Indian Journal of Trauma and Emergency Pediatrics

Point of care ultrasound is a very useful investigation in ICU for the diagnosis of various diseases as well as monitoring of the complications. As many intensivists have started using it; various new uses are being discovered in ICU setup and its spectrum of application is becoming wide. We report a case of “bilateral pneumonia with empyema and right femoral deep vein thrombosis”, in which psoas muscle hematoma could be diagnosed during a routine bedside sonography during resident teaching. The Ultrasound technique, findings and review of literature have been discussed. Bedside sonography in this case, resulted in earlier detection of psoas hematoma and its drainage. This case emphasises that bedside sonography is a simple investigation in ICU which can help the intensivist in making earlier diagnosis and management and so should be used routinely in critical care set-up. To the best of our knowledge the sonography images are unique and have not been discussed before.

Keywords: Point of care ultrasound (POCUS); Psoas hematoma

Hemolytic anemias are a myriad of conditions with similar signs and symptoms, but having numerous possible treatment options and outcomes. Hence, an accurate diagnosis is very important for treatment, counseling and prognostication of the disease. We present a male child with transfusion dependent anemia, jaundice and splenohepatomegaly. The standard tests for etiological work-up of anemia were normal/negative. He then underwent next generation sequencing, which revealed a mutation in the PKLR gene (confirming the pyruvate kinase deficiency). The child (at present) is being treated with regular packed red cell transfusions and monitoring of the ferritin level (for iron overload). It is emphasized that physicians treating anemic patients must maintain high level of suspicion for pyruvate kinase deficiency (PKD) in equivocal cases. Also, they need to be aware of the newer diagnostic methods available, like next generation sequencing including clinical exome sequencing.

Keywords: Hemolytic anemia; Hyperbilirubinemia, Next generation sequencing, PKLR gene, Pyruvate kinase, Transfusion.

Adolescence is a transition phase with physiological and psychosocial development. Excessive vaginal discharge is a common symptom in adolescent girls. It is challenging to differentiate between physiological and pathological leucorrhoea. Counselling plays a key role in treatment modalities. Reproductive health education is necessary for those who stand on the threshold between childhood and womanhood. Vaginal discharge is a symptom and not disease.

Keywords: Adolescent girls; Leucorrhoea; Physiological; Pathological.

Objective: To study the prescription pattern for acute diarrheal disease in children between 6 months to 5 years. Study design: Cross sectional study; Study setting: Diarrhoea Treatment Unit in a tertiary care hospital in Central Kerala; Study participants: Patients who presented to the Department of Pediatrics with ADD, referred from the periphery, between ages of 6 months to 5 years; Inclusion criteria: All patients presented to the Department of Pediatrics with ADD who were referred from the periphery during the period December 2017 to May 2018; Exclusion criteria: Incomplete prescription details, children with dysentery and other coexisting major illness; Results: Out of 132 children ORS, Zinc and Antibiotics were used in 70.5%, 59% and 51.5% respectively. The use of IVF (17%), pre/probiotics (8.1%) and antisecretory drugs (6.8%) were less. Good percentage of mothers (61%) used home available fluids. Conclusion: We have to still improve use of ORS and Zinc in ADD. Irrational use of Antibiotics shoud be discouraged.

Keywords: Acute Diarrheal disease; Prescription pattern; ORS; Zinc.