No abstract

The upper limb malformations in association with congenital heart defects occurring as autosomal dominant disorder are seen in Holt-Oram syndrome. It is a very rare disorder which can be detected with early prenatal ultrasound checkups. Here we are reporting two cases of holt-oram syndrome

Background: Antimicrobials are the most common medications used in NICU. Most often they are prescribed as a part of treatment for sepsis. They are also administered empirically in neonates during their hospital stay even without sepsis. The western countries have moved from empirical approach to evidence based approach but the literature review in developing countries shows the prevalence of irrational prescription of antibiotics because of empirical approach which is driven by the economic constraints of the patients. Objectives: To study the pattern of antimicrobial (AMA) drug use in neonates admitted to NICU. Methods: This is a retrospective observational study conducted in a tertiary care hospital in south India. The data was collected retrospectively and all the neonates treated with antibiotics were included in the study Results: Out of the 102 neonates admitted 76 (74.5%) received antibiotics. 52.6% of the neonates were term and 47.3% were preterm. Amikacin (93.4%) followed by Cefotaxime (68.4%) and Ampicillin (31.6%) were the most common antimicrobials used. 52.6% did not respond to first line of antibiotics whereas only 47.4% responded to first line drugs. Conclusion: Majority of the infants (75%) admitted in the NICU received antibiotics during their course of treatment. Greater number of Preterm neonates received antibiotics in comparison to Term neonates. There is decrease in susceptibility of organisms to first line antibiotics leading to exposure of neonates to multiple (>2) antibiotics. Key Word: antimicrobial pattern.

Introduction: Dengue is the most rapidly spreading mosquito-borne viral disease in the world.In India, there is increased proportion of Dengue cases with severe disease. Early recognition and prompt initiation of appropriate treatment are vital to reduce disease related morbidity and mortality. Objective: To study the clinical profile and outcome of hospitalized dengue fever cases in children during outbreaks. Methods: This is an observational prospective study conducted at tertiary care hospital. All children who presented with clinical features of dengue & dengue serology positive children were included in the study. Results: A total of 185 children diagnosed to have dengue fever were admitted in the hospital during the study period. The cases were classified according to WHO protocol as Dengue without warning sign (48.1%), Dengue with warning signs (27%) and severe dengue (24.8%). All the children had fever as the presenting complaint. The other predominant symptoms observed were vomiting (61.6%), abdominal pain (50.2%), rashes (30.2%), myalgia (24.3%), and bleeding manifestation (16.2%). The other significant findings noted were Hepatomegaly (52.4%), Ascites (47.01%), and pleural effusion (41%). Gallbladder wall thickness (80.4%) was the most common radiological abnormality. Mortality in this study was 1.08%. Conclusion: Children in the age group of 5-15 years were most commonly affected. Fever, Persistent vomiting, abdominal pain, Hepatomegaly, pleural effusion, were predominant presenting symptoms and signs. Early recognition, precise assessment and appropriate treatment with the help of WHO revised classification and management guidelines have reduced the mortality.

No abstract