Indian Journal of Trauma and Emergency Pediatrics

Morgagni hernia is a rare variety of Congenital diaphragmatic hernia and its diagnosis is usually incidental. When symptomatic, it is usually gastro intestinal. Cardio- pulmonary compromise due to hernia contents on lungs, heart and great vessels even in an uncomplicated hernia, poses a challenge for anaesthesiologist. Intra operative complications to be anticipated are hypoxia, hypercarbia, right to left shunt. Post operatively, atelectasis is an expected complication which could be prevented with adequate analgesia.

Keywords: Hernia sac; Laparotomy; Morgagni hernia.

Meningitis due to Salmonella Enteritidis is very rare in children. Only a very few case reports of Salmonella Enteritidis meningitis reported in immunocompetent infants. Usually the infection will be severe and may lead to longterm morbidity and mortality. So early diagnosis and treatment is important.

Keywords: Salmonella Enteritidis; Meningitis; Complications; Infants.

Autism spectrum disorder is characterised by inability of the child to socially interact with people , poor eye to eye contact, absent or perverted speech, abnormally received sensory stimuli (more or less than optimum response to sensory stimulus),self stimulating, self injurious behaviour ,with associated intellectual disability of varying severity, liking for sameness, abnormal stereotactic movements. Hyperactivity and sleep disorders are usually associated ,making it difficult for parents to look after the child. Mostly this abnormal behaviour is noticed at the age of 11/2 to 3 years. This is a progressive condition worsening with age.1 The incidence has been noticed to increase over the years in most parts of world.2 The incidence in western world is said to be around 1 in 59 children.3 In India the incidence has been estimated to increase but real prevalence is not known. Many of these children remain undiagnosed and untreated due to difficulty in diagnosis by health care personnel and poor understanding by parents. Two scales developed for Indian children4,5 have now made the work easy. Juneja et al found prevalence around 0.9/1000.6 This study will test the utility of deep touch pressure therapy on telomere length and development of the child.

Keywords: Deep touch pressure therapy; Autism Spectrum Disorder; Synopsis.

Background: Septic arthritis is not a common manifestation of neonatal infection but devastating if not detected or treated early. Its initial sign symptoms are nonspecific. Bacteria responsible for septic arthritis are changing from time to time as most of the cases of neonatal septic arthritis arise as a consequence of bacteremia. Aim: To highlight the magnitude of septic arthritis in neonate. Materials and Methods: A retrospective observational study was done in neonatal unit of Dhaka Shishu (Children) Hospital from October 2019 to March 2020. The medical records of those neonates were looked for prenatal, natal and postnatal history and examination findings. The onset of joint involvement, type of joints and number of joint affected was recorded as well as general and local symptoms were also recorded. All investigations were done including X ray and USG of joint. Results: Total 1903 neonates were admitted over 6 months. Among them 18 neonates were diagnosed as septic arthritis. In our study 58.8 % neonates were preterm, mean age of admission was 21.5±5 days and most common risk factor was nosocomial infection. They commonly (17 patients) presented with tenderness and limitation of movements. Among the involved joints 15 were knee, 3 hip and 1 shoulder joint. Twelve patients had positive blood culture, 10 patients had joint effusion evident by USG. Conclusion: All septic neonates should be looked for arthritis as its prevalence is not rare.

Keywords: Neonate; Septic arthritis. Key Message: All neonates with sepsis have to search for any joint manifestation present or not because neonatal septic arthritis is not very uncommon in our setup and need early diagnosis and treatment to avoid any devastating condition.

Purpose: This study was done to see and assess the cognitive and behavioral impairment in children with nephrotic syndrome and to find out any relationship with disease-specific or treatment specific characteristics. Methods: This one-year case-control study was conducted from October 2018 to November 2019 among the diagnosed case of nephrotic syndrome, age range 3-16 year without an active stage of nephrosis or infection. Control groups were selected from age and sex-matched patients admitted in the same hospital after controlled active disease and without any chronic illness. The Wechsler Intelligence Scale for children (WISC) for assessment of Cognitive function was performed in both groups. Moreover, to assess behavioral impairment, the Strengths and Difficulties Questionnaire (SDQ) were performed in both groups. Results: Among the case group steroid dependency was noted with 58.1% and about 27% received for prolong period (> 3months). A total cumulative dose before hospital admission was 384.16±206.94 mg/kg. All the domains of cognitive parameter and behavioral parameters affected significantly in nephrotic syndrome children than the control group(p<0.05). Mostly affected cognition domains were verbal 72% and processing speed 74%. Considering behavioral parameters, conduct 44.2% and hyperactive 14.2% disorders were affected severely among these children. Both the cognitive and behavioral impairment were significantly affected by prolonged corticosteroid therapy(p<0.0001). Conclusion: Severe psychosocial and emotional impairment are commonly seen among those children who are getting steroid for a prolonged period, which argues in favor of a low threshold for switching to sparing drugs.

Keywords: Cognitive; Behavior; Children; Nephrotic syndrome.