The incidence of peri-operative anxiety in Indian children is significant. Parental anxiety and socioeconomic background were found significant predictors of high pre-operative anxiety in our set-up.

Cushing's syndrome is characterized by any cause of excess cortisol in the blood and produces many physiologic consequences. Left untreated, Cushing's is associated with significant morbidity and mortality. Seventy percent of endogenous cases of Cushing's syndrome are secondary to a pituitary tumor; because of this, the primary mode of management is surgical resection of the tumor. Should hypercortisolism persist following surgical resection, further treatment options are limited. Metyrapone is an orphan medication that is often used in the diagnosis of the disease and occasionally for short-term treatment prior to surgery. Long-term treatment with metyrapone is usually discouraged due to the contradictory increase in ACTH production, acne, hirsutism, hyperkalemia, edema, and other mineralocorticoid effects. We present a patient with refractory Cushing's syndrome successfully treated for nearly 6 years with metyrapone with minimal adverse effects. This orphan medication may be a viable long-term treatment option for this difficult disease.

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A ccording to the 2011 Census report, India comprises 17.5% of the world's population [1]. The current neonatal mortality rate (NMR) was 25.3/1000 live births accounting for two-thirds of the infant mortality in India. According to the data from the National Neonatal Perinatal Database (NNPD, 2002-03), sepsis is one of the predominant morbidities in neonates. The most common clinical category of systemic infection was septicemia found in 88.1%, while pneumonia was diagnosed in 32.8% of infants with systemic sepsis [2]. Neonatal sepsis (NS) or neonatal bloodstream infection is a pertinent reason behind death in neonates and children under 5 years of age. Sepsis ranks at the higher position among reasons causing avoidable mortality in neonates. Patients who are suffering from human immunodeficiency virus (HIV), tuberculosis, malaria, and other infectious diseases may ultimately result in death due to the clinical condition of sepsis. Every year 2•9 million newborns die because of bacterial infection indicating it as a leading cause of mortality among them [3]. At present, there are a variety of tests available for testing sepsis in neonates such as complete blood count (CBC), C-reactive protein (CRP) test, absolute neutrophil count (ANC), immature to total neutrophil (I/T) ratio, erythrocyte sedimentation rate (ESR) [4], procalcitonin (PTC) test [5], and confirmatory tests like bacterial culture testing [3], and immune-histological test [4]. CRP test is one of the most trending tests in the study of NS. CRP is a homopentameric acute-phase inflammatory protein and binds to polysaccharides such as phosphocholine and activates the classical complement pathway of innate immunity by triggering C1q [6]. Elevated expression levels of CRP denote inflammatory conditions such as rheumatoid arthritis, cardiovascular diseases, and infection [7]. In the case of some bacterial infections, blood serum contains high levels of CRP but also decreases exponentially with a reduction in infection [4,8]. According to Dagan et al. [9], children are discharged without any treatment if they are found negative for signs of sepsis or with a single dose of intramuscular antibiotics, but may potentially suffer from sepsis. CRP should be considered in such patients where the diagnosis of sepsis is not straightforward. Our current research aims to determine the efficacy of shortterm versus long-term antibiotic treatment using serial CRP as