A total of 5726 blood specimens (from children aged 14 years and younger) were studied for the serological evidence of brucellosis. Ninety-three (1.6 per cent) showed diagnostic agglutinin titres with a geometric mean titre of 403 (SD +/- 547). Forty-three (59.7 per cent) blood specimens yielded the growth of Brucella melitensis. Thirty-nine patients (41.93 per cent) were shepherds, who constituted the major occupational group affected in the present series. More than 60 per cent of the patients had a history of both consumption of fresh goat's milk and close animal contact. The habit of consuming fresh goat's milk to obtain relief from chronic ailments was noted in nine patients. Seventy-three (78.49 per cent) were males and 20 (21.51 per cent) were females, with a male to female ratio of 3:1. The disease occurred mainly in the school age group (mean age 10.3 years). All the patients had an acute history of less than 2 months. Forty-nine (52.68 per cent) patients presented with persistent fever, 19 (20.43 per cent) with joint pain, and the rest with a combination of fever and joint pain with and without low backache, fever being the commonest complaint. One case presented with involuntary movements of limbs alone and the other with burning feet only. Pityriasis alba was the consistent physical finding, with fever in the majority of the patients. The major joint found to be involved was the knee (52.77 per cent). The synovial fluid obtained from the knee joint of five patients demonstrated Brucella agglutinins and also three grew B. melitensis. Eight patients presented with complications that included skin lesions (3), carditis (2), neurobrucellosis such as chorea (1), peripheral neuritis (1), and meningitis (1). Brucella melitensis biotype 1 was successfully isolated from the papular eruption of one out of three cases who presented with skin lesions. To our knowledge this is the fourth confirmed isolation of B. melitensis from skin lesions with brucellosis, reported in the literature. The cerebrospinal fluid obtained from the meningitis patient was positive for B. agglutinins. To our knowledge chorea of brucellar origin appears to be the first case reported in the literature. In 15 cases (16.13 per cent) brucellosis was suspected clinically whereas 78 (83.87 per cent) cases, only serological evidence of brucellosis confirmed the diagnosis. None of the cases relapsed. In our experience an initial combination therapy with a three-drug regimen followed by a two-drug regimen for a minimum of 6 weeks has been found to be effective in the prevention of a relapse.

Over the last few years there is a rise in use of button batteries in various toys and other electronic gadgets. Easy availability and small size of these batteries pose a significant risk of ingestion in small children. Button battery ingestion can lead to serious health hazards very rapidly. A case of button battery ingestion is presented in this paper.

Background: As children with diarrhoea are often prescribed antibiotics, it was decided to study the causative organisms. Rotavirus is a major cause of diarrhoea and diarrhoea related mortality in most parts of India. Rotavirus vaccine is available but expensive. According to the World Health Organisation (WHO) the vaccine should be used in areas where diarrhoea related under five mortality is around 10%. The situation in north Karnataka is not known. Objectives: To find proportions of rotavirus and nonrotavirus diarrhoea in children of north Karnataka and study the key clinical features of rotavirus diarrhoea. Study design and settings: Prospective observational study conducted in patients from the paediatric ward and outpatient department in a tertiary care hospital. Method: Children 1 to 36 months old, presenting with acute diarrhoea from July 2014 to May 2016 and fulfilling selection criteria were included. Demographic and clinical details were noted. Stools were collected within 24 hours and subjected to routine and microscopic examination, test for presence of reducing substance, bacterial culture and Rapid ELISA test for rotavirus using antigen detection micro-well ELISA kit by Premere Rotaclone. Results: A total of 168 children was recruited. Children positive for rotavirus ELISA were labelled as having rotavirus diarrhoea and comprised 52 (31%) of total, including 17 with mixed infection and 15% were bacterial culture positive. Most common age group affected was 7 to 18 months (79%). Male female ratio was same in rotavirus and non-rotavirus diarrhoea.

A 4years 6 months old male child born of non-consanguineous marriage presented with dysmorphic features excessive tearing from eyes. He had been operated for cleft palate. His development and birth history were normal. On examination, he had alopecia, epiphora, increased salivation, hypertelorism, low set ears, loss of eye lashes, bald tongue, oral leukoplakia, dystrophic nails, dental caries, loss of teeth, hypoplastic nipples, kyphosis and telangiectatic erythematosus.