Profile of fisting in term newborns.

BACKGROUND: Persistence of fisting of hands and cortical thumb is a predictor of abnormalities in development and dysfunction of the central nervous system, though this may be a normal finding in the immediate newborn period. AIM: To study the profile of fisting in early neonatal period. METHODS: Five hundred and fifty healthy term neonates were studied. Hand position was examined by a single observer between 24-48h of birth when the baby was awake and quiet. Complete fisting was defined as flexed fingers covering both proximal and distal palmer creases. If only the distal crease was covered, it was defined as incomplete fisting. Thumb position was observed as thumb by the side of the fingers, under the fingers and above the fingers. RESULTS: Of the total 550 babies, 338 (61.45%) had bilateral, 39 (7.09%) had right sided and 38 (6.91%) had left sided fisting and 135 (24.55%) had open hands. Of the 1100 hands, 669 hands (60.8%) had complete and 84 (7.63%) had incomplete fisting. "Cortical thumb" was found in 57% of fisted hands. There was no significant difference (p>0.05) in fisting according to the sex and weight of the babies. CONCLUSION: Fisting was a predominant hand posture among the babies (75.45%) but cortical thumb with bilateral fisting was seen in only 30% of babies.

Cefpodoxime - utility in respiratory tract infections and typhoid fever.

Cefpodoxime is a oral third generation cephalosporin active against most of gram positive and gram negative bacteria except Pseudomonas, B. fragilis and Entrococcous. Clinical studies have confirmed efficacy of cefpodoxime in acute otitis media, sinusitis and tosillopharyngitis. Twice daily administration and safety profile increases compliance and decreases failure rate. It has a role as switch over therapy from intravenous ceftriaxone in serious respiratory tract infections (RTIs). In areas where common respiratory pathogens show decreased sensitivity to penicillins and macrolides cefpodoxime can be used as empirical first line therapy in respiratory tract infections. It seems to be a promising molecule in pediatric typhoid fever because of its excellent activity against Salmonella species but clinical trials are limited.

Rickets: a cause of delayed walking in toddlers.

OBJECTIVE: Children with complaints of not able to walk were investigated for rickets by appropriate history, clinical examination, serum biochemistry and radiology. METHODS: Children more than 1 yr were included. Each child was evaluated keeping in mind the possible causes of delayed walking. Also each child was thoroughly examined and diagnosed by combination of clinical, radiological, biochemical findings and response to treatment. RESULTS: Out of forty-two non-walkers during the study period, 25 patients turned out to be affected by nutritional rickets (60%). On follow-up at 3 weeks of treatment, all 25 patients (100%) showed radiological and biochemical response. Five patients were lost to follow-up after 3 weeks of treatment. Seventeen patients started walking within 3 months of treatment. Two patients did not start walking even after complete biochemical and radiological resolution. Radiological resolution, with limiting factor being the healing of lower end of ulna, averaged 5 months. CONCLUSION: The study reveals that majority of ricketic non-walkers start walking within 2 to 5 months of appropriate treatment.

Plasmodium vivax malaria presenting with severe thrombocytopenia.

Haematological changes are common in malaria. Thrombocytopenia is a common finding in falciparum infection but rare in Plasmodium vivax. We report a case of 7-year-old male patient presenting with fever, petechial rash, and platelet counts of 6 x 10(9)/l due to Plasmodium vivax malaria.