TEACHING FILES

Ira Shah
This month's teaching File: A 5 years old boy presented with low grade fever, breathlessness and cough for 3 months. On examination, he has respiratory rate of 40/min with intercostals and subcostal retractions. He has subcutaneous crepitations in the neck and axillary region? What is the diagnosis?... 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 girl presents with fever and cough, vomiting, breathlessness and generalized tonic clonic convulsion followed by altered sensorium. On examination, she had hepatosplenomegaly with hypotonia with brisk reflexes She was suspected to have Reye's syndrome. How to investigate this case further?...
Answer: This child had an episode of acute encephalopathy with anicteric hepatitis suggestive of Reye's syndrome. Her predominant viral markers are negative. However one needs to rule out Hepatitis E in the child. If that too is negative, one must rule out an underlying metabolic disorder. Read and discuss this case in full details further...

EDUCATIONAL ARTICLE

Role of Vitamin K in Paediatric Practice. Pradipta Kumar Swain. Vitamin K was discovered in relation to bleeding neonates (HDN) the incidence of which without vitamin K prophylaxis was 4-10/1000 live births. Hence it is known as the anti-hemorrhagic vitamin and irrespective of sex, gestational age & cultural practices every newborn has a right to a dose of anti-hemorrhagic vitamin at the time of birth. Role of vitamin-K beyond neonatal period is coming up with development of its different actions at the cellular level like in osteoporosis, fracture, and vascular thrombosis.

CASE REPORTS

Subdural Empyema and Cerebellar Abscess in a Child due to Chronic Otitis Media. Amit Agrawal, Akshay Pratap, Nisha Bhatta, Anand Kumar The infratentorial variety of the subdural empyema, with coexisting cerebellar abscess, is a rare clinical entity that carries a high mortality rate. Clinical presentation of infratentorial subdural empyema encompasses a systemic febrile illness, headaches, and a stiff neck. The diagnosis is frequently delayed and often confused with that of meningitis. Cerebrospinal fluid analysis will confirm the diagnosis of meningitis in majority of the cases and will further delay the diagnosis as in present case. Read more...

VIEWERS CHOICE

Neurocysticercosis-Some Tips. Neeraj Jain, Vibha Jain, Deepak Seth. Read about how to deal with a child with Neurocysticercosis...

IMAGE GALLERY

SPOT DIAGNOSIS

Last month's answers:
Case 1: Supraventricular tachycardia
Case 2: Intraspinal tumor

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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