Obstructive Sleep Apnea and Hearing Loss: Is There Any Correlation?

Abstract Introduction Obstructive sleep apnea (OSA) is a breathing disorder related to sleep that has a negative effect on the behavior and health of people around the globe. Chronic hypoxemia and variations in the concentration of oxygen in the blood noticed in OSA individuals may have adverse effects on the process of auditory transduction and transmission. Objective To assess the effect of OSA on hearing and to find out the parameters that have more influence on hearing recorded during polysomnography of patients with OSA. Methods The present is a hospital-based, observational, analytical, cross-sectional study conducted over a period of one year. After application of the exclusion criteria, the patients were then submitted to the application of the Berlin questionnaire, as well as polysomnography, impedance, and pure tone audiometry (PTA). Results A total of 58 individuals were studied. Age, gender, and height were comparable among cases and controls, while weight, body mass index (BMI), and neck circumference were significantly higher in cases in comparison to controls. The mean PTA was significantly higher at 10 kHz or higher frequencies in cases in comparison to controls. Conclusion We observed that there is evidence that the auditory mechanism is affected in OSA patients. We recommend early auditory screening of OSA patients for timely diagnosis and to raise awareness about its prevention.

Associative role of methylenetetrahydrofolate reductase and thymidylate synthase 6bp del gene polymorphism in preterm delivery

Objective: Preterm delivery is a major adverse birth outcome, approximately 15 million babies are born prematurely every year. There are several causes for preterm deliveries. This study focuses on folate metabolic pathways. Dietary folate plays a crucial role in premature labor. We examined the relationship between methylenetetrahydrofolate reductase (MTHFR) (C677T) and thymidylate synthase (TYMS) 6bpdel polymorphism. Materials and Methods: A total number of 300 pregnant women were selected for this study; among which ( n = 150) were preterm and ( n = 150) were term delivery cases. The selected samples were further processed for molecular polymerase chain reaction-restriction fragment length polymorphism analysis. The demographic profile of birth status resulted significantly with ( P = 0.0001) proving chances of high infant mortality due to prematurity. Results: The genotype distribution of MTHFR C677T showed significant data ( P = 0.0021) whereas insignificant genotypic distribution was observed for the TYMS gene ( P = 0.067). Our results imply that genes that are involved in the folate pathway play a crucial role in early pregnancy. Conclusion: Advanced and better strategies can be brought to an improved intervention of folate at the time of pregnancy which will help to reduce the rate of premature deliveries.

The Net Promoter Score with Friends and Family Test applied to arthroscopic shoulder surgery

Background@#The Friends and Family Test (FFT) developed by the UK National Health Service evaluates whether patients are satisfied with a service provided, where improvements are needed, and how likely patients are to recommend the intervention. Calculated from the FFT, the Net Promoter Score (NPS) creates a recommendation metric for treatment. The primary aim of this prospective study is to evaluate NPS for arthroscopic subacromial decompression (ASD) and rotator cuff repair (RCR). Secondary aims are to postoperatively evaluate 1-year changes in patients’ Oxford Shoulder Scores (OSSs) in terms of the proportion of patients satisfied with their surgery and correlation with FFT. @*Methods@#During a 2-year period, all patients undergoing ASD or RCR completed questionnaires prospectively. Collected preoperatively and postoperatively at 1 year. @*Results@#: NPSs were 31 for ASD (n=32) and 52 for RCR (n=39). OSSs increased by 4.3 and 6.9 for ASD and RCR, respectively (P<0.001). Overall, 75% of ASD and 77% of RCR patients were either “satisfied” or “very satisfied,” respectively, with procedure outcomes. Scores from FFT had a positive correlation with improvement in OSS and satisfaction scores among patients undergoing arthroscopic shoulder surgeries (P<0.001). @*Conclusions@#The current study shows positive NPS outcomes in patients with ASD and RCR. Scores from FFT correlate well with both satisfaction and OSS among patients. NPS can be an adjunct to traditional patient-reported outcome measures to provide global evaluation of patient experiences to aid in determining the clinical value of common procedures in shoulder orthopaedics.

Posterior reversible encephalopathy syndrome in pregnancy: A case series of 5 cases

Posterior reversible encephalopathy syndrome (PRES) is a rare clinic-radiological syndrome associated with acute changes in blood pressure during pregnancy. It is characterized symptomatically by headache, seizures, altered mental status, and visual blurring. Radiological changes are white matter vasogenic edema affecting the occipital and parietal lobes of the brain. It is being increasingly recognized due to increased institutional deliveries and advances in imaging particularly magnetic resonance imaging (MRI). Despite the increasing detection, the prediction of PRES and patient factors affecting susceptibility is still not clear. Hence, we conducted a retrospective study to analyze the factors associated with PRES at our tertiary care center.

Pregnancies in anomalous uterus: series of three cases

Uterine malformations can result from various alterations in the normal development of Mullerian ducts that make up a diverse category of congenital anomalies. In most cases, the defect remains undiagnosed and exhibits the normal number of chromosomes. Very few malformations require any intervention after thorough investigations. The most frequently used classification by the American Society for Reproductive Medicine is comprehensive, but does not include cervical or vaginal malformations. The European Society of Human Reproduction and Embryology has postulated a consensus that precisely shows independent cervical malformations.

Prevalence of obstructive sleep apnoea among patients admitted with acute coronary syndrome in a hill state of northern India

BACKGROUND Obstructive sleep apnoea (OSA) is one of the emerging non-traditional cardiovascular risk factors. Studying OSA may contribute towards a better understanding of current concepts of atherogenesis and in guiding therapy. METHODS We conducted this cross-sectional study among 66 patients with acute coronary syndrome (ACS) in a tertiary care hospital from 1 January 2019 to 30 June 2020. We included patients of ST elevation myocardial infarction (STEMI)/ non-STEMI (on achieving Killip class I/II) and unstable angina and performed in-hospital overnight polysomnography (PSG) within 8 weeks of index event. Apnoea–hypoapnoea index (AHI) value 5–<15 was defined as mild OSA, AHI 15–<30 as moderate OSA and AHI >30 as severe OSA. We analysed data using Epi Info version 7.2.4 for Windows. RESULTS The 66 patients had a mean (SD) age of 57.7 (11.1) years and 54 (81.8%) were men. Forty-three (65.1%) patients had STEMI, 19 (28.7%) had non-STEMI and 4 (6%) had unstable angina. On PSG, the prevalence of OSA (AHI>5) was 78.8% (95% CI 67.0–87.9). Of these, AHI >15 was significantly associated with diabetes, hypertension and different measures of obesity (p<0.05). CONCLUSIONS This study, conducted in a hill state of northern India, showed a high prevalence of OSA in patients with ACS. Obesity, diabetes mellitus and hypertension were significantly associated with severity of OSA (AHI>15).

Demineralization of tooth enamel following radiation therapy; An in vitro microstructure and microhardness analysis

Objective: The objective of this study is to evaluate the effects of radiotherapy doses on mineral density and percentage mineral volume of human permanent tooth enamel. Materials and Methods: Synchrotron radiation Xray microcomputed tomography (SRμCT) and microhardness testing were carried out on 8 and 20 tooth samples, respectively. Enamel mineral density was derived from SRμCT technique using ImageJ software. Microhardness samples were subjected to Vickers indentations followed by calculation of microhardness and percentage mineral volume values using respective mathematical measures. Data were analyzed using paired t-test at a significance level of 5%. Qualitative analysis of the enamel microstructure was done with two-dimensional projection images and scanned electron micrographs using μCT and field emission scanning electron microscopy, respectively. Results: Vickers microhardness and SRμCT techniques showed a decrease in microhardness and an increase in mineral density, respectively, in postirradiated samples. These changes were related to mineral density variation and alteration of hydroxyapatite crystal lattice in enamel surface. Enamel microstructure showed key features such as microporosities and loss of smooth homogeneous surface. These indicate tribological loss and delamination of enamel which might lead to radiation caries. Conclusions: Tooth surface loss might be a major contributing factor for radiation caries in head-and-neck cancer patients prescribed to radiotherapy. Such direct effects of radiotherapy cause enamel abrasion, delamination, and damage to the dentinoenamel junction. Suitable measures should, therefore, be worked out to protect nontarget oral tissues such as teeth while delivering effective dosages to target regions

Demographic and Clinical Profile of Children with Severe Acute Malnutrition – An Experience from Nutritional Rehabilitation Centre in Jammu

Background: Childhood undernutrition remains a key public health challenge in India and is a significant contributor of Under-5mortality as these children have significantly higher risk of mortality and morbidity. Nutritional rehabilitation centres have beenset up by Government of India at facility level to provide medical and nutritional care to Severe Acute Malnourshied childrenunder the age of 5 years who have medical complications.Materials and Methods: Retrospective record based observational study conducted in NRC located at SMGS Hospital, GMCJammu. All the children upto 60 months of age, admitted in NRC during the study period, from September2018 to February2019 were included in the study.Aims and Objectives: To know the demographic details and clinical profile of comorbidities in children with Severe AcuteMalnutrition and to assess the outcome of these children.Results: A total of 118 children were admitted in the Nutritional Rehablitation Center during the study period 60% werefemales. 60% of the children were less than 12 months of age 20 % were between 13 and 24 months of life.Children belongedto all the districts, 22% from Jammu, 18% Reasi, 16% Udhampur, 15% Rajouri, 8% Kathua, 7% Poonch and 6% Samba.Bronchopneumonia (39.8%), Diarrhoea (30.5% ) and skin infections(11%) were the commonest morbidities. 73.5% of thechildren had associated anemia. Other comorbidities were septicemia (10.1%), CSOM (5.9%), UTI (5%), measles (5%) andtuberculosis (2.5%).Conclusion: Early diagnosis and standardized protocol based treatment in the NRCs has been very effective in reducing themorbidity and mortality in SAM patients.

Clinical Profile of Patients with Cerebral Palsy – A Hospital-based Study

Background: Cerebral palsy (CP) is one of the leading causes of childhood disability worldwide with the greatest burdenfound in developing countries. Motor impairments are the hallmarks of CP, but in many individuals, other impairments suchas vision, hearing, speech, cognition, behavior, and epilepsy may at times produce even greater activity limitation in daily life.Early diagnosis and comprehensive management with a multidisciplinary approach are required for satisfactory managementof a child with CP. In low- and middle-income countries, there are gaps in knowledge especially in spheres of epidemiologicalresearch, intervention, and service utilization.Materials and Methods: This cross-sectional observational study was conducted among the children coming to the inpatientand outpatient Department of Paediatrics SMGS Hospital, Government Medical College Jammu.Aims and Objectives: The aim of the study was to study the clinical pattern and etiological factors of CP and to determine the prevalenceof associated disabilities or handicaps in CP. Our study population included 100 cases of diagnosed CP up to 18 years of age.Results: A total of 100 children of CP were evaluated of which 59% were boys and 41% were girls. CP patients belonged tovarious age groups as, <2 years (46%), 2–4 years (30%), 4–6 years (12%), 6–12 years (10%), and 12–18 years (2%). CP patientscoming to our hospital belonged to various districts such as Jammu (27%), Rajouri (20%), Doda (17%), Reasi (11%), Udhampur(8%), Kathua (7%), Poonch (5%), and Samba (5%). The most common etiological factors were birth asphyxia (48%). The spastictype was the most common (65%), followed by ataxic (15%), dyskinetic (10%), and mixed (10%). Among the spastic quadriplegic,subtype was seen in 69%, diplegia in 23%, and hemiplegia in 8%. Speech delay was the most common associated problem(80%), followed by seizures (56%), feeding difficulty (46%), and contractures and deformities (20%). Formal vision assessmenthad been done in only 48% of the patients, among them, 30% had normal vision, 9% had refractive error, 7% were havingstrabismus, and 2% were blind. Spectacles were being used by only three patients. A mere 30% of the patients had undergonehearing assessment; among them, 6% were having moderate to profound hearing loss. Hearing aid was being used by twopatients. Physiotherapy services were being availed by 47% of patients. Early intervention and appropriate rehabilitation servicesshould be provided to such children to limit the disability. Medical college hospitals of India, where a number of these childrenreport with their various problems, can play an important role as nodal centers for evaluation and registration of such patients.

Acute bilirubin encephalopathy in term neonates: a hospital-based study

Background: Acute Bilirubin Encephalopathy and kernicterus is an important cause of cerebral palsy, developmental delay and hearing impairment in low-middle income countries. Interventions such as universal screening for neonatal jaundice, Rhesus immunoglobulins, intensive phototherapy and exchange transfusion have made kernicterus rare in high income countries, but in our set up such cases continue to be reported.  Methods: Retrospective observational study where case records of term neonates brought to the neonatal ICU with signs and symptoms of acute bilirubin encephalopathy during the years 2016 and 2017 were sought and analysed.Results: A total of ten term babies reported to the neonatal unit with severe hyperbilirubinemia along with signs and symptoms of bilirubin encephalopathy of which 60% were females. 90% had a birth weight of more than 2.5 kg and mean birth weight was 2.7±0.25 kgs. All the babies were out born. A 4 babies were born at home of which 3 pregnancies were completely unsupervised during the antenatal period. 90% of the babies were from the rural areas, 6 of the cases were from the districts Rajouri, Poonch and Reasi where the terrain is hilly, 2 from rural areas of Jammu and 1 from Kathua. Only 1 was from the Jammu city. The age at admission ranged from 3-9 days and serum bilirubin from 24 to 43.3 mg %. A 5 babies had ABO incompatibility, 1 Rh incompatibility, 1 sepsis, while no cause could be found in 3.Conclusions: Neonatal jaundice is often not easily appreciated by mothers and caregivers in the home setting until it becomes severe enough, at which point neurological damage may have already occurred. There is an urgent need to train the primary health care personnel in assessment and early identification of risk factors for severe neonatal hyperbilirubinemia. They can help the families to seek prompt treatment for this preventable cause of cerebral palsy and mental retardation.

Neurotoxic Snakebite In Jammu Region: Is It Cobra Or Krait

Background: The aim of this study is to analyze the clinical profile and outcome of the neurotoxic envenomation in children inJammu region and to identify the species based on the syndromic approach developed by WHO.Materials and Methods: A retrospective hospital record based descriptive study which analyses the case records of childrenreporting to pediatric emergency with signs and symptoms of neurotoxic envenomation.Results: A total of 22 cases of the neurotoxic envenomation reported between April 15 and October 15. These included 14males and 8 females between the age group of 2.5 years and 16 years. The highest incidence of snakebite was observed inthe age group of 4–8 years. A total of seven cases presented neuroparalytic symptoms and local signs suggesting cobra bite.Bite was reported in the afternoon or evening hours between 12.30 pm and 10.30 pm and 83% bites were outdoors. A total of15 children presented with neuroparalytic symptoms with no local signs suggesting krait bite. 86% of the bites were indoor withonset of symptoms between 12 am and 7 am.Conclusion: Both cobra and krait cause neurotoxic envenomation in children in Jammu region with krait bite accounting for 68%of the total cases. Most of these cases are brought to the pediatric emergency late. Training of the peripheral doctors regardingearly recognition of neurotoxic snakebite, species diagnosis as per the WHO syndromic approach, prompt institution of initialmanagement with neostigmine and after visit summary, endotracheal intubations and AMBU bag ventilation, and quick referralto a center with ventilator facility should help in reducing the morbidity and mortality due to krait and cobra bite in children.

Prevelance of Rheumatic Valvular Lesion in Dilated Cardiomyopathy: A Study of 1182 Cases of Idiopathic Dilated Cardiomyopathy in a Tertiary Care Hospital

Background: Congestive heart failure due to underlying primary myocardial disease idiopathic dilated cardiomyopathy is a major cause of heart failure in our country. Mitral regurgitation of varying severity are a common echocardiography features and annular dilation accompanying dilated LV is the presumed mechanism. Aims and Objective: To find the prevalence and pattern of rheumatic valve lesion in patients with Dilated Cardiomyopathy in view of high prevalence of chronic rheumatic heart disease in our country. Methods: An Echocardiography study and analysis of 1182 patients diagnosed as dilated cardiomyopathy in the age group of 20 to 90 yrs was conducted to ascertain the prevalence and spectrum of valvular lesion of rheumatic origin if any. Results: Total no of 1182 cases of DCM patients were included. Female sex dominated the study group 56 % vrs 46 % male patient. Maximum cases were in the age group of 60-70 yrs (56%) followed by 23 % in the age group of 50 to 60 yrs, Around 56 % of Patient diagnosed as DCM had evidence of underlying RHD with Mitral valve thickness with thick subchordal apparatus and/ or aortic valve involement. Mitral valve involvement was found as high as 79% of cases followed by Aortic valve involvement along with mitral valve involvement (21% cases). Conclusion: Prevalence of evidence of chronic rheumatic heart disease in around 56% in dilated cardiomyopathy is surprise finding in the present study and heightened awareness among the treating physicians about the high prevalence of associated rheumatic heart diseases in dilated cardiomyopathy and requires further evaluation to examine if there is causal relationship between the commonly prevalent disease.

Prevalence of Congenital Heart Disease in Sick Neonates: An Echocardiographic Evaluation.

Background: Congenital heart disease (CHD) is one of the major causes of mortality and morbidity in the paediatricpopulation particularly in neonates and infants of both the developing and developed countries. Importance of congenital defects is more prominent in infants and delay in recognition may adversely effect survival. Objective: To find the prevalence and pattern of CHD in sick neonates in a tertiary care hospital VSSIMSAR Odisha India catering to economically backward area of our country. Methods: A prospective analysis of case of 8.856 patients (0-1 month) was conducted to ascertain the prevalence and spectrum of CHDs. Results: A total of 232 patients out of 8.856, were found having CHDs measuring a prevalence of 26.2/1000 among sick neonates. About 202 (91.3%) were the acyanotics and 20 (8.6%) were cyanotic heart patients. 4 (1.7%)were complex congenital heart disease Among the acyanotic heart diseases the most frequent lesion seen in 126 (62.7%) followed by ASD alone or in combination was detected in 76 cases (37.6 %) followed by PDA alone or in combination in around 74 cases(36.6%). Combined defects PDA and VSD in 40 cases (20.2 %). Valvular PS was observed in 3% of cases among the cyanotic heart diseases Tetralogy of Fallot was the most frequent cyanotic heart disease seen in 9 cases. Conclusion: Prevalence of congenital heart disease is very high among the sick neonates though figure of 26.2/1000 among the sick neonates could be an over estimation of the actual disease burden in our community because of high prevalence of sick children. The study heightened awareness among the treating physicians about the high prevalence of cardiac diseases in sick neonates and early recognition is essential to reduce the mortality and morbidity associated with these ailments.

Pattern of Valvular Involvement in Asymptomatic Chronic Rheumatic Heart Disease

Background: Rheumatic Heart Disease (RHD) constitutes the most common form of Valvular heart disease in India. Rheumatic valvulitis most commonly affects the mitral valve (70% to 75%) followed by combined mitral and aortic involvement (20% to 25%), with isolated aortic disease being uncommon (5% to 8%). However no data is available regarding pattern of valvular involvement in asymptomatic chronic rheumatic heart disease. Aims & Objective: To study the pattern of valvular involvement in asymptomatic chronic rheumatic heart disease. Methods: Total no 12862 in the age group of 20 yrs to more than 90 yrs referred for perioperative evalution, preemplyoment check up, preinsurance check up annual routine health check up for general health, evaluation of atrial fibriiation ante-natal check up were included in the present studyconducted from April 2005 to January 2018. All were screened by standard routine echocardiography procedure. Results: Out of total no of 12862 persons screened Rheumatic valvular lesion was detected in 2057 persons with max prevalence in age group of 40 to 50 yrs. Mitral valve thickening with mild MR was detected in 42% cases followed by thick mitral valve mild MR mild AR in 14%, thick mitral valve with mild AR in 12%, thick mitral valve with mild MS mild MR mild AR in 8%, thick mitral valve with mod MR mild AR in 8%. Mild MS mild AR in 6% thick aortic valve with mild MR in 6%, moderate AR mild MR in 4% moderate MS mild MR in 4%, mod MS mild MR mild AR in2% severe MR mild AR in 2%. Organic Tricuspid Valve disease was detected in 6% of cases. Conclusion: Routine screening study involving asymptomatic patient evaluated by routine echocardiography revealed high prevalence of regurgitation lesion. Mild to moderate MR along with thick valves is the dominant lesion and stenotic lesion are less prevalent among the asymptomatic persons.

Prophylactic use of pregabalin for prevention of succinylcholine-induced fasciculation and myalgia: a randomized, double-blinded, placebo-controlled study / Uso profilático de pregabalina para prevenção de mialgia e fasciculação induzidas por succinilcolina: estudo randômico, duplo-cego e controlado por placebo

ABSTRACT BACKGROUND: Succinylcholine is commonly used to achieve profound neuromuscular blockade of rapid onset and short duration. OBJECTIVE: The present study compared the efficacy of pregabalin for prevention of succinylcholine-induced fasciculation and myalgia. DESIGN: Prospective, randomized, placebo controlled, double blinded study. MATERIALS AND METHODS: Patients of both genders undergoing elective spine surgery were randomly assigned to two groups. Patients in Group P (pregabalin group) received 150 mg of pregabalin orally 1 h prior to induction of anesthesia with sips of water and patients in Group C (control group) received placebo. Anesthesia was induced with fentanyl 1.5 mcg/kg, propofol 1.5-2.0 mg/kg followed by succinylcholine 1.5 mg/kg. The intensity of fasciculations was assessed by an observer blinded to the group allotment of the patient on a 4-point scale. A blinded observer recorded postoperative myalgia grade after 24 h of surgery. Patients were provided patient-controlled analgesia with fentanyl for postoperative pain relief. RESULTS: Demographic data of both groups were comparable (p > 0.05). The incidence of muscle fasciculation's was not significant between two groups (p = 0.707), while more patients in group C had moderate to severe fasciculation's compared to group P (p = 0.028). The incidence and severity of myalgia were significantly lower in group P (p < 0.05). CONCLUSION: Pregabalin 150 mg prevents succinylcholine-induced fasciculations and myalgia and also decreases the fentanyl consumption in elective sine surgery.

RESUMO JUSTIFICATIVA: A succinilcolina é comumente usada para atingir um bloqueio neuromuscular profundo, de início rápido e de curta duração. OBJETIVO: Comparar a eficácia de pregabalina na prevenção de mialgia e fasciculação induzidas por succinilcolina. DESENHO: Estudo prospectivo, randômico, duplo-cego e controlado por placebo. MATERIAIS E MÉTODOS: Pacientes de ambos os sexos submetidos a cirurgia eletiva de coluna foram aleatoriamente divididos em dois grupos. Os pacientes do Grupo P (pregabalina) receberam 150 mg de pregabalina oral uma hora antes da indução da anestesia e os pacientes do Grupo C (controle) receberam placebo. A anestesia foi induzida com fentanil (1,5 mcg/kg) e propofol (1,5-2,0 mg/kg), seguidos de succinilcolina 1,5 mg/kg. A intensidade da fasciculação foi avaliada por um observador, cego para a alocação dos grupos, com uma escala de 4 pontos. Um observador cego registrou o grau pós-operatório de mialgia após 24 horas de cirurgia. Para o alívio da dor no pós-operatório, fentanil foi usado em sistema de analgesia controlada pelo paciente. RESULTADOS: Os dados demográficos de ambos os grupos eram comparáveis (p > 0,05). A incidência de fasciculação muscular não foi significativa entre os dois grupos (p = 0,707), enquanto mais pacientes do Grupo C apresentaram fasciculação de moderada a grave em relação ao Grupo P (p = 0,028). A incidência e a gravidade da mialgia foram significativamente menores no grupo P (p < 0,05). CONCLUSÃO: Pregabalina (150 mg) previne mialgia e fasciculação induzidas por succinilcolina, além de diminur o consumo de fentanil em cirurgia eletiva de coluna.

Scrub Typhus in Children: Jammu Experience.

The present retrospective study describes clinical profile of the children hospitalized in SMGS hospital with Scrub Typhus infection in Jammu during period Oct 08 to Sept 09. 21 hospitalized children with clinical features suggestive of Rickettsial disease (fever, generalized rash) who tested ELISA positive for IgM against Scrub Typhus were included in the present study between the age of 5 years and 18 years. 52.4% children belonged to Sunderbani-Naushera - Rajouri belt and majority of them reported during the months of August to November. All children presented with fever and maculopapular rash. 61.9% had lymphadenopathy, 57.12% had edema and 46% patients had conjunctival congestion. 76.13%, 23.8%, 19.04%, 9.2% had hepatosplenomegaly , pain abdomen ,altered sensorium and gastrointestinal bleed respectively. All of the 21 children were treated with chloramphenicol. None of them died. Rickettsial infection is quite common in Jammu region and thus, high degree of suspicion, knowledge of geographical distribution and clinical features of Rickettsial disease helps in its early diagnosis and treatment.

Colloidion Baby.

A two day old male baby, third issue of a second degree consanguineously married couple with clinical features of colloidion baby is being presented. Early recognition of this clinical entity and early institution of appropriate therapy can definitely reduce morbidity and mortality in neonates.