Background: To evaluate the occurrence of myocardial injury in acyanotic congenital heart disease (ACHD) using highly sensitive cardiac troponin T (hs-cTnT) as a biomarker. Methods: An observational cross sectional study was conducted at a tertiary care center over a period of one year (April 2017 to March 2018). Stable children with ACHD aged between 6 months to 5 years were selected as cases and age matched children without ACHD as controls. Echocardiography was done in all the patients with clinical findings of ACHD. A total of 83 children (55 cases and 28 controls) were enrolled. The severity of the ACHD was determined by the defect size and the pressure gradient across the defect on echocardiography. Levels of hs-cTnT were measured using electrochemiluminesence assay. These levels were co-related with the defect size and the pressure gradient. Results: The mean levels of hs-cTnT were significantly higher among the cases (0.044 ng/ml) than the controls (0.005 ng/ml), (p < 0.001). A positive correlation was noted between the defect size and the levels of hs-cTnT (r = 0.276 and the p value = 0.042) and an inverse relationship of the levels of hs-cTnT was seen with pressure gradient (r =-0.444 and the p value = 0.001). The development of pulmonary HTN was associated with higher levels of hs-cTnT. Conclusion: Higher levels of hs-cTnT suggest myocardial injury in children with ACHD and may be useful to stratify children for early surgical intervention before irreversible damage occurs.

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Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is a severe drug-induced hypersensitivity reaction characterized by skin rash, fever, blood abnormalities, and multiple organ involvement. The diagnosis of DRESS syndrome is often delayed because of its variable presentation. DRESS syndrome induced by antituberculosis drugs has rarely been reported. A 45-year-old female patient taking anti-tubercular drugs since 2 weeks presented to our hospital with extensive skin lesion with mucosal involvement. The case responded well to treatment with systemic corticosteroids and withdrawal of isoniazid with no recurrence of lesions and further follow-up.