Background Hypertensive disorders of pregnancy lead to pathological changes in various organ systems of mother and fetus which contributes to maternal and fetal morbidity and mortality. It is a multisystem disorder which can involve end organs like kidneys, liver, eyes, hemopoietic system and placenta. Retinal involvement, though quite common, is rarely investigated. It is a unique site where the blood vessels can be directly observed. Observing retinal vasculature may provide clue to status of similar vessels in other parts of body including placental circulation. Methods Hospital-based descriptive study which included 150 patients diagnosed as preeclampsia/eclampsia, who were admitted in the intensive care unit. Written consent was obtained from study subjects. Data were collected by history taking and examination of the subjects using pre-structured questionnaire. Ocular examination was carried out by ophthalmologist, which included anterior segment examination, visual acuity and dilated fundus examination. Multiple qualitative and quantitative parameters were studied. Data were analyzed by SPSS 14.0 software. Results Ocular symptoms were seen in 22% of severe preeclampsia and in 100% of eclampsia patients. Blurred vision was the most common ocular complaint. Fundus changes were seen in 48.7% total study subjects. Arteriolar narrowing was the most common finding on fundus examination. Systolic blood pressure and serum creatinine were found predictive of changes in fundus (p = .000). Incidence of fetal growth restriction was found to be significantly associated with fundus involvement (p value .000). Conclusion Ophthalmic examination including fundus examination should be a routine in the investigational armamentarium of hypertensive disorders of pregnancy.
Tick paralysis is an uncommon, noninfectious, neurologic syndrome characterized by acute ataxia and ascending paralysis mostly seen in children. Early recognition and prompt management with tick removal helps in complete recovery. If untreated, ascending paralysis can lead to respiratory failure and death in 10% of the cases. Tick paralysis is usually considered as a differential in all cases of acute ataxia and generalized weakness in children and adults but seldom in neonates due to its rarity and differences in clinical presentation in the newborn period. In neonates, tick paralysis may present only as generalized weakness and lethargy with poor feeding. Even though tick paralysis is common in children <10 years of age, it has never been reported in a neonate. We report a case of tick bite paralysis in a baby who presented in the neonatal period, and identification of the tick and its removal that helped in rapid recovery.
Absence of the breast tissue is the least frequent of all the congenital breast anomalies. Amastia can be unilateral or bilateral and may have a syndromic association. Isolated congenital unilateral amastia is a very rare condition that is often misdiagnosed as Poland syndrome. Poland syndrome is a disease more common among males and often associated with other limbs, chest wall, and other digits anomalies, which makes surgical correction more tedious. Unilateral amastia in the absence of other anomalies may have a different etiology, and hence, it is worthwhile to explore other causes for the same. Herein, we present a rare case of a newborn with congenital unilateral right-sided amastia born through cesarean section in view of breech presentation.
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