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An epidemic of dengue haemorrhagic fever/dengue shock syndrome occurred in Chennai, South India in 1989 during and following the rainy season. Sixty-nine infants and children admitted to the Institute of Child Health and Hospital for Children with a brief febrile illness associated with skin and mucous membrane bleeds and/or shock were studied. Forty-nine had antibodies to dengue viruses. The specific serotype of the virus responsible could not be identified owing to cross-reacting antibodies. Primary infection occurred in 11 cases, secondary infection in 17 cases, antibodily titres were indicative of 'probable' dengue infection in 16 and were uninterpretable in five. In 11 cases, serology could not be done. The pattern of disease in these 60 cases was similar, with a high mortality. Haemoconcentration was not a feature in the majority and the Hess test was negative in all those tested. Nine cases with a similar but milder illness tested negative for dengue.

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Solid tumors as second malignancies are not common in children who have been managed for lymphoproliferative disorders. We report a case of adenocarcinoma (AC) of the colon as a second malignancy in a patient who was on maintenance chemotherapy for acute lymphoblastic leukemia (ALL). In children, primary AC of the colon is very rare; colonic AC occurring as a second malignancy in a child is rarer still. A case of AC of the colon following chemotherapy for ALL has not yet been published.

Transfusion-transmitted hepatitis C is a major concern among thalassemia patients. Our aim is to estimate the prevalence of Hepatitis C infection among thalassemia patients and to assess the treatment response, adverse effects of Peg-interferon based regimen and the new directacting antiviral drugs. Patients with thalassemia receiving regular blood transfusions with positive anti HCV antibodies during a period from January 2012 to June 2017 were analyzed. Serial HCV viral load and genotype and liver function tests were performed. Peg interferon and Ribavirin were used in patients diagnosed before January 2016 and patients diagnosed after January 2016 were started on the combination of Ledipasvir/Sofosbuvir. Thirty-two patients aged between 2 and 28 years were analyzed. Genotype 1 was the predominant type. Twentyone patients were initiated on Peg Interferon with Ribavirin, and 14 achieved sustained virological response. All of them had increased blood transfusion requirements with significant compliance issues. All eleven patients started on Ledipasvir and Sofosbuvir including 4 undergoing hematopoietic stem cell transplantation and 7 interferon failures showed sustained viral clearance with good compliance. Ledipasvir/Sofosbuvir combination can be safely used in thalassemia patients and in young children. The cost of therapy is less compared to peg interferon based regimen with good compliance and superior efficacy.