An Unusual Case of Acute Pancreatitis in a Child.

Ascaris lumbricoides is a common intestinal parasite in tropical regions.Pancreatitis due to worm infestation is an uncommon but important cause in this region. While there are reports of pancreatic duct invasion by round worms in adults, such cases are rarely reported in pediatric population. We report one such case in a sixteen year old child.

Study of Mumps in Children attending a Tertiary Care Centre.

Introduction: Mumps is a self-limiting viral infection of the salivary glands with systemic manifestations and complications. It primarily affects young children, with increased incidence in winter and spring. Mumps infection is endemic in developing countries because of poor vaccination coverage. This study is intended to highlight the increased number of mumps cases in children attending tertiary care center in Nepal and thus to emphasize the importance of mumps vaccination, so as to decrease the disease occurrence and disease burden by vaccinating all children. Materials and Methods: This was a prospective study done in Civil Service Hospital of Nepal over a period of 2 years from November 2009 to October 2011. All children less than 14years of age with symptoms of fever and parotid swelling were included in the study group. A detailed history pertaining to the disease was taken, that included; history of exposure and prior vaccination against mumps. Children were asked to follow up either after 5 days or in case of noticing any signs and symptoms of complication. Results: There were total 113 cases diagnosed clinically as mumps of which there were 71 males (62.83%) and 42 females (37.16%) with the peak incidence of disease in the month of March and September with 22 cases (19.46%) in each month. The increase incidence was seen in 4-6 years of age with 58 cases (51.32%). There were 70 patients (61.94%) that had history of exposure to mumps infection. All the patients in this study had either unilateral or bilateral parotitis. None of the children were vaccinated against mumps. And all the school going children had to be off school for a period of 3-5 days. Conclusion: There were large number of children with mumps and none of them were vaccinated. Child can be prevented from the infection by vaccination and thus avoiding possible sufferings and complications. Thus we recommend the use of mumps vaccination in Routine immunization programme.

Ectrodactyly: A rare anomaly of limbs.

Split-hand/split-foot malformation (SHFM) is a rare congenital malformation of the limbs with median clefts of the hands and feet and aplasia/hypoplasia of the phalanges, metacarpals and metatarsals. When present as an isolated anomaly, it is usually inherited as an autosomal dominant form. We report a case of nonsyndromic form of ectrodactyly because of its rarity.

Clinical Profile and Sensitivity Pattern of Salmonella Serotypes in Children: A Hospital Based Study.

Introduction: Enteric fever is a systemic infection caused by the bacteria, Salmonella enterica serovar Typhi (S.typhi) and Salmonella enterica serovara Paratyphi (S. paratyphi A, B and C). Most of the burden of the disease is limited to the developing world and the disease still has the issues like wide spectrum of clinical presentation and multidrug resistance. Objectives: This study was done to analyze the clinical profile and antibiotic sensitivity pattern in the cases of culture positive enteric fever. Methods: A prospective cross-sectional study was conducted in Civil Service Hospital from February 2010 to January 2011 in the paediatric population in the age group of 2 to 14 years. Children with Salmonella species isolated in blood culture were included in the study. Results: Out of the 40 children with culture positive enteric fever, male to female ratio was 1.3:1 with common age group between 11-14 years. S typhi was isolated in 25 cases while S. paratyphi in 15 cases. Clinical features of S. typhi and S. paratyphi were indistinguishable. Both S.typhi and S. paratyphi were found to be 100% sensitive to drugs like Ceftriaxone, Cefotaxime, Cefixime and Chloramphenicol. Sensitivity to Ofloxacin was 100% in S. paratyphi and 92% in S.typhi. Similarly sensitivity of Azithromycin was 92% and 93% for S.typhi and S. paratyphi respectively. Conclusion: Salmonella serotype is still 100 % sensitive to third generation cephalosporin. Some percentage of resistance is seen with Ofloxacin in S. typhi and with Azithromycin in both S.typhi and S. paratyphi.