(A Constituent College of Vinayaka Missions Research

Foundation –Deemed to be University, Salem)

NH-47, Sankari Main Road, Seeragapadi PO, Salem-
636308)

DEPARTMENT OF PAEDIATRICS
PG PART 1- CLINICAL MEETING
DATE : 28/02/2023 TIME :1:45PM
PRESENTER : Dr. P.KARTHIK BABU B.H.M.S.,
MODERATOR : Dr. RANGASAMY. K, MD [Pead]
GUIDE : Dr. E.RATHNASABAPATHI, MD [Hom]
SUPERVISIOR : Dr. C. RAJALAKSHMI,MD[Hom]
OBJECTIVE: To discuss the Differential diagnosis, Investigation, General
Management and Homoeopathic Management.
PRELIMINARY DATA:

NAME: master. AGE: 8 years SEX: male

Vigneshwaran.
RELIGION: Hindu ADDRESS: 4/292 Arasamaram st, kondalampatti, salem
INFORMANT: Mother RELIABILITY: Good
PRESENTING COMPLAINT:
Child came with the chief complaints of swelling over the lip and forehead since 2 years
of age on and off.
HISTORY OF PRESENTING COMPLAINT:
The Patient was apparently normal before 2 years of age, after he had suffered from
complaints of swelling over the lip and forehead on and off, getting resolved by its own.
No complaints of tenderness over the swelling, no c/o fever, no c/o difficulty in breathing, no
c/o urinary disturbance.
PAST HISTORY:
History of chicken pox at age of 3 years.
TREATMENT HISTORY: For his presenting illness he took medication from near by
clinic.
BIRTH HISTORY:
ANTENATAL HISTORY: OBSTETRIC SCORE :
G2P2L2A0
It is a booked and registered case in nearby PHC, attended regular antenatal visits

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NATAL HISTORY: Caesarean delivery at 28 weeks, Birth weight 1.300kg, Baby cry
immediately after birth, breast feeding started after 20days after birth, urine passed and
meconium were passed with in 24 hours. Evidence of congenital anomalies were found.
NEONATAL HISTORY: no jaundice, no cyanosis, history of NICU admission for 20days,
history of feeding problems, no convulsion, no umbilical discharge.
DEVELOPMENTAL HISTORY: There is delayed developmental milestones in all the
domains-GDD

GROSS motors-Sitting with support at 1year 6months SOCIAL- says bye-bye by about
1year
FINE motors- bidextrous reach LANGUAGE- talks meaning
less words
DIETARY HISTORY:
Baby was an exclusive breast feeding for 6 months, supplementary feeding started after 7
months.
SOCIO- ECONOMIC STATUS:
According to modified kuppuswamy scale: It is a Nuclear family, and they belongs to
lower class family, lived in pucca house with one room ,no separate kitchen and bathroom,
water source- municipality, no of people in family: adults – 3, child 1, income per month
4000/month.
IMMUNIZATION HISTORY: Given as per schedule.
FAMILY HISTORY: Non consanguineous marriage, no similar down syndrome in his
family
35 27

1year 8 month

CONTACT HISTORY:
No contact history of tuberculosis and COVID cases.

PERSONAL HISTORY:

Appetite : Normal Urine : Regular

Thirst : Normal Stool : Regular 2times/day
Sleep : Normal sleep pattern Sweat : profuse over head
GENERAL EXAMINATION:

Appearance:

No pallor, no cyanosis, no lymphadenopathy, no clubbing, no oedema, no jaundice.

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VITAL SIGNS:

Temperature : 98.6 F Pulse rate:102/min, no radio radial or radio

femoral delay, regular in rhythm
Respiratory rate: 30/ min Blood pressure:
ANTHROPOMETRY:

Height : 79.8cm Expected height : 87.8cm

Weight : 7.4kg Expected weight : 11.6kg
Head circumference:42cm Chest circumference:47cm Mid arm
circumference :12cm

HEAD TO TOE EXAMINATION:

Hand: palmar crease- single

Head: microcephaly, flat occiput, spare soft hair on scalp

Face: flat nose, low set ears, eyes slant upward palpebral fissure

Abdomen: scar of surgery – duodenal atresia

Lower limb: space between 1st and 2nd toe

SYSTEMIC EXAMINATION:

RS:

Inspection: Bilateral symmetrical, no drooping of shoulder, no muscle wasting, tracheal

position is normal, movement of chest is equal, no dilated veins in chest, no visible
pulsation, no sinuses, no scar mark, no spinal deformities.

Palpation: No crowding of ribs, vocal fremitus normal, apex beat normal, position of
trachea normal.

Percussion: Resonant note heard over supraclavicular, infraclavicular, suprascapular,

infra scapular, interscapular region.

Auscultation: Normal vesicular breath sound heard over lung field.

CVS: S1 and S2 sound heard over cardiac areas. No murmur felt

GIT:

Inspection: scaphoid shape of abdomen, normal position of umbilicus, no visible

pulsation, no dilated veins, no scar mark.

Palpation : No tenderness, organomegaly.

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Percussion: no fluid thrill, no shifting dullness.

Auscultation: normal bowel sounds heard.

CNS:

Higher functions were normal.

Cranial nerve examinations were normal.

Motor system examination: no wasting, muscle tone – normal, both superficial and deep
reflex were normal.

Meningeal signs were negative.