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Case Discussion on Neonatal Jaundice
Neonatal jaundice is characterized clinically by a yellowish discoloration of the skin, sclera, and mucous membrane and is caused by high total serum bilirubin (TSB). Unconjugated bilirubin's negative effects on the central nervous system are particularly dangerous for preterm infants and those born with congenital enzyme impairments. If left untreated, severe hyperbilirubinemia may produce acute and chronic bilirubin encephalopathy and bilirubin-induced neurological impairment.
About the Speaker
Dr Vishal Parmar
MBBS, DCH, MRCPCH Fellow in Neonatal Medicine PGPN Bostan Pediatrician Mumbai, India.
Approach to Case of Ataxia in Children
Ataxia in children is a neurological disorder characterized by impaired coordination, balance, and voluntary muscle movements. Ataxia is a term used to describe a group of disorders that affect the cerebellum, a part of the brain responsible for coordination and balance. There are various types of ataxia in children, including hereditary ataxias (genetic), acquired ataxias (due to injury or illness), and idiopathic ataxia (of unknown cause). Common symptoms include unsteady gait, tremors, difficulty with fine motor skills, slurred speech, and problems with eye movements. Hereditary ataxias often result from genetic mutations, while acquired ataxias may be caused by brain injuries, infections, or toxins. Diagnosis involves a thorough medical history, physical examination, neurological tests, and imaging studies like MRI or CT scans to assess the brain's condition. Management depends on the underlying cause. Symptomatic treatment may include physical and occupational therapy to improve motor skills and assistive devices for mobility. In cases of hereditary ataxia, genetic counseling is essential to assess the risk of passing on the condition to future generations. The prognosis varies based on the type and severity of ataxia. Some forms may be progressive, while others remain stable or improve with therapy.
Invasive Meningococcal disease and its prevention in children
Invasive Meningococcal Disease (IMD) is a severe infection caused by the bacterium Neisseria meningitidis, leading to potentially life-threatening conditions such as meningitis (inflammation of the brain and spinal cord membranes) and bloodstream infections. Symptoms often include high fever, severe headaches, neck stiffness, and sensitivity to light. Rapid medical attention is crucial due to the swift progression of the disease and its potential for serious complications. Preventive measures such as vaccines are important in controlling its spread.
Clinical approach to Cough in Pediatrics
When assessing and managing cough in pediatric patients, a systematic clinical approach is essential to identify the underlying cause and provide appropriate care. Begin by obtaining a detailed history, including the onset, duration, and characteristics of the cough, as well as associated symptoms. Recognize that the causes and management of cough can vary significantly with the child's age. Evaluate the severity of the cough and its impact on the child's daily activities, sleep, and feeding. Inquire about environmental factors such as exposure to tobacco smoke, allergens, or irritants. Verify the child's immunization status, as some vaccine-preventable diseases can cause cough. Review the child's medical history, including any previous respiratory conditions, allergies, or chronic diseases.
Transposition of Great Arteries : Clues on prenatal Diagnosis
Transposition of the Great Arteries (TGA) is a congenital heart defect in which the two main arteries, the aorta, and the pulmonary artery, are switched in their positions. Prenatal diagnosis of TGA is crucial as it allows for early intervention after birth. Routine fetal ultrasounds can provide the first clues. Suspicion arises when the normal cross over between the great arteries is not visualized. Blood flow patterns can be assessed with Doppler ultrasound. Other cardiac abnormalities might be detected during prenatal ultrasounds, such as a ventricular septal defect (VSD) often associated with TGA.
Clinical approach : Acute Myocarditis & Cardiomyopathy in Children
Acute myocarditis and cardiomyopathy are serious heart conditions affecting children. Myocarditis involves inflammation of the heart muscle, often triggered by viral infections. Cardiomyopathy encompasses various heart muscle diseases, including hypertrophic cardiomyopathy, the most common type in children. Symptoms may include chest pain, rapid heartbeat, fatigue, and swelling. Diagnosis involves tests like echocardiograms, and treatment varies based on the cause and severity, including medications, supportive care, and in some cases, heart transplantation. Early medical attention is crucial for better outcomes. Pediatric cardiologists play a vital role in managing these conditions in children.