Anaemia is functionally defined as an insufficient RBC mass to adequately deliver oxygen to peripheral tissues, thereby causing tissue hypoxia. Although red cell mass is the gold standard in the assessment of anaemia, its measurement is cumbersome and rarely performed outside of clinical research. Anaemia can also be defined as a reduction in haemoglobin (Hb) concentration, haematocrit or number of RBCs per cubic millimetre. As per the World Health Organization (WHO), the haemoglobin threshold for children aged 5.00 to 11.99 years is 11.5 g/dl and for children aged 12.00-14.99 years is 12.0 g/dl.
Iron deficiency is the most common nutritional deficiency in the world; responsible for a staggering amount of ill health, lost productivity, and premature death.
Iron is necessary for production of haemoglobin which contains more than one-half of the total-body iron. The demands for iron during erythropoiesis are created by three variables: tissue oxygenation, erythrocyte turnover, and erythrocyte loss from haemorrhage.
Signs and symptoms:
A newborn with a temperature that is even slightly above the normal range should be taken to the doctor as soon as possible; further, if the newborn has any of the following symptoms, he or she must be brought to a hospital for thorough evaluation.
• Excessive and continuous crying
• Listless baby
• Excessive weight loss
• Decreased urine output
• Difficulty in breathing
• Refusing to breastfeed
• Trouble swallowing
• Vomiting or diarrhoea
Though Adriaan van der Spieghel described the semilunar line (Linea Spigeli) in 1645, it was Josef Klinkosch, in 1764, who first defined Spigelian hernia as a defect in the semilunar line. Scopinaro was the first to report a lateral ventral hernia or Spigelian hernia in a pediatric patient in 1935. SH account for 1.5% of abdominal herniae in adults, however there have been sparse case reports of the same in the pediatric age group and even rarer instances in neonates where the aetiology is mostly congenital. Only 78 cases have been reported in the pediatric age group in a review of the literature from 1935 to 2015.
A five-day-old male neonate with 3.2 kg weight was referred for non-bilious vomiting and refusal of feeds. He was delivered by caesarean section and no congenital anomaly had been detected antenatally or at birth.
On examination, he was lethargic, pale, tachypneic, and dehydrated, with mild icterus. There was no cyanosis. He had passed normal meconium at birth. Further physical examination revealed epigastric fullness with tenderness. His investigations showed hemoglobin of 6 grams per decilitre (gm/dL), white blood cell count of 16,000 per cubic millimetre, low serum sodium and potassium, with C-reactive protein (CRP) level of 12 milligrams per decilitre (mg/dL).
The chest X ray showed a left sided diaphragmatic hernia.
Drug induced alteration in heart rate and rhythm are often encountered in clinical practice. Torsades de pointes (TdP), a polymorphic ventricular tachycardia with a prolonged QT interval, though often of very little consequence and self-limiting, can at times can be life threatening. The authors wish to highlight the various responsible drugs causing TdP with their common indications and likely causative mechanism(s). This would serve as a good guide to clinicians.
A 48-year-old female patient presented with a chief complaint of swelling of the left side of the upper jaw for the past 15 days. The patient had a history of occasional yellowish discharge from the gums, but no complaint of pain. On oral examination, a smooth surfaced dome-shaped swelling was noted on the palate in relation to the left maxillary canine. The swelling was soft in consistency and non-tender to palpation. The overlying mucosa appeared stretched.