Broca

A 6 months old boy old suffers from continuous diarrhea since 24 hours of his birth and has been in hospital since birth. If he does not get IV fluids, he deteriorates very shortly because of dehydration and electrolyte imbalance. Now he is maintained on total parenteral nutrition and 25 mEq, kg, d sodium replacement IV.

Is he suffering from sodium losing enteropathy or congenital microvillous atrophy?

A 4 years old girl presented with recurrent watery diarrhea for the past 6 months and edema for past 15 days. Her diet is only on dal and rice with calorie intake of 400kcal, day and proteins of 7gm, day. She had history of pica. On examination, her weight was 8.5kgs Her hair was depigmented and easily pluckable. She had generalized lymphadenopathy, pallor, angular cheilitis and beading of the ribs was present. Tongue was bald. She had conjunctival xerosis. On systemic examination, she was apathetic and had hepatomegaly. Her stool examination showed ova of hookworm, Trichuris trichiura, ascariasis and cysts of E. histolytica.

What nutritional deficiencies does this child have? How should this child be managed? How should this child undergo nutritional rehabilitation? What problems will she have as she grows older?

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These are questions asked by our viewers to the experts on the panel of Pediatric Oncall.

We give Kidrolyte {contains 5 percent dextrose along with electrolytes} to newborn on 3rd day. To give 6-8 mg/kg/min of glucose, how much 10 percent dextrose should be added?

A 4 months old boy presented with cough and cold since 7 days and increased rate of breathing since 3 days. There is no fever, refusal of feeds, lethargy. On examination, he has heart rate of 110/min with respiratory rate of 52/min without chest retractions. On systemic examination, bilateral hyperresonant note over lung fields with obliteration of cardiac dullness and bilateral crepitations and rhonchi. Liver and spleen are palpable. Other systems are normal. What is the possible diagnosis? How to work up for viral infection?

Mukul Aggarwal, Vikrant Sood

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Case 1: Tongue problem
Case 2: Pruritis in a 12 years old girl

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