TEACHING FILES
Ira Shah
This month’s teaching File: A 5 years old boy presented with low grade fever, breathlessness and cough for 3 months. On examination, he has respiratory rate of 40/min with intercostals and subcostal retractions. He has subcutaneous crepitations in the neck and axillary region? What is the diagnosis?... Read the entire teaching clinical query in the section of “TEACHING FILES” and try the correct answer.


Last month’s teaching file:
Query::A 2 year old girl presents with fever and cough, vomiting, breathlessness and generalized tonic clonic convulsion followed by altered sensorium. On examination, she had hepatosplenomegaly with hypotonia with brisk reflexes She was suspected to have Reye’s syndrome. How to investigate this case further?...
Answer: This child had an episode of acute encephalopathy with anicteric hepatitis suggestive of Reye’s syndrome. Her predominant viral markers are negative. However one needs to rule out Hepatitis E in the child. If that too is negative, one must rule out an underlying metabolic disorder. Read and discuss this case in full details further….

EDUCATIONAL ARTICLE

Role of Vitamin K in Paediatric Practice. Pradipta Kumar Swain. Vitamin K was discovered in relation to bleeding neonates (HDN) the incidence of which without vitamin K prophylaxis was 4-10/1000 live births. Hence it is known as the anti-hemorrhagic vitamin and irrespective of sex, gestational age & cultural practices every newborn has a right to a dose of anti-hemorrhagic vitamin at the time of birth. Role of vitamin-K beyond neonatal period is coming up with development of its different actions at the cellular level like in osteoporosis, fracture, and vascular thrombosis.

IMAGE GALLERY

SPOT DIAGNOSIS

Last month’s answers:
Case 1: Supraventricular tachycardia
Case 2: Intraspinal tumor

Try your clinical skills in the “SPOT DIAGNOSIS” for the fortnight and the lucky winner gets a child health CD – courtesy Pediatric Oncall 

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