Case report of multiple hepatic microabscesses in a term neonate

Neonatal liver abscess is a rare entity, which usually occurs in preterm infants with sepsis and certain risk factors like umbilical vein catheterization. Neonatal hepatic abscess has a non-specific clinical presentation, and a high index of suspicion for this condition is warranted in case of unresolving sepsis especially in the presence of risk factors. Ultrasonography of abdomen is an important investigation in a febrile neonate with sepsis. Here, we report a case of hepatic microabscesses in a term neonate without any significant risk factors. We want to report this case because of its rare occurrence particularly in a term neonate without significant risk factors. This case also emphasizes the utility of abdominal ultrasonography in a febrile neonate with unresolving sepsis

ASSESSMENT OF QUALITY OF LIFE, COMPLICATIONS AND POST-TRANSFUSION ADVERSE REACTIONS IN THALASSEMIA PEDIATRIC IN TERTIARY CARE HOSPITAL

Objective: To assess the quality of life, investigate complications and adverse transfusion reactions post blood transfusion in thalassemia pediatric.Methods: A prospective, observational study was conducted over a period of six months in the pediatric department of Bharati hospital and research center, Pune. Thalassemia patient profile form was used for collecting demographic details, to record adverse transfusion reactions and complications. Using PedsQLâ„¢ (Pediatric Quality of Life Inventory) questionnaire thalassemia patients, and the control group was interviewed to assess their quality of life.Results: Out of 39 patients who were enrolled, 28 patients were above the age of 3 y; their overall quality of life score was significantly lower in thalassemia pediatric than healthy control. School function was a most affected domain. 53.84% had post-transfusion fever, 5.1% of respiratory distress while 41.06% had myalgia, swelling at IV site, headache, and vomiting. Out of 39 patients, 24 patients examined for complications; 33.34% had hepatosplenomegaly, 25% had infections, 16.66% had splenomegaly, 13.88% had cardiac complications, 8.34% had bone deformity, and 2.78% had growth failure.Conclusion: It was found that there was a significant decrease in the quality of life domains in thalassemia pediatric compared to control group. School domain was most affected. Hepatosplenomegaly is one of the leading complications observed in this study. Most common transfusion-related reaction was post-transfusion fever. Public awareness and preventive measures such as pre-marital and prenatal testing should be done to eliminate this fatal disease.Keywords: Thalassemia, Quality of life, PedsQLâ„¢, Adverse transfusion reactions, Complication in Thalassemia

TO STUDY THE THERAPEUTIC MANAGEMENT, DRUG RELATED PROBLEMS AND CONCOMITANT USE OF DRUGSIN PATIENTS WITH CANCER

Objective: To study the prescribing patterns of chemotherapeutic drugs, concomitant drugs and to determine the drug-related problems in cancer patients.Methods: A prospective and retrospective observational study was conducted over a period of 6 mo in a tertiary care teaching hospital, Pune after ethical approval and informed consent. Patients were then interviewed for patient information like demographics, treatment, and associated drug related problems using specially designed proforma and then required data was introduced in Microsoft excel spreadsheets.Results: Out of 60 patients 50 were enrolled in this study during which 9 different sites of cancer were examined. The maximum number of patients with cancer resides in the age group of 51-60 y (32%) and more common in females in 27 (54%). The most prevalent risk factor and co-morbidity encountered were tobacco chewing 13 (26%) and hypertension 8 (16%), respectively. On the further evaluation of data, the findings suggested that the majority of patients were prescribed with an alkylating group of anti-neoplastic agents, paclitaxel+platinum-based compound regimen, and the drug paclitaxel. On screening, 167 drug interactions were observed, of these most of the interactions were in the moderate category. The most common organ system affected was gastrointestinal system 135 (30.80%) whereas the prevalent toxicity was hyperuricemia. Polypharmacy was not observed, whereas antacid (ranitidine) was frequently prescribed during hospitalisation and discharge.Conclusion: This study has highlighted certain facts and drawbacks in medication-related care which can be addressed by conducting future studies in cancer care in order to provide patient-specific outcomes

Congenital dyserythropoietic anemia type IV with kruppel-like factor 1 E325K mutation in a preterm neonate: Case and literature review

Background: Clinical, pathologic, and genetic heterogeneity is a challenge in identifying and classifying congenital dyserythropoietic anemia (CDA). CDA type IV, the rarest CDA with only 11 reported cases, results from KLF1 gene mutation. Clinical Description: A male preterm neonate presented with jaundice, anemia, pulmonary hypertension and hepatosplenomegaly in the immediate postnatal period, requiring multiple red blood cell transfusions. Management and Outcome: The workup for non-immune haemolytic anemia including red blood cell structural and enzymatic studies and were normal, with peripheral blood smear showing multiple polychromatic cells and numerous nucleated red blood cells including binucleate ones and fetal haemoglobin of 91.2%. Genetic testing revealed KLF1 E325K mutation suggestive of CDA type IV, though parental testing was normal, suggesting de novo mutation. The infant has been receiving packed RBC transfusion every three to four weeks initially and then every two months. The baby is now of twelve months of age, and receives oral vitamin B12 and folic acid supplementation for ineffective erythropoiesis. Though his weight is in the 3rd centile for age and height, he has been developmentally normal. Conclusions: Our report, the first description of a CDA type IV diagnosis in the neonatal period, adds to the limited knowledge of this disorder, which we also comprehensively review. The report highlights the phenotype of the disorder and the importance of neonatal genetic testing in a case of transfusion dependent anemia, having ruled out other causes