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July 2012 Volume-9 Issue- 7
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Pediatric Oncall
 
July 2012 Volume-9 Issue- 7 (ISSN - 0973-0958)
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TABLE OF CONTENTS
Access current issue (July 2012) online

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DIAGNOSTIC DILEMMA

A 10 years old boy presented with purposeless involuntary movements of right side of body for past 2 days which disappeared in sleep and accompanied by emotional liability. There is no fever, jaundice, drug ingestion or any other illness in past. On examination he has bilateral choreoathetosis (right side more than the left) with positive milk maid's sign, Jack in the box sign and pronator sign. Other systems are normal.

How to approach this case?

Previous Diagnostic Dilemma : Tuberculous Meningitis.

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TEACHING FILES
Ira Shah

A 3 years old boy born of non consanguineous marriage presented with hematemesis and malena 1 year ago and again with malena 6 months ago for which child required blood transfusion. There is no jaundice or bleeding from any other site. On examination, spleen is just palpable. Hemoglobin = 6.7 gm/dl, WBC = 6400/cu mm, platelets = 1,27,000/cu mm. LFT is normal. Ultrasound abdomen is normal. What is the cause of hematemesis and malena in this child?

Read the entire teaching clinical query in the section of "TEACHING FILES" and try the correct answer.

Last month's teaching file: A 12 years old HIV infected orphan was referred for further management. Both parents were also HIV infected and had died due to same. At 3 years, the child had PCP pneumonia. At 4 years, he was treated for pulmonary tuberculosis {TB}. At 6 years, he had herpes zoster ophthalmicus and molluscum contagiosum. At that time, he was treated with 2 drug Antiretroviral therapy {ART} consisting of Zidovudine {AZT} and Lamivudine {3TC}. At 6½ years of age, 2 more drugs? Stavudine {d4t} and Nevirapine {NVP} were added. At that time mantoux was done which was positive and child was retreated with antituberculous therapy {ATT}. Is the present regime likely to work?

Answer: The child may have developed TAMS and resistance to NRTI, though current regime may work.

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ORIGINAL ARTICLE
Poovazhagi V, Prabha Senguttuvan,
Padmaraj R


Prevalence of Microalbuminuria in Children with Type 1 Diabetes Mellitus.

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CASE REPORTS
Nibedita Mitra, N Kannan, G Kavita, V Senthil

Neonatal Dengue.

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LETTERS TO EDITOR (VIEWER'S CHOICE)
Jenisha Jain, Mayank Jain, Ajay Jain, Shohini
Sircar, C K Waghmare, Sagar Adkar


Epidermolysis Bullosa with Esophagobronchial Fistula.

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D P Mohapatra, Prashant Nigwekar

Neonatal Rickettsial Fever.

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IMAGE GALLERY
Kulkarni Siddharth V, Lakhkar Bhavana B



A six months female child came with swelling over bridge of nose since birth. The swelling had increased slightly since then. On examination, it was soft and cystic. What is the diagnosis_?

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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Sincerely,
Pediatric Oncall


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With increasing resistance to first line drugs, should category 2 treatment be modified_?

Yes, adding streptomycin to a failing regime will lead to more drug resistance
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Today's Poll
Should teicoplannin, colistin be used in case of neonatal sepsis where culture does not reveal any organism_?
No, it should be used only after drug sensitivity report
Yes, under guidance of an infectious disease expert
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