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

Idiopathic calcinosis cutis of the scrotum: a case report and review of the literature

Abstract Background Abnormal deposition of calcium in the skin or subcutaneous tissue is termed calcinosis cutis. Idiopathic calcinosis cutis of the scrotum is an uncommon entity. The pathogenesis of idiopathic calcinosis cutis of the scrotum is debatable. The condition presents as several brown to yellowish nodules on the scrotum, gradually progressive, and mostly asymptomatic. Here we report a case of idiopathic calcinosis cutis of the scrotum with a brief review of the literature and a discussion on pathogenesis. Case presentation A healthy looking, 50-year-old Nepali man presented with multiple growths on his scrotum for 15 years, which were mostly asymptomatic with an occasional complaint of itching. On physical examination, multiple pink to brown nodules ranging in size from 0.5 × 0.5 × 0.5 cm to 3 × 3 × 1 cm, which were painless and firm in consistency, were noted. On laboratory examinations the following were found to be within normal limits: serum calcium, phosphorus, parathyroid hormone, and vitamin D hormone levels; uric acid; alkaline phosphatase; and lipid profile. Based on clinical features and laboratory reports, a diagnosis of idiopathic calcinosis cutis of the scrotum was made. The nodules were excised under local anesthesia in several sittings, which gave a good cosmetic result with no evidence of recurrence in 1-year follow-up period. A histopathological examination revealed dermis with areas of fibrosis and calcification along with numerous multinucleated giant cells and an absence of any cystic structure. Conclusions Idiopathic calcinosis cutis of the scrotum is a benign condition, which remains mostly asymptomatic. It presents as progressive multiple nodules of varying numbers and sizes. A histopathological evaluation reveals areas of calcification. The cause is either dystrophic calcification of cysts or idiopathic. Excision is the treatment of choice

Unusual Vascular Anatomy in a Human Cadaver

During the routine dissection in the Department of Anatomy of Rural Medical College, Loni, we found a rare variation in branching pattern of common carotid artery (CCA) and external carotid artery (ECA) bilaterally. The knowledge of possible anatomical variations of CCA and ECA are especially important in surgery of head, neck and face; and also for radiologist to understand and interpret cerebral angiography. The case is reported here and the clinical significance of this variation is emphasized

ENT Disorders- a Study from Rural India

BackgroundThere is a lack of data on paediatric otorhinolaryngology from various Indian populations. This study was undertaken to determine the hospital prevalence of ENT disorders in paediatric population and their relationship with sociodemographic factors in a rural tertiary care hospital in India. Method  A record based, retrospective study conducted at Rural Medical College and Pravara Rural Hospital, Loni which provides tertiary level health care facilities in western Maharashtra, India. The entire paediatric patients reporting to the Outpatient Department of ENT (Ear Nose Throat) during the calendar year 2009 was eligible for inclusion.ResultsENT diseases in our study population were found to be more common among male children (53.2%). Majority of the paediatric patients belonged to age group 5-14 years (66.3%), were from lower socioeconomic status (61.2%), living in nuclear family (71.3%) and had illiterate mothers (70.8%). Diseases of auditory system (57.3%) were the most common group of ENT problems among the paediatric population, followed by pharyngoesophageal (27.4%) and nasal (15.3%) disorders. The most common ear, nose and throat disorders were otitis media (18.25%), rhinitis (5.8%) and tonsillitis (11.7%) respectively.ConclusionThe study suggests that otitis media, tonsillitis and rhinitis are the most common otorhinolaryngological problems in paediatric population visiting the ENT department of this hospital and contribute significantly to paediatric morbidity. The results from this study cannot be applied to the community as prevalence of these morbidities is likely to be even higher in the general population.