What are the indications of steroids in henoch shonlein purpura? can we get soft liver with sharp borders and firm liver with rounded borders? criteria for remission in acute lymphatic leukemia? why there is palmar erythema and parotid swelling in chronic liver disease? what is the etiology of reccurent parotitis in hiv? why step ladder type of fever is not seen in pediatric typhoid? which is the most suitable antifungal in treatment of febrile neutropenia?     Check out the answer

Lot of anti sickling agents have been mentioned in books besides butyrates .but further information is not available in latest journals or textbooks. Kindly discuss it. 2) we have a case of neonatal thrombocytopenia which mentioning briefly. Mother hiv +ve,totally asymptomatic except moderate splenomegaly. Patelet count 72000/mm,delivered be caserean. Baby brought for routine follow up on 2nd week of life. Thrombocyte count 52000 . Baby called for follow up for every week. Count 50000 & 16,000 (sixteen thousand) respectively.baby totally asympto matic at all visits. Pbs shows giant platelets but coagulation profile normal. What should be further plan of action?will antiplatelet antibodies test necessary? Should we transfuse the baby or give steroids? Is mother or baby's bone marrow indicated? (if any further infi reqed please let me know)     Check out the answer

Is it possible for the second child in a set of twins to be infested with HIV virus during birth from the Mother and the first twin not infested? The second baby came after 5 minutes on arrival of the first baby. They were delivered normally and they both weighed 3.5 and 3.4 respectively.     Check out the answer

Can one set of twins be HIV positive and the negative?     Check out the answer

What is the cause of gross wasting in HIV ?     Check out the answer

For prevention of mother to infanttransmission of hiv various trials are used like THAI, ACTG076 &HIVNET.But few physicians and gynacologist use combination therapy like DUOVIR (zidovidine+lamividine OR these two +stavudine or nevirapine DURING ANTENATAL period.(Of course that is justifiable) Iwant to know what retroviral drug to be given to infant of hiv positive mothers when various such combinations are used? 2)A request-"Qustion of the day" is a section where we can read other doctor's answera and opinions and it is definately nice to know othrs views. But it will be also useful if you add expert's answer for that particular qustion. Thanking you Yours sincerely Mangesh     Check out the answer

What drug can one prescribe for a 5 years old HIV positive child who is on TB treatment but has no appetite for food and when forcefully fed, the child vomites all that she ate     Check out the answer

Any online reference about WHO clinical case definition of HIV in children?Whether case definition issued for adults can be applicable to children also.i.e.2 major & 2 minor criterias.     Check out the answer

IAP has given guidelines for management of HIV (pcr positive)infants and children which depends on either CD4 COUNT VIRAL LOAD OR CLINICAL STAGING.(A,B OR C) the problem is every time it is not possible to ge y viral load or cd4 count as they are costly .And depending on clinical staging only it is difficult to treat .as co relation of low cd4 count and infection may not be there. I mean they can be relatively asymptomatic. On the other hand Nelson mentions that every pcr positive infant should be treated irrespective of viral load and cd4 count .Please comment.     Check out the answer

A 2 month old child coming with h/o of poor weight gain and fever for 2 weeks.the child was found to have generalised lymphadenopathy and malnourished,no BCG scar,hepatosplenomegaly.otherwise allwork outs are normal.mother found to be retroviral positive and the child does not have a BCG scar.can disseminated BCG tuberculosis be a differential diagnosis.how to confirm     Check out the answer

r/Sir i have a child who is a known case of hiv +ve since two years and is on septran prophylaxis.she is put on 3drug ART since 6 months (lamuvudine ,zidu,nevirapine) presented with pancytopenia and low retic counts .suggesting bone marrow supression .plz tell me what shall i do next about the ART and how do i treat other than giving a transfusion for the anemia .what is the role of Gcsf in these children. her cd4 counts are very low and her age is 6 yrs.     Check out the answer

This is regarding pediatric HIV 1)Iap HAS RECOMMENDED few simple measures to reduce breast milk HIV transmission like a-keep EBM standing for fewq hours b-boiling and pasteurising breast milk c-frrezing my qustion is how much feasible and useful they are ? DO THEY REALLY REDUCE THE VIRAL LOAD TO SIGNIFICANT EXTENT/ What is your experiance? 2)Iam working in an HIV project where we regularly do baseline investigation and DNA PCR The trial is related to nevirapine where we give 6 week nevirapine in babies enrolled in randomised cohort. IT has been observed that many babies develop anaemia or neutropenia or both where neither of these side effect has been mentioned as per as i know.will you please guide me? 3) Does mother receiving zidovidine antenataly will cause anaemia in baby?     Check out the answer

If a neonate born to HIV positive mother tests negative for HIV ELISA,can it be safely ruled out that baby is HIV Negative?     Check out the answer

8 year old male patient known case of retro viral positive , whose count was only 5 and was put on zidovudine,lamivudine and stavudine for 2 years. i knew that the combination of zidovudine and stavudine should not be used..so immediately i changed to zidovudine , nevirapine and lamivudine.........i wanted to change 2 drugs but i changed 1 drug onlyas pt was not affordable.pt was alright for 1 year but now he is decreasing weight from 25 to 21 now..but symptom free..please suggest me what iam suppose to do...     Check out the answer

Monotherapy role of lamivudine in hiv...any new therapy     Check out the answer

10 days old abandoned neonate. Parents not known.HE was admitted to an orphanage. Orphanage people are doing HIV ELISA for all admitted babies to them. They are not doing DNA pcr FOR CHILDREN BELOW 18 MONTH as they can not afford it. The abovesaid neonate turned to be ELISA +VE. The pediatrician of the orphanage started him on zidovidine.(i.e prophylaxis) My qustionis Is it correct to start baby on zidovidine prophylaxis when mother status is not known . 2)Doing PCR or Elisa (WHICHEVER APPLICABLE )ROUTINELY OF ALL admitted patient.     Check out the answer

Can we use comination of nevirapine and rifampicin by increasing the dose of nevirapine..if not why     Check out the answer

Pls tell me if a patient has received art in the past and has stopped it how does one approach. are there some guidelines. this will be a long ans as this will involve various factors. sachin d     Check out the answer

Respected sir, i am forwarding herewith my quary and your answer to that. Please refer to the second q i have asked to you which is regardingside effect of nevirapine. In our project we are giving 6 weeks nevirapine only to pcr negative babies and not as art to positive babies.my q was in our project many babies got neutropenia. As granulocytopenia has been mentioned as very rare side effect and that also in very few articles.so does nevirapine realy leads to neutropenia. Sorry for askng the q again     Check out the answer

A 12 year old female, hiv positive, presented with progressive abd distention since a year and severe short stature. no histiry s/o cns, cvs ,or hematological system involvement. h/o admission for 7 days at 6 yrs of age for fever(details not available). father died of kochs 5 yrs back. mother died postpartum??cause. younger sib also expired ?cause.pt is severely short statured ht age-6yrs wt 17 kg. huge (17cm) spleen. left lobe liver palpable 5 cms in mid sternal line. hb 6, p/s-hypo micro,wbc and plt--wnl. bili 1.3.bone age >12yrs. osteopenia on X-ray. what working diagnosis to keep in this case?? how to investigate further?     Check out the answer

12 yr girl,HIV +,family H/o TB +, had symptoms suggestive, had pulm.infiltrates and abd.LNpathy,FNAc of which showed AFB +. CD4 was 202,sr.albumin was 1.8. chld was also started on efavirenz based ART. 3 months after starting HRZE child ahs not shown any improvement, has developed ascites and pedal edema. present sr.alb is 1.6. ascitic fluid protein is 136 mg and there are 160 cells 80% lymphocytes. what should be further management of this child ?     Check out the answer

Hello madam/sir, I have a child 9 yr old put on AZT+3TC+NVP since 14 months with baseline Hb of 13.4gm, WBC 5000/cumm. On six months of treatment the CBC was within normal limits. Now she has developed pancytopenia with Hb 2.4 gm%, WBC1900/cumm, platelets 50000/cumm, MCV 109 fl. Could this be due to AZT(14 mon on treatment)? Do I need to change AZT?     Check out the answer