::Departments : Clinical : Department of Paediatrics
  
 
 
:
        Paediatrics Department Started Functioning Since 1952 When This Hospital Was Dhq Hospital.
In The Year Of 1990 This Dhq Hospital Was Converted As Gmkmch.
Dec 1994 Saw The First Batch Of Undergraduates Taking Upthe Pediatrics Exam From This Hospital.
Since Then Mbbs Course Is Being Conducted In This Hospital And Students Graduated From This Institution.
Pg Course (M.D.,) Was Commenced In The Year 2007. First Batch Of Pg Exam Was Held In 2009. Since Then Yearly Examinations Were Conducted For Pgs Under The Tamilnadu Dr. Mgr Medical University. So Far        8 Batches Of Pg Students Graduated From This Institute. Now We Have 3 M.D., Pg Students Per Year.


Periodic Academic Activities in the Department.

   Clinical class will be taken on all days in OPD and in wards in their respective units. Clinical classes in New Born ward taken on weekly Twice.
Monthly once they have an internal assessment examinations.
Prefinal MBBS students have their theory classes in paediatrics once in a week
Final MBBS students have two theory classes in a week.
Once in a month we conduct a symposium for UGs on the 4th Saturday.

TEACHING PROGRAMME FOR PGs
Apart from the routine OPD and ward work we conduct  a journal club ,a clinical society meeting, a symposium and dissertation review meetings on monthly basis.
Professors and Associate professors used to take clinical classes for PGs once in a week.

  Research and publication
        e-Journal publication by post graduates .
                 
Prizes and Awards 
a   Quiz for UG’s every year
b   Gold Medal exams for UG’s every year
c    PG Quiz every year
 ( All  sponsored by Indian Academy of Pediatrics )
               
Prizes and Awards won

a   Scientific paper  titled ‘CRADLE BABY SCHEME’ presented by PG Dr.Geethanjali  in East Coast Pedicon,  Pondicherry 2012 won Gold medal
             
  Internal Assessment
a)   Conducted every month for UG’s.
              
SERVICES OFFERED

Number of Units in the department -3

Op days and timings
All days from 7.30 a.m – 12 .00 noon

IP Unit and Admission day
     Unit I – Monday &  Thursday
    Unit II – Tuesday & Friday
    Unit III – Wednesday & Saturday
Sundays on Rotation

 Bed strength of Departments
General pediatric ward-60
Neonatal ward – 20

Average OP Statistics -200/day

Average IP Statistics
 General pediatric ward -60
 Neonatal ward  -60

CMCHIS BENEFICIARY

SO FAR 1424  PATIENTS WERE TREATED UNDER CMCHIS (UPTO 30..06.2016)

Special clinics conducted
  Monday       - well baby clinic & immunization clinic &  Asthma clinic
  Wednesday - well baby clinic & immunization clinic
 Thursday   -  Nutrition clinic
 Friday       -  well baby clinic& immunization clinic & Haematology clinic
 Saturday     - Adolescent Clinic

Lists of lab tests done
Pathological investigations likeComplete Hemogram, peripheral smear study etc
Biochemical investigations like urea , creatinine ,electrolytes, etc
Radiological investigations like X-ray, Sonogram, CT, MRI
Microbiological investigation  cultures,serology,etc
 
Statistics

 OP

 
MONTH
2013
2014
2015
2016
JANUARY
3406
4803
5884
3510
FEBRUARY
3386
4139
6459
3870
MARCH
2306
3911
 5067
3279
APRIL
2813
4234
 5394
2526
MAY
2554
3446
 4956
2483
JUNE
2432
3549
 5221
3464
JULY
3336
3977
 5020
3519
AUGUST
2926
4320
 5155
 
SEPTEMBER
3220
4511
 4805
 
OCTOBER
3874
3918
 4846
 
NOVEMBER
3657
4996
 4141
 
DECEMBER
5993
4537
 4878
 
TOTAL
39903
50341
61826
 

IP - PAEDIATRIC WARD
MONTH
2013
2014
2015
2016
JANUARY
374
321
417
477
FEBRUARY
270
325
364
439
MARCH
340
337
 429
434
APRIL
308
341
 362
406
MAY
324
355
 396
366
JUNE
319
448
 410
396
JULY
426
496
 524
463
AUGUST
354
561
 540
 
SEPTEMBER
359
457
 446
 
OCTOBER
405
308
 694
 
NOVEMBER
434
423
 704
 
DECEMBER
496
434
 779
 
TOTAL
4409
4806
6065
 
 

 
PAEDIATRIC ICU WARD TOTAL VENTILATOR CASE
       
 
 
 
 
MONTH
2013
2014
2015
2016
JANUARY
9
24
12
14
FEBRUARY
8
5
2
13
MARCH
8
13
6
18
APRIL
10
7
 2
14
MAY
9
8
 13
10
JUNE
9
5
 5
15
JULY
7
9
 3
15
AUGUST
8
11
 10
 
SEPTEMBER
4
6
 16
 
OCTOBER
8
6
 13
 
NOVEMBER
13
4
 8
 
DECEMBER
6
4
 1
 
TOTAL
99
102
91
 

Pediatric ICU
 
MONTH
2014
2015
2016
JANUARY
85
96
59
FEBRUARY
42
46
50
MARCH
43
 45
78
APRIL
35
 37
53
MAY
80
 95
45
JUNE
46
 49
69
JULY
42
 37
71
AUGUST
72
 74
 
SEPTEMBER
86
 75
 
OCTOBER
92
 76
 
NOVEMBER
85
 88
 
DECEMBER
69
 71
 
TOTAL
777
789
 

 
 
NICU WARD TOTAL VENTILATOR CASE
       
 
 
 
 
MONTH
2013
2014
2015
2016
JANUARY
36
36
35
47
FEBRUARY
35
26
49
45
MARCH
34
28
24
55
APRIL
46
48
 30
51
MAY
37
34
40
59
JUNE
30
32
30
38
JULY
22
26
 48
34
AUGUST
12
24
 48
 
SEPTEMBER
12
18
 64
 
OCTOBER
19
28
54
 
NOVEMBER
14
75
 62
 
DECEMBER
18
106
 68
 
TOTAL
315
481
552
 
 
 
 
IP – NEONATAL WARD
MONTH 2013 2014 2015 2016
JANUARY 349 367 283 307
FEBRUARY 315 309 274 313
MARCH 438 431 313 395
APRIL 431 472 342 339
MAY 472 464 375 336
JUNE 426 437 310 294
JULY 391 473 323 258
AUGUST 399 456 342  
SEPTEMBER 412 481 315  
OCTOBER 448 429 297  
NOVEMBER 385 490 282  
DECEMBER 391 363 294  
TOTAL 4857 5172 3750  



                   Performance of DEIC’s (April 2015 to June 2016 )
                                      Name of the district : Salem
 
                                                TOTAL CASE - DEIC - 2015
 
 
                       
S.N Month / Year RBSK SELF Health Facility / Delivery Point Total New  Born Referred for Surgery cases Surgery done cases
1 April 0 0 0 0 0 0 0
2 May 0 34 0 34 29 0 0
3 June 6 36 2 44 15 0 0
4 July 97 3 7 107 16 5 5
5 August 214 6 9 229 19 8 8
6 September 113 7 10 130 0 9 9
7 October 79 35 11 125 0 8 8
8 November 62 40 17 119 5 8 8
9 December 64 140 13 217 48 12 12
  Total 635 301 69 1005 132 50 50
 
 
 
 
S.N Month RBSK Self Health Facility / Delivery Point Total New Born Referred for Surgery cases Surgery cases
1 January 41 83 6 130 17 10 10
2 February 89 89 12 190 13 9 9
3 March 231 140 21 392 20 3 3
4 April 148 145 4 297 45 32 -
5 May 111 166 7 284 35 66 -
6 June 332 140 4 476 34 55 -
  Total 952 763 54 1769 164 175 22
                 
 
CMCHIS STATISTICS:
                                                                
                                                              2014  REPORT

 
MONTH TOTAL CASES CLAIMS APPROVED  TOTAL CASES
JANUARY 24 -
FEBRUARY 22 -
MARCH 28 69
APRIL 9 30
MAY 5 37
JUNE 18 44
JULY 46 27
AUGUST 70 53
SEPTEMBER 49 116
OCTOBER 55 46
NOVEMBER 32 27
DECEMBER
 
21 29
TOTAL 379 478
 
 
2015  REPORT
 
MONTH TOTAL CASES        PREAUTH APPROVED                     
           TOTAL CASES
CLAIMS APPROVED  TOTAL CASES
    NEW BORN     PAEDIATRIC     
           WARD
 
JANUARY 35 12 23 28
FEBRUARY 53 23 30 41
MARCH 23 7 16 14
APRIL 35 9 26 7
MAY 25 12 13 23
JUNE 37 27 10 34
JULY 41 34 7 55
AUGUST 53 36 17 58
SEPTEMBER 60 42 18 50
OCTOBER 67 46 21 36
NOVEMBER 43 30 13 61
DECEMBER
 
22 16 6 51
TOTAL 494 294 200 440
 
                                     
                                                      2016  REPORT
 
MONTH TOTAL CASES        PREAUTH APPROVED                     
           TOTAL CASES
CLAIMS APPROVED  TOTAL CASES
    NEW BORN     PAEDIATRIC     
           WARD
 
JANUARY 36 25 11 52
FEBRUARY 64 47 17 56
MARCH 39 31 8 26
APRIL 51 39 12 42
MAY 46 36 10 37
JUNE 33 26 7 33
TOTAL       246
 
 

 
 
 
LIST OF PUBLICATIONS BY THE DEPARTMENT
SL NO TITLE PUBLICATION
1 KNOWLEDGE, ATTITUTE AND PRACTICE OF NEONATAL CARE AMONG POSTNATAL MOTHERS IN A URBAN REFERRAL HOSPITAL.
Sundararajan.T.S, Kumaravel.K.S, Ilangovan.R
E-Journal of Tamilnadu
Dr. M.G.R. Medical University,Vol-2,No.6
( Nov-Dec 2012)
2 RASMUSSENS ENCEPHALITIS – A CASE REPORT
Sampath Kumar.D, Kumaravel.K.S, Prasantha kumar. G
E-Journal of Tamilnadu
Dr. M.G.R. Medical University,Vol-2, No.6
( Nov-Dec 2012)
3 A STUDY ON STATUS OF NEONATAL TRANSPORT TO A LEVEL THREE INTENSIVE CARE UNIT
Sampath Kumar.D, Kumaravel.K.S, Fathima Nadia.J
E-Journal of Tamilnadu
Dr. M.G.R. Medical University,Vol-2, No.6
 ( Nov-Dec 2012)
4 BACTERIOLOGICAL SURVEILLANCE OF EARLY ONSET NEONATAL SEPSIS AND THEIR ANTIBIOTIC SUSCEPTIBLITY PATTERN IN A LEVEL III NICU
Sampath Kumar, Kumaravel.K.S, Saranya.R
E-Journal of Tamilnadu
Dr. M.G.R. Medical University,Vol-2, No.2
( Mar-Apr  2012)
5 A CASE OF DOWNS SYNDROME WITH ATLANTO AXIAL INSTABILITY – NEED FOR ROUTINE SCREENING OF ATLANTO AXIAL INSTABILITY IN ALL CASE OF DOWNS SYNDROME
Thennadayalan Kamalakann, Kumaravel.K.S, Priyadharshini.
E-Journal of Tamilnadu
Dr. M.G.R. Medical
University, Vol-2, No.2       
( Mar-Apr  2012)
6 CLINICAL PROFILE AND MORBIDITY PATTERN OF CRADLE BABIES – 15 YEARS EXPERIENCE FROM A CRADLE BABY RECEPTION CENTRE
Sivagamasundari. R, Kumaravel.K.S, Geethanjali.A
E-Journal of Tamilnadu
Dr. M.G.R. Medical University,Vol-2,No.2       
( Mar-Apr  2012)
7 A RARE CASE OF HAEMOPHILIA – A IN A GIRL
Sundararajan.T.S, Kumaravel.K.S, Sundar.K.C
E-Journal of Tamilnadu
Dr. M.G.R. Medical University,Vol-1,No.2       
( Nov- Dec 2011)
8 CLINICAL PROFILE OF SCORPION ENVENOMATION IN CHILDREN – ONE YEAR EXPERIENCE IN A URBAN REFERRAL HOSPITAL
Sivagamasundari.R, Kumaravel.K.S, Amudha Devi. C

 
E-Journal of Tamilnadu
Dr. M.G.R. Medical University,Vol-1,No.2       
( Nov- Dec 2011)
 
 
 
DISSERTATION ACTIVITIES

 
  1. A STUDY ON BEHAVIOURAL DISORDERS IN 6 TO 12 YEARS CHILDREN WITH HIV ATTENDING ART CENTRE IN SALEM. DR.T.S.SUNDARARAJAN M.D,DCH, PROFESSOR & HOD, PAEDIATRICS, DR.PRASANTHA KUMAR, POST GRADUATE IN PAEDIARTICS,.
  1. A STUDY ON ETIOLOGY, CLINICAL PROFILE AND OUTCOME ON NEONATAL THROMBOCYTOPENIADR.P.SAMPATH KUMAR  M.D,DCH, ASSOCIATE PROFESSOR,PAEDITRICS, DR.S.RADHIKA , POST GRADUATE IN PAEDIATRICS.
  1.  A STUDY ON CARDIAC TROPONIN T(CARD TEST) IN EARLY DIAGNOSIS OF MYOCARDIAL INJURY IN PERINATAL ASPHYXIA AND ITS COMPARISION WITH OTHER MODALITIES, DR.T.S.SUNDARARAJAN, M.D,DCH,PROFESSOR,& HOD,PAEDIATRICS, DR.A.GEETHANJALI, POST GRADUATE IN PAEDIATRICS.
  1. A STUDY ON CLINICAL AND ECHOCARDIOGRAPHIC EVALUATION OF NEONATAL CARDIAC MURMURS AND THEIR FOLLOW UP AT 6 WEEKS OF AGE. DR.R.SIVAGAMASUNDARI, M.D,DCH, PROFESSOR & HOD OF PAEDIATRICS.DR.R.SARANYA, POST GRADUATE IN PAEDIATRICS.
  1. A STUDY TO EVALUATE THE SIGNIFICANCE OF SERUM CREATINE KINASE MUSCLE  BRAIN FRACTION (CK-MB) AND LACTATE DEHYDROGENASE (LDH) IN NEONATES WITH BIRTH ASPHYXIA DR.S.KANIMOZHI, POST GRADUATE IN PAEDIATRICS.
  1.  A STUDY ON NUTRITIONAL SURVEILLANCE IN HIV INFECTED CHILDREN LESS THAN 5YEARS OF AGE ATTENDING ART CENTRE, SALEM.DR.D.SAMPATH KUMAR, M.D,DCH, ASSOCIATE PROFESSOR, PAEDIATRICS,DR.ARYADEVI, POST GRADUATE IN PAEDIATRICS
  2.  A  STUDY ON CLINICAL PROFILE OF TUBER CULOSIS IN HIV INFECTED CHILDREN ,DR.R.SIVAGAMASUNDARI, M.D,DCH, PROFESSOR & HOD OF PAEDIATRICS,  DR.M.NIRMALA,POST GRADUATE IN PAEDIATRICS. 
     8. A STUDY ON PREVALENCE OF HEARING IMPAIRMENT BY USING OTO-      ACOUSTIC EMISSIONS IN BABIES IN GOVT MOHAN KUMARAMANGALAM     MEDICAL COLLEGE HOSPITAL, DR.T.S.SUNDARARAJAN M.D,DCH, PROFESSOR &           HOD, PAEDIATRICS , DR.K.C.SUNDAR POST GRANULATE IN PAEDIATRICS.

   9. A STUDY ON CLINICAL AND EPIDEIMIOLOGICAL STUDY IN BRONCHIAL   ASTHMA IN CHILDREN & ASSESSMENT AND ITS CORRELATION WITH SEREUM          IgE LEVELS, DR.T.S.SUNDARARAJAN M.D,DCH,PROFESSOR & HOD, PAEDIATRICS       DR.PRIYADHARSINI, POST GRADUATE IN PAEDIATRICS.

  10. A STUDY ON CLINICAL PROFILE OF NEONATAL SEIZURES IN NEWBORN   BABIES BORN IN GOVT MOHAN KUMARAMANGALAM MEDICAL MEDICAL    COLLEGE HOSPITAL, DR.T.S.SUNDRARAJAN M.D,DCH, PROFESSOR & HOD,       PAEDIATRICS ,DR.S.AMUDHADEVI POST GRADUATE IN PAEDIATRICS.

  11. A STUDY ON CLINICAL PROFILE OF PAEDIATRIC HIV INFECTION IN THE AGE        GROUP OF 18 MONTHS TO 12 YEARS AND TO CORRELATE WITH CD4         COUNT,DR.K.MUTHUKUMAR, MD,DCH,DR.SURESHKUMAR, DEPARTMENT OF             PAEDIATRICS.

  12. A STUDY ON CLINICAL PROFILE OF  TUBERCULOSIS IN HIV CHILDREN              DR.R.SIVAGAMASUNDARI, M.D,DCH, PROFESSOR & HOD OF PAEDIATRICS,DR.M.NIRMALA, POST GRADUATE IN PAEDIATRICS,

  13. A STUDY ON INCIDENCE OF CONGENITAL ANOMALIES IN NEWBORN IN TERTIARY CARE HOSPITAL,DR.R.SIVAGAMASUNDARI, M.D,DCH, PROFESSOR &           HOD OF PAEDIATRICS,DR.N.MANIVANNAN, POST GRADUATE IN PAEDIATRICS.
 
 

 
 
            CME ON PAEDIATRIC SUBSPECIALITIES CONDUCTED ON 30th OCT 2015

      1.  APPROACH TO  ACYANOTIC CONGENITAL HEART DISEASE     DR.MAGESH,D.M(CARDIOLOGY), ASSISTANT PROFESSOR ,DEPARTMENT OF           CARDIOLOGY,JIPMER,PONDICHERY.
      2.   APPROACH TO CHILDHOOD SEIZURES DR.SANGEETHA, D.M  (NEUROLOGY),        ASSOCIATE   PROFESSOR ,DEPARTMENT OF NEUROLOGY,CMC VELLORE.
      3.  APPROACH TO A CHILD WITH FEVER WITH HEPATOSPLENOMEGALY                                            DR.SIVASUBRAMANIAM ,DM(GASTROENTEROLOGY), ASSISATANT  PROFESSOR, DEPARTMENT OF MEDICAL GASTROENTEROLOGY.
      4.  APPROACH TO CHILD WITH HAEMATURIA, DR.NAGARAJAN, DM      (NEPHROLOGY) , HOD ,DEPARTMENT OF NEPHROLOGY , GMKMCH,SALEM.
      5.  APPROACH TO  CHILD WITH PEM DR.P.SAMPATHKUMAR  M.D,DCH,            ASSOCIATE             PROFESSOR , DEPARTMENT OF PAEDIATRICS,GMKMCH,SALEM.    

                                                                                                                                   

    INTERESTING CASES:

1.COFFIN  SIRIS   SYNDROME
PARTICIPANT: Dr.S.PRASANNA ,IInd yr PG[PEDIATRICS]
GOVT. MOHAN KUMARAMANGALAM MEDICAL COLLEGE, SALEM, TAMIL NADU.
GUIDE/PROFFESSOR:Dr.T.S.SUNDARARAJAN.,M.D.,DCH.,
SYNONYMS:DWARFISM-ONYCHODYSPLASIA,FIFTH DIGIT SYNDROME,MENTAL RETARDATION WITH HYPOPLASTIIC 5TH FINGERNAILS & TOENAILS AND SHORT STATURE-ONYCHODYSPLASIA.
 It is a rare genetic disorder that causes developemental delays and absent/Hypoplastic  FIFTH FINGERNAILS & TOENAILS.
EPIDIMIOLOGY: There has been reported to be around 31 cases by 1991.the number has grown and is reported to be around 140.
CHARECTERISTIC FEATURES:
  • mild to severe intellectual disability,also called as “developemental disability”
  • short fifth digits with hypoplastic or absent nails
  • low birth weight
  • feeding difficulties upon birth
  • frequent respiratory infections during infancy
  • hypotonia
  • wide mouth
  • sparse scalp hair
  • joint laxity
  • delayed bone age
  • microcephaly
  • coarse facial features,including wide nose,wide mouth and thick eyebrows & lashes.
 
CAUSES:AUTOSOMAL RECESSIVE is most likely,but SPORADIC mutations and AUTOSOMAL DOMINANT cases may also occur.
This syndrome has been associated with Mutation in ARID1B GENE, SOX11 gene.
REFERENCE:
  1. Levy P,Baraister M[May 1991].COFFIN-SIRIS SYNDROME.J.Med.genet.28[5]:338-41.doi:10.1136/jmg.28.5.338. PMC 1016855.PMID
  2. ‘Greenville:A home of one’s own-Ledger transcript’.Ledger transcript retrieved 13 june 2015
  3. Coffin siris @ webMD
Coffin siris syndrome genetic home reference 8 june 2015.retrieved 13 june 1015.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
2.MERMAID SYNDROME
                                       SYN: SIRENOMELIA
  • A very rare congenital deformity in which the legs are fixed together giving the appearance of a mermaids tail.
Inc:1/1 lakh live births (as rare as conjoined twins )
  • 100 times more likely to occur in identical twins then in single births or fraternal twins.
  • Usually fatal within a day or two of birth because of complications associated with abnormal kidney or urinary bladder development and function
  • More than half of the cases of SIRENOMELIA result in STILLBIRTH
  • MATERNAL DIABETES has been associated with caudal regression syndrome and SIRENOMELIA
  • A severe form of caudal regression syndrome
  • It occurs when the UMBLICAL CORD fails to form two arteries thus preventing a sufficient blood supply from reaching the fetus, due to insufficient blood supply ,fails to develop into two separate limbs.
  • It is caused by a deficiency of mesoderm migration of the caudal region of the embryo during granulation.
  • Mesoderm of this region is also involved in the development of the lumbosacral vertebrae as well as the urogenital and gastrointestinal system.
  • It is also associated with renal agenesis.
May be broadly divided into three main categories based on the number and morphology of the lower limbs
  • SIRENOMELIA DIPUS
Two fixed feet ,two tibia, fused fibula,two femur.
  • SIRENOMELIA UNIPUS
One rudimentary foot,two tibiae, fused femur.
  • SIRENOMELIA APUS
Absent feet, fused femur/tibiae,absent fibula.
  • ANTENATALLY can be diagnosed by USG
  • 1st case reported in black race.

 
B/O BABY, TERM/AGA/LBW/SIRENOMELIA DIPUS, delivered by LSCS,not cried after birth
Died within 1 hour of life.
Antenatal H/O: UNBOOKED CASE,not diagnosed

 

          3.CONGENITAL CHLOROQUINE  RESISTANT MALARIA IN
                                NEWBORN PERIOD                                                         
 
A 21 day old male neonate with weight of 3.2kg was admitted in our NICU ON 26.8.14
with history of fever and abdominal  distension of one day duration


         
 
Significant Antenatal history of
 Mother is primi 20 years old ,non consangunious marriage resident of tharamangalm,she is
booked and immunized.her LMP:24.10.13,EDD:10.8.14,H/O staying at thirupathi since conception Which is one of the high transmission risk zone in india ,
 H/O FEVER during her second trimester and investigated and found to be plasmodium vivax
positive on 14.5.2014 with GA of 29 weeks & H/O taking antimalarial treatment with no proper
evidence.  
  This baby delivered in our hospital by labour naturalis on 5.8.14 at 12.46am with apgar of 8/10 and 9/10, with a birth weight of 3 kg.Baby was on breast feed since birth .Baby passed urine and meconium on day 1 and
discharged on day 3 without any significant llness                                                                                                       
On examination                                                                               
On physical examination;
 The neonate was febrile(Temp-39 C )and pallor.
 No dehydration,
 cry,activity- fair with presents of cephalhematoma.
 On systemic examination;
 Cvs s1 s2 + no murmur. HR-145/min ,
 RS-BAE + tachypenic with SCR . RR-71/min
 P/A-soft with distensio,,SPLENOMEGALY + 3cm beloe left costal margin
 CNS-AF N,Tone and NNR are normal\


Investigations:
 
 ON LAB FINDING;
 Renal parameters ,blood sugar and s.electrolytes are within normal limits
 CBC-normal limit except his Hemogloblin10.4 gms%
 Pheripheral smear study demonstrates;
Smear positive for malarial parasite
plasmodium vivax                

                                                                                                                                           
      CRP-POSITIVE
 BLOOD C/S;
 E.COLI GROWTH IDENTIFIED with sensitive to amikacin,gentamycin and ofloxacin
 CXR-Suggestive of pneumonia
 Baby was treated empirically with iv ampicillin,cefotaxime for lateonset sepsis for 2 days,
 Then switched over to iv amikacin according to blood  culture and sensitivity pattern for E coli
 After smear confirmation of p.vivax ,diagnosed as congenital malaria , started syr chloroquine 30mg
stat followed by 15mg after 6hours,24 hours & 48 hour
 Baby was fever free after initiation of antimalaria drugs.
 Baby was developed fever and cough again after 7 days AND Repeat pheripheral smear study
demonstrates schzionts,trophozoite stage of pl.vivax seen with few ring forms along with lymphocytosis.
 So consider as chloroquine resistant congenital malaria
 Baby started with Tab. QUININE 15mg bd
 After 3 days of treatment baby is free from fever and cough                                                                                                                                                                                                                                                                                                                                                                          
DISSCUSSION                                                                                                            
           CONGENITAL MALARIA                                                                                                                                                 
Congenital malaria is rare disease,so far,300 cases reported in literature
 Congenital malaria was first described in 1876 More recent studies however suggest suggest that
incidence has increased and value between 0.3% to 0.33% have been observed from both endemic
and non endemic areas
Congenital malaria defined as the presence of plasmodium parasites in the erythrocytes of newborns aged less than seven days.It can be acquired by tranmission of parasites from the mother prenatally or perinatally.The first sign or symptoms most commonly occurs between 10 and 30 days of  age.                                                                                                                                                                            
Congenital malaria usually occur in the offspring of a nonimmune mother with p.vivax or p.malariae infection,it can be observed with any of the human malarial species
 Hence it is reported rarely ,in endemic areas , congenital malaria is an important cause of abortions,stillbirths,premature births,IUGR,and neonatal death
 
Signs and symptoms:
 
 The most common clinical features in 80% 0f
cases are FEVER,ANEMIA AND SPLENOMEGALY,
 Other features includes,
 Hepatomegaly
 Jaundice
 Regurgitation
 Loose stools,vomitting
 Poor feeding
 Drowsiness
 Restlessness
 Cyanosis
 Respiratory distress
 Possibly convulsion
 
Diagnostic techniques
 
 Peripheral smear study by microscope(thick and thin smears)-GOLD STANDARD
 Rapid Immunochromatographic test for p.falciparam-HRP2 and aldolase is approved for testing for p.falciparum and p.vivax
 PCR-More sensitine than microscopy but is technically more complex
 
Treatment
 
 Chloroquine is the drug of choice
 Infection with chloroquine resistant strain require multidrug therapy.
 Primaquine is not reqired for congenital malaria,because there is no persistant liver phase
in congenitally acquired infections
 There is no official data on how to use ACT IN THIS AGE GROUP,despite the fact that malaria can
occur at a very young age and that ACT offers greater efficacy and tolerability compared with
quinine which is often used in infants with clinical malaria
 
 
INSTRUMENTS DONATED BY MLA

 
LG AIR CONDITIONING MACHINE DONATED BY MR. KRISHNAN, MLA, BALPAKKI, SALEM. ON 27.02.2012 TO NEW BORN WARD.
 


 

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