Background: Acute lower respiratory tract infection (ALRTI) continues to be the biggest killer worldwide of children under 5 years of age. Objective: The objective of this study is to identify and assess the modifiable risk factors for ALRTI in children under 5 years of age. Materials and Methods: This prospective case–control study was conducted in the pediatrics department of a tertiary care pediatric hospital. A sample size of 106 cases and 106 controls were selected. A detailed general and systemic examination (including respiratory and heart rate measurements, anthropometry, and nutritional assessment) along with the routine hematologicalinvestigations and chest X rays was done in both cases and controls. Other specific investigations were done as per requirement in individual cases, and all the cases were treated as per the standard protocol depending on the type of ALRTI. Chi-square-test was used and p<0.05 was taken as statistically significant. Results: Statistically significant risk factors identified with increased incidence of ALRTI included incomplete immunization for age, low socioeconomic status, families having more than two under-five children at home, family history of moking, respiratory infections, overcrowding, use of biomass as fuel for cooking, lack of ventilation, not having separate kitchen, low birth weight, pre-lacteal feeding, lack of exclusive breastfeeding for 4–6 months, malnutrition, and anemia. Conclusion: The present study identifies various significant risk factors for severe pneumonia in under-five children.

Background: Febrile convulsion (FC) is the most common seizure disorder in childhood. White blood cell (WBC) and C reactive protein (CRP) are commonly measured in FC. Aims and Objectives: To compare WBC and CRP in febrile children, aged 6 months to five years, with and without FC, in order to determine whether leukocytosis and elevated CRP can be used as diagnostic tool for febrile seizure.. Materials and Methods: In this cross sectional study 214 children (112 with FC), aged 6 months to 5 years, admitted to in the first 48 hours of their febrile disease, either with or without seizure, were evaluated over a 12 months period. Age, sex, temperature; WBC, CRP and hemoglobin were recorded in all children. There was a significant increase of WBC (P <0.001) in children with FC so we can deduct that leukocytosis encountered in children with FC can be due to convulsion in itself. Results: When comparing FC and non-FC children, we encountered a significant increase of WBC (P =0.0005) in children with FC, measured at the time of admission to pediatric medicine ward. There was no significant difference regarding CRP between the two groups. In fact, elevated CRP is a result of underlying pathology.Conclusion: In stable patients, if there's no reason to suspect a bacterial infection or who don't have any indication of lumbar puncture, there's no need to assess WBC as an indicator of underlying infection. Any child with febrile seizure with a high CRP value should be evaluated for infection

Acute obstruction of a modified Blalock-Taussig shunt may result in life-threatening hypoxia in patients with shunt-dependent pulmonary circulation. We here report successful relief of shunt blockage due to thrombosis in immediate postoperative period with transcatheter thrombolysis by Urokinase in an infant. Our case highlights the need of early diagnosis as well as the important role of emergent catheter-directed thrombolysis as an effective rescue strategy to restore the patency of acutely thrombosed Blalock-Taussig shunt.

Immune thrombocytopenic purpura (ITP) is an autoimmune disorder characterized by increase in destruction of circulatory platelets and is the most common cause of acquired thrombocytopenia in childhood. ITP can be classified based on duration of thrombocytopenia as acute and chronic form. Recurrent ITP is defined as recurrence of symptoms, after at least three months of remission sustained without any treatment. It is a rare entity and seen in just 5% of all ITP cases. Further, its treatment is often cumbersome and warrants use of non-conventional drugs and splenectomy. Reported here is a case of ITP in a 10-year-old girl, who presented with three recurrences and all episodes were successfully treated with either oral Prednisolone or resolved spontaneously.

Here we presented a case of Citrullinemia type 1 in a full term male neonate who presented with an acute catastrophic collapse on the 3rd day of life. The key features of increasingly poor feeding, vomiting and progressive lethargy with or without seizures should quickly direct towards a metabolic origin. This case report also shows the importance of early biochemical and metabolic screening in newborns, to reach an early and definitive diagnosis of IEM and proper management of such cases. .