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.
Hypothyroidism is frequently encountered condition to a pediatrician. Passive effusions into serous cavities, sometimes to considerable amount are frequently noted. However, the significant ascites caused by this is rare in a child and in no instance, it is too excessive. So diagnosis is frequently delayed and patient frequently receive unnecessary procedures such as liver, even gastrointestinal biopsies. Analysis of ascitic fluid shows exudative nature with high protein. The case we present here is a 4-year-old female child with recurrent ascites, developmental delay and hypoproteinemia. High index of suspicion can lead to diagnosis. Over all prognosis is excellent after stating replacement therapy with L-thyroxine.
CNS tuberculosis accounts for only 10% of all cases of tuberculosis, carries a high mortality and morbidity. Tuberculoma of the brain is an important clinical entity. The main challenge in the management of brain tuberculoma is its diagnosis. Hereby, referring case of a 12 years old male child who presented with clinical picture of tuberculosis but radiologically NCC, hence posing a diagnostic dilemma as clinically it was in the favor of tuberculosis whereas radiologically inclination was towards neurocysticercosis. Based on clinical manifestations it was suggestive of meningitis, CSF picture was suggestive of hypoglycorrhachia. CT chest showed miliary pattern and neuroimaging showing multiple ring enhancing lesions. High index of clinical suspicion is required to make a diagnosis and evaluation with reports.
COVID-19 caused by SARS-Cov-2 virus has spread rapidly across the world. Children are just as like as adult to become infected with virus but have lesser symptoms and less severity of the disease. Necrotizing enterocolitis is one of the common gastrointestinal emergencies in neonatal intensive care unit. More than 85% of cases of NEC occur among preterm and very low birth weight. Preterm babies are vulnerable to develop NEC because of high incidence of perinatal distress factor, stasis of gut due to autonomic immaturity, poor barrier function of gut or immune defences, lack of feeding with human milk and higher incidence of nosocomial infections. During the current COVID-19 pandemic, no similar finding has been reported in the neonatal population to date. In this review we summarize the case report of two newborns admitted in our NICU who were COVID 19 positive presented to us with symptoms suggestive of necrotizing enterocolitis (NEC) and their outcome based on presence of comorbidity. Our case reports two case of two COVID-19 positive newborns admitted in our NICU with history, examination and investigations suggestive of necrotizing enterocolitis. Early initiation of antibiotics covering bowel flora, bowel rest and resuscitation, similar to our tried and true medical management of NEC, should be considered for initial management to avoid surgical intervention
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