Rajesh Kulkarni

• MD,MRCPCH
• Professor (Associate) at YCM PGI

Use of monoclonal rabies antibodies for PEP in a newborn

MDOT on Asthma in children

Several genetic disorders are associated with either a permanent deficit or a delay in central nervous system myelination. We investigated 24 unrelated families (25 individuals) with deficient myelination after clinical and radiological evaluation. A combinatorial approach of targeting and/or genomic testing was employed. Molecular diagnosis was ac...

Juvenile myelomonocytic leukemia (JMML) is a myelodysplastic/myeloproliferative neoplasm. It is a rare pediatric neoplasm occurring in early childhood. Herein, we present a case of JMML in a 4-year-old girl admitted for primary complaints of protrusion of eyes and fever for the past 15 days not responding to any medications. With findings of spleno...

Introduction Respiratory Syncytial Virus (RSV) is a leading cause of acute lower respiratory infection in children worldwide. Understanding its prevalence, variations, and characteristics is vital, particularly in the context of the COVID-19 pandemic. Objective The study aimed to investigate the RSV positivity rate, subtype prevalence, age and gen...

Constipation in Celiac disease

Background Klebsiella is an important causative organism of neonatal sepsis (NS), particularly in developing countries. This study aimed to analyze the demographic and clinical laboratory features of a fatal outbreak of Klebsiella spp. that occurred in a neonatal intensive care unit (NICU), identify the source of the infections, and propose infecti...

Coronavirus disease 2019 (COVID-19) infection in children predominantly presents with milder symptoms and is apparently less severe. However, 2% of acute pediatric COVID-19 cases possessed severe manifestations. Here, we describe a case study of a 4-year-old boy suffering from acute COVID-19 infection that presented like an adult ARDS requiring pro...

Background: Drug-resistant gram-negative (GN) pathogens are a common cause of neonatal sepsis in low- and middle-income countries. Identifying GN transmission patterns is vital to inform preventive efforts. Methods: We conducted a prospective cohort study, 12 October 2018 to 31 October 2019 to describe the association of maternal and environment...

Systemic lupus erythematosus (SLE) is an autoimmune disease-causing inflammatory tissue damage with multiple organ involvement. We report a 12-year-old girl who presented with 6-month history of high-grade intermittent fever and weight loss, psychiatric symptoms beginning 10 days before admission, and generalized tonic–clonic seizure 4 days before...

Dengue and viral hepatitis A are extensively endemic diseases in India. Coinfection of these infections is uncommon and poses difficulty for physicians to diagnose as their clinical features are quite similar and overlapping. This article presents with 8 paediatric age group cases reporting Dengue fever which occurred concomitantly with Hepatitis A...

Background Diffuse lung disease (DLD), conventionally known as interstitial lung disease (ILD), encompasses a spectrum of diseases involving the pulmonary parenchyma with impairment of gaseous exchange. Most of the diseases under DLD have similar presentations, but appropriate investigations can delineate the exact disease. Diffuse alveolar hemorrh...

terms of the creative common attribution license (http://creativecommons.org/licenses/by/4.0), which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms. Abstract Introduction: The corona virus disease (COVID 19)

Hypernatremic dehydration manifests typically in neonates in the first 2 weeks of life. Early post-partum discharge with lack of knowledge about techniques and adequacy of breast feeding in mothers, primi-parity, anxious elderly mother with lactation problems and caesarean delivery are major risk factors. Most of these babies are seen during the su...

Background: Thalassemia is considered as the most common single gene disorder worldwide. Preventive measures include identification of thalassemia carriers (traits) through screening, genetic counselling and prenatal diagnosis to reduce the incidence. This study aims at estimating the prevalence of carrier status detection among the extended famil...

Background SARS-CoV-2 was first reported in China in December 2019 and quickly spread across the world. Non-pharmaceutical interventions (NPIs) are the key to control the transmission of respiratory viruses. To stop the spread, NPI is widely recommended and is still followed by most countries. Methods At the National Influenza Center of the Indian...

Background There are conflicting data on the mother-to-child transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and few studies have described the clinical course of neonates infected with SARS-CoV-2. Objectives This study investigates the mother-to-child transmission rate and clinical profile of SARS-CoV-2-infected newbor...

Cytomegalovirus (CMV) is a common perinatal infection that tends to follow a silent course and only 5-15% of CMV-infected infants are symptomatic at birth, with signs and symptoms characterized by the involvement of multiple organs, particularly the reticuloendothelial and central nervous systems. (1,2)Gastrointestinal involvement is considered rar...

Background The Omicron variant of SARS-CoV-2 infection was seen to be more infectious but less severe in children than adults with reduced hospitalization rates. There is a paucity of data on hospitalized children with confirmed Omicron variant. Objective We describe demographic, epidemiologic, clinical, radiological, laboratory features and outcom...

10 year old boy with suppuration within skeletal muscles, manifesting as multiple abscesses

Rare Vasculitis in childhood-juvenile polyarteritis nodasa

Covid and Non covid cases in PICU

Background: The COVID-19 pandemic, is an ongoing global caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)..All patients were confirmed by either SARS-CoV-2 RTPCR test or covid Rapid antigen test. Results: Among the 84 patients with COVID-19, the most common symptoms were fever (67.8%), cough (42%), loose stools (16.7%), vomitin...

Background: Literature available on pediatric COVID-19 infection emphasizes on the clinical presentation and radiological changes. Studies on hematological profile of children in COVID-19 infection are very few, especially in India. Aim: To study the hematologic profile of COVID-19 infection in children. Methods: This is a cross sectional observati...

Objective: To study the impact of Severe Acute Respiratory Syndrome CoronaVirus-2 (SARS-CoV-2) disease Pandemic lockdown on routine childhood immunization, considering the limited healthcare and transport facilities while reaching the tertiary care hospital. Methods: It was a hospital based observational study done in a tertiary care centre in West...

Background There are few reports of COVID-19 in neonates and most are suspected to be due to postnatal transmission. Vertical transmission has been proven in only a couple of cases so far.Methods We describe early—onset, severe COVID-19 disease in a neonate with very strong evidence of vertical transmission of SARS-CoV-2.Results A COVID-19 suspecte...

Background Factor XIII deficiency is a rare disorder that may be congenital or acquired and is considered if a coagulation disorder is suspected, but the initial laboratory investigations are normal. Clinical Description A 10-year-old boy presented with a scrotal swelling and pain following minor trauma. Local examination showed redness of overlyi...

Child had delayed milestones,organomegaly,anaemia and adrenal calcification on Xray

Background Neonatal infections with resistant Gram-negative (GN) organisms are associated with high rates of mortality, with limited antibiotic treatment options. The role of maternal colonization and environmental GN organisms as reservoirs for transmission to neonates has not been well described. Methods We performed a prospective cohort study f...

Background COVID-19 is uncommon and less severe in children than adults. It is thought that infants may be at higher risk for severe disease than older children. There is a paucity of literature on infants with COVID, particularly those with severe disease. Objective We describe demographic, epidemiologic, clinical, radiological, laboratory featur...

RACT Diabetes mellitus is a metabolic disease characterised by chronically high glucose levels. Genetic factors have been implicated in the etiology following mutations in a single gene. An extremely rare form of diabetes mellitus is monogenic diabetes, a subset of which is permanent neonatal diabetes which is usually suspected in a child less than...

The COVID-19 pandemic has raised exigent medical, ethical and organizational challenges. While some excellent articles have been published about the ethical aspects of pandemics from a bioethicist’s perspective , there is meager published literature on clinician’s perspective. The issues important from a clinician’s point of view are duty to treat,...

Largest KAP study of Pune police towards COVID 19

Aarogya Setu app has helped curb COVID 19 in India.

Case report of covid 19

Background: Recently, hydroxychloroquine (HCQ) has been advocated by the Indian Council of Medical Research for prophylaxis of COVID-19, and the Food and Drug Administration has given emergency use authorization for its use in the treatment of severe COVID-19 disease in hospitalized patients. HCQ is generally well tolerated; however, concerns about...

BACKGROUND: India accounts for 27% of global childhood tuberculosis (TB) burden. Understanding barriers to early diagnosis and treatment in children may improve care and outcomes. METHODS: A cross-sectional study was performed among 89 children initiated on anti-TB treatment from a public hospital in Pune during 2016, using a structured questionnai...

Introduction: Limited literature is available on VAP in children, particularly from India.Hence this study aims to determine the incidence, clinical, laboratory, radiological and microbiological profile, risk factors, and outcomes of ventilator-associated pneumonia in pediatric patients. Methods: This is a prospective observational study which enro...

METHODOLOGY: A retrospective cross sectional study was done at a tertiary teaching hospital NICU. All out born neonates over nine months in 2014 were included. Demographic variables, weight, prematurity, transport details, and outcomes were documented. RESULTS: A total of 259 (35%) neonates of the total 755 admissions were out born. The commonest i...

Background: The 2016 UNAIDS report estimates about 2.1 million people living with HIV in India, of whom about 7 per cent are children under the age of 15 year. The primary objective of this study was to analyze the prevalence of anaemia in HIV Infected HAART naïve and HAART exposed children. The secondary objectives were to analyze the type of anae...

Surgery on an infant with factor VII deficiency is a risky affair, more so when the infant is premature and low birth weight. A 2-month-old infant with factor VII deficiency presented with obstructed right inguinal hernia. He had features suggestive of intestinal obstruction. The hernia was reduced, and the infant was initially managed conservative...

Objectives: To evaluate the sensitivity of the PRISM III score in patients admitted to PICU and to find a cut off PRISM III score. Method: Four hundred children admitted to the PICU of a tertiary care hospital over a period of 18 months were enrolled in this cross-sectional observational study. PRISM III score was calculated using variables after a...

Introduction: Muscular hypertrophy is a striking manifestation of hypothyroidism in children. This phenomenon, known as Kocher-Debre Semelaigne (KDS) syndrome, is associated with generalised muscular hypertrophy giving the child a Herculean appearance. The pathogenesis of the muscle hypertrophy is not elucidated; however it appears to be related to...

Every day, on average, 26 000 children <5 years of age die of malnutrition, mostly from preventable causes, and nearly all of them live in the developing countries. One-third of the malnourished children in the world live in India. Tackling malnutrition in children is a national emergency. Nearly 50% of children between 1 month and 5 years of age a...

D-trans allethrin, a pyrethroid, is commonly used as a coil mosquito repellant. There are very few reports of human toxicity due to D-trans allethrin. We present the case of an 11-month-old boy who presented to us with excessive salivation, altered sensorium and convulsions following alleged accidental ingestion of a coil containing D-transallethri...

Muscle Eye Brain syndrome overlap

Organophosphate (OP) poisoning is a potentially fatal but completely treatable condition that is still very prevalent in our country. Early recognition and treatment is of paramount importance in preventing fatality. Neonatal organophosphate poisoning is very rare. Only three cases have been reported so far in neonates; two accidental and one trans...

Rickettsial infections are re-emerging and are prevalent throughout the world. Due to low index of suspicion, non-specific symptoms and signs and absence of widely available sensitive and specific diagnostic tests, these infections are notoriously difficult to diagnose. We report here a case of rickettsial encephalitis who presented with headache,...

To analyse the factors associated with increased mortality among Indian Children with H1N1. Data were abstracted from available hospital records of children less than 12 y of age, who were admitted to Sassoon General Hospital in Pune, India, with confirmed pandemic 2009 H1N1 influenza infection from August 2009 through January 2010. Logistic regres...

Goldenhar syndrome

Cryptococcus

Benign recurrent sixth nerve palsy

To assess the effectiveness of an indigenously assembled Nasal Bubble CPAP (NB-CPAP) in children during present swine flu pandemic presenting with acute hypoxemic respiratory failure; in improving gas exchange and vital signs; and assess method safety. Thirty Six children with acute hypoxemic respiratory failure admitted to swine flu ICU during the...

we report a case of caroli's syndrome presenting at one year of age. The child had multiple cystic lesions in the liver communicating with intrahepatic bile ducts and multiple bilateral small cysts in kidney with congenital hepatic fibrosis diagnostic of caroli's syndrome.

Hemorrhagic cystitis as a complication of influenza A has been described. There is only one case report describing hemorrhagic cystitis in a child with novel pandemic 2009 H1N1 influenza A infection. We report two children with confirmed novel pandemic 2009 H1N1 infection who had hemorrhagic cystitis.

Long umbilical cord

Idiopathic Myelofibrosis (MF) is an extremely rare condition in children. It has a very variable clinical spectrum. Cases of secondary myelofibrosis associated with Vitamin D deficiency and Systemic Lupus Erythematosus have been reported from India .In this case report, the authors describe clinical signs, laboratory findings and histologic feature...

A full-term female neonate was delivered with meconium stained amniotic fluid by cesarean section by a 2009H1N1 positive 22-year-old second gravida mother, who developed symptoms 8 days prior to delivery. The neonate was completely and immediately isolated from the mother after delivery. Oseltamivir was started at birth to the neonate who had a pot...

Thrombotic thrombocytopenic purpura (TTP) is a rare disease in children with significant mortality in cases who do not receive appropriate treatment. The author describe a 3-year-old child who presented with skin bleeds, microangiopathic anemia, thrombocytopenia and right sided hemi paresis with aphasia and altered sensorium following platelet tran...

We report five cases of HIV infected children, who presented with flu-like symptoms and were diagnosed to have H1N1 infection (swine origin influenza). Four of these children were admitted with respiratory distress and pneumonia and were managed in swine flu isolation ICU. Two children required nonivasive ventilatory support. All children recovered...

Neurological complications have been described with seasonal influenza infection. We report encephalitis manifesting as seizures in a child with confirmed H1N1 infection. Treatment with oseltamivir was started. Child was discharged without any neurological sequelae.

In 1886, Giacomini coined the term os odontoideum .This entity is clinically important because the mobile or insufficient dens renders the transverse atlantal ligament (TAL) ineffective at restraining atlantoaxial motion. Translation of the atlas on the axis may lead to impingement of the upper cervical cord or vertebral artery. Os odontoideum is r...

We report a 10 year old boy presenting with bilateral hydronephrosis and peculiar facial expression suggestive of Ochoa Syndrome or Urofacial syndrome. He had chronic renal failure which was managed conservatively.

Macrodactyly

Lamellar Ichthyosis

Paramyotonia Congenita is a rare neuromuscular disorder characterized by paradoxical myotonia. Nine persons affected in a family over three generations are reported. The pro-band, who had the most severe symptoms, responded well to acetazolamide.This is the first report of kindred with paramyotonia congenita with proven Arg 1448 Cys mutation at SCN...

Asplenia is a well-known condition in which there is malposition and malformations of the abdominal and chest organs. We present a case of asplenia syndrome in an 8 month old infant who was diagnosed to have complex congenital cyanotic heart 4 months back .The infant was admitted this time with pyogenic meningitis. In this article we want to drive...