Correlation of Platelet Parameters With the Severity of Thrombocytopenia in Dengue Fever in Children Aged Less Than 18 Years at a Tertiary Care Centre: A Cross-Sectional Study.

Introduction Dengue is a tropical viral disease caused by dengue virus with varied severity ranging from dengue fever to dengue shock syndrome. In dengue infection, there is thrombocytopenia with platelet activation. According to various proposed theories, activation of platelets during thrombocytopenia leads to changes in platelet parameters like mean platelet volume (MPV), platelet distribution width (PDW), plateletcrit (PCT), and platelet index (PI). So, this study was conducted to correlate platelet parameters with the severity of thrombocytopenia in children with dengue fever at a tertiary care hospital.  Methods An observational cross-sectional study was conducted on 72 children below 18 years admitted with dengue infection at a tertiary care hospital. All 72 patients were divided into three groups depending on platelet count. Group I included individuals with a platelet count less than 50000/mm3, while group II comprised patients with platelet counts ranging between 50001/mm3 and 100000/mm3, and group III encompassed individuals with platelet counts exceeding 100001/mm3. Platelet parameters like MPV, PDW, PCT, and PI were analyzed on day one and day three of admission. These parameters on day one and day three were correlated with the severity of thrombocytopenia in all three groups. Results PCT values on day one and day three were statistically significant (p<0.05) in all three groups with p-value <0.001 with profound positive correlation, which means PCT value decreases with increasing severity of thrombocytopenia. PI in group I was statistically significant on day one (p=0.009) but not on day three (p=0.063). PI in group II was statistically significant (p<0.05) on day three (p=0.002), while in group III, PI was significant statistically on day one (p<0.001). MPV in group I, on day one (p=0.006) and in group II, on day three (p= 0.049) were statistically significant (p<0.05). PDW was statistically significant only on day one (p=0.031) in group I, while was not significant in groups II and III. Conclusion MPV, PDW, and PCT increase with a decrease in platelet count, whereas there is an increase in PI. These platelet indices could be used to predict the severity of thrombocytopenia and severity of the dengue fever. Along with MPV and PDW, PCT could be used to assess the severity of the disease progression.

Orocfacial digital syndrome type II -- Mohr's syndrome.

Orofacial digital syndromes are a heterogeneous group of rare malformative diseases, characterised by abnormalities of the oral cavity, maxillofacial region and digits. Orofacial digital syndromes are classified into ten types with orofacial digital syndrome type II, Mohr's syndrome being transmitted as autosomal recessive disorder. Here a case of a full term, female, born by lower segment caesarean section weighing 2.800 kg with respiratory distress, cyanosis, poly and syndactyly is reported.

Breastfeeding programme--right policy, wrong target?

To assess the knowledge of breastfeeding management among obstetriciansand the practices being followed in their hospital, 50 obstetricians in private practice in Nagpur, responded to questionnaires having 6 points covering the entire gamut of common issues regarding breastfeeding. All believed that breast milk is best for the baby. It was found that knowledge about various aspects of breastfeeding management is very poor. Unawareness about the adequacy of colostrum for a full term appropriate for date baby was almost universal. While the policy of promoting breastfeeding every year through public programmes is appropriate, the question is who should be the target? Prospective mothers or obstetricians? It is obvious from this study that obstetricians have significant educational needs in the area of breastfeeding management.