No abstract

Persistent hyperinsulinemic hypoglycemia of infancy (PHHI) is one of the commonest reasons for severe, intractable hypoglycemia in neonates. Dysregulated insulin secretion is the major underlying pathogenesis which results in hyperinsulinemia, hypoketonemia and hypofatty acidemia. The management is extremely complicated. Early diagnosis and aggressive management of hyperinsulinemic hypoglycemia is essential for prevention of hypoglycemia induced neuronal injury. Here we describe a baby diagnosed as PHHI who was unresponsive to medical management with diazoxide and underwent near total pancreatectomy. Genetic work up revealed a homozygous termination mutation in ABCC8 gene at amino acid position 1452 with heterozygosity in both parents.

Introduction: When mother’s milk is not available, Infant Milk Substitutes (IMS) must be supplemented with medical advice. Human milk can be digested easily because of the whey protein present in it and which is less in other animal milk. Considering this fact the manufacturers have attempted to make IMS as close to breast milk. Aim: To compare the composition of different IMS with breast milk, and with international guidelines given by European Society of Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN). Materials and Methods: A cross-sectional study was performed between April to May 2020, at a tertiary centre in Puducherry, India. Total 11 whey protein containing IMS brands that were commercially available in the Indian market for children aged up to six months were included in the study. The IMS for preterm babies and those without whey protein like hydrolysed milk, IMS with soya bean extract were excluded from the study. The details of IMS was collected and compared. The composition of the IMS was taken from the information provided by the manufacturer. The data was entered in Microsoft excel and was analysed using statistical software Statistical Package for the Social Sciences (SPSS) version 20.0. Results: With respect to calories, protein, fats and vitamins all IMS met the requirements. Nucleotide content exceeded in 18.1%. Sialic acid was added in 9% IMS. Iron content is more than the ESPGHAN requirement in 9% IMS. Conclusion: All the IMS were almost within the range advised by ESPGHAN. The children who fail to gain adequate weight can be given the brands with more calories. Babies with features of iron deficiency, can be given Brand VIII. For parents who cannot afford to buy the IMS with smart nutrients, they can choose the basic IMS which are of low cost, but meets the requirements.

A comparison of the results of Bhattacharya and Roy (1981) on the case histories of Weiss and Sulleymankoy ore bodies of eastern Turkey, with those of Yungul (1950) appears to be erroneous. (3) and (4) the depths are functions of a and d, where d is the absolute difference of the potential between maxima and minima obtained at x1 and xz (d = Ixl -x2 I). We are at a loss to know how the authors would be able to

Background: Dengue fever (DF) has become a worldwide health problem. There are only a few studies assessing management based on the classification by the World Health Organization (WHO). Hence, we aimed at assessing the outcome of children with DF before and after the implementation of the WHO protocol. Subjects and Methods: A retrospective hospital-based comparative study was done in a tertiary care center, Puducherry, to study the outcome of children diagnosed with DF before and after the implementation of WHO management 2012 protocol in the year 2014. All children (0–14 years) who were diagnosed with DF (NS1Ag or IgM ELISA positivity) during 2012–2016 were included. Medical records with incomplete data were excluded. They were divided into two groups: Group I – Children admitted for treatment of DF between January 2012 and December 2013 (24 months) and managed by close clinical monitoring and Group II – Children admitted for treatment of DF between January 2014 and December 2016 (36 months) and managed as per WHO protocol. Results: There was no statistically significant difference in the signs of shock and mortality between the groups. There was statistically significant difference of children with fluid overload during the recovery phase in Group II when compared with Group I. Conclusions: Close clinical monitoring during the critical phase may reduce the signs of fluid overload during the recovery phase.