Introduction: Hepatitis A virus (HAV) is a common communicable disease acquired from feco-oral route. It is endemic in fast developing urbanization areas. Poor sanitation is making this disease stay despite good vaccine availability. It may present with a range of clinical manifestations, from asymptomatic infection to fulminant hepatitis. Aims : To study the clinical profile of children with Hepatitis A infection. Materials and Methods: It's a retrospective analysis of children having Acute HAV diagnosed by IgM hep A in 6 months to 12 years of age in last one year in tertiary care hospital. Clinical features, complications were studied. Results: 27 cases were enrolled in our study. Mean age was 6.5 ± 3.9 years out of 27 cases. Fever (92.6%), gastrointestinal complaints (59.3%) and lethargy (37%) were the common presenting symptoms. 12 patients (44.4%) presented with irritability and altered sensorium. Physical findings were hepatomegaly (96.2%) and jaundice (100%) in all children. More than 4-fold increase in level of Aspartate transaminase and Alanine transaminase were noted in almost all cases. Prothrombin time was deranged in 12(44.4%) cases. Serum Ammonia was raised in 8(27%) patients. 8 cases (27%) developed fulminant hepatic failure out of which 2 cases had co-infection with dengue, 1 case had a history of consumption of nimesulide and 1 case had chronic liver disease & 7 cases (25.9%) succumbed to death. Rest 20 (74.1%) recovered completely. Conclusion: Though hepatitis A infection is a self-limiting disease, presence of co-infection, underlying liver disease and consumption of certain drugs can cause severe complications. Hence, all cases should be followed up till complete recovery.

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In this communication, we report the case of a one and a half month old baby boy with de novo duplication at the distal end of chromosome 7p who visited our facility at SSKM Hospital. The clinical manifestations associated with duplication at the end of 7p are mostly delineated and in most cases result from in inheritance of parental chromosome harbouring a balanced translocation. In this study, we describe de novo duplication and review the previously published literature from other parts of the world dissecting the genotype- phenotype correlation in such cases.

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C-reactive protein (CRP) is an acute-phase reactant protein of hepatic origin1 that increases following interleukin-6 secretion by macrophages and T cells. Its levels in the body rise or fall in response to various pathological and physiological conditions. CRP is used mainly as a marker of inflammation and infection. Measuring and charting CRP values can prove useful in determining disease progress or the effectiveness of treatments. Aims and Objectives: 1.To estimate of CRP in suspected infections at the time of admission and after 48hrs 2. Correlate CRP values with respect to suspected infection among children reporting in the Paediatrics/NICU; OPD and IPD.3.To find association of CRP levels with possible neonatal sepsis. Material and Methods, Study Design: It was a descriptive, prospective, observational, clinical, correlative study. STUDY SITE: The study was conducted at MGM Hospital, Kamothe and Kalamboli, Navi Mumbai. It's a tertiary care hospital situated at 50 kms from the city of Mumbai. Methodology: Each paediatric patient who came to MGM Hospital was initially categorized according to age till 2 months of age. Neonates were graded according to the signs and symptoms of FIMNCI. FIMNCI considers bacterial infections in young infants when signs or symptoms of sepsis, pneumonia or meningitis are present. Results: A total 59 cases were enrolled in the study in which infection was suspected at the time of admission based on the category in IMNCI/FIMNCI for suspicion of infection. Out of these, 50 cases were successfully followed up to 48 hours as was aimed at the beginning of the study and 9cases failed to complete a 48 hour study period due to various reasons. Majority of babies had shown positivity in HS-CRP at admission (43/50) as well as after 48 hours (46/50). Neonates were further categorised in 3 groups depending on clinical improvement and fall or rise of Hs CRP level was studied. It was seen that Hs CRP levels have decreased in group which had shown clinical improvement, however in both other groups it was showing rise. We have calculated independent t-value also for each group and it was seen that change in Hs CRP values after 48 hours was significant. Conclusion: The study revealed that Hs CRP levels were increased in all cases of suspected neonatal sepsis. They remained high in neonates who had deteriorated or remained same clinically at 48 hours of follow-up. However, they significantly reduced in neonates showing clinical improvement.

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Neonatal outcomes of eclamptic mothers and their significance in a rural tertiary healthcare institution which caters mainly agro-based village population largely representing the typical pattern of socio-economic and demographic characteristics of rural India is important for follow up and early intervention . This prospective, cross-sectional, observational, epidemiological study was conducted in the departments of paediatrics and obstetrics of Burdwan Medical College Hospital, West Bengal from April, 2012 to March, 2013. The study comprised of newborn babies born to 100 consecutive mothers admitted with eclampsia or with pre-eclampsia but subsequently developing eclampsia along with those born to 100 consecutive non-eclamptic mothers ( considered as control ) with normal blood pressure. The non-eclamptic mothers were selected after statistically matching the socio-demographic and nutritional profile like religion, caste, age, socio-economic status, parity, body weight and height with those of eclamptic mothers. Mothers less than 28 weeks of gestation or suffering from essential hypertension, chronic illness, epilepsy or taking any drug with teratogenicity and those giving birth to twin babies or babies with gross congenital malformation were excluded from both the groups. Eclampsia among rural population of India still remains a significant risk factor for neonatal morbidities like preterm and low birth weight, intra-uterine growth restriction and birth asphyxia. Increased incidence of late preterm births is also significantly associated with eclampsia.

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Jarcho Levine syndrome is a rare genetic defect characterised by multiple malformation of ribs and vertebrae. The syndrome has been described in two major subtypes: Spondylothoracic dysostosis and spondylocostal dysostosis. Infants affected with this syndrome have higher rate of recurrent respiratory infections. We present here a case of 4 month old boy, born of 3rd degree consanguineous marriage presented to us with history of cough, cold and fast breathing. He had history of recurrent lower respiratory tract infections requiring mechanical ventilation and extensive intravenous antibiotics. Skiagram showed Scoliosis, crab like chest deformity with fusion of anterior 1st and 2nd ribs on the left side. A 2 dimensional high resolution chest tomography showed areas of consolidation in posterior segment of right upper lobe and apicoposterior segment of left upper lobe consistent with the clinical findings. There were D3 and D5 hemi vertebrae with D6, D7, D8 butterfly vertebrae and partial fusion of D4-D6 to D7-D8 vertebrae and fusion of posterior elements of D3-D4 vertebrae on left side.

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A 6 months old male presented with recurrent multiple, diffuse, brownish macula-papular lesions all over the body since 3 months. The lesions on gentle stroking showed appearance of wheal and erythema. Histopathological examination revealed collection of mast cells in upper dermis suggesting a rare condition of cutaneous mastocytosis.

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Comprehensive oral therapy has decreased the deaths in last 3 decades. ORS has reduced the need for intravenous fluids and consequently hospitalization. The cost of ORS is also low and is within the buying capacity of most people in developing countries. However, it cannot be used with intractable vomiting or diarrhea. It is of limited use in severe dehydration with circulatory compromise but can be given after stabilization with intravenous fluids. As "some" dehydration does not produce appreciable electrolyte imbalance there is no need of electrolyte estimation for initiation or follow up therapy with ORS solution. However, certain insights may improve efficacy and acceptance of suitable rehydration solution in developing world. The keeping quality of the solution after reconstitution in potable water at different temperatures and humidity is not calculated. For 75 mEq/L of sodium the glucose requirement will be 37.5 mmol/L as 2 atoms of sodium constitutes a molecule. The initial experiment of Sladden and Dawson points to the same. Freshly prepared rice pulp or puffed rice pulp is a better candidate to replace glucose and is time honouredly practiced by people. Research in this direction is scanty. The existing intraluminal sodium and water is not taken into consideration. Theoretically simple glucose solution will allow absorption of fluid as sodium is already present in Jejunum. Addition of resistant starch to ORS as it does not increase the Osmolarity significantly should be brought under the ambit of research. In ReSoMal the high amount of dextrose should be scanned for its effect on the gut as potassium does not need glucose for absorption. The high Potassium also should to be tested for acceptability.

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