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Expert Opinion
Q. Some newborns protrude their tongue very often. What does it indicate?
Post Date : 26 Oct 2025
Expert Opinion:
If it is just a simple and transient protrusion, it is usually normal and just needs reassurance. It could be due to an exaggerated suck reflex, which would most likely subside spontaneously.
If the protrusion is persistent, it would be wise to check for other signs of hypothyroidism, like abnormal facies, generalized hypoactivity, jaundice, infrequent stooling, etc. A blood sugar test can be done, especially if it is a macrosomic (large) baby. If the protrusion is due to a large tongue {macroglossia}, it could be a sign of Beckwith-Wiedemann syndrome. Such babies are usually large and have some dysmorphic features with hypoglycemia. It is also necessary to do a thorough intraoral examination, especially in the sublingual region to check for any masses which could be hidden.

Q. What is the investigation for only microcephaly in a neonate? other p/e normal.
Post Date : 19 Oct 2025
Expert Opinion:
Get a neuroimaging done. If dysmorphism is present, karyotyping may be needed. If any suspicion of congenital infections, do a TORCH.

Q. Can we give K citrate in renal stones with normal lab data? Is it without risk?
Post Date : 12 Oct 2025
Expert Opinion:
Citrate is only recommended if the urine citrate levels are low, especially in calcium stones and uric acid stones. It is not recommended for all stones.

Q. I am seeing a lot of children between 3 and 9 years of age this season who have a history of fever f.......
Post Date : 04 Oct 2025
Expert Opinion:
They should not need long-term AED as obviously the seizures are provoked by fever and/or a neurotropic infection e.g., HSV6. You are right, an encephalitis should be more prolonged. Post-ictal sleepiness is sometimes profound after a long generalized seizure, but still not the same as loss of consciousness.


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