1. Sepsis presenting with Diabetic ketoacidosis like feature in Preterm neonate A thriving preterm neonate had new onset sepsis with off color skin and poor feed tolerance. A workup for sepsis was sent and antibiotics were upgraded to 2nd line agents. Inotrope was added for tachycardia with poor perfusion. By…
Tag: Pediatrics
Section Editor: Dr. Sujit Kumar Shrestha, MD Pediatrics, Fellowship Neonatology
PGMEE, MRCS, USMLE, MBBS, MD/MS 
Lesions of the Umbilical Cord in Newborn
Anatomy of Umbilical Cord Umbilical cord is a connecting link between fetus and placenta through which fetoplacental circulation occurs. It is formed from allantois carrying vessels from Fetus to Chorion and passing abdominal stalk. It is around 50 cm long and contains 2 umbilical arteries and 1 umbilical vein surrounded by…
PGMEE, MRCS, USMLE, MBBS, MD/MS 
Apt Test in Newborn: Maternal vs Neonatal Blood
We had few cases of suspected GI bleeding, admitted or referred to our NICU. One was case of Hematochezia and other was case of fresh blood in vomitus. Both babies were born to mother with Antepartum hemorrhage. The general condition of the babies were fine, and the vitals. There was…
Case Reports 
A case of child with Mucopolysaccharidosis : Hunter Syndrome
1st Published in Pedchrome in January 1, 2015 Case Summary A 6-year-old patient was found to have course facial features and short stature. Parents have noticed a developmental stasis since 4-5 years of age. The weight was normal. There were no any chronic illness, any significant birth and postnatal history…
Blog 
A Case of Gastroschisis : Media’s Irresponsibility
1st Published in Pedchrome in October 19, 2012 National Newspapers of Nepal like Kantipur Daily and Nayapatrika had published some news regarding the Case of Om Hospital where the papers irresponsibly declared that the doctor’s negligence had led to the death of a new-born. According to the Om Hospital Authority,…
PGMEE, MRCS, USMLE, MBBS, MD/MS 
Osteogenesis Imperfecta : Mnemonic
Synonym: Brittle Bone Disease Incidence: 1 in 20,000 Gene defect: Col1A1 (17q) and Col1A2 (7q) Mnemonic: Remember “one” for “bone”. Collagen one is the main composition of bone. OI is a disorder of bone. Hence, the defect is is in Col1. Features Mnemonic: BLOOD Sillence Type Inheritance Features Mnemonic Collagen…
PGMEE, MRCS, USMLE, MBBS, MD/MS 
BIND score in severe hyperbilirubinemia
Bilirubin-induced neurologic dysfunction (BIND) Score is used to assess bilirubin induced encephalopathy in neonates with severe hyperbilirubinemia. Johnson et al developed the BIND score to help identify an infant who requires more aggressive monitoring and management. The scoring system has 3 parameters: 1. Cry pattern 2. Behavior and mental status…
Blog 
Breast Engorgement in Newborns : Galactorrhea or Witch’s Milk
Scenario Concerned parents appear in the Out patient Department, with a newborn who has bilateral breast engorged and obviously secreting milk. Parents had tried to squeeze the milk out but instead the breast got further engorged. Few months before a neonate was admitted for Intravenous antibiotics for similar problem, after…