A 4.5-month-old girl presented to us with continuous fever for 10 days and loose stools for 2 days. She received short courses of multiple oral antibiotics during this period however, was not relieved. Initial investigations were suggestive of urinary tract infection for which broad spectrum antibiotics were started. However, fever persisted even after 72 h of antibiotics. Blood counts showed persistently high total leukocyte count and increasing platelet count, along with high C-reactive protein. Consequently, a diagnosis of Kawasaki disease (KD) was suspected, which was supported by echocardiographic findings. After she received intravenous immunoglobulins, her fever subsided and lab parameters showed significant improvement. This case highlights an unusual presentation of KD in an uncommonly young age group without much clinical pointers except for persistent fever.

Tetra-Amelia syndrome is a very rare disorder characterized by the absence of all four limbs. “Tetra” is the Greek word for “four” and “Amelia” refers to the failure of an arm or leg to develop before birth. This syndrome can also cause severe malformations of other parts of the body, including the face and head, heart, nervous system, skeleton, and genitalia. Tetra-Amelia syndrome with diaphragmatic defects (pulmonary hypoplasia) in a newborn is extremely rare entity. We report a very rare case of Tetra-Amelia associated with congenital diaphragmatic hernia.

itamin D has been traditionally known as an anti-rachitic factor or sunshine vitamin. In 1922, Edward Mellanby discovered Vitamin D while researching a disease called rickets. Besides its pivotal role in calcium homeostasis and bone mineral metabolism, Vitamin D in the endocrine system is now recognized to subserve a wide range of fundamental biological functions in cell differentiation, inhibition of cell growth, and immunomodulation [1][2][3]. Vitamin D modulates the transcription of cell cycle proteins, which decrease cell proliferation and increase cell differentiation of several specialized cells of the body, namely, osteoclastic precursors, enterocytes, and keratinocytes [4,5].Vitamin D status during pregnancy appears to play a role in fetal skeletal development, tooth enamel formation, and general fetal growth and development [6,7]. The Vitamin D stores of the newborn depend entirely on the Vitamin D stores of the mother. If the mother is Vitamin D deficient, the infant will be deficient because of decreased maternal-fetal transfer of Vitamin D. Resurgence of prolonged exclusive breastfeeding has led to a coincident increase in the incidence of Vitamin D deficiency in infancy. Worldwide public health authorities recommend exclusive breastfeeding for the first 6 months of life for all infants. However, breast milk does not generally supply the adequate amount of Vitamin D [8] due to which, breastfed infants are at risk of Vitamin D deficiency [9].Infants who are breastfed but do not receive supplemental Vitamin D or adequate sunlight exposure are at an increased risk of developing Vitamin D deficiency or rickets [10,11]. Human milk typically contains Vitamin D concentration of 25 IU/L or less [12]. Thus, the recommended adequate intake of Vitamin D cannot be met with human milk as the sole source of Vitamin D for the breastfeeding infant; although, there is evidence that ABSTRACT Introduction: Vitamin D is essential for growing children and its deficiency may have a catastrophic effect on growing children. Various reports state that Vitamin D deficiency is widely prevalent in the Indian population including infants and children. Objective: The objective of the study was to assess the efficacy of 400 IU of oral Vitamin D3 supplementation for term healthy breastfed Indian infants. Materials and Methods: The prospective, double-blinded cross-sectional study included 100 newborns divided into two randomized groups, A and B through a computer-generated program. Group A received 1 ml (400IU) Vitamin D drops daily for 3 months along with the breast milk whereas the Group B was only breastfed. Serum Vitamin D, Calcium, and alkaline phosphatase levels were measured in both the groups at birth and 3 months follow-up. Results: At birth no significant difference was observed in the serum level of Vitamin D, calcium and alkaline phosphatase in both the groups; however, at 3 month follow-up visit the Group A babies who were supplemented with Vitamin D 400 IU/day had a significantly more Vitamin D level (27.61 ± 11.95 ng/...