No abstract

While exchange transfusion has been advocated as an adjunctive treatment in severe falciparum malaria complicated by heavy parasitaemia, its role in severe life-threatening disease refractory to standard life support measures is less well recognised. We describe four children with severe falciparum malaria, multi-system involvement and heavy parasitaemia in whom we undertook exchange transfusion because of their deteriorating clinical condition despite antimalarials and supportive therapy. All patients received quinine (one also received artesunate). All patients improved dramatically following the procedure, with subsequent complete clinical recovery.

Triple A syndrome is characterized by achalasia of the cardia, alacrima, adrenocorticotrophic hormone (ACTH) resistant adrenal insufficiency and progressive neurological abnormalities including autonomic nervous dysfunction. An 8-year-old girl presented to the pediatric intensive care unit with sudden loss of consciousness and was diagnosed subsequently to have this condition. The authors present this condition since it is easily treatable and can be fatal if undiagnosed.

Background: Congenital heart diseases are the predominant causes of paediatric morbidity and mortality. This study was done to know the clinical profile, various acute presentations, and risk factors for repeated hospitalizations and their outcome in children with congenital heart diseases.Methods: This prospective observational study of children in the age group of 0 hour-12 years, who were previously diagnosed and or newly diagnosed with congenital heart diseases.Results: A total of 102 children were present during the study period. The most common age group for congenital heart disease was infancy with 46.1% (47 cases) of children. Acyanotic heart diseases were observed in 73.5% (75 cases) of the total, followed by cyanotic CHD with 14.7% (15 cases), complex CHD with 9.8% (10 cases), and the least, valvular diseases with 2% (2 cases). The most usual presenting symptoms in children with CHDs were breathlessness with 66.7% (67 cases), followed by fever with 54.9% (56 cases) and cough with 48% (49 cases. In this study, 23.5% (24 cases) of the children were completely immunized. The protein-energy malnutrition was present in 51% of cases (52 cases). The 16.7% of them (17 cases) have got the motor developmental delay predominantly. The dysmorphic features were present in 19 cases (18.6%) of total cases. The chest X-ray findings were abnormal in 58.8% (60 cases). The most common risk factor(co-morbidity) in children with CHD was noticed to be anaemia in 43 cases (42.2%).Conclusions: The infancy and early childhood are the most common age group for the presentation of CHDs. Most of them had the associated risk factors (co-morbid) like nutritional anaemia, pneumonia, and failure to thrive.

No abstract