Sickle cell disease (SCD) is a term used for a group of genetic disorders characterized by production of Hb “S”. Sickle cell hemoglobin opathy occurs due to mutation of beta-globin gene situated on short arm of chromosome 11, where adenine is replaced by thymine in base of DNA coding for the amino acid in the sixth position in beta-globin chain. This leads to an amino acid change in beta chain of Hb molecule, from glutamic acid to valine. The result is profound change in the molecular stability and solubility of Hb “S”. Authors are reporting a 8-year-old girl who is a known case of sickle cell disease presented with complaints of intermittent pain abdomen and vomiting since 30 days. Investigations revealed elevated pancreatic enzymes with radiological evidence of pancreatitis. Packed red blood cell transfusion and appropriate supportive therapy given and child recovered well.

Background: Aim was to study clinical, socio- demographic and laboratory profile and outcome in children with scorpion envenomation up to 12 years of age. This study conducted to provide better insights in to the socio-demographic, clinical, laboratory profile of scorpion envenomation in rural health setting in India.Methods: This was a hospital based, prospective observational study done in children up to 12 years of age admitted in a tertiary care centre between March 2018 to April 2020 with history of scorpion envenomation, presence of sting mark or scorpion seen in vicinity of child by parents or near family members. Unknown bites or stings and cases were the clinical manifestations are not compatible with scorpion sting were excluded.Results: During the study period, 28 children were admitted for scorpion sting. Maximum number of cases were noted in the age group of 3-6 years and there is equal distribution of cases among males and females .Majority of cases from rural areas, 46.42% of the cases had black scorpion sting, most of the stings occurred during evening time and spring season. The most common sting sites were the distal part of the extremities. Pain at the sting site and local swelling were the most common presenting symptoms. The common signs noted were tachycardia. The most common ECG changes were noted in the present study was sinus tachycardia (46.42%) fallowed by ST segment changes noted in 21.4% of children. Commonest complications noted myocarditis, pulmonary edema, myocardial dysfunction, peripheral circulatory failure. One patient died due to pulmonary edema. Majority of the cases recovered without any sequale.Conclusions: Scorpion envenomation is a preventable emergency among children and closely associated with environmental condition, socioeconomic status and child activities. Supervised outdoor play, early hospitalization, close monitoring of vitals and management of complications and supportive care may reduce the mortality and morbidity.

DRESS syndrome is a serious life threatening condition characterized by skin eruption, haematological abnormalities and multi organ involvement that can be fatal if unrecognized especially in patients with liver failure. Diagnosis may be difficult because it is rarely seen in children and it can mimic many different conditions. Author report a case of 12 year old female presented to this emergency department with moderate grade fever, skin rash and jaundice following dapsone ingestion. She was evaluated and was diagnosed as DRESS syndrome and successfully treated with steroids.