DIAGNOSTIC DILEMMA
Pediatric Oncall
A 2 years 9 month old presents with recurrent focal convulsions since Day 2 of life and speech delay. Initially she had high lactate with high ammonia and low biotidinase levels. Is the diagnosis of biotidinase deficiency correct? Read more...

Last fortnight's query of a child with recurrent intractable seizures and now dystonia had several replies and a diagnosis of Rasmussen's encephalitis seems most likely. However it remains a diagnosis of exclusion.

TEACHING FILES

Ira Shah
This month's teaching File: A 38 day old girl born prematurely at 32 weeks presents with non-resolving pneumonia with severe hypoxia. What organism is causing pneumonia? 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 presents with coarse features, delayed development, hepatomegaly and spasticity with corneal clouding. What is the diagnosis and how to investigate further?
Answer: Mucopolysaccharidosis. One should screen for hydrocephalus, pancytopenia, kyphoscoliosis and cardiomyopathy. Read more...

ORIGINAL ARTICLE

Maternal Knowledge and Perception about the Breast Feeding and Factors Influencing it -A Study in Urban Low Socioeconomic Class of Pune. Ashwin Borade, Neeta Hanumante. A study that depicts that exclusive breast feeding up to 6 months of age is still not routinely practiced and Illiteracy, primigravida, younger age and mothers living in nuclear family were found at significant higher risk of not following EBF. Read more...

CASE REPORTS

Neonatal presentation of Renal Tubular Acidosis type IV - a case report. Ana Cristina Simoes e Silva, Regina Maria Pereira, Frederico Jose de Carvalho Godinho, Sergio Veloso Brant Pinheiro. 12 day old boy presents with type IV RTA. Read more...

VIEWER'S CHOICE

IMAGE GALLERY

This is a 4 year old child. What is the bone age?

Last month's answers:
Case 1: Calcified granuloma
Case 2: Crouzon's syndrome

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

Sincerely,
Pediatric Oncall

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