Indian Journal of Trauma and Emergency Pediatrics

  Pneumocephalus is a condition characterized by the presence of air in the cranium and it is mainly caused by trauma or a neurosurgical procedure. Meningitis is an extremely rare cause of pneumocephalus. Only isolated case reports of meningitis leading to pneumocephalus is reported in literature. E coli meningitis leading to pneumocephalus is still rare. A rare case of spontaneous pneumocephalus in an infant, caused by E coli meningitis, with computed tomography finding and review of literature is presented here. 

Keywords: Pneumocephalus; E coli; Meningitis

  Nature and nurture are two important factors in the flowering of an individual personality. Adolescence is a period of growth and adolescent girl need counselling with a friendly approach and positive outlook giving scientific facts. Communication is the primary means by which information is exchanged. Adolescent girls have distinct gynecological problems which should be diagnosed and treated promptly because reproductive health problems at this age have potential of affecting not only their own health but also the health of future generation. Confidential doctor-patient relationship is the foundation of counselling adolescent girl. Successful counselling to adolescent girl will take care of medical, social, behavioral and psychological dimension. 

Keywords: Adolescence; Counselling; Gynecological Problems; Communication.

  PMS may be present in individuals with family history of depression, postpartum depression in previous pregnancy, mood disorders. In some patients genetic factors, obesity are the causes. Pyridoxine deficiency, calcium deficiency are some of the nutritional deficiency causes. Pyridoxine deficiency is the main factor in PMS. PMS may be due to luteal phase deficiency, which in turn occurs due to progesterone deficiency. Premenstrual changes are burning issue having both the psychiatry and gynaecology related symptoms and adverse social consequences. Detailed interaction and reassurance of the patient goes a long way in reassuring the adolescent girl. 

Keywords: Premenstrual Syndrome; Adolescent Girl; Pyridoxine; Progesterone.

  50 children (30 males and 20 females) aged between 6 to 10 years suffering from nocturnal enuresis were studied. Clinical manifestation were 8 (16%) had frequency of micturation, 9 (18%) had urgency of micturation, 9 (18%) had twice or thrice in a week bed wetting 11 (22%) had daily bed wetting 5(10%) had pain while passing urine 4 (8%) had abdominal straining during micturation, 6 (12%) had bed wetting only in specific situation. Co-morbidities in nocturnal enuresis children were, 4 (8%) had constipation/soiling, 7 (14%) had poor attention in school, 3 (6%) had learning difficulty, 5 (10%) had complexity behavior 6 (12%) had UTI 4 (8%) had over activity of detrusor muscle 3 (6%) had neurogenic bladder 2 (4%) had congenital anomalies. Comparison of efficacy of pharmacological and non pharmacological trials and results shown that, dry bed training 60% response and 40% relapse In alarm 55% had response and 10-45% had relapse. In the motivation therapy. 20% had response and 3% had relapse, In the treatment of Desmopressin response was 50-55% and 40-45% was relapse. In Imiprine administration, 30- 50% was response, and 70-90% was relapse In oxybutyrins 35.60% response trial and result and 40% was relapse. This practical study to treat the nocturnal enuresis will be quite useful for pediatrician, psychiatrist and urologist to evaluate the etiology and treat the patients efficiently.

Keywords: Nocturnal; Emotional; Behavior; Pharmacologic; Bed Wetting

  Background: Chest X-ray (CXR) is an important diagnostic and interventional imaging modality in critically sick children admitted in PICU. But the data on their association with clinical decisions and interventions are scant. Methods: It was a retrospective descriptive study conducted in PICU. A total of 60 consecutive children aged one month to 14 years were included and all CXR done on those during PICU stay constituted the sample size. We collected data on indication of CXR, diagnosis on CXR and matching of indication and diagnosis, decision and actions taken after CXR. Results: A total of 200 CXR were available. Mean number of CXR per patient were 3.67. At 1st day of admission CXR was done for almost all the patients. The interventions were done in 32 events based on CXR findings while in 40 events there were no interventions associated with CXR. Longer duration of PICU stay, ARDS and persistent pneumonia were associated with increased number of CXR. There was good matching of clinical diagnosis and CXR diagnosis as in a very few cases diagnosis was picked up on CXR when it was missed on clinical assesment. Conclusion: A good number of CXR can be avoided like post intubation for ET position, daily CXR in ARDS. Although pre-extubation CXR were associated with action but we opine these can be avoided and patients can be extubated on clinical judgement. Some baseline X ray for bronchiolitis and GBS could have been avoided.

Keywords: Chest X-ray; Pneumonia; PICU; Ventilator Associated Pneumonia; VAP; ARDS; Pediatric.

  Elbow dislocations in the paediatric age group are very rare, as similar forces tend to cause supracondylar fractures also. Closed dislocations are an emergency and should be reduced as quickly as possible. The reduction techniques are rather simple and safe. The aim of our study was to analyse the outcomes (functional and clinical results) of isolated elbow dislocations in children. Our results showed that most cases can be treated safely with excellent outcomes by closed reduction followed by immobilization with above elbow posterior splint/ simple arm sling and then physiotherapy. 

Keywords: Paediatric Elbow Dislocations; Outcome Analysis; Robert’s Criteria