Dear Doctor:

As stated in the previous newsletter, Pediatric Oncall now has an entire new layout, which is more interactive and user friendly. We have introduced many new sections to aid the doctors in better diagnosis and management of their patients. The various new sections are:

• Submit articles: Pediatric Oncall is a premier pediatric website and has a global reach with a hit rate of over 1.2million hits/month. To proclaim your clinical study, write a review article, report an unusual case or just have doctors over the world opine on a problematic case (“Diagnostic Dilemma”), we have now introduced a submission form whereby you can send your article online and our editorial team w! ould review it who will give an opinion about acceptability on the basis of originality, scientific reliability of the article and then put it online on Pediatric Oncall.
  

http://www.pediatriconcall.com/fordoctor/diagnosisdilemma/submitarticle.asp

• Diagnostic Dilemma: You can send in a particular difficult case that is leading nowhere in diagnosis and this case is put online on www.pediatriconcall.com and an S.O.S newsletter would be sent to all the registered doctors on Pediatric Oncall. Thus, the pediatric fraternity will join hands together and try and answer the dil! emma as fast as possible.
  

Present problematic case:

A 2-year-old male child born of non-consanguineous marriage from Uttar Pradesh (area endemic for Kala Azar) presents with

· Fever since 1 year

· Splenohepatomegaly

· Generalized edema

· Chronic malnutrition

· Generalized lymphadenopathy

· Pancytopenia with hypersplenism

· High ESR

· Hypoalbuminemia

· ! High alkaline phosphatase

· ? Sea blue histiocytosis on bone marrow aspiration.

· No LD bodies on bone marrow or splenic aspiration

· Bilateral optic disc pallor

· Normal blood sphingomyelinase levels

· HIV negative

· Mantoux test negative

You can answer the dilemma at the link given below:

http://www.pediatriconcall.com/fordoctor/diagnosisdilemma/listdilemma.asp

· Diagnostic Aid: This tool allows you to enter the clinical features to obtain a reasonable and relevant differential diagnosis. This aid is still in its pilot phase and is constantly being updated. At present, one may get a quite accurate result for genetic disorders. Your valuable suggestions for upgradation of this aid are very essential.

http://www.pediatriconcall.com/fordoctor/pediatricanalysis/pediatricanalysis.asp

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Latest articles on Pediatric Oncall:

Case Reports:

· VITAMIN K DEFICIENCY: What do you do when a 4 and half years old male child presents with sudden onset left sided hemiplegia and MRI brain is suggestive of right front parietal bleed?

http://www.pediatriconcall.c! om/fordoctor/casereports/Vitamin_K_deficiency.asp

· CHYLOUS ASCITIS: A 7 years old male child presented with gradually increasing abdominal distension. Ascitic tap is milky. How to approach a case of chylous ascitis?

http://www.pediatriconcall.com/fordoctor/casereports/Chylous_ascitis.asp

· TEACHING FILES: A 3 years old girl presents with proteinuria and hepatosplenomegaly and is diagnosed as Nephrotic syndrome. Are we missing something?

Discuss the previous teaching files - A clinical case: “A 10 year old girl with renal failure and joint pains” in the section of “DISCUSSION GROUPS”.

Latest articles on PARENT CORNER:

· DIETARY MANAGEMENT DURING DIARRHEA AND VOMITING: Read more about fluid and food management in infants and children with gastroenteritis.

http://www.pediatriconcall.com/forpatients/DietandDisease/dietary_mgt.asp

· A GLASS OF MILK FOR YOUR KID: Read about the virtues of milk and how to make your child who abhors milk.

http://www.pediatriconcall.com/forpatients/DietandDisease/a_glass_of_milk.asp