An Atypical Case of Parotid Gland Swelling and Arthritis in a Child.

Background: Early onset sarcoidosis is a rarely reported disease in children. Case characteristics: 2½-year-old girl with chronic enlargement of bilateral parotid glands and polyarthritis. Observation: Biopsy of salivary gland revealed non-caseating granuloma. Outcome: Polyarthritis and salivary gland swelling resolved completely after starting oral corticosteroids. Message: Sarcoidosis is an important differential diagnosis in young children with joint and salivary gland involvement.

Modifiable Factors for Prevention of Childhood Mortality.

Objective: To know the disease-related causes of child mortality and identify socially modifiable factors affecting child mortality among hospitalized children aged >1 month-18 years in a referral hospital of North India. Methods: Causes of death (ICD-10 based) were extracted retrospectively from hospital files (n=487) from 17 March 2003 to 30 June 2012. Modifiable factors were prospectively studied in 107 consecutive deaths from 6 October 2011 to 30 June 2012. Results: Pneumonia, CNS infections and diarrhea were the most common disease-related causes of child mortality. Conclusions: Amongst modifiable factors, administrative issues were most common followed by family-related reasons and medical-personnel related problems.

Locked-in Syndrome as a Presentation of Snakebite.

Snake bite is a common condition in tropical countries. Neurotoxic features of snake bite vary from early morning neuroparalytic syndrome to various cranial nerve palsies. Locked in syndrome (LIS) is a rare presentation. We present four children that had LIS; three patients had total and one had incomplete LIS. All patients made successful recovery with polyvalent anti-snake venom and supportive management. This case series highlights the importance of early diagnosis of LIS in snake bite.