Endoscopic Third Ventriculostomy in Hydrocephalus: An Institutional Experience in Tertiary Care Centre

Introduction: Hydrocephalus is a clinical condition in which anexcess of CSF fluid accumulates within the ventricular systemof the brain. The treatment of hydrocephalus depends onpatient’s clinical condition and etiology. Neuroendoscopy isbecoming more widely used for diagnostic and therapeuticpurposes of many different conditions including treatment ofhydrocephalus.Materials and Methods: This prospective study of 52 patientswas carried to analyze the safety and efficacy of EndoscopicThird Ventriculostomy (ETV). 24 cases of obstructive and 28cases of communicating hydrocephalus underwent ETV.Results: Most (43%) of the patients were less than 10 years ofage. 59% of patients having obstructive hydrocephalus andonly 28% of patients having communicating hydrocephalus hadgood outcome.Conclusion: ETV should be considered as first line oftreatment in patients of obstructive hydrocephalus.

Consensus Statement of the Indian Academy of Pediatrics in Diagnosis and Management of Hemophilia

Justification: Despite having standard principles of management of hemophilia, treatment differs in various countries depending onavailable resources. Guideline for management of hemophilia in Indian setting is essential.Process: Indian Academy of Pediatrics conducted a consultative meeting on Hemophilia on 18th September, 2016 in New Delhi, whichwas attended by experts in the field working across India. Scientific literature was reviewed, and guidelines were drafted. All expertcommittee members reviewed the final manuscript.Objective: To bring out consensus guidelines in diagnosis and management of Hemophilia in India.Recommendations: Specific factor assays confirm diagnosis and classify hemophilia according to residual factor activity (mild 5-40%,moderate 1-5%, severe <1%). Genetic testing helps in identifying carriers, and providing genetic counseling and prenatal diagnosis.Patients with hemophilia should be managed by multi-specialty team approach. Continuous primary prophylaxis (at least low-doseregimen of 10-20 IU/kg twice or thrice per week) is recommended in severe hemophilia with dose tailored as per response. Factorreplacement remains the mainstay of treating acute bleeds (dose and duration depends on body weight, site and severity of bleed).Factor concentrates (plasma derived or recombinant), if available, are preferred over blood components. Other supportive measures(rest, ice, compression, and elevation) should be instantly initiated. Long-term complications include musculoskeletal problems,development of inhibitors and transfusion-transmitted infections, which need monitoring. Adequate vaccination of children withhemophilia (with precautions) is emphasized

BFHI in a tertiary care hospital does being baby friendly affect lactation success.

To study the impact of Baby friendly policies on lactation success, a semi-structured questionnaire was administered to mothers of babies attending the well baby clinic of an urban tertiary care Baby Friendly Hospital. The feeding practices of outborn babies was compared to inborn babies( Baby friendly hospital). No major differences were found in the duration and success of lactation among the 2 groups. More intensive efforts and public awareness is required if the ideals of a baby friendly hospital are to be met.

Spectrum of purpura fulminans.

Purpura Fulminans is a severe disorder of acute onset with high morbidity and mortality. It is characterized by DIC with thrombocytopenia, hyofibrinogenemia, hypothrombinemia and anemia. It most often occurs in young with sudden appearance of symmetrical, tender, ecchymotic skin lesions usually involving the lower extremities. An infectious and noninfectious etiology has been proposed. Early recognition and early therapy with appropriate antibiotics and heparin is known to limit both morbidity and mortality. This article reports 5 cases of Purpura Fulminans treated at our centre with review of etiology, pathogenesis, clinical features and treatment.