Reaction to Yadav S et al: Invalid presentation of bilateral synchronous presentation of spermatocytic seminoma

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Sciatic Nerve Injection Palsy in Children

How to Cite This Article: Harsh V, Chengazhacherril R.B, SharmaK, Kalakoti P, Gupta U, Ahmad W, Kumar A. Sciatic Nerve Injection Palsy in Children. Iran J Child Neurol. Autumn 2016; 10(4):86-87. Letter to Editor Pls see PDF file. References1. Toopchizadeh V, Barzegar M, Habibzadeh A. Sciatic Nerve Injection Palsy in Children, Electrophysiologic Pattern and Outcome: A Case Series Study. Iran J Child Neurol 2015 Summer;9(3):69-72.2. Sunderland S. Miscellaneous causes of nerve injury. London: Churcill Livingstone; 1991.3. Lehmann HC, Zhang J, Mori S, Sheikh KA. Diffusion tensor imaging to assess axonal regeneration in peripheral nerves. Exp Neurol 2010;223(1):238-44.4. Takagi T, Nakamura M, Yamada M, Hikishima K, Momoshima S, Fujiyoshi K, et al. Visualization of peripheral nerve degeneration and regeneration: monitoring with diffusion tensor tractography. NeuroImage 2009 ;44(3):884-92.5. Barry JM, Harsh V, Kumar A, Patil S. Injection nerve palsy: What’s to blame? J Neurosci Rural Pract 2013;4:481.6. Greensmith JE, Murray WB. Complications of regional anesthesia. Current opinion in anaesthesiology. 2006;19(5):531-7.7. Barry JM, Harsh V, Patil S. Are our intramuscular injections nerve-friendly? What are we missing? Simple techniques to prevent, recognize and manage nerve injection injuries. Int J Stud Res 2014;4(2):25-8

Clinicopathological Correlates in a PRNP P102L Mutation Carrier with Rapidly Progressing Parkinsonism-dystonia

Parkinsonism-dystonia is rare in carriers of PRNP P102L mutation. Severity and distribution of prion protein (PrP) deposition may influence the clinical presentation. We present such clinic-pathological correlation in a 56-year-old male with a PRNP P102L mutation associated with a phenotype characterized by rapidly progressing parkinsonism-dystonia. The patient was studied clinically (videotaped exams, brain MRIs); molecular genetically (gene sequence analysis); and neuropathologically (histology, immunohistochemistry) during his 7-month disease course. The patient had parkinsonism, apraxia, aphasia, and dystonia, which progressed rapidly. Molecular genetic analysis revealed PRNP P102L mutation carrier status. Brain MRIs revealed progressive global volume loss and T2/FLAIR hyperintensity in neocortex and basal ganglia. Postmortem examination showed neuronal loss, gliosis, spongiform changes, and PrP deposition in the striatum. PrP immunohistochemistry revealed widespread severe PrP deposition in the thalamus and cerebellar cortex. Based on the neuropathological and molecular-genetic analysis, the rapidly progressing parkinsonism-dystonia correlated with nigrostriatal, thalamic, and cerebellar pathology

Determinants of Recurrent Diarrhoea among Children

BackgroundAbout 2 million episodes of diarrhoea occur each year in India. Of the 6.6 million deaths among children aged 28 days to 5 year; deaths from diarrhoea are estimated to account for 1.87 million. An average Indian child less than 5 years of age can have 2-3 episodes of diarrhoea.  Mother's literacy, family income, feeding practices, environmental conditions are important determinants of the common childhood infection like diarrhoea. The present study was undertaken to study these important determinants of recurrent diarrhoea among children under five in a rural area of western Maharashtra, India.Method  A cross-sectional study was conducted in six randomly selected villages of Ahmednagar district in western Maharashtra, India. Three villages from two primary health centres and 652 children under five from these villages were chosen by a simple random sampling technique (every fifth child enrolled in Anganwadi). House-to-house survey was done and data was collected by interviewing the mothers of these children. Nutritional status was assessed by measuring the weight and mid-arm circumference of the child. Statistical analysis was done with Microsoft Excel and StatistiXL 1.8 using percentage, proportions and chi-square test wherever applicable.ResultsThe prevalence of recurrent diarrhoea was 9.81%. Recurrent diarrhoea was more common in the age group of 13 - 24 months (29.6%) and 25 – 36 months (23.4%) and children belonging to lower socioeconomic class (64%). Malnutrition was significantly associated with recurrent diarrhoea and 21% of malnourished children had the same. Recurrent diarrhoea was significantly more common (39.1%) among children with introduction of top-up feeds before four to six months.ConclusionLow socioeconomic status, bad sanitary practices, nutritional status and weaning practices significantly influence the prevalence of recurrent diarrhoea

Shprintzen-Goldberg syndrome presenting as umbilical hernia in an Indian child

Shprintzen-Goldberg syndrome (S-G) is a rare connective tissue disorder characterised by craniosynostosis, craniofacial dysmorphism, skeletal, cardiovascular, neurological, and other abnormalities. We herein present a case of a 5-year-old Indian child who presented to our clinic with reducible umbilical hernia since birth, mental retardation, and delayed developmental milestones. After meticulous clinical examination with subsequent integration of clinical findings and investigations, we diagnosed her to possibly have Shprintzen-Goldberg syndrome. An attempt to compare the findings of our index case with the classical features as described by Greally et al. has been made. Given the rarity of this syndrome and the paucity of medical literature measuring the magnitude of this condition in the Indian population, this case serves to promote awareness of this rare entity

Pattern of injury in fatal road traffic accidents in a rural area of western Maharashtra, India

BackgroundFatal road traffic accidents (RTA) are a major cause of concern all over the world. The outcome of injuries sustained in an RTA depends on various factors including but not limited to: the location of the event, type of vehicle involved, nature of the roads, the time of accident, etc. AimsThis study aims to investigate and evaluate prospectively the socio-demographic profile and pattern of injuries in victims of  RTA in the rural area of district Ahmedanagar of Maharashtra state. MethodThis prospective study included all victims of road traffic accidents that presented to our emergency room from 1st June 2007 through 31st May 2009 and were either found dead on arrival or died during the treatment. All the included victims were autopsied at the post-mortem centre of Rural Medical College, Loni. ResultsNinety-eight victims of RTA were studied during the period. The most commonly affected age group was 20-39 years. Men died in RTA more than women. Fatal RTAs were more prevalent on the secondary road system (47.97 per cent) and especially involved pedestrian and two wheeler vehicle users. Large numbers (n=63, 64.28%) of victims either died on the scene or during transportation. Numbers of skeletal injuries (199) and internal organ injuries (202) exceeded the total number of victims (98) clearly indicating the multiplicity of injuries. The majority of RTA victims (n=46, 46.93%) died due to head injury. The study showed that most of the deaths in road traffic accidents, brought to a tertiary care rural hospital, took place either on the spot or within 24 hours of injury which is very alarming and highlights the need for taking urgent steps for establishing good pre-hospital care and provision of trauma services at site.ConclusionThere is an urgent nationwide need of computerized trauma registry to bring out the risk factors, circumstances, chain of events leading to the accidents and will be extremely helpful in policy making and health management at the national level in India

Anaemia and Pregnancy in Rural India

BackgroundAnaemia is the most frequently observed nutritional diseases in the world. In India, anaemia is the second most common cause of maternal death, accounting for 20% of total maternal deaths. This study aims to determine the prevalence of anaemia and to explore factors associated with anaemia in one rural Indian pregnant population.Method  The study was conducted in the Maternity Clinic of Pravara Rural Hospital (PRH), Loni, Ahmednagar, Maharashtra, India... Only pregnant women who were 12-20 weeks of gestation were eligible for inclusion. Anaemia was classified as per the World Health Organisation (WHO) grading criteria. The diagnosis of anaemia was undertaken using the standard peripheral blood smear examination. Consenting participants were interviewed using a pre- structured, pre-tested questionnaire.ResultsThree hundred and ten subjects were enrolled, of whom 232 (74.8%) were found to be anaemic. The majority (50.9%) demonstrated moderate anaemia while mild and severe anaemia were recorded in 70 (30.17%) and 44 (18.9%) respectively. A highly significant association was found with the mother‘s age, educational and socio-economic status, religion, parity and Body Mass Index (BMI). Other factors such as family structure and size, dietary habits and attainment of menarche were not significantly associated with anaemia.ConclusionVery high prevalence of anaemia (74.8%) early in pregnancy is an indicator of the failure of WHO and national programmes aimed at reducing anaemia in this group. Those pregnant for the first time are at greatest risk of developing anaemia