Indian Journal of Trauma and Emergency Pediatrics

Anomalous origin of the left coronary artery fromthe pulmonary artery (ALCAPA) is an extremelyrare and fatal, but a treatable congenital anomaly ofthe coronary circulation. ALCAPA usually presents
as myocardial ischemia, cardiomegaly and heartfailure in infancy. About 90% of the infants diewithin the first year of life, if left untreated. Timely
diagnosis by echocardiography and coronarycomputed tomography angiography with surgicalcorrection is life-saving. Herein, we report a sixmonth-old infant with ALCAPA who presented with dilated cardiomyopathy, congestive cardiac failure and failure to thrive. The patient underwent surgical correction for the same but succumbed to
the refractory congestive cardiac failure. All infants who present with cardiomegaly and congestive cardiac failure with electrocardiographic (ECG) changes suggestive of myocardial ischemia, should
be evaluated for ALCAPA syndrome.

Keywords: ALCAPA; anomalous origin of the coronary arteries; Bland-White-Garland syndrome; congenital heart disease; dilated cardiomyopathy; echocardiography; heart failure.
 

Background: Wiskott-Aldrich is an X-lined recessive disorder typically characterized by thrombocytopenia, eczema and recurrent infections.
We present a 11 month old male child with classical symptoms of thrombocytopenic purpura, eczema and recurrent infections. The diagnosis of WiskottAldrich syndrome was made based on history,
physical examination and preliminary laboratory investigations. He was managed with antibiotics, platelet transfusion and symptomatic skin care.

Conclusion: Need for lifelong monitoring and
higher levels of therapy as needed was informed to
the parents.

Keywords: Atopic dermatitis; eczema; recurrent bacterial infection; Thrombocytopenic purpura
 

Alka B Patil, Akshay N Jagtap, Sneha U Sanap. Cystic Teratomas in Adolescent Girls. Indian J Trauma Emerg Pediatr. 2020;12(3):19–25.
Diagnosis and Management of ovarian masses in adolescent is a challenging problem faced by gynaecologist. Amongst germ cell tumours mature teratoma is the most common. These masses arise from totipotent cells in the ovary and are benign in nature. Abdominal pain and palpable abdominopelvic mass is the commonest clinical presentations. Complications of cystic teratomas are torsion,hemorrhage, rupture, infection and malignant
transformation. Rokitansky nodule, dermoid mesh
and tip of iceberg sign are USG signs of mature
cystic teratomas. ovarian cystectomy has proved
to be safe method. Surgical treatment for teratomas
by laparoscopy or laparotomy is discussed. Early
diagnosis and preservation of fertility should be the
aim. Counselling to adolescent girls and her parents is vital.

Keywords: Mature Cystic Teratoma; Immature Cystic Teratoma; Dermoid, Adolescent; Ovarian cystectomy

Objective: To compare the effectiveness of Paracetamol versus Paracetamol and Tepid sponging in the management of fever.

Methods: Children admitted with fever randomly grouped into two groups. PCM was given in the dose of 15-20mg/kg, 6hrly in Group 1 (odd number group) and PCM plus TS was given in even number group
(Group 2). Temperature was measured after half an hour and after one hour. Fischer exact test was done to compare the relief of temperature between the two groups.

Results: Total 34 children were included in both the groups. 38 children were between I2 mo to 36months 30 were above 3 years.38 males and 30females included in the study. Commonest cause for fever was viral fever, upper and lower respiratory tract infections. Fever was absent after 30 mts in 26 children in Group 1 (PCM alone ) and in 31 children
a in Group II. At the end of one hour 33 out of 34 chidren had no fever in Group 2, where as in group 1 27/34 had no fever. It was observed that there was a statistically significant difference in temperature relief rates in the PCM plus TS group (Group 2) when compare to PCM alone (p value-0.027). That is the PCM plus TS had a significantly faster relief than the PCM only group. At the end of one hour also, it was
observed that 33 out of 34 children in combination group had relief of high temperature when compared to PCM alone group. This difference was also found to be statistically significant (p value-0.011).

Conclusion: PCM with TS is more effective in controlling fever than PCM alone. No adverse effects noted with TS. TS well tolerated when it is done properly under supervision and no adverse effects
noted.

Keywords: Fever; Paracetamol; Tepid sponging; Temperature To compare the effectiveness of Paracetamol versus Paracetamol and Tepid sponging in the management of fever.

Methods: Children admitted with fever randomly grouped into two groups. PCM was given in the dose of 15-20mg/kg, 6hrly in Group 1 (odd number group) and PCM plus TS was given in even number group
(Group 2). Temperature was measured after half an nhour and after one hour. Fischer exact test was done to compare the relief of temperature between the two groups.

Results: Total 34 children were included in both the groups. 38 children were between I2 mo to 36 months 30 were above 3 years.38 males and 30 females included in the study. Commonest cause for fever was viral fever, upper and lower respiratory tract infections. Fever was absent after 30 mts in 26 children in Group 1 (PCM alone ) and in 31 children
a in Group II. At the end of one hour 33 out of 34 chidren had no fever in Group 2, where as in group 1 27/34 had no fever. It was observed that there was a statistically significant difference in temperature relief rates in the PCM plus TS group (Group 2) when compare to PCM alone (p value-0.027). That is the PCM plus TS had a significantly faster relief than the PCM only group. At the end of one hour also, it was
observed that 33 out of 34 children in combination group had relief of high temperature when compared to PCM alone group. This difference was also found to be statistically significant (p value-0.011).

Conclusion: PCM with TS is more effective in controlling fever than PCM alone. No adverse effectsnoted with TS. TS well tolerated when it is done properly under supervision and no adverse effects
noted.

Keywords: Fever; Paracetamol; Tepid sponging; Temperature

The aim of laryngoscopy is to obtain good visualization of vocal cords to facilitate smooth endotracheal intubation. Many factors have shown to
influence Laryngoscopic view of vocal cords. These include forward displacement of mandible, prominent or absent teeth, backward displacement of tongue. Difficult Mask Ventilation i.e., Bones. Laryngoscopy and endotracheal intubation trigger major stress
response, in the form of increased catecholaminesleading to tachycardia and hypertension, which may be catastrophic in patients with cardiovascular disease.1,2 Present study was done to evaluate the ease
of intubation and there effect on hemodynamic parameters by using two different laryngoscopy blades. Taking Mallampati grading, Cormack and Lehane grading into consideration the various parameters were studied.The McCoy blade, which is a modification of the Macintosh blade with its levering tip significantly reduces the duration of laryngoscopy, improves the visualization of the larynx. less increase in
hemodynamic parameters during laryngoscopy and intubation, early return of hemodynamic parameters towards baseline following intubation.

Keywords:Mac Coy; Macintosh blade; Laryngoscopy;
Glottic exposure; Hemodynamic changes.