Bacterial resistance to antimicrobials is recognized by the WHO as a major health threat of the 21st century. Antimicrobial resistance threatens the effective prevention and treatment of an ever-increasing range of infections. Infections such as tuberculosis and septicaemia which decimated populations are once again responsible for mortality in epidemic proportions. Bacterial resistance is driven by the continued use of antimicrobials and it is unlikely that the danger of resistance can be effectively diminished by the discovery of new antimicrobials.

A child of 2.5 years old had an intractable seizure, clinically had megalencephaly and mental retardation. On evaluation, video EEG showed fronto-central seizures and dysfunction R 1, scalp EEG showed bilateral paroxysmal bursts, MRI brain showed prominent vascular spaces in the hemisphere, GE reflux scan showed GERD. Other investigations were within normal limits. The child was treated with antiepileptics and antireflux measures and also rehabilitation.

Seckel Syndrome first defined by Seckel in 1959, is a rare (incidence 1:10000) genetically heterogeneous, autosomal recessive disorder presenting at birth. This syndrome is characterised by a proportionate dwarfism of prenatal onset, severe microcephaly with a bird headed appearance (beaked nose, receding forehead, prominent eyes and micrognathia) and mental retardation in addition to the characteristics craniofacial dysmorphism and skeletal defects, abnormalities have been described in the cardiovascular hematopoietic, endocrine, gastrointestinal and central nervous system. Usually such patients have poor psychomotor development.

ABSTRACT Background: The status of breast milk practices is dismal in India in spite of specialized nutrient to newborns by way of breast milk. Culture influences breastfeeding decisions of mothers which have an influence on overall growth, development, health and nourishment of infants and children. Objectives: Assessing the maternal information, approach, and practices towards breastfeeding among mothers. Breastfeeding correlation with a number of antenatal visits, hospital education, maternal education, parity, mode of delivery, holding the baby after delivery, socioeconomic status, employment, religion and sex of the child, and pre- lacteal feeds. Methods: In a study, 400 mothers with children up to 2 years attending hospitals over a one year period. Data was collected using a self-administered standardized questionnaire. Statistical Analysis: The data was analysed regarding mean, frequencies, percentages, Chi-Square test and Spearman’s correlation test. Results: Breast feeding was deferred in mothers who delivered by Caesarean section due to mothers being kept for observation. Forty-three point eight % of mothers initiated first breast feeds within an hour. Eighty-eight point six % had initiated breastfeeds within one to four hours, however, it was. Prelacteal feeds were given by twenty-seven % mothers. Most mothers fed colostrum to the infants. Mean duration of exclusive breastfeeding was four and a half months. There was no association between duration of exclusive breastfeeding with parity, hospital education, holding of baby socioeconomic status and sex of the child. 34% of mothers administered in addition to breast feeding bottle-feeding. The mean age of starting complementary foods was 6 and half months. Conclusion: Due to cultural factors and other social promotional activities, the majority of the mothers had adequate knowledge and a positive attitude towards infant breastfeeding practice. Delay in the initiation of breastfeeding will impact education programs and neonatal feeding practices

The pandemic of AIDS (Acquired Immuno-Deficiency Syndrome) is unique in more ways than one. It has innumerable social, cultural, demographic, political and economic dimensions, knowing no boundaries, the virus cuts across all population groups. The virus is preferentially bent towards those who are primarily in their economically productive years, i.e. 15 years to 49 years. This makes it even more vital to understand its impact on populations who are directly and indirectly shaping the economy. Being in the most productive age group, they are important contributors to the family, society and the economy. Given the ILO estimates globally there are 20 million workers living with HIV/AIDS, (Human Immuno-deficiency Virus), the implications of the pandemic for industrial workers assume a pointed significance. The psycho-social emotional deprivation resulting from the suffering of a family member from HIV/AIDS is not limited to factors operating within the family. The objectives of this study are : To study the problems and perspective of HIV positive people and To find out the stigma related to their status. 50 samples we have selected in this regard. This study is concerned, the majority of respondents who are suffering from HIV infection in Indian families in general and in Dakshina Kannada district, in particular, have carried with them own types of stigma, isolation, and discrimination at large level. They have considered it as one of the deadly disease caused by in numerous ways. Not only effect on our family member and often considered it a disgrace to have an infected person in the family but the whole society practices it as a stigma. They have a strong feeling that if they disclosed their status to their employees, colleagues, friends, family members, and other members would reject them. Their physical and emotional ailments will make difficult for them to function effectively in a different place. Again due to all these stress the physical appearance, loss of weight, the side effects of the medicines will make them difficult to work.

In Human Immuno-deficiency Virus and Acquired Immuno-Deficiency Syndrome (HIV/AIDS), the HIV virus attacks the immune system, which defends the human body against pathogens. When there is balance against the immune system, the people living with HIV/AIDS (PLHA) become more susceptible to opportunistic infections (OIs). With the bodies immune system is not capable of defending itself against Opportunistic Infections, the PLHA ultimately submit to them. In developed countries, the cost of antiretroviral (ARVs) has been borne completely by the state; as a result, there has been a decrease in the number of deaths on account of HIV in the past 15 years. On the other hand, the number of deaths in developing countries due to HIV continues. In this paper, the researchers have made an attempt to examine the status of health of women in urban areas with respect to HIV infection. With this specific aim tried to know the reasons for the HIV/AIDs infection and its effect, consequence on women health particularly. By adopting field survey, interview and case studies methods, 50 samples have been taken and analyzed them systematically.

In Human Immuno-deficiency Virus and Acquired Immuno-Deficiency Syndrome (HIV/AIDS), the HIV virus attacks the immune system, which defends the human body against pathogens. When there is balance against the immune system, the people living with HIV/AIDS (PLHA) become more susceptible to opportunistic infections (OIs). With the bodies immune system is not capable of defending itself against Opportunistic Infections, the PLHA ultimately submit to them. In developed countries, the cost of antiretroviral (ARVs) has been borne completely by the state; as a result, there has been a decrease in the number of deaths on account of HIV in the past 15 years. On the other hand, the number of deaths in developing countries due to HIV continues. In this paper, the researchers have made an attempt to examine the status of health of women in urban areas with respect to HIV infection. With this specific aim tried to know the reasons for the HIV/AIDs infection and its effect, consequence on women health particularly. By adopting field survey, interview and case studies methods, 50 samples have been taken and analyzed them systematically.

In Human Immunodeficiency Virus and Acquired Immuno-Deficiency Syndrome (HIV/AIDS) epidemic, today has become not only a public health issue but also one that is seriously affecting the dynamics of the social, cultural, economic and developmental pace of the society. India has a population of 1.2 billion people, around half of whom are adults in the sexually active age group. The first AIDS case in India was detected in 1986 and since then HIV infection has been reported in all states and union territories. Estimated number of people living with HIV/AIDS, 2009 People living with HIV/AIDS is 2.39 million. Adult (15 years or above) HIV prevalence is 0.31%. Previously it was thought that around 5 million people were living with HIV in India - more than in any other country. Better data, including the results of a national household survey conducted in 2005-2006, led to a major revision of the prevalence estimate in July 2007. It is now thought that around 2.39 million people in India are living with HIV. Of these, an estimated 39% are female and 4 % are children. HIV prevalence in India may have declined slightly in recent years, though the epidemic is still growing in some regions and population groups. AIDS the killer diseases of the century is spreading with enormous rapidly and has now emerged as serious socio-economic and public health problems. The aim of the study is to find out changing scenario of Health Problems due to HIV infection. The objectives are to find out the socio-economic background of the respondents and to know the health issues of the positive people. The fifty samples 25 male and 25 female were selected from ART centre of Dakshina Kannada Districts at Karnataka State, India for this study.

Human Immuno-deficiency Virus and Acquired Immuno-Deficiency Syndrome (HIV/AIDS) is one of the most effective diseases which is associated with different terms and concept like labeling, stereo typing, separating and discriminating the people who are positive. Even though, there is a reason, causes and preventive measures of HIV/AIDS society has considered the positive people are very dangerous and treated them as useless, as social evil and God’s curse etc and also discriminate them. This different attitude of publics have made them to keep themselves isolate from family, community and society. Due to this strong social stigma the positive people try the maximum part of their life in maintaining the secrecy. The present paper deals with demographic status of HIV/AIDS positive people in Dakshina Kannada and their degree of interaction in the family, community and society and also the problems they going to face in their day to day life. The researcher had collected information from various centers, hospitals, agencies and support group. The methodology is used in this study is field survey, interview and case studies method. 25 cases have been studied in depth. The main objectives are to know the impact of HIV on the people, family and in society, and to find out perception of peoples attitude, stigma and discrimination towards the HIV positive people.

The objectives of the present study were to determine the type and morphometric measurements of Foramen magnum (FM) in dry human skulls of Dakshina Kannada district of Southern India. Material and Methods: The present study included 50 adult human skulls of which 32 were males and 18 females. The type of foramen magnum observed macroscopically. Antero-posterior (APD) and transverse diameters (TD) were measured by using stainless steel electronic digital callipers. Foramen magnum Index (FMI) was calculated by using formula FMI = APD/TD. Results: Present study observed 4 types of shapes of foramen magnum, among them ovoid type was found higher frequency (48%). Antero-posterior diameter is a distance between Basion and Opisthion 34.95 mm in males and 34.58 mm in females out of 34.81 mm. The transverse diameters 28.66 mm in males and 28.84 mm in females out of 28.73 mm. Foramen magnum index = 1.2 was considered as ovoid and found in 56% of skulls. Conclusion: We believe that the present study provided additional information about the morphology and morphometric analysis of foramen magnum which is important to radiological, and neurosurgical literature.

Male breast carcinoma is a rare entity. Here, we present a case of mixed mucinous carcinoma i.e. composite mucinous carcinoma with infiltrating ductal carcinoma component in a 55 year old man. Patient clinically presented with a lump in his right breast. Histopathological examination of the breast mass showed tumor cells arranged in nests, cords, cribriform pattern in a mucinous stroma and a part of tumor was showing features of infiltrating ductal carcinoma with desmoplastic stroma.

An eight year old child was admitted with breathing difficulty and ingestion of ten dapsone tablets, on examination cyanosis was detected and methemoglobinemia was found. The child was treated with supportive measures intravenous methylene blue and ascorbic acid as the methemoglobinemia did not reduce to an acceptable level, an exchange transfusion was done the child improved gradually.

Acquired Immune Deficiency Syndrome (AIDS) is the leading cause of death in children under age five, in many parts of Africa and South East Asia. The interval between exposure to Human Immunodeficiency Virus (HIV) and the development of AIDS is shorter in children than in adults. Infants infected with HIV have a high chance of developing AIDS within one year and dying before age three. In the remainder, AIDS progresses more slowly; the average child patient survives to adolescence. In the past, the world has faced many pandemics like cholera and plague. At the turn of the 20th century, the world faced influenza pandemic [1]. Every fifty to sixty years, the world has faced a new disease that has been of the nature of an epidemic. These diseases have left a trail of death and morbidity. There has been widespread fear and stigma attached to the victims due to ignorance and fear. As the diseases have progressed people have made efforts to study the issues. They have found the cause, spread, cures, and vaccines to prevent the spread of the disease. The aim of the study is to know the Impact of HIV/AIDS on the Psychosocial Development of Children and the objectives are to study the knowledge and awareness about HIV/AIDS. And to study the psychosocial problems faced by the children. In this regard, the researcher conducted a survey of 50 samples of children below the age group of 18 from the community.

Incidence of auxiliary head of the flexor pollicis longus muscle has been described repeatedly. Accessory head has been noted arising from the lateral or more rarely from the medial border of the coronoid process of the ulna. During routine dissection, we found a rare case of an additional slip of tendinous origin of flexor pollicis longus muscle from the medial epicondyle of the humerus. However, such anomaly was not found on the left side. The embryological source and clinical impact of the current incident are discussed.

Acquired Immune Deficiency Syndrome (AIDS) is the leading cause of death in children under age five, in many parts of Africa and South East Asia. The interval between exposure to Human Immunodeficiency Virus (HIV) and the development of AIDS is shorter in children than in adults. Infants infected with HIV have a high chance of developing AIDS within one year and dying before age three. In the remainder, AIDS progresses more slowly; the average child patient survives to adolescence. In the past, the world has faced many pandemics like cholera and plague. At the turn of the 20th century, the world faced influenza pandemic [1]. Every fifty to sixty years, the world has faced a new disease that has been of the nature of an epidemic. These diseases have left a trail of death and morbidity. There has been widespread fear and stigma attached to the victims due to ignorance and fear. As the diseases have progressed people have made efforts to study the issues. They have found the cause, spread, cures, and vaccines to prevent the spread of the disease. The aim of the study is to know the Impact of HIV/AIDS on the Psychosocial Development of Children and the objectives are to study the knowledge and awareness about HIV/AIDS. And to study the psychosocial problems faced by the children. In this regard, the researcher conducted a survey of 50 samples of children below the age group of 18 from the community.

Sclerosing stromal tumour (SST) is a rare benign ovarian tumor of the sex cord stromal type, occurring predominantly in the second and third decades of life. This tumour is characterized microscopically by having a pseudolobular pattern with cellular areas separated by hypocellular densely hyalinised, edematous stroma interspersed with few prominent blood vessels. Histopathological features which differentiate it from other stromal tumors. We are presenting this case because of its rarity and its simulation with various other ovarian tumours; here we have made an effort to highlight the histomorphological features and microscopic differential diagnoses of this rare tumour.

A 3 years old child with a history of ingestion of Paracetamol tablet due to fever Presented with rashes all over the body, nikolsky sign positive diagnosed as toxic epidermal necrosis, was treated With supportive management antibiotics and dexamethasone nursed on banana leaves which were autoclaved, the child improved within 10 days.

A 3 years old child with a history of ingestion of Paracetamol tablet due to fever Presented with rashes all over the body, nikolsky sign positive diagnosed as toxic epidermal necrosis, was treated With supportive management antibiotics and dexamethasone nursed on banana leaves which were autoclaved, the child improved within 10 days.

Psychiatric patients have got an increased morbidity and mortality to other physical health problem. The most problem they are facing is the lifestyle factors such as the use of substances and the decreased physical activity. These patients are mainly restricted to their home. If mental ill patients do not create any problems to the family members and their neighbouring families, the family members are happy and not so much bother about the patients. And if they are not creating any problems for others, family members are not bothered or motivated to treat the mentally ill patients. Hence the lack of motivation from the other family members results in mentally ill patients showing the symptoms of the high risk of being affected by other health problem. There is the availability of treatment to the mentally ill patient. There was only a little availability of the treatment facilities for the psychiatric patients. So the lack of services available and the most vulnerable nature made them more adherent to the problems. There is a direct relationship between the physical and mental health of the patients. In this study the researcher dealing with only the minor issues such as substance abuse, obesity, hypertension, diabetes along with the mental illness, and it would be a way to understand the problems of these patients. The main aim of the study is to study the problems of mentally ill patients and the objectives are; to study the physical health status of the mentally ill patients; and to study the lifestyle factors such as smoking and alcoholism affected the life of mentally ill. The detail studies of 5o intake patients from the hospital where the psychiatric department exist are taken. The interview schedule is used and more observation and case records were referred to get the history. Secondary data is also considered for the research study.

BACKGROUND: Neonatal hyperbilirubinemia is a common problem seen in the newborn period, is usually mild and transient without long-lasting sequelae. Bilirubin induced neurologic damage may occur and auditory pathway is the most sensitive past to bilirubin toxicity. Auditory brainstem response (BERA) provides an electro physiologic means of assessing ascending auditory pathway and to localise the lesion. AIMS: To assess the effect of bilirubin toxicity on brainstem auditory pathway among neonates with hyperbilirubinemia using BERA and compare with control of normal newborns. MATERIAL AND METHODS: BERA was recorded in twenty five term newborns admitted to Tertiary care hospital, with hyperbilirubinemia at level exceeding exchange transfusion (mean bilirubin level 25.4+/- 4.66 mg/dl). They were compared with 25 term normal newborns without any risk factor for hearing impairment. The results were analysed by Gaussian test (Z), student unpaired ‘t’ test, chi square test and Mann-Whitney U test. RESULTS: At least one of waves I, III and V was absent in 8% of newborn with hyperbilirubinemia. There was statistically significant prolongation of mean latencies of waves III and V and mean I-V interwave latency in hyperbilirubinemia newborn compared to normal neonates. Auditory threshold was elevated in 6 out of 25 jaundiced newborn. Significant positive correlation between BERA abnormalities and bilirubin levels was found with respect to presence of waves I, III and V and auditory threshold. No significant positive correlation was found between bilirubin levels and BERA latencies. CONCLUSION: BERA abnormalities were noted in form of absence of waves I, III, V,prolongation of latency and interwave latencies and increased auditory threshold in newborns with hyperbilirubinemia as compared to normal neonates. BERA abnormality was also found to be transient and was normal in most of these patients during follow up.

A child of 2.5 years old had an intractable seizure, clinically had megalencephaly and mental retardation. On evaluation, video EEG showed fronto-central seizures and dysfunction R 1, scalp EEG showed bilateral paroxysmal bursts, MRI brain showed prominent vascular spaces in the hemisphere, GE reflux scan showed GERD. Other investigations were within normal limits. The child was treated with antiepileptics and antireflux measures and also rehabilitation

Task shifting is an optimum alternate solution in the healthcare system to address the acute shortage of professionally qualified healthcare workers in developing countries. This will temporarily help in solving the big problem of providing quality and timely health services to the needy people. Despite many trained health care professionals, our health care system is struggling to provide optimum services to the patients due to many reasons including the high burden of infectious diseases, emigration of trained professionals, difficult working conditions, and low motivation by country governments. Even though, the permanent solution to this problem is to create more professional doctors by increasing training courses, training facilities through modifying government policies and enhancing resources to do so, such actions and resultant solutions take a long time to realize in practice. Hence a quick optimum solution is needed to address the critical shortage of trained healthcare professionals. It is logically argued and in many places practically proven that out of many alternatives, the best alternative for healthcare executives in any hospital of primary health centres is the strategic decision of thinking and implementing the so called strategy of task-shifting. In this paper, we have analysed the process of task-shifting by considering its advantages, benefits, constraints, and disadvantages using an analysing technique called ABCD analysing framework. As per the ABCD framework, the various determinant issues of related to the task shifting for organizational health service performance are identified using focus group method are : (1) Organizational Issue, (2) Alternative Acceptors Issue, (3) Donor Physicians Issue, (4) Patients and Relatives Issue (5) Societal Issue, and (6) Country Issue. Each determinant issue has sub-issues called key attributes used for analyzing the advantages, benefits, constraints, and disadvantages which are the four major constructs of the framework. The factors affecting the various determinant issues of for task shifting for each key issues under four constructs are derived and 172 critical constituent elements (CCE) of these factors are listed under the ABCD constructs.

Malaria is a major public health problem in India. Changes in blood cell counts are a well-known feature of malaria. Hence an attempt has been made to assess the role of leucocyte ratios in malaria as predictors of malaria infection and its clinical severity. Methods: A retrospective observational cohort study was carried out in a tertiary care teaching hospital over a period of 2 months. A total of 171 samples and 48 controls were included in the study. All the absolute and differential white blood cell counts were done. The neutrophil-lymphocyte count ratio (NLCR), monocyte-lymphocyte count ratio (MLCR) and monocyte-neutrophil count ratio (MNCR) were calculated by using the absolute neutrophil, lymphocyte and monocyte count respectively. The results were analyzed statistically using SPSS software for windows. Results: Among 171 cases 145(84.8%), 19(11.1%), 7(4.1%) were Pl. vivax, Pl. falciparum and mixed malaria respectively. 52 cases were severe and 119 were non-severe. 52, 45, 47, 27 were parasitemia grade 1, 2, 3, 4 respectively. NLCR, MLCR and MNCR showed a sensitivity of 60.8%, 71.7%, 70.8% and specificity of 43.8%, 60.4%, and 56.3% respectively in malaria diagnosis. There was no association of NLCR, MLCR, MNCR with the type and severity of malaria. NLCR, MNCR correlated with varying grade of parasitemia. Conclusion: The results show the ratios NLCR, MLCR and MNCR have a better sensitivity but less specificity. The sensitivity and specificity for MLCR are the highest and can be used as a supportive to a screening test. The ratios can be used to show the presence of malaria parasite but there is no association with the type and severity of malaria. MLCR is a good predictor of malarial presence. NLCR and MNCR are associated with parasitemia.

Hyper IgE Syndrome (HIES) is a rare primary immunodeficiency disease. Most of HIES cases are sporadic. Autosomal dominant HIES is caused by mutation in signal transducer and activator of transcription-3 (STAT-3). A number of mosaicism HIES has been reported that is associated with intermediate phenotype. Autosomal recessive HIES is due to mutation in Dock-8 or cytokinesis-8 and TYK-2 or tyrosine kinase-2. The common manifestations are atopic eczema, staphylococcal dermatitis, cellulitis and folliculitis (cold dermal abscesses that are not warm, painful and without redness), recurrent pneumonia and pulmonary abscesses, osteopenia and recurrent bone fracture. The diagnosis of standard HIES is based on clinical suspicion. There is no specific treatment for HIES. The treatment should be based on the prevention of developing infections. Prophylactic antibiotics such as cotrimoxazole and IVIG are administered. Hematopoietic stem cell transplantation was done for all types of HIES, but there is a little information and experience about the long term results of this therapy.

The advents in technology through continuous innovations have supported to improve the quality of the human life in the society. One of the innovation due to the invention of ICT based online/mobile high-speed internet is e-business which allowed the development of online shopping/purchase of both intangible and tangible commodities online. The major advantage and benefit of this online model is its ubiquity, convenience, and low cost to the customer. The online shopping/purchase model is now becoming popular especially among youngsters. One variation of this e-purchase model is online pharmacy model where a consumer can purchase the prescribed drug online to take some of the advantages of this model. In this paper, we have studied the customer’s attitude, views, and concern on this new channel of drug distribution using the data collected by online questionnaire from the general population. The data obtained from this survey is analysed, assessed and interpreted. Based on information collected and focused group study, the online pharmacy model is analysed using ABCD analysis framework. The various issues related to online pharmacy, affecting factors are studies under ABCD constructs using ABCD listing methodology. Based on the outcome of the study, many recommendations are suggested for developing proper controlling mechanism/regulations for drug control authorities of the country to avoid misuse of the online channel for the drug purchase.

Hailey-Hailey disease (HHD), also called as familial benign chronic pemphigus, is a rare autosomal dominant blistering skin disease with waxing and waning in its clinical course. It is characterized by the presence of flaccid vesiculo-pustules, crusted erosions or expanding plaques in the areas of friction such as neck, axilla, groins, and perineum. Histopathologically shows suprabasal separations, inconspicuous dyskeratosis, acantholytic cells within the epidermis, giving a dilapidated brick wall appearance. Here we have discussed about the clinical and histopathological features of HHD and various differential diagnosis for this disease.

Hailey-Hailey disease (HHD), also called as familial benign chronic pemphigus, is a rare autosomal dominant blistering skin disease with waxing and waning in its clinical course. It is characterized by the presence of flaccid vesiculo-pustules, crusted erosions or expanding plaques in the areas of friction such as neck, axilla, groins, and perineum. Histopathologically shows suprabasal separations, inconspicuous dyskeratosis, acantholytic cells within the epidermis, giving a dilapidated brick wall appearance. Here we have discussed about the clinical and histopathological features of HHD and various differential diagnosis for this disease.

The advents in technology through continuous innovations have supported to improve the quality of the human life in the society. One of the innovation due to the invention of ICT based online/mobile high-speed internet is e-business which allowed the development of online shopping/purchase of both intangible and tangible commodities online. The major advantage and benefit of this online model is its ubiquity, convenience, and low cost to the customer. The online shopping/purchase model is now becoming popular especially among youngsters. One variation of this e-purchase model is online pharmacy model where a consumer can purchase the prescribed drug online to take some of the advantages of this model. In this paper, we have studied the customer’s attitude, views, and concern on this new channel of drug distribution using the data collected by online questionnaire from the general population. The data obtained from this survey is analysed, assessed and interpreted. Based on information collected and focused group study, the online pharmacy model is analysed using ABCD analysis framework. The various issues related to online pharmacy, affecting factors are studies under ABCD constructs using ABCD listing methodology. Based on the outcome of the study, many recommendations are suggested for developing proper controlling mechanism/regulations for drug control authorities of the country to avoid misuse of the online channel for the drug purchase.

UTI is initiated and caused by a number of factors, an understanding of the causation helps to Diagnose and treat it adequately. Organisms and host factors responsible for the occurrence and pathogenesis, are crucial in the diagnosis and treatment to prevent serious sequelae. Ecoli is a main organism causing UTI.

A child of 2.5 years old had an intractable seizure, clinically had megalencephaly and mental retardation. On evaluation, video EEG showed fronto-central seizures and dysfunction R 1, scalp EEG showed bilateral paroxysmal bursts, MRI brain showed prominent vascular spaces in the hemisphere, GE reflux scan showed GERD. Other investigations were within normal limits. The child was treated with antiepileptics and antireflux measures and also rehabilitation.

UTI is initiated and caused by a number of factors, an understanding of the causation helps to Diagnose and treat it adequately. Organisms and host factors responsible for the occurrence and pathogenesis, are crucial in the diagnosis and treatment to prevent serious sequelae. Ecoli is a main organism causing UTI.

UTI is initiated and caused by a number of factors, an understanding of the causation helps to Diagnose and treat it adequately. Organisms and host factors responsible for the occurrence and pathogenesis, are crucial in the diagnosis and treatment to prevent serious sequelae. Ecoli is a main organism causing UTI.

Metabolic Syndrome in adolescent in India is of recent origin due to the better socioeconomic conditions and the growing obesity epidemic. An 11 year old female child presented with features of Metabolic Syndrome and Oppositional Defiant Disorder. Child was treated with antihypertensive medication and put on dietary and exercise regimen. Child was given counselling for the Oppositional Defiant Disorder after being evaluated by Psychiatrist.