Himalayan Institute of Medical Sciences
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Item Yellow Fibrous Cord‑Like Penile Discharge in a Preterm Neonate — Fungal Balanoposthitis(PUBMED, 2024-03-01) Chinmay Chetan; Saikat Patra; Brajendra Singh; Girish GuptaA 1785 g male neonate was born at 31 wk gestation, to an inadequately treated syphilitic mother. The neonate was diagnosed with congenital neurosyphilis. Injection benzathine penicillin G stat dose along with injection ceftriaxone was started through peripherally inserted central catheter. At DOL 24 he developed thick yellowish cord-like gelatinous odourless discharge from the penis, measuring 9 mm×4 mm (Fig. 1). Physiological phimosis was present, with no signs of inflammation and urinary retention. No perianal rashes were noted. Oral thrush was present. Histopathological examination of discharge and suprapubic urine KOH mount revealed budding yeast cells with pseudohyphae. Local clotrimazole cream and injection fluconazole was started. Local hygiene was maintained. The discharge culture grew Candida albicans sensitive to fluconazole.Item Correlation of Point-of-Care Lung Ultrasound Scoring System with Clinical Score and Chest X-ray Score for Newborns with Respiratory Distress(PUBMED, 2025-07-07) Brajendra Singh; Chinmay Chetan; Saikat Patra; Girish Gupta; Vinayak Madhukar Jedhe; Shoham MajumderObjectives To determine correlation between the lung ultrasound score with the chest X-ray score and the Downes score in neonates with respiratory distress. Methods All consecutive neonates admitted in the neonatal intensive care unit (NICU) with respiratory distress were checked for eligibility at admission. Clinical scoring was done using Downes score immediately. 12 area lung ultrasound scoring was done using Brat Score by trained experts. Chest X-ray scoring was done from high quality anteroposterior images. The findings of the three scores were then compared and correlated using Pearson correlation coefficient. Results One hundred neonates were enrolled with mean gestational age of 34.8 ± 3.6 wk and mean birth weight of 2063.7 ± 722 g. A positive correlation was found between Downes score and lung ultrasound score (Pearson correlation coefficient 0.712, p-value < 0.001) but not between lung ultrasound score and chest X-ray score. In the subgroup analysis, a statistically significant correlation was found between lung ultrasound score and Downes score for babies > 32 wk gestation but not for those < 32 wk gestation. Conclusions In neonates admitted to NICU with respiratory distress, lung ultrasound score correlates well with Downes score, especially in babies with gestational age > 32 wk.Item Dual fluid silhouette in X-ray of the abdomen: a diagnostic flag for neurogenic bladder with urinary ascites(PUBMED, 2024-06-04) Brajendra Singh; Chinmay Chetan; Aisha Naaz; Girish GuptaA neonate presented with abdominal distension and decreased urinary output. X-ray revealed dual abdominal fluid condition-ascites with a distended bladder, along with vertebral anomalies. The possibility of urinary ascites and neurogenic bladder was kept, which was further confirmed on evaluation. Here, we emphasise the crucial role of abdominal X-ray as a diagnostic tool in uncovering this intricate medical puzzle. By detailing the clinical presentation, diagnostic approach and treatment strategy, the report contributes insights into the rare and complex abdominal condition.Item Assessment of Central Catheter Tip Position in Neonates by Ultrasonography Versus X-ray(SCOPUS, 2024-06-01) Prachi Patwal; Chinmay Chetan; Brajendra Singh; Vinayak Madhukar Jedhe; Girish GuptaCentral catheters are frequently inserted in neonatal intensive care units. The tip of these catheters should be in the correct position; otherwise, it may lead to life-threatening complications. X-ray has been universally used as a standard imaging modality to localize the position of central lines. Ultrasonography is an upcoming promising modality. We compared the catheter tip localization using ultrasonography versus X-ray.Item Biotinidase deficiency-masquerade of primary immunodeficiency disease in neonate(PUBMED, 2024-12-15) Chinmay Chetan; Brajendra Singh; Saikat Patra; Girish GuptaBiotinidase deficiency, a rare metabolic disorder characterised by abnormal biotin metabolism, affects the biotin-dependent carboxylase functions. Primarily characterised by neurological and skin disorder, it may present with myriad features. Early recognition is important for preventing long-term morbidities. Here, we describe a case of a neonate presenting with seizures and a clinical picture suggestive of immunodeficiency. Multiple superficial abscesses along with septic arthritis of the left knee and left hip led to suspicion of primary immunodeficiency disorder. On evaluation, there was severe biotinidase deficiency. The neonate was supplemented with biotin, after which there were no further episodes of severe infection requiring hospitalisation, seizures or skin manifestation. This case report highlights the wide spectrum of clinical picture these disorders may present with and the low threshold for their evaluation and treatment.Item Overcoming odds: neonatal survival in absent right main pulmonary artery with unilateral right pulmonary hypoplasia(PUBMED, 2025-03-07) Debajyoti Banerjee; Brajendra Singh; Saikat Patra; Girish GuptaA unilateral absent pulmonary artery with unilateral pulmonary hypoplasia is an exceptionally rare congenital anomaly. This case report details the management of a neonate diagnosed antenatally with absent right main pulmonary artery and right pulmonary hypoplasia. The neonate developed respiratory failure within 24 hours of birth and was successfully managed with invasive ventilation and conservative treatment. Despite episodes of bronchiolitis during infancy, the child demonstrated normal growth and development at 1 year. This case highlights the importance of early diagnosis, multidisciplinary care and vigilant follow-up in achieving favourable outcomes in rare congenital conditions.