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139
Monthly Clinical Meeting
At Department of Pediatrics, SSG Hospital, Vadodara.
1. 8.00 am to 8.20 am Unusual case .. Short Presentation
- Dr. Anand Naragal
2. 8.20 am to 8.40 am Case report of calverian tuberculosis
- Dr. Varsha Shah
3. 8.40 am to 9.00 am Journal Scan
- Dr. Snhel Shirolawala
Clinic Meeting Sponsored by:
Samarth Life Sciences Pvt. Ltd. INSED ATOMISER
(Midazolam nasad spray (5 mg/ml))
20-08-2009
Thursday
140
Quiz - 5
Regarding the cumulative scores, Dr Sanjeev Goel is leading with the score of 44, Dr Bhavesh Shah and Dr Nisarg are having second position at 42 & Dr Parul Valia having nearly the same score of 41. Dr Hitesh Desai is at 39 and Dr Samir Shah having score of 38. I think it will be interesting to witness the dynamics of the scores.
Q. 51 A 10 year old boy with insulin dependent diabetes, on a twice daily routine of long and short acting insulin, reports regular hypoglycemia while playing football in the afternoon. To prevent this problem, you should advise him to
a. give less short acting insulin before breakfast
b. test his urine for sugar before playing football
c. give up playing football
d. eat extra carbohydrate such as a small chocolate bar before football and to take glucose tablets when he begins to feel lightheaded.
Q.52 A 3 years old boy is brought to hospital after choking while eating peanuts. He was wheezy for a few minutes but is now asymptomatic. Regarding this which of following is a correct statement?
a. a chest X-ray is not indicated because a peanut is not radio-opaque.
b. the risk of lung damage is less because the inhaled material is organic.
c. if he remains asymptomatic for 24 hours and physical examination is normal, he may be safely discharged home without further investigation.
d. bronchoscopy should be performed as soon as possible.
Q.53. All of the following conditions can be reliably diagnosed by mucosal biopsy except
a. Sucrase deficiency
b. Cystic fibrosis
c. Helicobacter Pylori infection
d. Hirschprung’s disease.
Answers to Quiz No. 5 are
41. A
42. B
43. A
44. D
45. B
46. B
47. D
48. D
49. B
50. D
Congratulations to the top scorers. The names of the top scorers are as follows :
Score 09 :
- Dr Sanjeev Goel,
- Dr Nisarg Shah
- Dr Samir Shah,
Score 08 :
- Dr Parul Valia, - Dr Bhavesh Shah,
- Dr Ashutosh Patel - Dr Hitesh Desai
Score 07 :
- Dr Sanjay Majmudar,
With kind permission from AOP Vadodara, Post Graduate Students of the Pediatric Department Medical College Baroda were happy to participate this time for the quiz. Practicing pediatricians with busy practice have scored much better. I think students should work hard to improve their performance.
Score 07 :
- Dr Amit Jetani - Dr Neha Jain
- Dr Saurabh Modasiya - Dr Manan Parikh
Score 06 :
- Dr Mandar Kale - Dr Sushma T. S.
- Dr Komal Parekh, - Dr Tarun Parmar
Dr. Paresh Thakkar
141
Q.54 All of the following may be the presenting feature in case of Coaractation of the aorta except
a. clinical features suggestive of septic shock in an infant
b. pain in the legs on exercise in a school age child
c. rib notching on a chest X-ray.
d. postural hypotension in an adolescent.
Q.55 A 13 year old child is having low grade fever and arthralgia. There is past history of hepatitis A infection 1 year before. 10 days before he had pharyngitis which was treated with penicillins. On examination he is having BP of 154 / 92 and mild pitting pedal edema. Rest systemic examination is normal. Regarding laboratory investigations, Hemogram is normal, urine showing large amount of protein and presence of plenty of RBCs and RBC cast in urine microscopy. S Creatinine is 1.7, serum electrolytes and blood urea is normal.
Which of the following is likely cause of his renal dysfunction?
a. Allergic reaction to Penicillins
b. High levels of compliment
c. Immune complex mediated damage
d. Previous infection with Hepatitis A.
Q.56 A 4 year old child is brought to the emergency room by the parents. Parents found him in the floor of bathroom barely breathing. The contents of the medicine cabinet as well as the cleaning products kept under the sink appear to have been disturbed. His heart rate is 150/min, Respiratory rate is 8/min, BP is 60/35. The child is intubated. Multiple attempts to establish venous access have failed. Regarding fluid management which of the following would be the most appropriate next step
a. Administration of fluid via Naso-gastric tube.
b. obtaining Central venous access
c. taking intra-osseous line
d. performing saphenous cut down
Q.57. A 12 year old child with Chronic Persistent Asthma presents with cough and breathlessness. He is on inhaler therapy and some other oral drugs for the treatment of asthma. He has suffered 4 episodes of respiratory tract infection out of
which he was required to be admitted twice. Presently on examination he is having tachypnea with significant respiratory distress and cyanosis. Respiratory system examination is showing bilateral extensive rhonchi. Which of the following blood gas analysis and electrolyte values are most closely matching with the given clinical situation?
pH pCO2 pO2 Na K Cl HCO3
a 7.3 22 98 140 4.0 105 16
b 7.55 25 99 140 4.0 108 25
c 7.34 54 52 137 4.0 96 35
d 7.24 24 99 136 4.0 96 12
Q.58 A 16 year old boy has been reported to emergency room after suicidal ingestion of Aspirin tablets. On examination the child is drowsy and tachypnic. Which of the following blood gas analysis and electrolyte values are most closely matching with the given clinical situation?
pH pCO2 pO2 Na K Cl HCO3
a 7.3 22 98 140 4.0 105 16
b 7.55 25 99 140 4.0 108 25
c 7.34 54 52 137 4.0 96 35
d 7.24 24 99 136 4.0 96 12
Q.59 A six month old boy has been brought to emergency room by mother. He has developed intense burning, itching and redness of the skin after sun exposure for five minutes. Urinary porphyrins are of normal levels. Which of the following is most likely diagnosis for this child?
a. Congenital Erythropoietic Porphyria
b. Erythropoietic Protoporphyria
c. Heriditory Coproporphyria
d. Porphyria Cutanea Tarda
Q.60 Colitis is associated with all of the following except
a. Cow milk protein allergy
b. Coeliac disease
c. Campylobacter infection
d. Hirschsprung’s disease.
Please email your answers
[email protected] or send sms to
Dr. Paresh Thakkar on 9426032150
Last Date : 31st August 2009
142
The Matters of MoneyDr. Niranjan Shendurnikar
It’s a wise idea to treat money with respect. Money
plays an important role in our lives and it is a
common tendency that as we earn more, we also
want more of it. The way that you are going to
utilize your money and set your financial priorities
would to a large extent determine the way you are
going to live your life. Whether one is a salaried
person or a businessman, each one wants to keep
his/her money intact, acquire assets and let the
money beget more money.
Financial education or financial literacy is
basically learning how to spend money wisely and
what to do rightly after you make it. The good idea
about money should be to keep it longer, invest it
wisely and make it work for you. The financial
success stories of McDonald’s, Henry Ford,
Naresh Goyal, Azim Premji, Sunil Mittal and many
others are a result of their brilliant minds,
entrepreneurship, technical brilliance and
managerial skills. Sylvia Porter, a renowned
financial expert says that the money can be
translated into a beauty of living, or a support in
misfortune, on education or future security. Many
people often go overboard buying different stuff
and things. While there may be nothing wrong in
having things but if becomes your only pursuit, it
would never make you totally satisfied. Do not let
the stuff and things dominate you.
We are living in exciting and prosperous times
where we have potential growth opportunities and
expanding new directions for economy. If we have
timely information and are willing to be bold and
take some risks we can convert our money into
real power, energy and happiness. Interest rates
go up and on, gold values fluctuate, real estate is
finally coming out of dumps and the stock market
is doing a war dance. How do you decide where
to invest your money? No doubt your needs may
be less but we need to save now when we can.
The first step towards wealth creation is saving.
You must spend less than you earn, then save and
invest the difference wisely. Let your savings
become the seeds of your wealth. Strategies such
as setting financial goals, and assessing the
involved risks should be able to guide you through
your financial planning and responsibilities ahead.
Apply your financial knowledge consistently in
your personal and professional finances to let you
become a financial success in your life. Plan your
investments before hand to reap optimum profits
and minimize the risks. Think about your goals,
children’s education, marriage, medical expenses
and retirement and plan step by step. Diversifying
the investments, not putting all the eggs in one
basket, considering market fluctuations and
optimizing short term and long term investments
have become increasingly essential to ensure
good value for your money.
Never, never lose control of your assets. It was
not a long ago ‘Baghbaan’ and quite a few other
movies showed us what a great folly it would be to
mix together a filial love and assets. People have
entrusted their hard earned money to others only
to have their trust betrayed later. Be financially
independent, secure and powerful. If money is
what you want to make and grow, make financial
literacy a continuous process. Don’t earn to spend
only. Learn to earn to make your money earn for
itself. Let your own financial intelligence make the
money work for you rather than you working for
money. Let your meticulous planning become the
harvest for tomorrow’s returns. Examine, analyze,
reassess your financial needs, develop a strategy
and get rewarded happily and financially!
and the father(Thomas Button) takes the baby and
abandons him on the porch of a nursing home.
Given a little chance of survival, but who does
survive and over the course of the story Benjamin
becomes to grow younger biologically. Benjamin
is raised by a black woman who’s a caregiver at a
seniors’ home. Daisy's grandmother was a
resident at that home, which is where she first met
Benjamin. Although separated through the years,
Daisy and Benjamin remain in contact throughout
their lives, reconnecting in their forties when in age
they finally match up. Subsequently after many
years, they both fall in love each other at about
same biological age. They experience the 1960s
together, in large part blissfully but increasingly
aware of Benjamin growing younger while Daisy
grows older. Interspersed in between are the
beautiful relationship shown between Benjamin
and his caretaker/mother, his affair with a married
older woman, explorations over the seas and
Russia and his relationship with his dying father.
Towards the end, 84-year-old Benjamin, who is
now physically an infant, closes his eyes as to
sleep and dies in Daisy's arms.
There are several poignant moments through out
the movie.There is an abundance of rich story
telling backed by fantastic performances. This is a
kindly sweet hearted movie filled with lots of truly
touching stuff about impermanence, love and loss.
The movie is a masterful piece of art replete with
outstanding cinematography, special effects,
make up work and the set design, for which it has
deservedly won three Oscar awards. David
Fincher, the director has treated the script with a
visual bravura and narrative gusto usually beyond
the routine Hollywood mainstream. The story is
indeed curious and a long one indeed (nearly
three hours) with a rambling exploration of time
and what one makes of it during his/her life.
143
The Curious Case of Benjamin Button Dr. Niranjan Shendurnikar
The Hollywood movie , The Curious case of
Benjamin Button (2008) is an epic fantasy tale set
up in the historical period after World War 1 and
thereafter. The movie rolls backwards from the
year 2005 on the day when Hurricane Katrina hits
New Orleans in USA and elderly Daisy Williams
who is on her death bed asks her daughter
Carolene Williams to read to her the diary which
recounts the entire extra ordinary life of her long
term friend Benjamin Button As the narration
begins the viewers are taken back to the era at
the end of World war 1(1918) when a baby
boy(Benjamin Button), played superbly by Brad
Pitt, is born with the unusual appearance and
physical maladies of an 85-year-old man. The
mother of the baby dies shortly after giving birth,
144
Movie Review
Jay(Saif Ali Khan) enters into a relationship with
Meera Pandit (Deepika Padukone). They are
practical, material people who do not allow their
hearts to rule over their head. Especially, Jay does
not believe in ‘love’, ‘marriage’ and being committed
to one soul mate all through one’s life. Jay has been
aspiring to migrate to the US for some time and been
working at it. Meera works into fresco paintings. She
gets a job assignment in India. When she decides to
move to India, they mutually decide to end their
commitment to each other and move on in life on a
happy note. They even throw a ‘breakup party’ for
their friends, and make it known to all that they are
Dr Bankim Parikh
separating out and hence once again ‘available’.
Soon they start missing each other. Their friendship
blossomed further. They became more casual, more
frank and outspoken, and began enjoying their
friendship more than ever before. It was somewhere
here that Meera realizes that this relation is much
more than friendship. Jay, though he feels and goes
through the emotional trauma of missing Meera,
refuses to admit that he can ever fall in ‘love’ or have
permanent relationship. Both try to have new
partners in their respective lives, but cannot forget
each other. It takes a long time for Jay to finally
realize, accept, and admit that he was in love with
Meera.
Interspersed in this story is another story in
flashback- that of Sardar Veer Singh ( Rishi Kapoor)
and Harleen (Gisssele). Veer’s younger days are
played again by a turbanated Saif ali Khan in double
role. This story is that of ‘love at first sight’; fully
committed to each other, of sacrifice, decision to be
together for eternity – a complete contrast to the
main story.
The common factor between the two stories is that
despite the changes in the way one thinks and
behaves in these ‘progressive’, practical times, the
‘feelings’ remain the same over the ages. ‘Love’ has
remained the same over times immemorial.
[email protected] Love aajkal
My rating ***
Bankim Parikh
Indiatimes rating ***
Release Date : July 31, 2009
Director : Imtiaz Ali
Star Cast
Saif Ali Khan...... Jai Vardhan Singh
Deepika Padukone...... Meera
Giselle Monteiro...... Harleen Kaur (introducing)
Rishi Kapoor...... Veer
Rahul Khanna...... Meera's boss
Neetu Singh...... Veer's wife
Vir Das...... Shonty
Raj Zutshi...... Harleen's father
Singers :
Neeraj Shridhar,
Master Saleem,
Suzi Q,
Sunidhi Chauhan,
Mohit Chauhan,
Rahat Fateh Ali Khan
K K
Lyricist : Irshad Kamil
Music Director : Pritam Chakraborty
145
02 Sept. Kairavi Pancholi
02 Sept. Jahnavi Sanjay Shah
03 Sept. Satish Daksha Shah
04 Sept. Himanshu Parul Chauhan
04 Sept. Rupal Bhavesh Shah
06 Sept. Nita Mehul Shah
07 Sept. Kamla T.B Patel
07 Sept. Rajesh Urmi Parikh
08 Sept. Ramila Dhanteja
09 Sept. Atharva Ravindra Pradhan
10 Sept. Sahil Sanjay Majmudar
12 Sept. Disha Ashvin Shah
13 Sept. Harshil Haresh Patel
13 Sept. Neha Mukesh Chandiramani
Birthdays and Anniversaries
Birthdays
15 Sept. Beena Divyakant Patel
16 Sept. Ashutosh Patel
16 Sept. Parita Satish Pandya
17 Sept. Arun Phatak
18 Sept. Nitin Agarwal
20 Sept. Sanjay Shah
22 Sept. Nirupa Munshi
22 Sept. Heena Ritesh Shah
22 Sept. Swetal Sunil Fajalia
23 Sept. Shalin Bankim Parikh
25 Sept. Dhairya Shreyas Shah (Jr.)
26 Sept. Arpit Nina Joshi
27 Sept. Saakshi Sanjeev Goel
With Best Complements from :
Vrundavan PharmaDeepak Sheth (Kaka) Mobile : 98254 59318
94265 62272Available :
All Pediatric range, Syrup, Susp. Medicine, Antibiotics,
Injections Tablets of ethical generic company
Surgicals Goods :
Mediflon, Neocan, Vainflow, Neoflon,
I/V Set, S/V Set, P/D Set, Dis. Sy.- BD
11, Shivang Flats, B/h. Suryanagar Bus Stop, Waghodia Road, Vadodara - 390 019.
146
AMRIT KRISHNAHEART CARE CLINIC
102, A-1, Sheetal Apartment, Opp. Panchratna,Subhanpura Road, Ellorapark, VADODARA-23
Dedicated Pediatric Cardiologist
M.D. (Ped.), Fellowship in Pediatric Cardiology
Dr. Mahesh Bhatt
Visit By Appointment Only
Contact No. 09825029744
147
HAEMOCARECENTRECentre for Diagnosis & Treatment Counseling
Blood Cancer
Leukemia
Lymphoma
Myeloma
v
v
v
Anemia
Congenital
Acquired
v
v
ITP (Immune Thrombocytopenic Purpura)
Hemophilia A & B
Von Willebrand Disease
DIC
TTP
Other Congenital & Acquired Bleeding Disorder
v
v
v
v
v
v
Bleeding Disorders
Thrombotic Disorders
DVT (Deep Vein Thrombosis)
Pulmonary Embolism
Cerebral Vein Thrombosis
Congenital & Acquired Thrombophilia
v
v
v
v
Dr. Seema Bhatwadekar M.D.Consultant Haematologist & Oncohaematologist
101, Berry's Plaza, 11-A, Shrinagar Soc., Above samsung Shoroom,
Akota Road, Vadodara - 390 020. Ph. (C) 0265-2321776 (M) : 93745 11709
E-mail : [email protected]
Please visit our Website – topranilabs.com for details
E mail - [email protected]
Toprani Advanced Lab Systems
Stem Cell Estimation (CD34 Positive) by Flow Cytometry
According to ISHAGE guidelines
(Please contact lab for details)
Also available CD4/8/3 and HLA B27 by Flow Cytometry
New Introduction
Pediatric Surgeon
Dr. Siddhartha NayakM.S.(Gen. Surgery)
M.Ch. (Pediatric Surgery: P.G.I.; Chandigarh)
On Panel:
[1] S.S.G.H. and
Govt. Medical College
[2] K. G. P. Children Hospital
[3] O.N.G.C.
Hospital :
Sanstha Vasahat, Pratap Road,
Raopura,Vadodara -390 001
Mobile: 98250 62271
Tele No: 0265-245 99 77
148
Did you know?
• It is one of the commonest congenital anomalies only second to spina bifida and cleft lip and palate.
• It is also the commonest anomaly which is missed by clinicians during routine check ups.
• Not correcting it in time (before school going age which is now 2 years) can lead to severe psychological effects on child’s mind.
• Most hypospadias can now be corrected as single stage repair with fistula rate of as low as 5 -10 %.- starting at 1 year of age.
• As high as 20 % of proximal
At Neel Surgical Hospital for children…………
• More than 200 cases of hypospadias operated in last 7 years
• Modern techniques for surgery and treatment like
- Caudal anesthesia – more safe, excellent post op pain relief.
- Usage of loops for proper placements of microstitches.
- Silastic catheters for urethra to minimize irritation.
- Drugs to decrease postoperative bladder spasms.
are employed.
• All thru out the stay child is kept busy with children friendly staff, cartoon shows, Children’s Books from ‘My library’ and
Neel Surgical Hospital for childrenKaram Dham Complex, Near Atithigruh , Akota, Baroda.
For appointments : please call 0265-2312680
Hypospadias
Dr. Darshana Naik MD
Consultant Pediatric Neurologist
Fellow Pediatric Neurology, Hinduja Hospital, Mumbai.Fellow Pediatric Neurophysiology, London,UK
Asian Child Neuro Clinics and Cerebral Palsy Centre2nd Floor, Park Avenue Building, Opp. Parimal Garden, Besides Piramyd Mall,
Ellisbridge, Ahmedabad. Phone : 079 - 26400640 • 9924181291
Facilities Available :
EEG, VideoEEG, EMG, NCV, BERA, VEP, SSEP, ERG
IQ test, Aptitude test, ADHD, Autism management
VISITING PEDIATRIC NEUROLOGIST : (BARODA)
1) Kashiba Children Hospital : First SATURDAY OF MONTH 9-11 AM
2) Unity-Sterling Hospital : First SATURDAY OF MONTH 11-1 PM
DEVELOPMENTAL CENTRE
KRISHNA
149
Services offered :
• Early intervention program for the NICU graduates
• Hearing screening by OAE
• Diagnostic BERA
• PT, OT, Neurodevelopment techniques
• Speech therapy
• Dasii & IQ testing
• Cognitive stimulation, Play therapy
• Counseling for behavioral problems
• Special education for LD & MR children
• Sensory integration for autistic children
Olive 2, Bhavanipura Society, Next to Haveli, Nizampura, Vadodara - 2. Ph. : 0265-6581121Time – 9: 00 A.M. – 7: 00 P.M – Prior appt. necessary
'TOWARDS A BETTER FUTURE'
202, Nimbalkar Chambers,
Kharivav Road,
Dandia Bazaar,
Vadodara.
Ph. – 2410390
S-9, National Plaza,
R.C. Dutt Road,
Alkapuri,
Vadodara.
Ph. - 2359792
150
OM ORTHODONTIC CLINIC
email : [email protected] • www.dranjugohilparikh.webraj.com
101, Profit Centre, Kalaghoda, Sayajigunj, Vadodara - 390 005.
Tel : (C) 6544699, 2225999 (M) 98250 40106 (R) 2433888
Dr. Anju Ajit Gohil / Parikh (M.D.S.) Orthodontist
Specialist in :
Correcting Protruded & Irregular Teeth &
Abnormally Growing Jaws.
Consulting & Visiting Orthodontist
Visiting Hours : 10 am to 1 pm
5 pm to 8 pm
Exclusive
Orthodontics
Best compliments from
Padmasana Dental ClinicDr. Bhavna Haresh Dave
M.D.S. (Pedodontia)
Specialist in: Children Dentistry
151
With Best Compliments
Dr. Bhavesh M. ThakkarPediatric Interventional Cardiologist
Mobile : 9898022444
Add. : 1. U. N. Mehta Institute of Cardiology and Research Centre, Ahmedabad
2. Krishna Heart Institute, Ahmedabad
Distributors/Stokists : (Surgicals)
• B-d India Ltd.
• Medicare Hygiene Pvt.ltd.(medica Brand Dressing Material)
• Sangam Healthcare Products Ltd. (safti Brand Of Products)
• Kohinoor Products( Gauze/bandages)
• Deepak Surgical (gallant Razor/skin Mate Skin Stappler/parakin
Latex Gloves/cardio Tec Ecg Electrodes/daxi Flo I.v.regulator.
• Kam Som Industries (abs.cotton)
• Melody Plastic Products Pvt.ltd. (pov.iodine Etc.)
• Safeflo Urin Bag.
• Jms ( I.v/tape/scalp Vein Etc)
• Primwear(india)
DOSHI SURGICALS
“Dealers In Surgical Disposable Items, Rehabilitation Aids, Consumer Goods, Wide Range Of Innovative Medical Items. “
Established: 1995 Mobile No: 9825043592
Other Dealings :
* Ethicon (j&j) Sutures / * Nulife Gloves / * Kaltex Gloves / *alpha / I.v.fluids / leucoplast / b.brown / romsons/etc
Orthopedic/rehabilitation Aids
• Lp Supports,usa( Exclusive Range Of Neoprene &
Elastic Supports)
• Ortho-royal Inc.,bombay (wide Range Of Rehab/
splints/footcare)
• Foot & Ankle Co.,bombay( Foot Care Products/footwear)
• Samson Scientific & Surgicals.indore
• Falcon Heating Pads
Proprietor: Bhadresh Doshi
Useful Products:
Quality Walking Aids/ Toilet Chairs/ Commodes / Wheel Chair/ Urin Pots/ Bed Pan/ Water Bed/ Air Bed/steam Inhalers/
weighing Scale/ Etc.
152
Head by
Dr. Jitendra Jethani
Consultant Pediatric Ophthalmologist
MS, DO, DNB, FNB
For Appointment Call
0265 - 2410932, 2426311
Services Available :
Age appropriate vision testing
Orthoptic workup
Amblyopia management
Pediatric Neuroophthalmology set up
Orthoptic exercises
Surgical services available :
Pediatric Cataract : with posterior capsulorrhexis
Sutureless squint surgeries
oblique muscle surgeries
Transpositions/Jensen's/Knapp's/Harada Ito surgeries
Management of double vision/diplopia.
Dr. Thakorbhai V. Patel Eye Institute
Sheth M.L. vadiwala Eye HospitalHaribhakti Complex, Vinobha Bhave Marg, Salatwada, Vadodara - 01.
[email protected], www.tvpei.org 0265 - 2410932
Pediatric Eye careOne of its kind in the city
Fully functional
Offers
122