Pancreatitis-panniculitis-polyarthritis (PPP) syndrome is a rare extra-pancreatic manifestation of pancreatic disease. Its pathogenesis is probably related to the direct release of pancreatic lipase into the bloodstream, causing systemic fat necrosis. Initial treatment involves symptomatic relief, while addressing the underlying pancreatic enzyme leakage through endoscopic or surgical interventions. We report the case of a 10-year old girl who presented with abdominal symptoms, ascites, pleural effusion, panniculitis, and arthritis, and was ultimately diagnosed with chronic pancreatitis with associated PPP syndrome. She was successfully treated with percutaneous drainage, antibiotics, and endoscopic pancreatic duct stenting. This case highlights the importance of recognising systemic signs of pancreatic disease in children, which, if left untreated, can lead to significant morbidity and mortality.

Accurate heart rate assessment is vital during neonatal resuscitation. While pulse oximetry is widely used, it may delay heart rate detection in the delivery room. Electrocardiography however may offer a faster, more reliable alternative.

Chronic kidney disease (CKD) is a growing public health concern, frequently diagnosed at advanced stages owing to delayed presentation, particularly in low- and middle-income countries. Our cross-sectional study was conducted at a tertiary care centre in Andhra Pradesh, India, to estimate the prevalence and identify factors associated with late-stage presentation of CKD to nephrologists. Among 200 newly diagnosed CKD patients, 116 (58%) presented in stage IV or V, indicating late referral. A high proportion of these (60.3%) were males and from urban areas (62.1%). They also had significantly lower mean haemoglobin levels. There is need for early screening, improved referral pathways, and targeted interventions to reduce the burden of late-stage CKD.

Metabolic bone disease (MBD) is a significant concern in very preterm neonates, with clinical signs often delayed compared to biochemical and radiological markers. MBD was defined as serum phosphate <1.81 μmol/L and alkaline phosphatase >600 IU/L or alkaline phosphatase >1000 IU/L. Key risk factors included lower gestational age, lower birth weight, prolonged total parenteral nutrition, delayed attainment of full enteral feeding (>7 days), cholestasis, bronchopulmonary dysplasia, and anaemia requiring transfusion. Logistic regression identified delayed attainment of full enteral feeding (>7 days) as a significant predictor for developing MBD.

Hand, foot, and mouth disease (HFMD) is a common viral illness predominantly affecting children, but atypical presentations can occur, especially in areas of reduced resistance, such as burn scars. We present two cases with atypical HFMD lesions localised to a previously healed scald burn area, with classic lesions on the hands and feet. This unusual presentation highlights the role of immune dysregulation in healed burn scars, predisposing them to infection.

Melioidosis, caused by , is an under-recognised tropical infection that often produces visceral abscesses. Hepatosplenic involvement is less commonly described and can mimic pyogenic or tubercular disease and commonly affects patients with diabetes, alcohol use, or immuno-compromised conditions. We report a retrospective series of 10 culture-confirmed patients from a tertiary care centre in India presenting with liver or splenic abscesses diagnosed by imaging and culture. Treatment comprised intravenous meropenem or ceftazidime followed by oral trimethoprim-sulfamethoxazole. Close follow-up is essential to ensure eradication and reduce relapse.

Endoscopy remains the gold standard investigation for assessing the severity of corrosive digestive injuries. Our prospective observational study aimed to validate the 'Med-Tu chart' for the evaluation of corrosive injury, where endoscopy is not available, and found it to have an acceptable diagnostic accuracy in detecting the severity of corrosive ingestion.

Scabies is a neglected tropical disease and its florid form, crusted scabies, although rare, may have life-threatening complications. It is described in both immuno-competent and immuno-compromised individuals. When an individual harbours millions of mites, it manifests as crusted scabies, which mimics various dermatologic disorders and can potentially cause community outbreaks. This report describes two cases of crusted scabies and differentiates it from common dermatologic mimics.

Milk curd syndrome is an infrequent, iatrogenic cause of bowel obstruction in neonates and early infants, which arises mainly due to inspissation of formula feeds or dried cow's milk, but is very uncommon after feeding with unmodified animal milk, such as goat's milk. A systematic review aims to gain a deeper understanding of its demographics, causes, clinical profile, diagnosis, and management. If treated promptly, outcomes are favourable.

Bicytopenia is not uncommonly encountered in clinical practice; it may reflect either marrow failure or a consumptive process such as haemolysis with thrombotic microangiopathy (TMA). We describe a case of a patient with bicytopenia caused by severe Vitamin B12 deficiency, where there is laboratory evidence that is suggestive of haemolysis in what is known as pseudo-TMA phenomenon. Lack of awareness of this entity may lead clinicians to misdiagnose such cases as microangiopathic haemolytic anaemia (MAHA) or thrombotic thrombocytopenic purpura (TTP), which could lead to inappropriate immunomodulatory treatment or plasmapheresis being administered. To distinguish between true MAHA/TTP and pseudo-TMA from severe vitamin B12 deficiency, reticulocyte and vitamin B12 levels are useful tests in the first instance, while ADAMTS13 activity is the definitive test to diagnose TTP if suspected.

A high incidence of multidrug resistance (MDR) exists in many special neonatal care units, and ours is no exception We therefore evaluated the short-term outcomes of 135 neonates with severe sepsis on intravenous colistimethate sodium (Colistin) therapy and its effect on the incidence of nephrotoxicity. We found 17.5% resistance with hardly any nephrotoxicity amongst 57 Gram-negative bacteria, suggesting colistin as a reasonable choice as a reserve drug, even in centres with high MDR incidence.

We report a case of a 35-year old woman with prolonged fever, cytopenia and massive splenomegaly, initially misdiagnosed as steroid-refractory auto-immune haemolytic anaemia with thrombocytopenia. Whole-exome sequencing revealed pathogenic variants in three genes, none of which explained the clinical picture. A subsequent bone marrow examination identified Leishman-Donovan bodies, confirming visceral leishmaniasis (VL). This case illustrates the pitfalls of over-reliance on next-generation sequencing and immunologic tests in the absence of a clear clinical hypothesis. In cost-conscious healthcare settings such as India, simpler and less expensive diagnostic modalities, such as bone marrow microscopy, remain crucial, especially for endemic infections such as VL. High-end molecular diagnostics should be interpreted with caution, with clinical correlation and an awareness of the limitations and incidental findings common to such testing.