Indian Journal of Trauma and Emergency Pediatrics

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The low concentration of vitamin K in human breast milk and the predisposition to vitamin K deficiency bleeding following exclusive breast feeding is emerging as a matter of concern especially in developing countries where exclusive breast feeding is vigorously advocated to promote optimal health in the infant. Most reports of late HDN have been in babies born at home and not given vitamin K prophylaxis, In rural areas of our country (due to lack of knowledge of vit. K prophylaxis) late HDN is not uncommon in Hospital deliveries also.

Keywords: Hemorrhagic Disease of Newborn; VIT. K prophylaxis.

Asthma is a chronic disease of the respiratory tract characterized by recurrent episodes of airway nflammation and obstruction, showing evidence of reversibility of obstruction. Despite advances in the understanding of asthma and development of effective medical interventions for treatment of asthma (and for prevention of morbidity), children continue to present to the emergency departments of health care institutions with acute asthma exacerbations. An accurate assessment of the severity of the acute attack is essential to ensure optimal treatment. Asthma exacerbations are defined as ‘acute or sub-acute episodes of progressively worsening shortness of breath, cough, wheezing, and chest tightness – or some combination of these symptoms.’ The pathophysiology of an asthma exacerbation includes airway edema, mucus secretion and smooth-muscle spasm (bronchospasm). The foundations of the treatment of acute asthma are bronchodilators, corticosteroids and oxygen. Before the initiation of therapy, and as therapy is initiated, a brief, focused history and physical examination should be obtained. Escalation of the therapy (aminophylline, magnesium sulfate, rarely mechanical ventilation, etc) may be necessary in severe exacerbations. This review details the assessment and treatment of acute episode of asthma in children.

Keywords: Aminophylline; Asthma; Beta-2- agonists; Children; Hyperinflation; Pulmonary; Ronchi; Salbutamol; Steroids; Terbutaline.

Guillian Barre syndrome is most common cause of rapidly progressing paralysis in children in most countries. It is charachterized by rapidly progressing weakness, often symmetric with relative paucity of sensory symptoms. It often follows upper respiratory tract or gastrointestinal infections and has been associated with a variety of other systemic disorders. Intravenous immunoglobulin therapy and plasma exchange hasten recovery and have greatly reduced the mortality and morbidity. Studies on pathogenesis demonstrate that antibodies against myelin components and macrophages play a major role in causing injury to the myelin or axons.

Keywords: Childhood polyneuropathy; Demyelination; Ganglioside antibodies; Plasmapheresis; Plasma exchange.

Aim: To analyze the etiology, treatment, Posterior Capsule Opacification (PCO) rates and visual outcome in children with traumatic cataract Methods: Retrospective, non-comparative review of 41 children (d”16 years) with traumatic cataract managed at a single institution during a 2-year period with regard to demographic data, mode of injury, management, development of PCO and visual outcome. Results: Wooden stick (8/41, 20%) was observed to be most common mode of injury, followed by stone (4, 10%) and cracker injury (4, 10%). Mean preoperative visual acuity was 2.4±0.7 logMAR units, which improved to 0.3±0.4 logMAR units post operatively. PCO developed in 14 children (50%), of whom 3 had acrylic and 11 had Polymethylmethacrylate (PMMA) lenses. PCO developed in 9 out of 11 (82%) children with intact posterior capsule and in 5 out of 17 (29%) children with primary posterior capsulorrhexis. Conclusion: In view of the higher rates of PCO occurrence in children with intact posterior capsule, primary posterior capsulotomy irrespective of the age is recommended in pediatric traumatic cataract.

Keywords: Traumatic cataract; Epidemiology; Surgical intervention, Posterior capsule opacification.