Everybody wants to get success in their life but on the cost of their health. Due to that the chances of irrationality of drugs increase in which self-medication is one of the major cause. The basic principle for the rational use of drug is better supply of drugs, better prescribing and lower costs for health care. When the basic principle of rational use of drugs is not fulfill it leads to irrationality which further leads to adverse effects and toxicity. There are number of factors which contributes to irrationality either they are inter-related to each other or they directly have affects and it may cause some effects on health and economic consequences. There is a cycle for rational use of medicine which help the clinician to prescribe the appropriate drug for appropriate disease condition, if each step is followed appropriately the irrationality improves. The concept of "rational use of medicine" can at times be confusing and not easily appreciated by patients, healthcare providers, policy makers, or the public, all of whom needs to collaborate effectively to address this challenge and the policy makers should be need to update with current trends.
Results With reference to our cases, we review the management protocols for ingested FB in paediatrics patients. Conclusions Urgent Endoscopic removal (within 2 hours) is indicated in-. All symptomatic patients . Sharp foreign body . Esophageal foreign body . Foreign body in the stomach if-Age <5 years->2 cm in diameter and >5 cm in length Age >5 years->2.5 cm in diameter and >6 cm in length Non urgent endoscopic removal should be followed in-. Magnetic foreign bodies within 24 hours . Ingested button batteries in stomach impacted for >48 hours . Blunt small nontoxic foreign body in the oesophagus for more than 24 hours.
An 11 year old female child presented with generalized body swelling, ascites and hepatomegaly. She had history of recurrent loose stools since last 5 years. Initial work up revealed ascites, and hepatomegaly. Serum proteins were within normal limits. Initial USG revealed isoechoeic space occupying lesion in segment VII of liver with ascites. USG Doppler revealed attenuation of blood flow in right hepatic vein. Ascites suddenly improved after 5 days, repeat USG revealed that all three hepatic veins and inferior vena cava were patent. CECT abdomen showed hemangioma measuring 2.1 X 2.6 X 1.36 cm in segment VII of liver with fatty liver with ascites with mesenteric lymphadenopathy. Serum tTGlevel carried out because of short stature and history of diarrhea was 372U/ml (normal 0-20 U/ml). Celiac disease was confirmed on biopsy. Hence the diagnosis of celiac disease with transient obstruction of hepatic veins due to hemangioma or thrombus. Keywords: Budd Chiari; Ascites; Celiac disease
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