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OBJECTIVE:To study the clinical profile of children admitted with diabetic ketoacidosis (DKA) in Sri Aurobindo Institute of Medical Sciences (SAIMS) Indore. METHODS: We retrospectively analysed the case records of 30 children admitted with DKA to our intensive care unit, from Jan 2011-Jan 2015. Information regarding personal details, chief complaints, clinical features, laboratory parameters, management and outcome was recorded using a predesigned pro forma. RESULTS: The median age at presentation was 8 years (range 9months-13yrs); 12 boys and 18 girls were enrolled. Diabetes was newly diagnosed in 20 cases and known cases of type1 diabetes were 10. Commonest presenting complaints were fever (66%), rapid breathing (60%), vomiting (60%), and altered sensorium (26. 6%). Average length of PICU stay was 58. 6hrs. All of the cases had elevated HbA1c, except one. Co-morbities found were UTI in 12 (40%), dysentery in 2 (6. 6%), and viral hepatitis in1 (3. 33%). Cerebral edema was seen in 1 case. There was no mortality in our study. CONCLUSION: DKA in children if diagnosed early and managed timely has good outcome. Poor compliance is most important precipitating factor in known cases of T1DM.

Antibiotic resistance represents one of the biggest challenges, and there is an urgent need for plant-based antimicrobial agents that enable managing this crisis effectively. In this work, we aimed to investigate the antibacterial activity of Astragalus candolleanus (A. candolleanus) hydromethanolic root extract against Gram-positive (Bacillus subtilis and Staphylococcus aureus) and Gram-negative (Escherichia coli, Salmonella typhimurium, Pseudomonas aeruginosa, Klebsiella pneumoniae, and Kocuria rhizophila) strains by the cup-plate method. The root was powdered and extracted with 70% methanol by cold maceration for 5 days. Preliminary phytochemical screening was performed with different solvents in the order of increasing polarity. Pure compounds were isolated by column chromatography and were characterized through liquid chromatography-mass spectrometry. Targeted predictions of the isolated compounds were also studied using Swiss Target prediction software and prediction of activity spectra for substances. The extract showed a broad zone of inhibition against pathogenic bacteria. Four pure compounds were isolated, of which a novel terpenoid compound has been identified as stemmadenine along with scillirosidin, cephalotaxine, and myxoxanthophyll. The structures of the isolated phytoconstituents were elucidated by spectral analysis. The four pure components isolated from the roots of A. candolleanus are suggested to be effective against tested pathogens. Overall results of drug design suggest that myxoxanthophyll is a promising bioactive compound endowed with antibacterial activity.

Acute intermittent porphyria (AIP) and ichthyosis vulgaris both are autosomal dominant disorders with incomplete penetrance caused by the deficiency of porphobilinogen deaminase enzyme and filaggrin protein, respectively. We report a rare case of a 9-year-old boy having two genetic diseases with an unclear association. An acute attack of AIP is characterized by gastrointestinal symptoms and neuropsychiatric manifestations. Although rare in the first decade of life, the presence of reddish urine with a typical presentation such as abdominal pain, hypertension, seizure, and paresthesias lead us to the diagnosis of AIP. The precipitating factor in the present case was prolonged fasting in Ramadan.

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Mounier Kuhn syndrome, also known as tracheobronchomegaly is a rare idiopathic disorder characterized by significant tracheobronchial dilation. It results in recurrent lower respiratory tract infections and bronchiectasis. In severe cases, patients may present with acute respiratory distress requiring hospital admission and ventilatory support. The diagnosis is easily missed as tracheobronchomegaly is overlooked on plain chest x-ray. Here we present an interesting report of our patient who presented with recurrent cough and shortness of breath. A diagnosis of bronchiectasis was first thought of. Computed tomography scan revealed a final diagnosis of this rare disorder. Management of the disease is only supportive and depends on the severity of the condition.