Indian Journal of Trauma and Emergency Pediatrics

Seven and a half months old male infant presented to emergency with chief complaints of fever from 6 days cough since 6 days, rash since 3 days. In view o increasing respiratory distress, H1N1 PCR was sent which came positive. As it was unusual presentation of H1N1, to rule out other viral illnesses rubella and measles serology was sent of which Measles serology came strongly positive. To our knowledge this is the first case report of H1N1 and measles presenting simultaneously in same patient.

Keywords: H1N1, Measles, Rash.

Background: Neuroradiological findings in Dengue are nonspecific. Only a few cases of transient splenial hyperintensity (TSH) in MRI Brain due to dengue fever have been reported. We report a case of 13- year old boy with acute febrile illness, delirium and severe headache who was diagnosed with dengue encephalopathy; neuroimaging showed transient splenial hyperintensity (TSH). Conclusion: Complete clinical recovery was achieved with symptomatic managment.

Keywords: Dengue encephalopathy; Transient splenial hyperintensity.

Immunization schedule is not simple as before. Many new vaccines are introduced, many yet to come. Immunization in special situations like organ transplantation, immuno suppressed conditions, travel to in/outside, are common and schedule is confusing. Pediatricians should aware about newer vaccinations in common practice and how to advice immunization in special situations.

Keywords:Immunization; Special circumstances; Vaccine; Immunization schedule.

Background and Aim: To evaluate the effectiveness of clonidine as adjuvant to ropivacaine in subclavian perivascular approach to brachial plexus block for prolonging the duration of sensory and motor blockade and analgesia also. Methods: Patients were randomly divided into two groups. Patients in Group R (n = 30) were administered 25 ml of 0.75% Ropivacaine + 1 ml normal saline and Group RC (n = 30) were given 25 ml of 0.75% Ropivacaine + 1 ml 75 microgram of clonidine. Results: The onset and the duration of sensory and motor block was signi ficantly faster and prolonged in Group RC compared to Group R. Hemodynamic variables did not differ between groups in the postoperative period. Conclusion: Clonidine 75 microgram in combination with 0.75% Ropivacaine was found to be hastening the onset of sensory and motor block and improved postoperative analgesia in brachial plexus block.

Keywords: Ropivacaine; Clonidine; Brachial plexus Block.

Background: Patient satisfaction is an important attribute of care in modern hospitals; private setups generally score better over public institutions. There are few objective studies to assess patient satisfaction in Indian public hospitals, which could identify their strengths and weaknesses for further planning. Objectives: To assess— (a) extent of patient’s satisfaction with different domains of Pediatric services in the study hospital, using caregivers as surrogate informants; (b) effect of selected demographic characteristics on satisfaction level. Patients and methods: In this observational study, 400 caretakers of hospitalized children were interviewed on day of discharge using a 25-point prevalidated questionnaire evaluating satisfaction rates in four major domains of hospital care. Results: Overall satisfaction rate (SR) was 94.5%. Domain-wise, it was highest with quality of medical care (94.0%) and least with information and communication (76.3%). SR in the domains of staff behavior and hospital environment was 89.8% and 85.8% respectively. Top three dissatisfiers were— (a) not informed about avenues of financial support (27.7%), (b) not informed about hospital rules (65.8%), (c) doctors did not introduce themselves (66.5%). SR was lower in female respondents and in those staying with male children. Female respondents were less satisfied with environment and staff behavior, while undereducated respondents were more unsatisfied with information and communication. Conclusions: This study reveals unexpectedly high level of satisfaction with services of study hospital, driven by quality of medical care, which masked the deficiencies in other domains. Lack of communication was leading cause for dissatisfaction followed by hospital environment, which need attention.

Keywords: Communication; Doctors; Hospital services; Parental satisfaction; Behaviour.