Objective:To evaluate the treatment outcome of second line drugs used in directly observed treatment, short-course (DOTS)-Plus regimen under Revised National Tuberculosis Control Program (RNTCP).Materials and Methods:A prospective, observational study was carried out on multidrug resistant tuberculosis (MDR-TB) patients enrolled for DOTS-Plus regimen at TB and Chest Disease Department from January to December 2009. Demographic details, symptoms, sputum examination and adverse drug reactions were recorded in a case record form. Patients were followed up for 24 months. The data were analysed by Fisher's exact test and paired student's ‘t’ test.Results:Out of 130 patients, 51 (39%) were cured, 7 (5%) completed the treatment, 25 (19%) died, 30 (23%) defaulted and 17 (13%) failure. A significant increase in body weight (P < 0.0001) was observed at the end of the 24 months. Out of 89 patients with sputum culture conversion, majority (73) turned negative within first 3 months. Female gender (P < 0.05), conversion of sputum culture from positive to negative (P < 0.0001), and radiological improvement (P < 0.0001) were found to be positive predictors of a successful treatment outcome. While smoking habit (P < 0.05) and alcohol consumption (P < 0.05) were negative predictors of successful treatment outcome. Thirty five (26%) patients developed ADRs that required withdrawal of causal drug. The most common ADR was joint pain due to pyrazinamide (11) followed by neurological and psychiatric disturbances due to cycloserine (9).Conclusion:The treatment outcome of standardized regimen in MDR-TB patients was low. The long duration of treatment and defaulters are major challenges for a successful outcome.

Background: Congenital hypothyroidism is well known cause of prolonged unconjugated hyperbilirubinemia and appears to be associated with the delayed maturation of hepatic uridine diphosphate glucoronyl transferase enzyme activity. Methods: This is a prospective, longitudinal and randomized study 100 babies are taken consisting of all newborn, age less than 28 days, admitted to hospital with exaggerated physiological jaundice. Results: One case of congenital hypothyroidism in exaggerated jaundice based on raised TSH levels. Rest of the cases (99%) having normal TSH levels. One case (1%) having TSH level of 48µu/ml on D7 of life indicating congenital hypothyroidism. TSB of this baby is 21.3 mg%.  One baby is having TSH level of 30.4µu/ml on D3 of life which subsequently decreased to normal physiological limits on D7 of life. Conclusion: Though the present study is unable to make significant correlation between cause and effect relationship of neonatal exaggerated jaundice and congenital hypothyroidism, but as one case has diagnosed to be suffering from congenital hypothyroidism, TSH should be considered as a screening test for all babies suffering from exaggerated physiological jaundice besides the other predisposing factors responsible for causation of hypothyroidism. Keywords: Neonatal hyperbilirubinemia, Preterm, Congenital hypothyroidism

Background: The aim of the study was to study the clinical profile, laboratory parameters of enteric fever cases in pediatric age group. Methods: This was a prospective study carried on Pediatric patients aged 1 to 14 years with clinically suspected enteric fever (fever for 5 days or more with no primary focus on clinical examination) and proven either by positive blood culture or Widal test with significant titre (level of both H or O antibodies of 1 in 160 dilution or more by tube method) were enrolled in the study. Results: The mean white blood cell (WBC) count was 8256.32±1236.12 cells/cumm. Out of 100 patients, 73(73.00%) had WBC count within the normal range (4000-11000 cells/cumm). 3(3.00%) had leucopenia, while 24(24.00%) had leucocytosis. 4(4.00%) patients had thrombocytopenia Conclusions: Enteric fever is major cause of febrile illness in children (especially school going). Fever with abdominal pain, vomiting and diarrhea were major clinical manifestations. There was 100% sensitivity to ceftriaxone, which was highly effective as monotherapy. Keywords: WBC, Typhoid, Clinical profile.

Background: To study clinical presentations and complications of P. vivax malaria Methods: A prospective hospital-based clinical observational study was conducted on 100 patients under age of 14 years were enrolled in the study. Result: The most common presentation was fever followed by pallor. Among the total of 100 cases studied 2 cases died with a case fatality rate of 2%. Among the total of 100 cases studied 5 cases (10%) required ICU admission. Conclusion: P. vivax monoinfection tends to have severe complications in children. There is a need to review severity criteria for P. vivax malaria. Keywords: Vivax, Fever, ICU