Indian Journal of Trauma and Emergency Pediatrics

Pericardial catheterisation is a vital procedure to drain and relieve life threatening cardiac tamponade. But like any other invasive procedure it is not devoid of complications related to misplacement. We present a case of ruptured amoebic liver abscess into the misplaced pericardial pigtail catheter into the liver. This case calls attention to the fact that extreme caution should be taken while putting pericardial catheter in presence of contiguous intraabdominal abscess as it may provide a low resistance passage for the catheter leading to misplacement. Fortunately it drained the liver abscess and our patient did not have any complication related to the misplacement.

Keywords: Cardiac Tamponade; Misplaced Pericardial Catheter; HepatoPericardial Fistula. 

Neurocysticercosis is caused by the infestation of human central nervous system with larval stage of Taenia solium. Many previous studies have reported poor outcomes in cases of intraventricular form of the disease. We present the case of an elevenyearold male child who presented with complaints of fever, headache, vomiting and seizures. He was misdiagnosed elsewhere as tuberculoma two years back. A solitary, nonmigratory cyst was visualized in the fourth ventricle on the magnetic resonance imaging scan done this time (intraventricular neurocysticercosis). Patient was treated with antihelminthics, steroids and anticonvulsants and is asymptomatic on followup. A repeat magnetic resonance imaging scan done 18 months later revealed complete resolution of the intraventricular neurocysticercosis. Points of interest in the present case (intraventricular neurocysticercosis) are the initial misdiagnosis, absence of severe hydrocephalus and presentation as seizures.

Keywords: Albendazole; Brain; Cyst; Cysticercus; Intraparenchymal; Intraventricular; Seizures; Taenia; Magnetic Resonance Imaging. 

The Polycystic Ovarian Syndrome is a complex condition in women associated with psychological, reproductive & metabolic features. The syndrome is diagnosed when following three criteria are present:

1. Anovulation/ Oligo ovulation. 2. Biochemical hyperandrogenism. 3. Polycystic ovaries observed ultrasonographycally. Clinical and biochemical features of PCOS can arise due to excess androgen secretion by ovary due to LH secretion from genetically programmed HP unit long before puberty likely during intrauterine life. Puberty triggers PCOS in predisposed girls. Syndrome is result of interaction of genetic and environmental factors. Diagnosis of PCOS in adolescent girls is based on abnormal uterine bleeding pattern and evidence of hyperandrogenism. PCOS is known to be associated with reproductive morbidity and increased risk of endometrial cancer. Diagnosis is important because of increased metabolic and and cardiovascular risk.

Keywords: Polycystic Ovarian Syndrome; Adolescence; Hyperandrogenism; Insulin Resistance Anovulation. 

Introduction: It has now become apparent that the majority of hospitalacquired hyponatremia in children is iatrogenic and due in large part to the administration of hypotonic fluids to patients with elevated Arginine vasopressin levels (AVP). The practice of administering hypotonic parental fluids was established over 50 years ago, before recognition of the fact that there are numerous potential stimuli for AVP production in most hospitalized patients.

Methodology: Hospitalized children who fulfilled inclusion criteria and not having any of the exclusion criteria were considered for the enrolment after written informed consent. Venous blood samples were taken at enrolment for estimation of serum sodium, potassium, chloride, blood sugar, blood urea, serum creatinine.

Results: The incidence of hyponatremia in group B was highly significant 25% (p value 0.006) in comparison with group A (RL) which was only 6.66% and was not significant. The incidence of hyponatremia in group B was highly significant 30% (p value 0.049) in comparison with group A (RL) which was only 15% and was not significant.

Conclusion: There is significant increase in the hospital stay in hyponatremic patients more so in group B.

Keywords: Hyponatremia; Multiple Electrolytes; Maintenance Therapy. 

Introduction: Diarrhea due to gastroenteritis is the most common cause of hypovolemic hyponatremia in children. Emesis causes hyponatremia if the patient takes in hypotonic fluid, either intravenously or enterally, despite the emesis. Most patients with emesis have either a normal sodium concentration or hypernatremia

Methodology: All children (3 months to 12 years) who were admitted to pediatric ward, who required intravenous maintenance fluid therapy for at least 12 hours, with serum Na in between 135 and 150 meq per litre were included in the study Results: 25% of hyponatremic patients were in respiratory diseases group, so this is group at risk of developing hospital acquired hyponatremia.

Conclusion: Duration of stay was increased (>5 days) in hyponatremic patients (p value 0.005), more so in hyponatremic group B patients (53% p value 0.001).

Keywords: Disease; Hyponatremia; Hospitalised Children.