Psychiatric comorbidity is associated with many dermatological disorders. It may be the cause for skin problem or may be the effect of a skin problem as skin being a visual organ. A 28-year-old female presented with multiple red lesions on the skin with unusual morphology and was diagnosed as dermatitis simulata. She gave history of multiple episodes of similar illnesses with admissions in various hospitals and being evaluated and dropping off in between treatments. After detailed psychological evaluation, patient was diagnosed as case of Munchausen syndrome.
Febrile seizures are the most common cause of convulsions in children and a frequent cause of emergency hospital admissions. Indian studies suggested that up to 10% of children experience a febrile seizure. Febrile seizures are defined as an event in infancy or childhood usually occurring between 6 months to 6 years of age associated with fever but without evidence of intracranial infection or defined cause. OBJECTIVES: To determine the frequency of low serum zinc level in children presenting with febrile seizures at tertiary care hospital, Bangalore. METHOD: This is an observational cross sectional study conducted at the Department of Pediatric Medicine, tertiary care hospital, Bangalore, from January 2013 to January 2014. Children (6 months to 6 years of age) presenting with febrile seizures who satisfied inclusion and exclusion criteria were enrolled for the study. Cause of fever was determined after detailed history, physical examination and relevant investigations. Three milliliters centrifuged blood sample was preserved in acid washed test tube. Separated serum was used to measure serum zinc level by calorimetric method. RESULTS: Out of 100 children enrolled, male to female ratio was 1.4:1, 56% of children were below the age of 2 years with mean age of the children was 24 months. Upper respiratory tract infection was the most frequent cause of fever apparent in 70 children (70%), followed by dengue fever 11 children (11%), acute gastroenteritis 6 (6%), urinary tract infection and otitis media in 4 children each (8%), Viral fever in 5 child (5%). Frequency of low serum zinc level was 62% in children with febrile seizures. INTERPRETATION AND CONCLUSION: This study reveals that there is positive correlation between low serum zinc levels and febrile convulsions.
Jaundice is the most common and important abnormal physical problem in the first week of life. Due to immaturity of the bilirubin metabolism approximately 60% of term new borns and 80% of preterms (1) develop jaundice in the first week of life which may require phototherapy. The commonly known side effects of phototherapy are loose stools, hyperthermia, dehydration fluid loss, skin burn, photoretinitis, low platelet count, increased red cell osmotic fragility, bronze baby syndrome, riboflavin deficiency and DNA damage. (1,2) A lesser known side effect, but potential complication of phototherapy is hypocalcemia. (3) An observational study was done in department of pediatrics, Kempegowda institute of medical sciences, Bangalore during the period December-2014 and January 2015. All the terms and preterms requiring photo therapy were enrolled in the study. Duration of phototheraphy was ranging from 24 to 48 hours. Serum calcium was measured pre and post phototherapy 80% of babies developed hypocalcemia following phototherapy and also noticed that longer the duration of phototherapy more severe the hypocalcemia.
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