The Prevalence and Pattern of Congenital Anomalies Among Neonates Admitted in a Tertiary Care Hospital in the Andaman and Nicobar Islands: A Retrospective Study

Introduction Congenital anomalies (CAs) constitute a significant determinant of neonatal mortality in India, and past studies have elucidated their diverse clinical presentations across different geographic regions. Given the limited availability of region-specific data in our locale, this study was initiated to elucidate the prevalence and phenotypic manifestations of congenital anomalies in live births within the distinctive setting of the Andaman and Nicobar Islands, India. Methods This retrospective observational study was conducted at the Department of Pediatrics of the Andaman and Nicobar Islands Institute of Medical Sciences (ANIIMS), located in Port Blair, during a defined one-year period extending from June 2022 to May 2023. All live births presenting with congenital anomalies within this stipulated timeframe were systematically enrolled in the study, and data was meticulously extracted from their respective medical records. The study data was methodically collated and organized utilizing the EpiData software (EpiData Association, Odense, Denmark), followed by a comprehensive descriptive analysis executed through the application of the PSPP software (GNU Project, Boston, MA). Results Among the 1661 neonates admitted during the study's defined period, a total of 61 neonates (3.7%) were identified as having congenital anomalies. Among these anomalies, cardiovascular anomalies were found to be the most prevalent, succeeded by gastrointestinal and central nervous system anomalies. Notably, major congenital anomalies were discerned in 20 out of 61 neonates, constituting approximately 33% of the neonatal population with anomalies. Neonates afflicted with congenital anomalies displayed a mortality rate of 11.5%. Conclusion The effects of congenital anomalies on individuals, families, and the society are far-reaching. Early identification and timely referral and intervention are the key factors in decreasing the mortality and morbidity associated with congenital anomalies.

Solitary Osteochondroma of the Tibial Tuberosity Mimicking Osgood-Schlatter Lesion: A Rare Cause of Anterior Knee Pain in Adolescents: A Case Report

Osteochondroma arising from the tibial tuberosity is very rare. We report such a case which mimicked OsgoodSchlatter's disease in an adolescent. A 12 years-old boy presented with swelling over his right proximal tibia of one year duration associated with pain in the last three months. Examination revealed a 4 x 2cm bony mass arising from the proximal tibia. Radiographs revealed an osteochondroma of the tibial tuberosity. Computer tomography and magnetic resonance imaging confirmed the continuity of the medulla of the bony mass to that of the parent bone. Excision biopsy was done. At the final follow up, he was asymptomatic and returned back to his daily activities. We present this case for its rarity, challenges involved in diagnosis and the difficulties encountered in planning the surgery because of involvement of the apophysis and extensor mechanism attachment in a skeletally immature boy.

Fabrication of nano-silver particles using Cymodocea serrulata and its cytotoxicity effect against human lung cancer A549 cells line

The present study reports, green synthesis of bioactive silver nanoparticles (AgNPs) under different temperature (60°C, room temperature and 4° refrigerator) using the aqueous extract of sea grass Cymodocea serrulata as a potential bioreductant. Increased temperature fabricates more AgNPs compare to room temperature and refrigerator condition. At first the reduction of Ag(+) ions were confirmed through color change which produces an absorbance spectra at 420nm in UV-Visible spectrophotometer. Additionally various exclusive instrumentations such as X-ray diffraction (XRD), Dynamic light scattering (DLS), scanning electron microscope (SEM) analysis and Transmission electron microscope (TEM) were authorizes the biosynthesis and physio-chemical characterization of AgNPs. From Fourier transform infrared spectroscopy (FTIR) analysis, it was identified that the water soluble fractions of the sea grass mainly responsible for reduction of ionic silver (Ag(+)) into (Ag(0)) nano-ranged particles and also they act as stabilizing agent to sustain the durability of NPs for long period of time. Further, synthesized AgNPs shows potential cytotoxicity against human lung cancer A549 cells (LD50-100μg/ml). The overall results suggest that C. serrulata is a valuable bioresource to generate rapid and eco-friendly bioactive AgNPs towards cancer therapy.

Cryosupernatant and Immunosuppression as Effective Alternative Therapies for TTP in Three Pediatric SLE Patients

Thrombotic thrombocytopenic purpura (TTP) and systemic lupus erythematosus (SLE) very rarely present simultaneously and pose a diagnostic and therapeutic dilemma to the physician. Prompt diagnosis and management with plasma exchange and immunosuppression is life-saving. To describe the effectiveness of cryosupernatant and steroids in pediatric SLE with TTP. We describe three children aged 12-14 years with SLE who were diagnosed with TTP based on fever, CNS manifestations, ANA, anti-dsDNA, anti-sm positivity, hypocomplementemia, and microangiopathic anemia with thrombocytopenia. All three children were managed with cryosupernatant and steroids without plasmapheresis. All children improved with cryosupernatant and steroids. All attained remission within 10 days. They were doing well at last follow up without relapse or flare. Cryosupernatant and steroids may be an effective therapy for Thrombotic thrombocytopenic purpura with systemic lupus erythematosus.

Tentorial venous sinuses: an anatomic study

OBJECTIVE

Certain neurosurgical procedures require sectioning of the tentorium cerebelli. The presence of venous sinuses within the tentorium makes these procedures difficult. The aim of this study was to investigate the incidence, size, location, configuration, and pattern of venous drainage of these sinuses.

METHODS

The tentorium cerebelli was studied in 80 fresh cadavers. After the skull cap and the supratentorial portion of the brain were removed, the tentorium was inspected for the presence of venous sinuses. Their location, size, configuration, and pattern of venous drainage were noted. Subsequently, the infratentorial structures were removed via the tentorial incisura. The tentorial sinuses were again studied. In certain cases, the sinus was opened and a probe passed inside to confirm its presence.

RESULTS

The tentorium cerebelli was revealed to contain sinuses in 86% of the cadavers. These sinuses were classified into the following three types: Type I sinuses constituted 25% of the total and were most often located in the medial one-third of the tentorium. They were larger than the other types, frequently occurring with a branching "stag-horn" configuration and a tendency to drain into the straight sinus, the torcular herophili, and the medial one-third of the transverse sinus. Type II sinuses constituted 25% of the total and were most often located in the lateral one-third of the tentorium. They were smaller than the other types, and tended to drain into the duction of the transverse sinus and superior petrosal sinus and into the lateral one-third of the transverse sinus. Type III sinuses constituted 50% of the total and were located in the medial one-third of the tentorium. Their size ranged from small to medium. Unlike Type I sinuses, no branching pattern was observed. These sinuses tended to drain into the straight sinus, the torcular herophili, and the medial one-third of the transverse sinus. In the present study, the medial one-third of the tentorium was observed to be the most vascular part. No venous sinus was observed in the anterior part of the tentorium.

CONCLUSION

Venous sinuses are common in the tentorium cerebelli. In this study, they were observed in 86% of the cases. They can be classified into three types, based on their location, size, configuration, and pattern of drainage. The medial one-third of the tentorium is the most vascular part. A knowledge of these sinuses may be helpful while sectioning the tentorium. The importance of these sinuses in treating vascular and neoplastic diseases of the brain is highlighted. A brief review of the embryology of these sinuses is also presented.