1. The high mortality of extremely low birth weight babies is still a major concern in our neonatal unit. We need to make all efforts to reduce it. The maximum number of ELBW deaths occur in the first 48 hours and then after seven days. Hence, improved perinatal management and prevention of late onset sepsis would help in reducing mortality.
2. Birth asphyxia is the major reason for mortality in all weight categories within the first 48 hours, hence increased training of personnel in neonatal resuscitation is needed.
3. Sepsis is the commonest cause of mortality in the bigger babies which means that health-care associated infections and its prevention should be taken up in the form of prevention of cross-transmission, barrier nursing and antibiotic stewardship.
4. Detailed and regular evaluation of unit mortality statistics based on weight, gestation, duration of life, perinatal risk factors, resuscitation, antenatal steroids administration, and other factors should be done to identify risk factors of mortality especially in low birth weight babies.
Patients with HIV infection are at a risk of developing severe illness from either varicella or herpes zoster. Progressive primary varicella, a syndrome with persistent new lesion formation and visceral dissemination, may occur in HIV infected patients and may be life threatening. In the remaining cases and in infections at a later stage of pregnancy, the fetus is either not infected or suffers a subclinical infection with persistence of immunoglobulin G (IgG) at 1-2 years of age. The low levels of lymphocytes, natural killer (NK) cells, cytokines and virus specific immunoglobulins seen in utero and in infancy may result in an inability to maintain the latency of VZV leading to the early appearance of zoster in children.
Gormally and Treem have identified the following pointers for underlying organic causes:
• High-pitched/abnormal sounding cry.
• Lack of a diurnal rhythm.
• Presence of frequent regurgitations, vomiting, diarrhoea, blood in stools, weight loss, failure to thrive.
• Positive family history of migraine, asthma, atopy, eczema.
• Maternal drug ingestion.
After conducting a good history and physical examination the aetiology can point to organic or non-organic causes. Hunger cry is a major cause of crying but incessant crying after adequate feeding or not taking feed while crying makes us suspect other causes of crying, such as those listed below.
1. Infantile colic and behavioural cries
2. Genitourinary system
3. Other Infections
4. Gastrointestinal Anomalies
5. Musculoskeletal system
7. Other causes
• Foreign body in airway
• Supraventricular tachycardia
• Diaper rash
• Cow’s milk allergy
• Sickle cell anaemia and crisis
• DTP immunization
• Insect bites
• Pseudotumor cerebri
• Electrolyte and acid base imbalance
A 4-month-old child was brought by the mother to the paediatric ward of Goa Medical College with the chief complaint of abdominal distension in the past 7 days. There was no history of fever or any drug intake. On general examination, the patient appeared pale, and there was no icterus or lymphadenopathy noted.
On systemic examination, the neurological examination was normal. The patient was conscious and alert. Abdominal examination revealed the liver was 4 centimetres below the right costal margin, firm, non-tender, and with a smooth surface. The spleen was 6 centimetres below the left costal margin, firm, extending up to umbilicus. No free fluid was noted.
Canalicular adenoma is an uncommon benign neoplasm of the salivary glands. It occurs almost exclusively in the upper lips, next common site being the buccal mucosa. Parotid gland is a rare site for its occurrence. It is most likely to occur in the elderly.
Although canalicular adenoma is a rare entity, especially when it is not located on the upper lip, it is important to consider this tumor type when differentiating between pleomorphic adenoma, basal cell adenoma, Warthin’s tumor, and especially adenoid cystic carcinoma, when this occurs in the parotid gland. Histopathological biopsy is required for accurate diagnosis, because it may be difficult to differentiate canalicular adenomas from other diseases using FNACs alone.
Here we report a case of a 43-year-old male, who presented with a history of a swelling below the right ear. The patient was subjected to a fine needle aspiration cytology (FNAC) and the diagnosis of pleomorphic adenoma was made. The lesion was subsequently excised and sent for histopathology.
A 33-year-old female presented to the neurology department with complaints of loss of smell (anosmia) and decreased hearing in the left ear. Patient was a known case of multiple cranial neuropathies, that was diagnosed one year ago. On examination, there was a swelling in the right preauricular region measuring 3 x 2 centimetres. The swelling was a firm, nodular swelling.