Indian Journal of Trauma and Emergency Pediatrics

Lead is a heavy metal and It was used in many materials and products before the risk to children was known. Lead poisoning is the presence of too much lead in the body, and is the most common preventable pediatric health problem. It is caused by exposure to lead that is either eaten or breathed in the form of dust. Lead poisoning is a medical condition caused by increased levels of the heavy metal lead in the body. Lead interferes with a variety of body processes and is toxic to many organs and tissues including the heart, bones, intestines, kidneys and reproductive and nervous systems. The body carries the lead in the blood to soft tissues and bones, where it can be stored for many years.  It interferes with the development of the nervous system and is therefore particularly toxic to children, causing potentially permanent learning and behavior disorders. Lead goes down iron or calcium absorption pathway in GIT. Children absorb lead well orally, Lead absorption is enhanced if diet is poor in iron or calcium. Lead can be inhaled. Lead poisoning can be treated with Special drugs, called chelators. Lead poisoning can be prevented by taking the simple precautions around the house and environment.  

Keywords:  Lead; Lead poisoning; Symptoms; Chelators; Prognosis; Prevention.  

‘Fetal Malnutrition’ is the failure to acquire adequate quantum of fat and muscle mass during intrauterine growth. ‘CAN score’ (Clinical Assessment of Nutritional score) is a simple, practical, clinically applicable scoring system, developed to identify newborn babies with fetal malnutrition. A cross-sectional study was undertaken at NKP Salve Institute of Medical Sciences and Research Centre and Lata Mangeshkar Hospital. The study group included 60 live full term neonates and duration of the study was two months. The objectives of the study were: 

1.     To estimate occurrence of fetal malnutrition in full term neonates using CAN score. 

2.     To compare CAN score with other anthropometric criteria used to assess fetal growth. 

The following results were obtained: 

1.    Out of 60 neonates, 7 (11.6%) had fetal malnutrition by CAN score. 

2.     A significant correlation was found between neonates classified as malnourished by CAN score and         each of the criteria tested; like birth weight ,length, head circumference and ponderal index. (p             value<0.001).  

The study emphasizes the importance of CAN score as a simple clinical index for identifying Fetal Malnutrition and its potential to predict neonatal morbidity associated with Fetal Malnutrition without the aid of any sophisticated equipments.

Keywords: CAN score; Fetal malnutrition; Ponderal index.   

Introduction: Femoral shaft fractures account for 1.6% of all paediatric bony injuries. Angulation, malrotation and shortening are not always corrected effectively by conservative methods. Fixation of femur fractures in children & adolescents by flexible intramedullary nailing is becoming widely accepted because of the lower chance of iatrogenic infection and prohibitive cost of in hospital traction and spica cast care. Method: A prospective study of 90 cases of fracture shaft femur was done in BMCRI from 2009 to 2011 Children and adolescents between the age group of 5-15 years with femoral shaft fractures excluding subtrochanteric and supracondylar fractures were included. All patients underwent titanium elastic nailing fixation for the femur fracture. Clinical parameters like pain, comfort to the patients, early mobilization, operative technique, radiological evaluation for union, stages of weight bearing till complete recovery and any associated complications were studied. Patients were followed up for a period of 6 months at 4,8,12 and 24 weeks after surgery. Result: The outcome was excellent in 70 cases, satisfactory in 20 cases and there were no cases of poor outcome. No cases got infected, 2 cases had valgus malunion and 15 cases had limb lengthening. Conclusion:  Flexible intramedullary nail leads to rapid fracture union by preservation of fracture hematoma and limited soft tissue exposure. It also helps in preventing damage to the physis, is fairly a simple, reliable technique with a shorter learning curve with negligible complications. 

Keywords: Paediatrics; TENS; Femoral diaphyseal fractures. 

Gynaecological emergencies of adolescents are peculiar to particular period & can pose difficulties in diagnosis & management. It is clinically challenging for gynaecologists to manage adolescent with profuse bleeding per vaginum. Genital examination in this age group requires sensitive approach & gentleness to preserve their psychosexual health & future fertility potential, various etiological causes are explored with emphasis on anovulatory bleeding, coagulopathy, trauma, sexual abuse, tumours. 

Keywords: Adolescent; Per vaginum bleeding; Coagulopathy; Trauma; Tumour.