Paediatrics in India

Our rich heritage of Ayurveda has detailed description of maternal and child health care. Sushruta in his Sushruta Samhita, had devoted a chapter to Kaumarabrita (service to children).1 This was perhaps the first record of Paediatrics in ancient India. Paediatrics was called Kaumarbhritya tantra.2 The Atharva Veda (1500 BC) describes children's diseases and Kaushika Sutra included Paediatrics.1,2 Kashyapa and Jeevaka (400 BC) were well known Paediatricians of ancient India.1,2 Kashyapa Samhita deals exclusively with Paediatrics.1,2 Charaka wrote in details about the care and management of newborn in Sarira-Sthana and Ashtanga-Hridaya.1 The Charaka Samhita in fact mentions an international conference of scholars.2 Kaumarbhritya and Prasuti tantra talk of prenatal care, and also lay emphasis on neonatal care, care of the baby including feeding and management of illnesses of children.3 This includes - maternal care (with respect to food, drink, leisure, restricted work, sleep, etc.), neonatal care (cleaning, dressing, bath, procedure akin to cardiac compression), care of the umbilical cord, breast feeding (including concept of a wet nurse), annaprasana (initial eating of solid food), daily care of eyes and skin, and common symptomatology in childhood illnesses.2,

Chloroquine induced parkinsonism

A case of parkinsonism is reported in a 5-years-old male child following prolonged use of chloroquine. The patient presented with reduced spontaneous movements and speech with an expressionless face and a parkinsonian gait but no tremors. His investigations including CT scan brain, CSF study and serum ceruloplasmin were normal. Chloroquine was discontinued and the patient was started on oral trihexyphenidyl. The patient showed gradual recovery and the drug was successfully withdrawn. The toxic manifestations were only transient and reversible

Necrotizing myelitis in an immunocompetent child: a case report with review of literature

A few cases of necrotizing myelitis have been reported in adults since its first description in 1973. No case has been described in the pediatric age group. A 12-year-old boy, who presented with acute flaccid paraplegia, loss of sphincter control and sensory loss showed features suggestive of necrotizing myelitis on magnetic resonance imaging. Investigations carried out could not reveal a specific etiological or pre-disposing factor. No clinical improvement occurred despite the therapy

A prospective, randomised, double-blind study of comparative efficacy of immediate versus daily cleaning of stethoscope using 66% ethyl alcohol

OBJECTIVE: Studies have demonstrated frequent contamination of stethoscope and usefulness of different disinfectants. Albeit, studies on the precise mode of cleaning and frequency of cleaning are lacking. This study was carried out to determine efficacy of 66% ethyl alcohol as disinfectant, rate of recontamination without cleaning and benefits of daily versus immediate cleaning. METHODOLOGY: Prospective, randomised, double blind study of 100 stethoscopes. Four cultures were obtained: before cleaning (Group A), immediately after cleaning with 66% ethyl alcohol (Group B), at the end of 4 days without cleaning (Group C) and at the end of 4 days after cleaning once a day (Group D). Samples were analysed using standard microbiological methods and Colony-forming unit (CFU) count and residual microorganism was computed for all the positive cultures. Medical staff was asked about the cleaning practices. Statistical analysis was carried out using 95% confidence interval and Chi-square test. RESULTS: 90% of the stethoscopes were contaminated with one or more microorganisms. Immediate cleaning and daily cleaning were associated with a significant reduction in the rate of contamination to 28% and 25% respectively. CFU count in groups B and D dropped to less than 10 in 75% and 84.7%, while the mean residual rates were 5.2% and 3.65% respectively. Groups B and D showed no statistically significant difference in terms of efficacy of disinfection. CONCLUSIONS: 66% ethyl alcohol is an effective disinfectant. The effects of immediate cleaning and cleaning once a day on residual flora on the diaphragm of stethoscope is comparable

Letter to the Editor - Congenital Heart Disease with Rheumatic Fever and Rheumatic Heart Disease: A Coincidence or an Association?

The incidence of congenital heart disease (CHD) is about 8 per 1000 live births.1 The prevalence of rheumatic heart disease (RHD) in school-aged children is estimated to be in the range of 2-11 per 1000.2,3 Hence, the occurrence of both these conditions in the same patient can be considered to be uncommon. We carried out a retrospective study in a tertiary referral centre with an aim to analyse the co-existence of CHD and Rheumatic fever (RF)/ RHD