July- 2005 Newsletter - Pediatric Oncall

Upcoming conference

MAHANEOCON: Avail details and online brochure of 5th Annual Conference of Maharashtra State Chapter of National Neonatology Forum to be held at Aurangabad in October 2005.

http://www.pediatriconcall.com/fordoctor/Conference/natlonal_neonatology_forum.asp
MADHYA PRADESH PEDI NEOCON 2005: Avail details and online brochure of Ethical Child Care in 21st Century XXXVI th Annual State Conference Of IAP & VIth Annual Conference Of M. P. State NNF to be held at Jabalpur in November 2005.

http://www.pediatriconcall.com/fordoctor
/Conference/pedi_neocon2005_invitation.asp
MAHAPEDICON 2005: Avail details and online brochure of XVI Annual Conference Of IAP Maharashtra State Branch to be held at Amravati in November 2005.

http://www.pediatriconcall.com/fordoctor
/Conference/mahapedicon2005.asp

Latest articles on Pediatric Oncall:

DIAGNOSTIC DILEMMA:
This month’s diagnostic dilemma: A 10 month old child presented with fever, anemia and hepatosplenomegaly since 2 months. Her hemoglobin electrophoresis was normal, bone marrow aspiration showed cellular marrow. Her serology for viral markers was negative. Fever responded to erythromycin but anemia persisted and required frequent transfusions. What is the differential diagnosis? Read the complete case and answer the dilemma…

http://www.pediatriconcall.com/fordoctor/diagnosisdilemma/listdilemma.asp

Last month’s query of a 10 month old with recurrent pneumonia and BAL growing pseudomonas with F 508 mutation analysis for CFTR being negative and normal sweat chlorides with negative HIV ELISA and normal serum immunoglobulin had several replies from our viewers with many suggestions including immunodeficiency, cystic fibrosis and tracheo-esophageal fistula. The authors have replied that the bronchoscopy did not show any fistula and workup for immunodeficiency revealed T cell defect.

TEACHING FILES:
This month’s teaching File:
A 4 month old presented with neonatal cholestasis. Investigations revealed negative TORCH titres, normal excretion on MRCP, normal thyroid function tests and liver biopsy showed cholestasis with multinucleation. What is the etiology of neonatal cholestasis? Read the entire teaching clinical query in the section of “TEACHING FILES” and try the correct answer.

http://www.pediatriconcall.com/fordoctor/teaching/clinical_propblem_list.asp

Last month’s teaching file:
Query: A 6 month old child had recurrent convulsions since day 10 of life. On examination he had tachycardia with cardiomegaly and hypertension and beading and wrist widening with X-ray of wrist showed white line of calcification. What is the diagnosis?
Answer: This child has cardiac dysfunction with convulsion. Hypocalcemia causing convulsions is unlikely as rickets is healing as the white line of calcification has appeared on the X-ray. The other abnormal finding in this child was hypertension. Cause of hypertension is Coarctation of aorta, which can lead to convulsions as well as cardiac dysfunction. The highlight of this case is that every time the child had a convulsion, he was diagnosed as hypocalcemic convulsions but never were the lower limb pulses felt. Infact the femoral pulses should be felt in all newborn babies, as coarctation of aorta is a clinical diagnosis and can be picked up early and intervened early. Discuss this case further in DISCUSSION GROUPS

EPIDEMIC ALERT:
Consensus Statement of IAP Committee on Immunization & IAP Delhi Branch on Meningococcal -
An infection outbreak in Delhi. (Based on the discussion followed by approval of the draft prepared at the meeting of IAP Delhi Branch held at Kalawati Saran Children Hospital on 15th May, 05). Read more…

http://www.pediatriconcall.com/fordoctor/Medical_original_articles/Meningococcal_infection.asp

PRACTICAL GUIDELINES:
CHILDHOOD ONSET OF ADULT METABOLIC DISEASES
Panna Choudhury, Consultant Pediatrician, Maulana Azad Medical College & Lok
Nayak Hospital, New DelhiThere is an emerging epidemic of noncommunicable diseases like obesity, hyperlipedemia, heart disease, diabetes, stroke and cancers. Pediatricians have a very important role to play in the control of these epidemics with the accumulating evidence that most of these diseases have their origin in childhood, and particularly linked to obesity. Read more…

http://www.pediatriconcall.com/fordoctor/
diseasesandcondition /Faqs/metabolic_diseases.asp

ORIGINAL ARTICLE:
ACUTE RESPIRATORY DISTRESS SYNDROME (ARDS)
Vishal Dublish, Ira Shah Read about ARDS – its definition, clinical features, pathophysiology and management issues.

http://www.pediatriconcall.com/fordoctor/diseasesandcondition
PEDIATRIC_EMERGENCIES/AcuteRespiratorySyndrome.asp

CASE REPORTS:
GLUTARIC ACIDEMIA – TYPE 1: Read about a 16 month old child who presented with shock, severe metabolic acidosis and no evidence of infection and investigations revealing Glutaric Acidemia Type1.

http://www.pediatriconcall.com/fordoctor/casereports
/glutaricacidemia_type1.asp

IMAGE GALLERY: Try your clinical skills in the “SPOT DIAGNOSIS” for the fortnight and the lucky winner gets a set of 3 child health CDs – Courtesy Pediatric Oncall

This fortnight’s spot diagnosis:What is the procedure the child is undergoing?

Last months answers :
Case 1: Cephalhematoma
Case 2: Hyperthyroidism – Dr K S Vaswani

http://www.pediatriconcall.com/fordoctor/imagegallery/imagegallery.asp

Sincerely,

Pediatric Oncall


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