Budd-Chiari syndrome (BCS) denotes a heterogeneous group of diseases characterized by hepatic venous outflow obstruction at the level of the hepatic veins or inferior vena cava resulting in portal hypertension. Traditional approach to treatment of BCS involves systemic thrombolysis and surgical portosystemic shunt or transjugular intrahepatic portosystemic shunt in progressive cases of BCS or as a bridge to transplantation. Recently, an increasing number of successful reports of BCS therapy have involved endovascular techniques, including angioplasty and stent placement. The present report illustrates successful percutaneous recanalization of complete hepatic vein occlusion by angioplasty and stent implantation in a patient with membranous obstruction.KEYWORDS: Budd-Chiari syndrome, hepatic vein obstruction, hepatic vein stent, inferior vena cava stenosis, endovascular treatment Objectives: Upon completion of this article, the reader should become familiar with Budd-Chiari syndrome and current approach to its diagnosis and treatment, including hepatic vein and inferior vena cava stent placement. Accreditation: Tufts University School of Medicine (TUSM) is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. Credit: TUSM designates this educational activity for a maximum of 1 AMA PRA Category 1 Credit TM . Physicians should only claim credit commensurate with the extent of their participation in the activity.Budd-Chiari syndrome (BCS) results from hepatic venous outflow obstruction at the level of the hepatic veins or inferior vena cava. Although traditional management of BCS involves thrombolysis or surgical portosystemic shunt creation, an increasing number of successful reports of BCS therapy have involved endovascular techniques, including angioplasty and stent placement. We describe successful percutaneous recanalization of complete hepatic vein occlusion by angioplasty and stent implantation in a patient with membranous obstruction, and subsequently discuss clinical aspects of BCS. CASE REPORTA previously healthy 7-year-old boy was referred to our institution with a 2-month history of abdominal distension and decreased energy. The patient had no history of abdominal pain, jaundice, bruising, or acholic stools. Laboratory examination at another hospital revealed

MPV values are higher in uncontrolled DM patients when compared with controlled DM patients and a higher percentage of them develop microvascular complications like Diabetic Retinopathy suggesting that mean platelet volume could indicate and play a more important role in the detection of vascular complications of Diabetes.

INTRODUCTIONStridor is one of the life threatening symptoms presenting to the Emergency Department. 1 The word stridor is derived from the Latin word "Stridulus", which means creaking, whistling or grating. Stridor is harsh, vibratory sound of variable pitch caused by partial obstruction of the respiratory passages that results in turbulent airflow through the airway. Stridor is a sign of airway obstruction, so it demands immediate attention and thorough evaluation to uncover the precise underlying cause. 2 This study on paediatric stridor is to suggest an approach to evaluate and manage the underlying cause.Aims of the study 1. To find the causes of stridor in paediatric age group of newborn -to 12 years.2. Early identification of the cause to initiate treatment of stridor. ABSTRACTBackground: Stridor is one of the life threatening symptoms presenting to the Emergency Department. Stridor is a sign of airway obstruction, so it demands immediate attention and thorough evaluation to uncover the precise underlying cause. This study on paediatric stridor is to find the causes of stridor in paediatric age group are to identify the cause to initiate treatment of stridor, suggest an approach to evaluate and manage the underlying cause. Methods: Retrospective study of series 515 cases in paediatric age group, below 12 years of age presenting with respiratory distress to the Emergency department/ENT department. The primary management was to maintain the airway in all cases. Intravenous line established intravenous fluid/antibiotics /steroids/racemic adrenaline, followed by history of the respiratory distress from the parents/ caretakers. Then according to the provisional diagnosis evaluation is done by radiological investigation/ endoscopy. Results: Laryngomalacia was the most common cause of infant stridor in less than one year of age in 348 cases, while Foreign body aspiration is the most common cause of stridor in age group one to 12 years in 122 cases. 358 cases (69%) were treated conservatively and cause related management was done in 157 (31%). Endoscopy and imaging offers the best methods in evaluating and treatment of pediatric stridor. Conclusions:The management of stridor in pediatric age group is a team work of ENT surgeons, Pediatrician, Pediatric surgeons, anaesthetist. The airway maintenance is the main management followed by ENT examination, evaluation by imaging, endoscopy and treatment of the cause. We follow the airway management algorithm in order to evaluate the child for diagnosis of the cause for treatment and successful outcomes of stridulous pediatric patients.

<p class="abstract"><strong>Background:</strong> Benign laryngeal lesions are a spectrum of laryngeal diseases where symptoms vary from discomfort in throat, pain in throat, change of voice to stridor. Prompt diagnosis and intervention will reverse the conditions in certain laryngeal lesions.</p><p class="abstract"><strong>Methods:</strong> A prospective study was carried out in department of ENT, Madras Medical College/Institute of Child Health, Chennai between August 2013-November 2015 of non-malignant lesions of larynx. All these cases underwent a thorough ENT examination, examined under direct laryngoscope or micro laryngeal examination as the situation warrants. Benign non –neoplastic lesions are usually treated by excision biopsy and the biopsy results were confirmed.  </p><p class="abstract"><strong>Results:</strong> This study included 50 cases of non-malignant lesions of larynx. In our study 34% of the cases fall in the age group of 20-30 years, followed by 22% in age group of 0-10 years. The mean age group was 26 years. Males were 72% and female constituted 28%. The hoarseness is the common symptom in 36 patients, while stridor was the predominant symptom in 14 patients. The treatment modality followed were micro laryngeal excision in 40 cases, tracheostomy in 6 cases.</p><p class="abstract"><strong>Conclusions:</strong> Management of the non-malignant lesions of larynx<strong>, </strong>by early diagnosis with effective conservative management in the initial stages, will reduce the necessity of the surgery. Counselling, voice rehabilitation, micro laryngeal surgery is the best modality.</p>