Intra-pericardial teratoma, most often a benign tumor, is an extremely rare condition in a newborn. It can be a diagnostic and therapeutic challenge if it presents with massive pericardial effusion. Complete surgical excision of the tumor is necessary because of its association with tissues of malignant potential. A 16-d-old newborn was diagnosed with intra pericardial immature teratoma (IT) and managed successfully with multidisciplinary team approach by prompt referral for complete surgical resection followed by adjuvant chemotherapy with carboplatin, etoposide and bleomycin (JEB) to prevent recurrence. The infant is now on close follow up with monitoring of serum alpha fetoprotein (AFP) levels and imaging studies for early diagnosis of recurrence of tumor and chemotherapy related complications.
A 14 year old girl with bilateral genu valgum of 6 years duration was brought for evaluation of primary hyperparathyroidism. She had clinical features of rickets such as frontal bossing, rachitic rosary, lumbar lordosis and fixed adduction deformity of the left leg. She had undergone osteotomy earlier for correction of these deformities without benefit. Laboratory investigations showed hypercalcaemia and hypophosphataemia, with elevated alkaline phosphatase and parathyroid hormone levels. A skeletal survey showed generalized decreased density of bone and brown tumours and, coincidentally, a right renal calculus. A computerized tomography scan of the neck and thallium-technetium subtraction scan delineated an adenoma of the left superior parathyroid gland, which was surgically removed. Parathyroid adenoma manifesting with bone deformities, especially genu valgum, is very rare in children. Early diagnosis and prompt treatment is essential to prevent such deformities.
Background: COVID-19 pandemic has caused worldwide havoc since the first case was discovered in China in December 2019. The infection has caused less severe infections and fewer deaths in children compared to adults. During the first two waves of COVID-19, the mortality rate in children has been <3% in India though more severe infections and hospitalizations were seen during the second wave. This study was undertaken at a tertiary Pediatric COVID care center during the third wave to understand the clinical, morbidity profile and outcomes in neonates born to COVID positive mothers and children who are COVID positive. Methods: Neonates born to COVID positive mothers and children between the age group 1 month to 12 years admitted in Government general hospital, Kakinada, Andhra Pradesh from 1January 2022 to 31March 2022 were included in the study. Their demographic, clinical, morbidity profile, treatment details were noted and outcomes observed.Results: All neonates were found to be RTPCR negative. 28% of neonates were born prematurely and 16% had birth asphyxia. Respiratory distress was the most presenting symptom. Death was seen in 4 newborns due to perinatal complications. More children less than 10 years required admission.15% of children were asymptomatic. Fever, cough, and running nose were the most presenting complaints. 2 children who had co-morbidities at the time of admission died.Conclusions: The third wave of COVID-19 did not cause any significant change in morbidity and mortality in children compared to the previous two waves.
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