Background and Aims: Subclinical Vitamin B12 deficiency is a very common entity in the Indian subcontinent with devastating clinical and socio-economic consequences. The objective of this study was to estimate the proportion of vitamin B12 deficient children and to evaluate their clinical profile. Setting and Design: This prospective analytical study was conducted in a tertiary level care institute in Northern India. Materials and Methods: Children with clinical pallor, were included in this study. Detailed history, height, weight percentiles and characteristic features of vitamin B12 deficiency were recorded and complete blood counts, mean corpuscular volume and vitamin B12 levels were done. Statistics: For Qualitative data was analyzed using Pearson Chi square tests and quantitative data was analyzed using two sided independent samples t tests. Results: A total of 111 children were included. 64.8% ( n = 72) had vitamin B12 deficiency. Lethargy (63.9%) and weight loss (62.1%), Knuckle pigmentation were common features. One-fourth of the children were on vegetarian diet. Neurological manifestations were significantly associated with fragile hair ( p 0.056) and knuckle pigmentation ( p 0.027). Younger children had more weight loss ( p 0.001), knuckle pigmentation ( p 0.019) and hypotonia ( p 0.045). One fifth of children presented with neurological manifestations. Conclusions: Two-thirds of the anemic children had vitamin B12 deficiency. There was a bimodal age distribution with regard to B12 deficiency. Neurological manifestations were predominant in younger children [<6] and hematological abnormalities were more frequent in older children [≥6 years]. Estimation of vitamin B12 levels forms an essential component while evaluating children with anemia, despite mixed dietary habits and normal MCV.

Oro-facial-digital syndrome (OFD) is a disorder with varied inheritance patterns. They deal mainly with abnormalities of the face, digits, i.e., fingers and toes, and oral cavity. Hypoplasia of nasal alar cartilage, broad nasal bridge, frontal bossing, and micrognathia are the common facial abnormalities observed in its multiple potential forms. Among the oral features, lobulated tongue, multiple frenulae, and cleft lip/palate are the common findings. The subject presented in our case manifested cleft of the hard palate at the time of presentation, along with other diverse features, which could not match any of the defined OFD types in literature. Furthermore, follow-up of the infant observed closure of the palate spontaneously, without any intervention. Hence, the purpose is to add to the knowledge the typical features of this unspecified type of OFD, along with this unique unprompted cleft palate closure, which aroused the need of close watch in such cases.

BACKGROUND The aim of this study was to evaluate the incidence and pattern of tuberculosis in bronchial asthma patients receiving inhalational corticosteroid therapy by MDI. MATERIALS AND METHODS Eighty-four patients taking MDI steroid for bronchial asthma and seventy-eight patients suffering from similar disease but not receiving MDI steroids were followed up for twenty months to study the incidence and pattern of tuberculosis. RESULTS Five patients (5.5%) receiving MDI steroid developed tuberculosis as against none among the control (p<0.05). Out of five patients, who developed tuberculosis, two developed sputum smear positive pulmonary disease, one had sputum smear negative disease and two had extra pulmonary tuberculosis in form of pleural effusion and gland tuberculosis one each. All patients were treated with standard antituberculous therapy using RNTCP guidelines and all patients recovered from the disease. CONCLUSION Inhalational corticosteroid in the form of MDI causes a significant risk of incidence of tuberculosis.

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Short stature (SS) is defined as “height below the third percentile or less than two standard deviations below the median height for that age and sex according to the population standard”. Short stature is not itself a pathology or disease but sometimes may be present as a manifestation of some underlying pathological condition. This condition is seen to impact adversely on the psychological wellbeing of the affected individuals and gives rise to the social stigma which further worsens the quality of life of short-statured persons. Hence, there is a need to acknowledge and break this stigma thereby improving the psychological wellbeing of the short-statured population.