Pediatrics

Baclofen Treatment for Pain in Nonfunctional Children with Cerebral Palsy

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Recurrent and chronic pain of moderate intensity has been documented in most children suffering from cerebral palsy (CP,) the common cause of disability in children (2:1000 live births). The spastic, hypertonic element of this congenital motor disorder may be one an important source of pain. 70% of children with CP experience recurrent chronic pain of moderate intensity on a daily or weekly basis.

Cerebral Palsy
Cerebral Palsy

Physiotherapy required on a daily basis involves painful exercises and may be limited by pain. Pain evaluation in children is generally based on childrens’ report or parents’ impression. However, in severely disabled children with limited communication, pain assessment is challenging. Difficulty in pain evaluation may lead to underestimation of pain resulting in under or over treatment. Read More>>>>>>>>>

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Amaurosis Fugax and Cycloplegia in an Adolescent

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Amaurosis fugax (AF), mainly occurring in adults, is defined as transient monocular loss of vision lasting from seconds to minutes usually reported in middle aged and elderly people. It is associated in them with atherosclerotic process of the ipsilateral internal carotid artery  representing in impending stroke.

Amaurosis Fugax
Amaurosis Fugax

The diagnosis of AF was mainly based on the patients’ reports that could not be regularly examined during the acute short- lived episodes. Commonly, they described a “mosaic” or “jigsaw” pattern of isolated scotoma that progressively enlarged resulting in complete visual loss. The amaurosis fugax study group considered various multiple deficiencies other than cerebro-vascular associated with AF including coagulation and immunological reasons.  Read More>>>>>>>>

Mastitis Neonatorum: An Interesting and Uncommon Condition Seen in Infants

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A 21 day old male infant was admitted to NICU with swelling of right breast and fever from last 3 days. Baby had documented fever of 101ºF at the time of admission. Baby was exclusively breast feed with no history of decrease acceptance of feed. Examination showed enlargement of the right breast with erythema, tenderness and having size of 5 × 5cm.

Redness and erythema
Redness and erythema

Contralateral breast was normal with neither being erythematous nor tender. There was oozing of milk from the breast from the last few days. Mother gave a history of squeezing the breast when there was slight swelling of breast with milk discharge. Baby was treated with analgesic (paracetamol drops) and antibiotic (cefotaxime) and was discharged in good condition. Read More>>>>>>>>>

Obstetric Fistula – An Unceasing Scourge in the Developing World

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Obstetric fistula is a devastating problem known to mankind from time immemorial. It is an abnormal opening into the vagina leading to continuous involuntary leakage of urine and/or faeces following childbirth. The commonest type is vesicovaginal fistula. Other variants include rectovaginal fistula, urethrovaginal fistula, ureterovaginal fistula and vesicouterine fistula.

Obstetric Fistula
Obstetric Fistula

It is a complication of childbirth seen among reproductive-age women who lack access to quality maternity care. It is characterized by urinary and/or faecal incontinence and the resultant shame and social exclusion.While obstetric fistula has virtually disappeared from the developed world, it has remained unremitting in the developing world due to poverty, illiteracy, noxious cultural practices and fragile health systems that have shown minimal improvement over time.  Read More>>>>>>>

Road Traffic Injuries and Road Safety Measures-Can We Do Any Better?

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Road traffic accidents are the leading cause of death for people between 15 and 30 years, causing over a million deaths each year. According to the Global Burden of Disease Study 2013, leading causes of death for young people aged 10-14 years were road injuries, HIV/AIDS and drowning (25.2%), for people aged 15-19 years and 20-24-years it was transport injuries, in 14.2% and 15.5% respectively.

Road Safety Measures
Road Safety Measures

Global Status Report on Road Safety 2015 shows that low and middle-income countries have twice the mortality of high-income countries and 90% of global road traffic deaths. In addition to a huge health impact, road traffic accidents are estimated to cause economic losses around 5% of gross domestic product (GDP) in low and middleincome countries and approximately 3% of GDP globally. Read More>>>>>>>>>

Shwartz Jampel Syndrome: Rarest of the Rarest Case/A Rare Cause of Blepharospasm

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Schwartz Jampel Syndrome (SJS), also known as chondrodystrophic myotonia is a very rare autosomal recessive congenital disorder associated with generalised myotonic myopathy, joint contractures, bone dysplasia and blepharophimosis. The prevalence rate has been reported to be less than 1 per million, with total reported cases found to be about 129.

Characteristic filled facies in both siblings
Characteristic filled facies in both siblings

The primary cause was attributed to a mutation in the HSPG2 gene in the 1p34-p36 region on chromosome 1. The encoded protein, Perlecan, is a multifunctional proteoglycan present in basement membranes of cartilage and muscles. SJS has been classified into two types – Type 1 and Type 2. Read More>>>>>>>>>>

Floppy Infant with Respiratory Failure: A Case of Infantile Polymyositis

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Inflammatory myopathies are heterogenous group of skeletal muscle diseases with onset ranging from infancy to adulthood. Three distinct groups: dermatomyositis, polymyositis and sporadic inclusion body myositis are defined. Polymyositis affects predominantly adults but rarely children and infants.

Transversely cut skeletal muscle tissue
Transversely cut skeletal muscle tissue

A few case reports on infantile polymyositis, clinically presenting with moderate to severe muscle weakness, generalised hypotonia, with elevated serum creatine kinase (CK) activity, myopathic electromyography changes and inflammatory cell infiltrates on muscle biopsy have been reported. In this report we describe a floppy child with respiratory failure, elevated CK and muscle biopsy showing features of polymyositis. Read More>>>>>>>>