Dental Treatment of a Child Suffering from Non-bullous Congenital Ichthyosiform Erythroderma under General Anesthesia

Non-bullous congenital ichthyosiform erythroderma (NBCIE) is an autosomal recessive form of inherited icthyosis appears as fine white scales that gradually replace collodion membrane. This case report describes management of 5 years and 11-month-old child with NBCIE suffering from early childhood caries (ECC) under general anesthesia. How to cite this article: Choudhary R, Satish V. Dental Treatment of a Child Suffering from Non-bullous Congenital Ichthyosiform Erythroderma under General Anesthesia. Int J Clin Pediatr Dent 2015;8(2):157-162.

An interesting case of primary hypoparathyroidism

Primary hypoparathyroidism can occur due to an activating mutation of calcium sensing receptor (CaSR). Most patients remain asymptomatic and therefore not diagnosed until adulthood. We present a 38-year-old lady who had a history of muscle cramps since 8 years. She presented with vomiting, abdomen pain and body ache, showed clinical evidence of hypovolemia, severe hypocalcemia, hypokalemia, hypomagnesemia, hyperphosphatemia and metabolic alkalosis. Her 24 h urinary phosphorus was low and 24 h urinary excretion of sodium, potassium and chloride were high. Her intact parathormone was on the lower side of the normal range. She improved once we had corrected her biochemical abnormalities. By excluding acquired causes of hypoparathyroidism, we are able to conclude that this may be a case of primary hypoparathyroidism due to activating mutation of CaSR.

Case report of a small outbreak of epidemic dropsy

Epidemic dropsy results from use of edible oils adulterated with Argemone mexicans oil. We report of the disease in a family caused due to sesame oil adulteration. Peculiarity to report this disease is that it occurred due to consumption of contaminated sesame seeds oil instead of mustard oiland secondly epidemic dropsy is also not very common in western Rajasthan. Five members of a family presented to the hospital with history of generalised body swelling, itching and marked cutaneous flush. Few of them also have shortness of breath, dry cough, palpitation, diarrhoea, vomiting and haemoptysis. On physical examination rashes, pallor and signs of cardiac failure were present in few patients. None of them had neurological symptoms and signs. After multiple interviews history of consumption of home made sesame seeds oil was explored in the family and the differential diagnosis of epidemic dropsy was made. Edible oil sample of the sesame seeds oil turned out to be positive for sanguinarine. Sanguinarine and dehydrosanguinarine are two major toxic alkaloids of Argemone oil, which cause widespread capillary dilatation, proliferation and increased capillary permeability. Leakage of the protein-rich plasma component into the extracellular compartment leads to the formation of oedema. There is no specific therapy. Removal of the adulterated oil and symptomatic treatment of congestive cardiac failure and respiratory symptoms, along with administration of anti-oxidants and multivitamins, remains the mainstay of treatment.

Chlamydia pneumoniae seropositivity in adults with acute ischemic stroke: A case-control study

BACKGROUND

Causative role of Chlamydia pneumoniae infection in patients with acute ischemic stroke (AIS) remains unresolved till date.

AIM

To investigate the role of C. pneumoniae antibodies in AIS.

MATERIALS AND METHODS

Patients with AIS and sex- and environment-matched controls were enrolled. Antibodies to C. pneumoniae (IgA, IgG and IgM) were measured using enzyme-linked immunosorbent assay (ELISA).

RESULTS

A total of 51 patients and 48 controls were enrolled. The IgA seropositivity was significantly associated with AIS (unadjusted odds ratio 3.1; 95% CI 1.38, 6.96; P = 0.005), whereas IgG (unadjusted OR 0.44; 95% CI 0.18, 1.09; P = 0.07) and IgM (unadjusted OR 1.1; 95% CI 0.36, 3.3; P = 0.88) were not. There was no difference in IgA or IgG positivity in different stroke subtypes. On multivariate analysis after adjusting for sex, hypertension, diabetes mellitus, smoking and alcohol, the IgA seropositivity yielded an adjusted OR for stroke (4.72; 95% CI 1.61, 13.83; P = 0.005), while IgG seropositivity did not (OR 0.25; 95% CI 0.08, 0.83; P = 0.23).

CONCLUSIONS

An increased risk of AIS was demonstrated in patients seropositive for C. pneumoniae for IgA antibodies.

Are we good at thromboembolic disease prophylaxis - an audit of the use of risk assessment forms in emergency medical admissions

Venous thromboembolism (VTE) is a major cause of morbidity and mortality in hospitalised patients. Thromboprophylaxis is an effective strategy for VTE prevention in high-risk patients. An initial audit in our district general hospital trust showed poor adherence to the thromboembolic risk factors consensus group recommendations and so a risk assessment form (RAF) was devised. We present repeated audits to assess the RAF uptake and its effects on VTE thromboprophylaxis. We also present data analysing perceptions among doctors of the RAF and reasons for its poor completion. We provide compelling evidence that the RAF is an invaluable tool in the assessment of VTE thromboprophylaxis.

Building for the future: influence of housing on intelligence quotients of children in an urban slum

INTRODUCTION

Interventions on behalf of the marginalized in society can assume many formats. In an urban slum the Government of Delhi built one-room houses for some of the residents in what is termed a 'plot area'. Not all residents could be accommodated in the project and the remainder continued to live next door in shanty houses of the slum. Nineteen years later, young children who had migrated with their parents, have grown up and have children of their own. We looked at the development of the children living in the two types of accommodation.

METHODS

A total of 373 children were studied. All children (n = 200) between the ages of 3.5 and 5.5 years in a cluster of five residential blocks in the plot area were studied. As a control, children in two large clusters of shanty houses (n = 173) were also studied. For development assessment the Central Institute of Education (CIE) Test was performed. This is an Indian adaptation of the Standford-Binet Test. Multiple regression analysis was utilized to determine the factors that influenced IQ most.

RESULTS

The mean IQ of the children in the plot area was 92.5 (s.d. 13.38) and in the shanty houses 89.5 (s.d. 12.9) (p = 0.05). Analysis showed that the most significant factors affecting IQ were malnutrition in the first 6 months of life and attendance of the child at pre-school. For nutrition in the first 6 months, there was no difference between the groups. For attendance at pre-school, 110 of 200 in the plot area and 47 of 173 in the shanty houses were attending pre-school (p < 0.01).

CONCLUSION

We find that children living in the permanent houses had a significantly better IQ than those in shanty houses. A review of the literature did not reveal a comparable study.

Hospital epidemiology of dry eye

One hundred consecutive cases of dry eye were studied to comment upon its epidemiological aspects. The incidence of dry eye amongst ophthalmic outpatients was 0.46% with a male:female ratio of 1:1.22. Fifty seven percent of the patients were above 50 years of age. The incidence was higher amongst outdoor workers and people from rural areas with poor socioeconomic status. The influence of hot and dry climate and nutritional status on dry eye incidence is discussed.

The long-term prognosis of patients with out-of-hospital cardiac arrest but no inducible ventricular tachycardia

The long-term prognosis of patients successfully resuscitated from cardiac arrest who do not have acute precipitating factors and in whom ventricular arrhythmias cannot be induced during baseline electrophysiologic testing is controversial. The purpose of this investigation was to evaluate the long-term risk of recurrent sudden death and determine the clinical, angiographic, hemodynamic, and electrophysiologic predictors of recurrent cardiac arrest in such patients. Twenty-six (37%) of 71 consecutive patients with a single episode of aborted sudden death did not have inducible ventricular arrhythmias (less than 7 intraventricular responses) during baseline drug-free electrophysiologic study and they form the basis of this report. Their mean age was 54 +/- 13 (mean +/- SD) years and the left ventricular ejection fraction (LVEF) was 0.47 +/- 0.17. After a mean follow-up period of 16 months, 11 patients (42%) had a recurrent cardiac arrest (fatal in 10 patients). The actuarial incidence of recurrent cardiac arrest was 30 +/- 10% at 1 year and 55 +/- 13% at 3 years. Patients with LVEF less than or equal to 0.40 had a significantly higher occurrence of recurrent cardiac arrest than those with LVEF greater than 0.40 (p = 0.02; 1-year actuarial incidence of 57 +/- 17% versus 13 +/- 19%). Patients with recurrent sudden death had a significantly greater incidence of dilated cardiomyopathy (55% versus 7%; p = 0.02) and baseline frequent premature ventricular contractions (PVCs greater than 10/hr; 64% versus 17%, p = 0.036) or nonsustained ventricular tachycardia (36% versus 0%; p = 0.37) than patients without these characteristics.(ABSTRACT TRUNCATED AT 250 WORDS)