Indian Journal of Trauma and Emergency Pediatrics

Semecarpus anacardium (SA) commonly known as ballataka or bhilwa has been used in various traditional systems of medicines or various ailments since ancient times. Chemical and phytochemical analyses of its nut reveal the presence of biflavonoids, phenolic compounds, bhilawanols, minerals, vitamins and amino acids which show various medicinal properties. The fruit and nut extract shows various activities like anti atherogenic , anti inflammatory, anti oxidant, anti microbial, anti reproductive, CNS stimulant, hypoglycemic, anti carcinogenic and hair growth promoter. Here we present a rare case of SA poisoning with convulsion, behavioral changes and orange discoloration of body and its fluids, no such presentation has been reported till date to the best of our knowledge.

Keywords: Semecarpus anacardium; Orange coloured urine; convulsion.

The aspiration of a foreign body represents an important cause of morbidity and mortality during childhood. Its consequences depend crucially on the degree of obstruction. Usually there is one or maximum two foreign body aspiration in a child at same time reported in literature. Here we present a rare case of multiple foreign bodies’ aspiration in one year old child with a normal radiograph of chest which was saved due prompt and emergency intervention. Foreign body aspiration must always be considered in the differential diagnoses of a child presenting with acute onset of rapid respiration and wheezing without any other obvious systemic cause.

Keywords: Multiple foreign bodies; Trachea; Bronchus; Aspiration; Bronchoscopy.

Injuries are the leading cause of death in children surviving beyond their first birthday. The most important step in the science of injury control is prevention of injuries followed by minimization of damage and post injury care. For prevention of childhood injuries an understanding of the risk factors and the mechanisms of injury in various settings such as at home, at play and on road is essential. This article is therefore an attempt toaddress these concerns related to prevention of childhood injuries.

Keywords: Injuries; Accidents; Injury control; Childhood injuries.

Objective: To assess the utility of Modified Glasgow Coma Scale (MGCS) in pediatric non-traumatic coma and to predict the immediate outcome. Design: Prospective observational study. Setting: PICU of tertiary care teaching and referral hospital. Study group: Consecutive children (n=100) between 5 months to 15 years with acute non-traumatic coma. Methodology: MGCS and brainstem reflexes were assessed at 6 hourly intervals for 72 hours from the time of admission. The lowest score of the MGCS and worst brainstem reflexes were used for the analysis. Outcome measure: Survival or death. Results: The likelihood of death in patients with MGCS score <8 was much higher than when MGCS score was ³8, with odds ratio 21.4% and p<0.001. Among the individual components of MGCS, lower ocular response scores (p<0.001) and motor response scores (p<0.001) were better predictors than verbal response scores (p-0.01). Absence of one or more brainstem reflexes was associated with adverse outcomes and death (p<0.001). There was statistically significant correlation between MGCS and brainstem reflexes in predicting the immediate outcome with spearman correlation coefficient of +0.724 with p<0.01. Conclusion: Ocular, motor response scores and brainstem reflexes were more predictive of the short term outcome than the total MGCS scores. A score incorporating ocular response, motor response and brainstem reflexes needs to be evaluated to assess the outcome in non-traumatic coma in the pediatric population.

Keywords: Coma; Glasgow Coma Scale; Outcome.