Background: Respiratory distress syndrome (RDS) requires management by oxygen therapy and mechanical ventilation. Continuous positive airway pressure (CPAP) being simple, cost-effective, and non-invasive respiratory support is used to prevent airway injury as well as the development of bronchopulmonary dysplasia. Objectives: The study was to describe the comparison of nasal septum necrosis and to categorize severity of nasal septum trauma while using nasal prongs and nasal masks for nasal CPAP (nCPAP) in neonates with RD. Materials and Methods: A prospective randomized controlled study was carried out in 200 neonates admitted in neonatal intensive care unit and these neonates were randomized to receive either nasal mask or nasal prong as an interface for nCPAP. Complete blood count, C-reactive protein, blood culture, and chest X-ray were done. All infants were observed for 72 h for the development of nasal septal necrosis in each interface. All variables were analyzed with the help of Chisquare test. Results: Of the total 200 neonates included in the study, 9% neonates of prong group developed nasal septum necrosis, while no incidence of septum necrosis noted in mask group. Conclusion: Nasal masks were comparatively better than nasal prongs as nasal septum trauma occurred only in neonates with nasal prongs group.
We report a case of a two day old female child with congenital facial palsy, bilateral microtia, congenital heart disease, renal ectopia and unilateral hypoplasia of depressor anguli oris muscle. These constellation of symptoms have not been found together in any case before. This unknown syndrome could be considered to be in a gray zone between Caylers Cardiofacial syndrome and Pearls syndrome.
Allgrove syndrome is an autosomal recessive disease which is characterized by Achalasia, Alacrimia and ACTH-resistant Adrenal deficiency with progressive neurological manifestations. Allgrove syndrome is caused due to mutations in AAAS gene, localized on chromosome 12q13. This report relates to an 8 years old female child who had complaints of vomting, fever, cough, hyperpigmentation and poor weight gain. Barium swallow, ophthalmic examination and ACTH stimulation test proves that patient has Allgrove’s syndrome. Management consisted of initiation of cortisone therapy which was successful in improving the hyper pigmentation. Patient was planned for surgical intervention for achalasia cardia on follow-up. Allgrove’s syndrome may be an under diagnosed disorder. High index of suspicion is needed when patients present with such complex symptoms. Diagnosing and timely intervention helps in reducing the morbidity and mortality.
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