Dear dr, 8y old child with pallor and short statur.Everything in history and exam. is normal ,apart from this point...at the age of 2months operated on for pyloric stenosis. the surgeon made a mistake when he injured the mucosa he sutured it+ jejeno-gastrotomy which is not done basically.Does this explain the anaemia and short stature..? If yes ...how?     Check out the answer

Sir/Madam, My child was suffering from initial stages of pneumonia also stools after every feed. He was medicated for 2 weeks. Altacef, nutrolin-B, Cheston, Levolin was the medicines given for him for 10 days. Along with this he was taken for nebiliser. Fever was on and off, so blood test was taken. the results are given below. Now the problem is his appetite is very low. his weight is only 6 kgs at his 8th month. Seems to be very lean and small but very much active. Again mild cough and cold started. please suggest me to prevent and protect him from cough and cold. how to get rid of it. How to increase his appetite. (During medications he ate for every 4 hours). Child's Name : Gokul Age : 8 months. Birth weight : 2.52 kgs. Now the weight is : 6 kgs. Child Active. Stools passed twice a day. Sitting by himself. Trying to stand. Food given: rice, nestum, geeth powder, mother's milk, smashed apple. Blood test report : Total WBC Count : 7,700 Cells/cu mm. Differtial Count Neutrophils : 50% Lymphocytes : 43% Eosinophils : 07% Monocytes : 00% Basophils : 00% Erythrocyte sedimentation rate At 30 mts : 25 mm At 60 mts : 60 mm Grouping : 'B' RH : Positive Haemoglobin : 10.1 G/dl P.C.V : 33% R.B.C Count : 3.36 millions/cu mm M.P & M.F[Q.B.C Method] : Negative. S.G.P.T : 14 IU/ml ------------------------------------------ Blood Smear Study: Hypochormic : normocytic erythrocytes normal leucocytes with lymphocytosis and eosinophilic. thrombocytes : adequate in number. blood parasites : nil abnormal cells : nil immature cells : nil ----------------------- Stools test: Nature of specimen : FAECES Macroscopic Colour : Brownish yellow consistensy : semi solid mucus : nil frand blood : nil parasites : nil MICROSCOPIC Protozoa : nil cysts : nil Ova : nil RBC : nil Pus Cells : nil Vegatables cells : + Crystals : nil Chemical Reaction : -- Reducing substance : +++ Occult blood : -- Urine Culture : No growth. These above test were taken on 17-11-2006.     Check out the answer

A 18 year old boy a product of nonconsengeneous merrage,presented as chronic anemia under evaluatin since 2000. Pt was having c/o eassy fatigability, palness of body,intermitant abdominal pain, swelling over body[diagnosed as iron deficiency anemia]. pt was positive for occult boold in stool repeatdly, investigated further with colonoscopy,USG And Rbc labelled GI bleed scan which were normal a urine routin ex normal Hb electrophorasis normal. A CT enteroclysis reveled jujunal wall thickning ?jujunal polyp. But there is no H/O frank blood in stool, no H/O recurrent enteritis. O/E marked pallor, mallor erythemaus rash over fase, mild hepato splenomegaly, no rash over body, no LNpathy,no arthritis. A younger sister of patient is also having anemia and abdominal pain interminantly but not investigated. So what is a final diagnosis.     Check out the answer

A 30 day old newborn ,had rh incompatibility ,rh + ,mother rh-having Hb 8 gm,normocytic normochromic anemia.Given iron drops instead of blood transfusion.After 15 days ,Hb level increased only half gm. Why no response with iron? What should be line of treatment.Continue iron drops or give blood?     Check out the answer

In G6PD CAN WE FOUD SPLEENMEGALLLY WHY bec is cosider as hemolytic anemia why no spleenmegally????     Check out the answer

If the platelets are low in an aplastic anemia patient and she is bleeding from a wound secondary to thrombocytopenia. she is anaffording and we cant mobilise platelets for her as they are not available in or out of our hospital . what drugs can be used to stop or reduce the bleeding in this case ? atleast temporarily to buy time     Check out the answer

4 years female presentd with sudden attack of fever,loose motion.NoF\H of favism,or blood transfusion. O\E:GC is good, she has striking pallor,no icterus ,no hepatosplenomegaly,no significant lymphglands. lab.values:HBg 6g%, Ret.count 10% ,normocytic hypochromic blood picture,normal platelet count,no hemoglobinuria ,no blood in the stool.what further suggestions to reach diagnosis.     Check out the answer

Anemic child 1 yr 6 mth has oral intolerance,gets diarrhoea as soon as iron drops are given.which preparation are most suited to such babies.what should be solution to this problem?Is it appropriate age for Hb electrophoresis     Check out the answer

I would like to know how can i mange a case of autoimmune hemolytic anemia (agglutinin cold antibodies), one year old, her hemoglobin 7gm%,her blood group AB+ which isn`t compatible with the same blood groups in our bank.     Check out the answer

Female child years old with chronic pallor for 2 years and needed blood transfusion 4 times previously. there is no fever , hepatosplenomegaly or lymphadenopathy Investigations: HB : 5.5 gm/dl RBCs : 2500000 platelets : 120000/cc wbcs : 11000 hb electrophoresis : Hb A1     Check out the answer

4 year-old boy, known case of Chronic Granulomatous Disease, on Co-Trimoxazole prophylaxis. He was admitted 3 weeks ago with herpetic stomatitis, secondary to HSV type I. Upon admission the child was febrile, and having petechial lesions & herpetic stomatitis. There was no lymphadenopathy & no hepatosplenomegaly. His CBC showed Pancytopenia (WBC 1700, absolute neutrophil count 260, RBC 2.6, hemoglobin 7, platelets 20,000). Retcis 5.4% .Peripheral blood film showed slight spherocytes, target cells, shistiocytes and mild hypochromia. Renal function test, liver function test & coagulation profile were normal. He was given a course of Ceftazidim, Cloxacillin (for 10 days) & Acyclovir IV for 4 days. His herpetic stomatitis resolved, fever subsided, and blood culture had no growth. The possibility of viral or drug-related bone marrow suppression was the initial impression, but being an immunodeficienthost, thuoghto our knowledge CGD is not associated with leukemias, and with a ? family history of leukemia, malignancy had to be ruled out. Bone marrow aspiration showed hypercellular marrow with no abnormal cells. So the investigations were directed to possible autoimmune process with ? Evans syndrome. Direct Coombs' tests done twice were negative. ANA and anti-platelet antibodies were negative. Other investigations showed a total bilirubin 23 umol/L, direct 4. Haptoglobin <0.06 g/L (NR 1-2.3), serum ferritin 179.9 (NR 30-400), triglyceride 1.32. Ham test weakly positive. Urine analysis was normal. The patient was given 2 doses of IV immunoglobulin but the pancytopenia persisted. He was given GC-SF, and the neutropenia responded. He also received Prednisolone 2 mg/kg/day for 6 days but with no response regarding the platelet count, and so it was discontinued. His CBC after this 3 weeks period showed WBC 5940, ANC 2140, RBC 1.61, hemoglobin 5.1, platelet 13,000, retics 32.4 % . His general codition remains stable & afebrile, with no new findings on his physical examination. What is your impression? Your suggetions are welcome to best_pedia@yahoo.com . Thanks for your time and for helping this child.     Check out the answer