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There are several causes for sudden onset unilateral mydriasis, however impending transtentorial uncal herniation needs to be ruled out. This unique case highlights an uncommon adverse response to a common mode of treatment that leads to a diagnostic dilemma. A 3-year-old boy with a ventriculoperitoneal (VP) shunt for an obstructive hydrocephalus presented with an acute respiratory distress. He developed unilateral mydriasis with absent light reflex during treatment with nebulisers. An urgent CT scan of the brain did not show any new intracranial abnormality. A case of pharmacological anisocoria was diagnosed that resolved completely within 24 hours of discontinuation of ipratropium bromide. Although ipratropium-induced anisocoria has been reported in children, but to our knowledge none in a child with VP shunt for hydrocephalus. This emphasises the urgency in evaluating unilateral mydriasis to rule out life-threatening conditions. Clinicians should remember that ipratropium administered through ill-fitting face masks could cause this completely reversible adverse effect.

A comparative study of mental health problems among 11-17 year old Indian school children living in areas with persistent political violence and children of the same age group living under standard … Sri Lanka J. Child Health 2015; 44(2) Results: Three hundred and eight students participated in the study. Group 1 comprised 154 students from Kashmir Srinagar area and Group 2 comprised 154 students from Kolkata city schools. There were 79 boys and 75 girls in Group 1 and 74 boys and 80 girls in Group 2. Among Group1 participants, 42% had a total SDQ score between 20-40 compared to 17.5% in Group 2 that can be classified as abnormal by published cutoffs (p <0.05). In Group 1, the common problems in those with abnormal SDQ score were emotional problems in 47 (30.5%), conduct problems in 63 (40%) and peer relationship problems in 28 (18%). Males were more likely to have higher ratings in emotional, hyperactivity, conduct and total SDQ scores than girls. Girls rated higher in peer relation problems and had low (abnormal) pro-social scores in group 1. Both genders had significantly higher total abnormal SDQ scores in more than one domain of mental health when compared with group 2 using the two tailed test for

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