No abstract

Thus, region specific nomograms for PEFR for assessing the severity and monitoring of airway obstruction in relation to age, sex, weight and height of children can be determined.

We report a neonate who presented with failure to thrive, non-bilious vomiting and upper abdominal distension starting at one week of age. A barium upper GI study confirmed the diagnosis of organoaxial volvulus of the stomach, and the child underwent a successful laparoscopic gastropexy. At one year of follow-up the child is asymptomatic. We discuss the technique and review the literature.

Metabolic alkalosis is an uncommon acid/base disorder in children in which serum bicarbonate concentration is increased. Two most important causes of metabolic alkalosis are emesis and diuretic use. However, in the absence of these two etiologies, a thorough investigative workup is of paramount importance to reach a definitive diagnosis. A case having severe metabolic alkalosis diagnosed as a case of Bartter syndrome is being reported.

Our aim was to study the clinical profile, immediate outcome and risk factors associated with poor outcome in critically ill children presenting with seizures requiring PICU admission. As seizures lasting 10 min or more can potentially cause brain damage, we included all children regardless of seizure duration. The records of 157 children aged 1 month to 16 years admitted in the PICU at a tertiary hospital in India with seizures as the presenting symptom during a three-year period were studied retrospectively. Median age of patients was 4 years. 34 (21%) had pre-existing epilepsy and 33 (21%) had previous developmental delay/neuro-deficit. Seizure duration was > 30 min in 75 (47.7%) and 56 (35.6%) required the use of more than 2 antiseizure drugs. 101 (64%) had acute symptomatic seizures, 28 (17%) remote symptomatic and 27 (17.1%) had unknown cause. New onset neurological deficit was seen in 18 (15.6%) and 14 (8.9%) died. Young age, high PEWS score at presentation, prolonged/recurrent seizures, CNS infection, need for multiple antiseizure drugs and ventilation/pressor use were risk factors for poor outcome. Neurological outcome and survival of children in our study were good. Further all-inclusive studies irrespective of seizure duration are needed to obtain a complete picture of critical children presenting with seizures.