Pankaj Garg

Acanthameba meningitis with successful outcome

We report a rare cause of sub acute meningitis in a 15-yr-old immunocompetent female child with successful outcome. The etiological agent was Acanthameba. The child was sucessfully treat with combination of Ketoconazole. Rifampicin, cotrimoxa zole and for a period of 9 month.

NICU in a community level hospital

Objective: To study the clinical profile and outcome of neonates in NICU of a community hospital and highlight the importance and problems in neonatal care at a community level hospital.Methods: Retrospective analysis of case records during the period Jan. 2001–Dec. 2003. Data regarding antenatal care, maternal morbidity, place of birth, age at admission, birth weight, gestational age, diagnosis, relevant investigations, duration of stay and outcome were recorded on a preset proforma. A cost analysis for average expenses per newborn per day for different morbidities was also done. Neonatal data was analyzed among survivors and expired using approapriates statistical tests. Probability of less than 5% was taken significant. Factors found significant on univariate analysis were subjected to logistic regression model to study independent predictor of fatality.Results: A total of 168 neonates were admitted during the study period. The overall survival rate was 65%. 42(25%) neonates expired and 5.4% were referred to higher centers. The commonest morbidity in survivors was hyperbilirubinemia. Prematurity with HMD and neonatal sepsis were the commonest cause of mortality. 36(24.3%) expired within 48 hr of admission (Mean 33.2 hr). 31(17.8%) could not be referred and none survived. The difference of birth weight, gestational age and duration of stay was statistically different in survivors & expired. These variables retained their significance on multivariate analysis and thus were independent predictors of fatality. An average expense of Rs 400–500/day/newborn was charged in the NICU.Conclusion: In a country of limited resource 65% neonates requiring NICU can be managed at community level hospitals.

Infantile colic — Unfolded

Infantile colic is a common complaint for which mothers bring their babies to pediatricians. Though the condition has been a cause of controversy and a subject of extensive research, no consensus is yet reached on its definition, etiopathogenesis and management. This article reviews the existing literature on present subject.

Unusual presentations of Salmonella Typhi infections in children

We report on three children with Salmonella typhi presenting with fever and urticaria, thrombocytopenic purpura and meningitis. We suggest that clinicians should consider S. typhi infection as a diagnosis even when the presenting features are more typical of other illnesses.

Weaning advice to mothers: a point to ponder over.

Weaning is the most critical period for the growth of the child. This is the time when growth faltering and nutritional deficiencies manifest in children. Despite significant efforts of the national nutritional policy and reproductive and child health programme of the Government of India community intervention and education efforts in mothers have a long way to go. Also there have been laudable and praiseworthy efforts by the Government in enacting the Infant Milk Substitutes Act prohibiting the promotion of the food products as weaning foods. (excerpt)