Friday, October 17, 2014

Cracking the code of theory: Bronchiectasis

Second post in series" cracking the code of theory" ready to go online. The topic of Bronchiectasis is not only usefull in theory but in practicals as well.


About Dr Ranjith kumar CS
He is Currently persuing DM in medical oncology from JIPMER, completed DNB from Kanchi Kamakoti Child Trust Hospital with a GOLD MEDAL in his hand, has great academic interests and contributed about 9 chapters  in scott pediatriks clinical methods in 3rd edition as author and is one of the co-author at dnbpediatrics.com
Bronchiectasis a disease characterized by irreversible abnormal dilatation of the bronchial tree
Children with bronchiectasis (not due to cystic fibrosis), the male to female ratio was 2 : 1.

Etiology and Pathogenesis:

Infections:
Bordetella pertussis, measles, rubella, togavirus, respiratory syncytial virus, and Mycobacterium tuberculosis

Non –Infectious :
Ciliary dyskinesia, immune deficiency syndromes

Congenital:
1. Williams-Campbell syndrome, in which there is an absence of annular bronchial cartilage

Saturday, October 11, 2014

Neonatal hypoglycemia: Sugar them up

By Ajay Agade
Neonatal hypoglycemia is a common disorder and in fact an emergency in neonates considering the devastating ill effects of hypoglycemia on neurological outcomes ranging from severe neurological dissability like seizure to social morbidity of scholastic backwardness. 

Even a single episode of asymptomatic hypoglycemia which might have been unnoticed may put the neoante at risk for developing long term neuro- developmental  sequelae and hence should be urgently treated. 

In a series of 151 infants with neonatal hypoglycemia followed  for 1-4 years the occurrence of seizures as part of the neonatal neurological syndrome was associated with  a clearly abnormal outcome in 50% and with transient neurological abnormalities an additional 12%.
Koivisto M, Dev Med Child Neurol. 1972; 14(5): 603-614.
A recent Indian study by Udani and co-workers has concluded that neonatal hypoglycemia is the most common etiology of remote symptomatic infantile onset epilepsy
Udani V. Indian Pediatr 2009; 46: 127-131
During residency rotation in Neonatal ICU,s or Nurseries, one should know how to suspect neonatal hypoglycemia by identifying high risk babies, identify the possible symptoms in those symptomatic babies, and know by heart how, at what threshold should we treat them, for how long, and what all work up do we need to send to arrive to the diagnosis of hypoglycemia.

Monday, October 6, 2014

Cracking code of theory: Chelation therapy

Hi all, as promised this is the first post in series " cracking the code of theory" Begining with a very common question asked in theory exams on iron chelation.


Iron overload results from:
1. Ongoing transfusion therapy
About Dr Ranjith kumar CS
He is Currently persuing DM in medical oncology from JIPMER, completed DNB from Kanchi Kamakoti Child Trust Hospital with a GOLD MEDAL in his hand, has great academic interests and contributed about 9 chapters  in scott pediatriks clinical methods in 3rd edition as author and is one of the co-author at dnbpediatrics.com

 2. Increased gut absorption of iron

 3. Chronic hemolysis.

Extra iron should be removed to prevent organ damage
1.      Bound to transferrine &  Ferritine
2.      NTBI (unstable) (Non chelatable) Fe+3------ >Fe+2 (chelatable) ----->Produces
 Free Radical ----->Damage to body tissues (Liver,Heart)
1ml RBC=1.16mg of iron