Indian Journal of Trauma and Emergency Pediatrics

Trigeminal neuralgia (TN), also known as tic douloureux, is sometimes described as the most excruciating pain known to humanity. The pain typically involves the lower face and jaw, although sometimes it affects the area around the nose and above the eye. This intense, stabbing, electric shock-like pain is caused by irritation of the trigeminal nerve, which sends branches to the forehead, cheek, and lower jaw. It usually is limited to one side of the face. The pain can be triggered by an action as routine and minor as brushing your teeth, eating or the wind. Attacks may begin mild and short, but if left untreated, trigeminal neuralgia can progressively worsen. Although trigeminal neuralgia cannot always be cured, there are treatments available to alleviate the debilitating pain. Normally, anticonvulsive medications are the first treatment choice. Surgery can be an effective option for those who become unresponsive to medications or for those who suffer serious side effects from the medications.

Burns and related injuries are common causes of death and disability. The highest incidences of burn cases occur in children and adults. In children less than 2 years of age, contact with hot surfaces and scald burns are the most common presentation to the hospital. The practice of cooking at ground level or sleeping with a burning lamp are some of the causes. Early management of this type of burn results in better outcomes. In this case we describe the role of negative pressure wound therapy (NPWT) as an adjuvant in the management of paediatric thermal burns.

Background: In this study, we wanted to study the incidence, risk factors and clinical and bacteriological pattern of nosocomial infections in PICU.

Methods: This study was conducted in the PICU of 900 bedded Tertiary hospital. 74 suspected cases of nosocomial infections were studied prospectively, identified as per the guidelines laid down by CDC.

Results: The incidence of nosocomial infections was 29% (N=255). Bloodstream infections were the most commonly observed in the present study (43.24%, 32/74) followed by Urinary Tract Infection (UTI) (32.43%, 24/74), Nosocomial pneumonia (16.21%, 12/74), and SSI (8.1%, 6/74). There were two patients with more than one nosocomial infections. The average duration of stay in children with NI the overall length of stay was 589 days with an average of 7.95 days compared to 4.63 days in children without NI.

Conclusions: The risk of nosocomial infection was directly related to the duration of stay in the PICU and the duration of placement of indwelling catheters /tubes. Age and sex were the important independent risk factors for causing nosocomial infections as the incidence was more in the 2 months age group. BSI occurred more commonly in males while UTI in females. Other risk factors like malnutrition, immuno-compromised status and underlying illness were also associated with nosocomial infections. The most common organism was E. coli (sensitive to amikacin) followed by klebsiella and maximum sensitivity to piperacillin-tazobactam. Length of stay in PICU more in children with NI. There was no significance in mortality between both groups.

Abbreviations: NI- Nosocomial infections. PICU- Pediatric intensive care unit. UTI- Urinary tract infections.