Subclavian artery supply disruption sequence-Klippel-Feil and Mobius anomalies.

Fetal vascular disruptions can cause specific patterns of birth depending on the location, extent and timing of the disruptive event in the embryonic life. An example of this is subclavian artery supply disruption sequence occurring around 6 weeks of gestation which causes various combinations of Poland, Klippel-Feil and Mobius anomalies. A one-month-old child with features of all three anomalies along with other associated features is described here.

Measles outbreak in a Periurban area of Chandigarh: need for improving vaccine coverage and strengthening surveillance.

OBJECTIVE: An outbreak of measles was investigated in the periurban areas of Chandigarh Union Territory, during the months of December 1998 to February 1999. Mainly the children below 15 years of age were affected. The children of migrant labourers belonging to the neighbouring states of Uttar Pradesh and Bihar constituted the majority of population in the area under study. They belonged to lower socio economic status with low immunization coverage. METHODS: A total of 2968 houses were surveyed for epidemiological investigations in the areas of colony No. 5, Ramdarbar, Palsora and Pandit colony of Kajheri, covering a population of 14,601 and 7.3% (216/2968) of families were affected in the outbreak. RESULTS: Two hundred and eighty three cases of measles were reported with an attack rate of 4.5% and male to female ratio of (M:F) 5.3%:3.6%. Among the measles cases, 48.8% had received measles vaccination. The outbreak was investigated by detecting measles specific IgG/IgM antibodies either in acute or convalescent serum samples or both. Due to inadequate surveillance system and containment measures, the outbreak was in full swing during the winter months. Measles related complications were reported in 31.1% cases (i.e. diarrhoea in 15.2% and Pneumonia is 7.1%). CONCLUSION: Following smallpox and guinea worm eradication, WHO's next thrust, is on eradication of poliomyelitis and measles. Hence, strengthening of disease surveillance as well as vaccination policies are mandatory to achieve disease control in these areas.

Cutaneous manifestations of hydroxyurea therapy in childhood: case report and review.

Hydroxyurea is commonly used in the treatment of various myeloproliferative disorders. In conventional pediatric clinical practice, its use is limited to benign hematologic conditions such as sickle cell disease and thalassemia. Long-term hydroxyurea use is associated with various adverse mucocutaneous effects including hyperpigmentation, alopecia, leg ulcers, and lichenoid eruptions. We report a 10-year-old boy with chronic myelogenous leukemia who presented with hyperpigmentation of the skin and nails 3 months after the start of hydroxyurea therapy. Melanonychia of all 20 nails with involvement of all three mucocutaneous areas (skin, nails, and mucosa) at presentation was a unique feature in our patient. With the recently increasing pediatric use of hydroxyurea in a variety of disorders, its benign and not so uncommon cutaneous adverse effects are emphasized here.

Management of hemophilic pseudotumor of thumb in a child.

A case of hemophilic pseudotumor of the thumb in a child is reported. Combined treatment with radiation therapy and factor VIII replacement resulted in complete resolution of the lesion with no recurrence at the 6-month follow-up. The combination of radiotherapy and factor replacement should be strongly considered in the treatment of bone pseudotumors in children.