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Donath-Landsteiner haemolytic anaemia (DLHA), also known as paroxysmal cold haemoglobinuria, is a very rare and difficult condition to diagnose as well as treat. Here, we present a case of a 55-year-old Hispanic woman who presented with severe intravascular haemolytic anaemia in the setting of a viral illness 2 weeks prior to presentation. Direct antiglobulin testing revealed mixed results: positive for either complement, IgG or both on various occasions which led to a battery of tests including the Donath-Landsteiner antibody testing which turned out positive establishing the diagnosis of DLHA. She was initially treated unsuccessfully with supportive care in the form of packed red blood cell transfusions and steroids as well as rituximab for about 4 weeks but her condition improved on cyclophosphamide, and she is on the road to recovery after 10 weeks of hospital stay.

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Background: Poisoning and drug overdose is a common medical emergency for children. Majority of childhood poisonings are unintentional. To see the change in epidemiology and spectrum of poisoning in children during COVID period this study was conducted because COVID-19 has changed the mental, socioeconomical, education status of people which also effected mental health of children. Methods: Prospective cross-sectional observation study was done in 95 children aged 0-15 years over a period of two and half years at tertiary care centre of Uttarakhand. Results: Most common age group was affected was 1-5 years (44.21%). Most common poisonous substance intake was pesticides and insecticides 18.9% followed by medications 17.89%. Most of the children (44.21%) were asymptomatic at time of presentation and required only observation care. Conclusions: During COVID time medicine became more common after pesticides in developing country. This spectrum is close to studies done in developed countries. Family education, interaction with children, close vigilance and proper storage of poisonous substance is important to avoid such incidences.