As per the GOI circular on price capping of Orthopaedic Knee implant by NPPA(National Pharmaceutical Pricing Authority), new prices of knee implants have been implemented effective 16th August 2017. For details on knee implant pricing across our hospitals. CLICK HERE | As per GOI’s circular dated 02nd April 2018 on price-capping of stents by NPPA(National Pharmaceutical Pricing Authority), new prices of coronary stents are revised with effect from 01st April, 2018. For details on stent pricing.CLICK HERE

A case of Systemic Lupus Erythematosus presenting as Stevens-Johnson Syndrome - Dr Nicola Flynn

An 11-yr-old girl was referred to Fortis Hospital, Anandapur, with a probable diagnosis of Stevens-Johnson Syndrome. The child had a history of “flu-like illness” for which she went to a doctor. She was prescribed some antibiotics, which did not seem to help her. A few days later she started having rashes over her face and body with persistent fever. On admission to our hospital, she had high grade fever for the last 15 days with severe mucocutaneous involvement of the face, ears, body, lips, pharynx and oral cavity. There was profound facial edema and extensive vesicobullous lesions with foul-smelling discharge and bleeding. She looked very unwell and disoriented, with a productive cough. Laboratory investigations revealed mild pancytopenia with a normal CRP. Chest X-Ray showed Right lower lobe consolidation.. Blood C/S was sent and IV Ceftriaxone(80mg/kg/day) was started. Serum Na was 116 for which a correction was given and sensorium improved. But the child was still very sick. Some rashes were in a butterfly distribution which lead to a suspicion of SLE and a Dermatological opinion was sought. Blood for ANA was sent, which was highly positive. ANA Profile was done which was positive for Anti-DsDNA, Anti-RNP and Anti-Sm Antibodies. C3 and C4 were low. Urine examination revealed Nephrotic range proteinuria with hematuria. The child was started on IV Methyl Prednisolone(30mg/kg/day) resulting in a rapid improvement of symptoms. 5 days later she was shifted to Oral Prednisolone (2mg/kg/day) and Hydroxychloroquine(5mg/kg/day) was started. Pediatric Nephrologist was consulted and Kidney biopsy was done which showed Diffuse Segmental Proliferative Lupus Nephritis [ISN/RPS Class IV (S) - A]. Child was started on MMF at a dose of 600mg/m2 BSA. She was discharged following significant improvement in her symptoms and is still on regular follow-up. She was treated by Dr. Nicola Flynn.


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