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Introduction: Role of CT scan, MRI, ophthalmoscopy, direct monitoring by a transducer probe in identifying raised intracranial pressure (ICP) in emergency department is limited. There are few studies correlating elevated optic nerve sheath diameter (ONSD) measured by point of care ultrasound (POCUS) with raised ICP in pediatrics emergencies. We studied the diagnostic accuracy of ONSD, crescent sign, and optic disc elevation in identifying increased ICP in pediatrics. Methods: Prospective observational study was done between April 2018 and August 2019 after ethics approval. Out of 125 subjects, 40 patients without clinical features of raised ICP were recruited as external controls and 85 with clinical features of raised ICP as study subjects. Their demographic profile, clinical examination, and ocular ultrasound findings were noted. This was followed by CT scan. Out of 85 patients, 43 had raised ICP (cases) and 42 had normal ICP (disease controls). Diagnostic accuracy of ONSD in identifying raised ICP was evaluated using STATA. Results: The mean ONSD in case group was 5.5 ± 0.6 mm, 4.9 ± 0.5 mm in disease control group and external control group was 4.8 ± 0.3 mm. Cut-off of ONSD for raised ICP at ≥4.5 mm had a sensitivity and specificity of 97.67% and 10.98%, while ≥5.0 mm showed a sensitivity and specificity of 86.05% and 71.95%. Crescent sign and optic disc elevation had good correlation with increased ICP. Conclusion: ONSD ≥5 mm by POCUS identified raised ICP in pediatric population. Crescent sign and optic disc elevation may function as additional POCUS signs in identifying raised ICP.

For an efficient management and development of groundwater resources, it is imperative to have a reliable database on groundwater resources. In this regard, present study was conducted during 2015–18 in Mahatma Gandhi Chitrakoot Vishwavidyalaya, Chitrakoot, Satna, Madhya Pradesh, India. Dynamic groundwater resources of study area have been estimated by using the guidelines of the groundwater resources estimation committee (GEC-1997), Ministry of Water Resources, Government of India. In this study, rainwater infiltration factor (RIF) techniques and different conventional norms were used for groundwater recharge estimation. The assessments of groundwater units were categorized based on stage of groundwater development for the year 2016. The annual groundwater draft for all uses such as domestic and irrigation was 5931.54 ha m. The annual groundwater recharge in the study area was 8666.81 ha m and net annual groundwater availability was 8318.85 ha m. The groundwater utilization and stage of groundwater development had also been determined and the overall stage of groundwater development of Babina block was found to be 71.30%. There was no significant rise or fall of water levels during both the pre-monsoon and post-monsoon intervals in the study area. Considering the stage of groundwater development, it has been categorized that Babina block of Jhansi district, a part of Bundelkhand region falls under ‘SAFE’ category of groundwater development with excellent potential for the future groundwater development.

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