Anemia is a major global health problem, especially in developing countries. This problem is largely preventable & easily treatable. In India prevalence is approximately 51%. The NFHS 2005-2006 revealed that at least 80% of Indian children aged 12-23 months are anemic. Most children with anemia are asymptomatic and have abnormal Hb or hematocrit level on routine screening. Anemia in infancy and early childhood is associated with behavioral and cognitive delays, and lower scores on test of mental and motor development. Aims & Objectives : To study clinical profile and factors associated with severe anemia. Materials and Methods: This study was conducted in the Department of Pediatrics, Pt. B.D.S. PGIMS, Rohtak. The patients of age group 6 months to 59 months having severe anemia (Hb <7 gm/dl) were taken as subjects.Results: Out of 100 patients 51 belonged to iron def anemia (51%), 15 belongsed to megaloblastic anemia (15%). The mean hemoglobin was 5.22 that ranged from 2 to 7 gm//dl with standard deviation of 1.389. mean MCV was 76, whereas MCH, MCHC were 20 and 26 respectively. Most of anemic children belonged to grade 3 and 4 degree of malnutrition (76%). Conclusions: Prevalence of anemia in children admitted at PGIMS was high. Characteristics strongly associated with severe anemia included unemployment among caregivers and malnutrition. Iron deficiency anemia and megaloblastic anemia were the common types.

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Background: Intramural hematoma of the duodenum is a rare cause of acquired duodenal obstruction. It is often a diagnostic dilemma and a high degree of suspicion is required to make an early and accurate diagnosis in children. Case Report: A 2-year-old child presented with bilious vomiting and abdominal distension. X-ray abdomen showed high intestinal obstruction. Ultrasound and CT scan abdomen gave suspicion of pancreatic pseudo-cyst near head of pancreas. At surgery, an intramural hematoma of the duodenum was found and drained. Conclusion: Intramural duodenal hematoma is a rare entity especially in children and should be considered in differential diagnosis of acquired duodenal obstruction.

We describe the case of an antenatally diagnosed massive cardiac tumor in a fetus requiring cardiorespiratory support immediately following birth. We further discuss the successful management of this case and highlight the importance of a multidisciplinary team in managing such complicated cases. ( Level of Difficulty: Advanced. )

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