Clinico-radiological Correlation of An Uncommon presentation of Caffey’s Disease

Caffey’s disease which is also known as infantile cortical hyperostosis usually affects young infants <6 months of age. It is a rare,mostly self-limiting disease. It is characterized by a triad of soft tissue swelling, cortical thickening of the underlying bone, andhyperirritability. The mean age of the presentation is 9-11 weeks of age. It typically involves the mandible, clavicles, ribs, and diaphysisof the long bones. We report a case of Caffey’s disease presenting at an early age of 6 weeks, affecting long bones, with symmetricalinvolvement of ulnar bones, and thrombocytosis as an uncommon presentation. On follow-up for 48 months, there were no recurrences

Congenital varicella syndrome in a neonate

Congenital varicella syndrome is an extremely rare disorder occurring in <2% of the babies born to women infected with varicella between 7 and 28 weeks of pregnancy. The characteristic symptoms consist of skin lesions in a dermatomal distribution, neurological defects, eye diseases, and skeletal anomalies. We present a case of a newborn male baby who was shifted to neonatal intensive care unit

Congenital absence of the sternum in a neonate

Congenital absence of the sternum is a rare chest wall malformation resulting from the failure of midline fusion during embryonic development. It is a potentially life-threatening congenital midline defect. Only sporadic cases have been reported in literature. The abnormality can cause significant morbidity, and like other congenital anomalies can have associated defects. Repair of congenital absence of the sternum should ideally be undertaken in the neonatal period when the chest wall is highly compliant, and hence, primary closure can thus be achieved without significant cardiopulmonary compression. As the patient ages, chest wall compliance decreases and closure will become progressively difficult as venous return and lung compliance are increasingly compromised. We report a case of congenital absence of the sternum as it is very rare and because it was successfully operated in a neonate period

Analysis of Factors Hindering the Measles Elimination among Children at a Tertiary Care Hospital in South India

Introduction: Measles is a highly infectious acute viral disease that can lead to serious complications and death. Effective immunisation coverage for measles will play a pivotal role in its elimination strategy. So, the global commitment, strengthening of health infrastructure and effective vaccine coverage are essential to achieve a world that will be free of measles. Aim: To assess the factors associated with the occurrence of measles and to determine the factors responsible for non compliance to measles vaccination. Materials and Methods: A cross-sectional study was conducted in the Department of Paediatrics at Niloufer Hospital, Hyderabad, India, during the period from October 2019 to March 2020 among the children clinical diagnosed with measles. The patients were evaluated for fever, rash, respiratory and other clinical symptoms associated with measles. History of measles vaccination and vitamin A administration were taken. Blood samples of patients were collected and measles specific IgM antibody detection test was done by Enzyme-linked Immunosorbent Assay (ELISA). Data was statistically analysed and presented as numbers and percentages were calculated. Results: Among 129 children, clinically diagnosed with measles, the predominant age group of children affected was 1-6 years 68 (52.71%). Overall, 38 (29.5%) were vaccinated and 85 (65.9%) were unvaccinated during routine immunisation schedule. MeaslesContaining Vaccine (MCV) coverage during Supplementary Immunisation Activities (SIAs) was also very limited (19.3%). Out of 129 cases, 121 (93.7%) were confirmed positive by measles IgM ELISA, 5 (3.8%) samples gave equivocal results and 3 (2.3%) were negative for the test. Conclusion: Inspite of the availability of effective and inexpensive measles vaccine for decades, vaccination coverage remains inadequate across the globe. So, effective implementation of vaccine services and monitoring of its surveillance system are needed for eradication of measles

Disease Spectrum and Triage Assessment among Children Presenting to the Paediatric Emergency Department at a Tertiary Care Centre in Telangana, India

Introduction: Triage is a sorting process to quickly assess patients upon their arrival in the emergency department which helps to stream them to an appropriate location and adequate treatment. Triage assessment helps in recognising the commonly presenting childhood emergencies to optimise quality of care delivered in the Paediatric Emergency Department. Priority attention can be given to the critically ill or injured patients as how long the patient can safely wait, is predicted by triage. Aim: To provide data on disease spectrum and triage assessment of children presenting to an exclusive Paediatric Emergency Department. Materials and Methods: This was a cross-sectional study which was conducted from October 2020 to September 2021 over a period of one year in the Paediatric Emergency Department at Niloufer Hospital, a tertiary care children hospital in Hyderabad, Telangana, India. All children in the age group of one month to twelve years triaged by five-level Canadian triage and acute scale were included in the study. Data was collected from the register maintained at the Emergency Department. Descriptive statistics was used to analyse the data. Micosoft excel sheets were used for recording data. Results: During the study period, 7986 children were admitted with 5718 (71.6%) males and 2268 (28.4%) females. A total of 4352 (54.5%) patients were less than one year age. Neurological emergencies, acute febrile illnesses, respiratory illnesses were most common reasons for emergency visits. The number of chidren presenting with triage level 1,2,3 were n=4369 (54.71%). Conclusion: Majority of the patients attending the Emergency Department were less than one year old and acute febrile illnesses and seizures were the most common causes for admissions. Triaging and priorisation of pediatric emergencies is strogly recommended for early recognition of life threatening illnesses and to improve outcomes. Specially trained nurses, healthcare professionals trained in Basic Life Support (BLS) and Paediatric Advanced Life Support (PALS) will go a long way in reducing morbidity and mortality

Symptomatic Early Congenital Syphilis: A Common but Forgotten Disease

Congenital syphilis is a severe, disabling infection often with grave consequences seen in infants. It occurs due to the transmission of the disease from an infected mother to the unborn infant through the placenta. This long forgotten disease continues to affect pregnant women resulting in perinatal morbidity and mortality. The continuing prevalence of this disease reveals the failure of control measures established for its prevention. We put forth a case of symptomatic congenital syphilis presenting with skeletal manifestations at birth, a rare finding in literature. The report stresses upon the importance of implementing the World Health Organization's recommendation that all pregnant women should be screened for syphilis in the first antenatal visit in the first trimester and again in the late pregnancy

Outcome of high-flow nasal cannula therapy in children with acute respiratory distress in a tertiary care centre: A prospective cohort study

Background: High-flow nasal cannula (HFNC) therapy is a relatively non-invasive new therapy for respiratory distress and has shown potential in reducing invasive ventilation. Recent studies have suggested that HFNC therapy can also be effectively and safely used in patients having respiratory distress with a wider age range of severity and etiologies.  Aim: To assess the outcomes of patients placed on a high flow nasal cannula as a primary mode of treatment for children with respiratory distress. Methods: This is a prospective observational study was conducted on patients with acute respiratory distress who require hospitalization in  Age groups from 1 month to 12 years old between August 2021 and December 2021 at  Tertiary Pediatric Center in Hyderabad. The study was approved by the ethical committee and parental consent was obtained prior to initiation.  We calculated a sample size of 350 using 0.05 alpha error and 90% power. Statistical analysis was performed using IBM SPSS23 version (IBM 2015) and significance was assessed at the 0.05 level. Results: A total of 362 children (176girls and 186boys) started HFNC therapy.  The HFNC failure occurred in 20 (5.5%) children after a median (IQR) time of 2 (1.75-24) hours