal cases, having a significant coefficient of correlation (r>0.5) with time. Carvedilol was more effective than propranolol statistically (p = 0.035 and p = 0.034 respectively), only at 4 and 5 month follow-up period. Conclusion: Beta blockers are effective in preventing variceal bleed in children with portal hypertension. Long term efficacy of carvedilol and propranolol was similar.