Pediatrics

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>>>>>>>>

Severe GERD with Non Resolving Pneumonia Requiring Surgical Intervention for Survival

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Gastroesophageal reflux is defined as the passage of stomach contents into the esophagus with or without regurgitation (spitting up) and vomiting. It is a normal physiologic process that occurs throughout the day in infants and less often in children and adolescents.

Intercostal retractions
Intercostal retractions

For healthy infants, GER episodes usually occur postprandial and last for less than three minutes. To pediatricians, the most noticeable symptom is regurgitation occurring daily with most infants aged less than three months. This symptom is usually resolved by the age of 12 months. The disease that might develop secondary to persistent GER is referred as GERD. To avoid diagnostic testing and unwanted medication, determining GERD from GER is essential. Read More>>>>>>>>

Palmar Grasp Reflex in Human Newborns

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Human babies exhibit spontaneous movements and primitive reflexes elicited by proper stimulations. According to Colson et al., these reflexes and spontaneous movements develop during fetal life and observed in healthy infants born in terms. Capute and Accardo reported that they may be related to voluntary movements, originating from the brainstem, but later being suppressed by myelinization of the supraspinal centers.

Palmar Grasp Reflex
Palmar Grasp Reflex

The palmar grasp reflex is elicited in babies up to four months after birth, by touching the radial part of the palmar surface, between ring and index fingers. The reflex response is the rapid flexion and adduction of the fingers of the stimulated hand.The presence of palmar grasp reflex allows to measurement of the flexor tonus necessary for grasping movements of hands, and, possibly of legs. According to Herschokovitz et al., its existence is important so the infant is capable to perform manual grasping in his first weeks of life. Read More>>>>>