Are we requesting the right consent.

Medical treatment can only be administered with consent of a competent patient. Giving the treatment without consent is failure to respect patient’s autonomy; violating an individual’s right to self-determination. Methods: We conducted a cross sectional study to evaluate the consent forms from various hospitals. Consent forms of 372 out of 750 medical institutes in Nagpur were evaluated under 20 ethical and medico legal aspects of an ideal consent form. Results: Most of the consent forms lack important clauses of an ideal consent form that can go against the treating doctors in the court of law. Conclusions: Doctors need to be trained to design a consent form. They need to be made aware of the medico legal rights of the patient. The consent form is for the patients to acknowledge that the nature and purpose of treatment has been fully explained, understood and consented to. Remember patients never consent to doctor’s negligence but only to risks and complications.

DOOR Syndrome.

DOOR syndrome is a rare multisystem genetic disorder, consisting of deafness (sensorineural), onychodystrophy, osteodystrophy, and mental retardation. Seizures reported frequently in this condition are often refractory to treatment

Rickets in exclusively breast fed babies.

Articles appear periodically in Indian and western literature, about occurrence of vitamin D deficiency in exclusively breast fed babies. Some countries have formulated guidelines for prevention of vitamin D deficiency in such babies. In this study, twenty cases of nutritional rickets were diagnosed in exclusively breast fed babies between December 2003 and December 2006. None of them received vitamin D supplementation. Through this study, we hope to initiate further research and debate among the policymakers on whether or not vitamin supplementation should be given to all exclusively breast fed babies and lead to a formulation of clear cut guidelines in the Indian context.

Infliximab treatment in refractory Kawasaki syndrome.

Kawasaki syndrome is one of the commonest vasculitides in pediatric age group with devastating consequences if not treated early. Intravenous Gammaglobulin leads to rapid amelioration of clinical symptoms and significantly decreases the risk of development of coronary artery aneurysms. Occasionally, Kawasaki disease may be resistant to I/V IgG. We present our experience with one such patient who ultimately respondend to infliximab therapy.

Panayiotopoulos syndrome.

Panayiotopoulos syndrome is a benign childhood epileptic illness characterized by episodic autonomic symptoms. We present a 9 year old boy with this condition, who presented with episodes of severe vomiting, fever, deviation of eyes and altered sensorium, characteristic EEG in the form of multiple occipital spikes and normal neuroradiologic and metabolic investigations.

Breastfeeding programme--right policy, wrong target?

To assess the knowledge of breastfeeding management among obstetriciansand the practices being followed in their hospital, 50 obstetricians in private practice in Nagpur, responded to questionnaires having 6 points covering the entire gamut of common issues regarding breastfeeding. All believed that breast milk is best for the baby. It was found that knowledge about various aspects of breastfeeding management is very poor. Unawareness about the adequacy of colostrum for a full term appropriate for date baby was almost universal. While the policy of promoting breastfeeding every year through public programmes is appropriate, the question is who should be the target? Prospective mothers or obstetricians? It is obvious from this study that obstetricians have significant educational needs in the area of breastfeeding management.