Incontinentia pigmenti is rare X-linked dominant disorder. There is no consistent expression of Incontinetia pigmenti in female child, but in male child, they always lead to death in utero. Vesicular, verrucous, hyperpigmented, and atrophic stages are the four stages of Incontinetia Pigmenti and it is uncommon for all stages to be seen in a same case. It is a rare genodermatosis, with only very few cases of male child with Incontinentia pigmenti have been reported. Thus, we report this case due to its extreme rarity and the child showed all the first 3 stages on followup.

Ataxia means impaired co-ordination of voluntary muscle movement. It is a physical finding, not a disease and the underlying etiology needs to be investigated. It can be the patient’s presenting complaint or a component among other presenting symptoms. Cerebellar dysfunction or impaired vestibular or proprioceptive input to cerebellum can cause ataxia. Though there are several etiologies post infectious ataxia is the most common one in children. But other rare etiologies of ataxia should also be considered based on the clinical presentation. We try to emphasise on this point by presenting a case of post traumatic cerebellar ataxia – a rare entity in children.

Introduction:The importance of breast milk (BM) is unquestionable for any neonate. Our neonatal intensive care unit (NICU) does not have a human milk bank and depends entirely on the availability of mothers' own milk. Hence this quality improvement (QI) initiative was designed to improve expressed breast milk (EBM) usage.Objective: To increase the quantity of EBM in postnatal mothers, whose neonates were admitted in NICU on day-3 of life, from the baseline of 15ml per day to 60ml per day over an 8-week-period. Method:In our neonatal unit, we found many challenges faced by mothers in initiation and maintenance of breast feeding. This study involved systematic implementation utilizing QI strategies; baseline data were collected in the initial weeks and the important causes for less usage of BM were found using a fish bone analysis. Plan-do-study-act cycles were conducted to test change of ideas like counselling sessions and methods of milk expression with help of pamphlets, charts and videos. This series of changes led to increase in BM expression.Results: There were 48 deliveries during the study period of which 26 were included in study. Baseline data collection revealed that the average quantity of expressed mothers' milk intake per day was 15 ml, and use of other mothers' milk and formula feeds was 50%. Within the 8-week-period of implementation, average quantity of EBM improved _________________________________________ 1

Central diabetes insipidus, though uncommon in children, has varied causes, the commonest ones being genetic mutations, infiltrative disorders, infections. Isolated central diabetes insipidus is not one of the often encountered conditions in the pediatric practice. Here we report a case of 2 ½ years old female child who presented to us following history of polyuria for 2 months, who was confirmed to have central diabetes insipidus which was later evaluated to be secondary to Langerhans cell histiocytosis. Magnetic resonance imaging (MRI) and histopathological studies further helped in confirmation of the diagnosis. Langerhans cell histiocytosis is a rare, multifarious, and underdiagnosed hematologic disease in which isolated diabetes insipidus can be the sole presenting feature before other manifestations. Hence, this diagnosis could strongly be considered in the work up of central diabetes insipidus in children.

Background: According to the World Health statistics, in 2016 more than 100000 deaths were caused due to unintentional poisonings. Children are vulnerable due to their smaller body surface area, an inherent behaviour of negation, curiosity in exploring their surroundings, their initial phallic stage where they tend to put any objects they come across into their mouth.Methods: This study is a hospital based retrospective observational study where the records of all the children admitted due to poisoning, accidental or intentional from June 2012 to November 2018 were reviewed. All the children admitted due to food poisoning and idiosyncratic drug reactions were excluded from the study.Results: A total of 203 cases of accidental ingestion were admitted during the study period, of which the majority of the patients were male children. The age group varied from 5 months to 14 years. Majority of the accidental ingestions were due to kerosene (108), followed by insecticides (25) and cleaning agents (20).Conclusions: Poisoning in young children is unintentional and accidental; hence the introduction of safe child resistant containers should be encouraged in storing harmful chemicals. Knowledge about the chemicals, awareness about their hazardous effects and education of the care givers about safe storage would be the first step in the prevention of accidental ingestion. Establishment of a reporting system from all the health care centres and establishment of poison information system at all the levels is the need of the hour.