Extended Breast Feeding: A Proposal for Further Study

In this brief communication, I will put the issue of an extended duration of breast-feeding into the context of existing psychoanalytic literature on the subject. I would like to bring attention to the fact that psychoanalytic professionals have given it insufficient attention. 

 To underscore the importance of the issue, I will raise developmental questions, but not attempt to provide probable answers insofar as such would hopefully come only with greater focus on the issue, including both clinical and empirical investigations. While oral sucking deprivation is equally of importance, it is not my focus in this proposal. While I am strongly in favor of breast-feeding for its psychological benefits for the nursing couple, my interests are to inquire as to the possible consequences of extended breast-feeding.  Read more>>>>>>>>>>>>>>

Juvenile Batten Disease Past and Present Diagnosis

Juvenile Batten disease or Juvenile neuronal ceroid lipofuscinosis (JNCLs) inherit in autosomal recessive pattern leading to neurodegenerative disorder of onset in children between 4 to 8 years. The symptoms associated with this disease include cognitive decline, seizures, movement disorder, progressive dementia, epilepsy and retinopathy which was first described in 1903. 

This disease has estimated incidence range from 7/100,000 births worldwide and caused by genetic mutations which lead lipo fuscins to accumulate within the tissues of human body. In NCLs, nearly 400 pathogenic mutations have been reported and they are included in NCL Mutation Database. Till date, there is no established treatment available which can prevent or stop the disease pathogenesis. Nearly fourteen genes have been reported to be found associated with various types of neuronal ceroid lipofuscinosis and these genes harbor majority of mutations leading to development of batten disease phenotypes. Read more>>>>>>>>>>>>>>>>

Realizing Personalized Medicine in Asthmatic Children Requires Large-Scale Collaboration

Although asthma treatment is effective in many children, there is large variability in the response as evidenced by improved symptom control, reduced exacerbations and lung function improvement. A study by the National Heart, Lung, and Blood Institute’s Childhood Asthma Research and Education Network detailed theresponses of 144 children with mild-to-moderate asthma to 8-weeks of treatmentwith inhaled corticosteroids (ICS) in a randomized cross-over design. 

A large variation in lung function improvement from baseline was found. Change in asthma-controlled days showed a similarly wide distribution, varying between an increase of seven asthma controlled days per week to a decrease of four asthma-controlled days per week. One mechanism for heterogeneity in treatment response seems likely to be due to genetic variations within the asthma population. These genetic variants may be due to either innate differences in underlying disease subtype all manifesting clinically as asthma or to pharmacokinetic or pharmacodynamics influences on drug level or target.  Read more>>>>>>>>>>>>>>>>>

A Rare Case of Congenital Teratoma Arising from Hard Palate in a New Born

A female neonate was born at 39 weeks gestation on 15 Feb, 2012 to a 24 yrs old primigravida. The mother was a booked case but antenataly no congenital abnormality was detected. Polyhydramnios during pregnancy suggested impaired fetal swallowing. Mother was admitted in this hospital at term. Taken foremergency LSCS because of non-progress of labour. The neonate was born by LSCS with a large mass was coming through the mouth and neonate had developed respiratory distress. Neonate was immediately intubated. 

The intubation was difficult and bag and tube ventilation was given. And neonate was immediately transferred to NICU on T-piece ventilation. Examination showed an obstructive polypoid mass that included areas covered in skin and hairs, and cystic, ulcerated lobes.Computed tomography showed a complex mass protruding from the oral cavity. 3D analysis showed arises from the palate. It consisted of cystic, fat, bony, and neural elements, with defined teeth within the bone. Though there was no evidence of intracranial involvement. The tumour was cauterised from its base and deliver the mass excised on 1st day of life. Read more>>>>>>>>>>>>>

Pseudohypoaldosteronism Secondary to High Output Ileostomy

A female infant was born at 35 weeks gestational age with birth weight of 2.6 kg. Antenatally, she was found to have an abdominal mass of unknown origin, so the patient was admitted to neonatal intensive care unit immediately after birth. Abdominal and pelvic computed tomography scan showed a huge cystic lesion with marginal calcification and compression effect on the intestine. Diagnostic laparotomy was done in the first day of life and showed ileal perforation with meconium cyst formation. 

Drainage of meconium was done with terminal ileum resection and creation of ileostomy. Postoperatively, the patient received total parental nutrition for one week, after which feeding was started gradually and intravenous fluids were discontinued completely within 2 weeks. At one month of age, the infant developed severe dehydration due to excessive losses of gastrointestinal fluids through the ileostomy. She had delayed capillary refill and hypotension. Laboratory testing revealed hyponatremia, hyperkalemia and metabolic acidosis. Blood glucose was normal. Read more>>>>>>>>>>>>>>>>