Objective: Congenital heart disease has an overall incidence of 8 per 1000 live births. It can be grouped into acyanotic congenital heart diseases (without a shunt or with a left to right shunt) and cyanotic congenital heart disease (with a right to left shunt). Cyanotic congenital heart diseases are those inborn lesions of the heart and great vessels in which there is shunting of blood from right side of the heart to the left side with the result that de-oxygenated blood enters the systemic circulation, thereby decreasing its oxygen saturation and causing cyanosis. The commonest of these diseases is Tetralogy of Fallot's. Only a few of these diseases are compatible with life beyond 12 years of age. Methods: The present study was carried out in the department of Pediatrics, Mahatma Gandhi Memorial Medical College, Indore from January 2012 to July 2013 (duration of study was one and half years). During this period thirty children with congenital cyanotic heart disease between 6 months to 5 years of age were included in this study. Blood parameters assessed were Hemoglobin (Hb gm%), Mean Corpuscular Volume (MCV) fl and Ferritin levels. Results: The mean hemoglobin in cyanotic heart disease cases was 13.39 gm/dl with a S.D. of 2.38. In the control group the mean hemoglobin was 9.57 gm/dl with a S.D. of 1.29. Mean MCV in cyanotic heart disease cases was 71.47 fl with S.D. of 9.28 and in controls it was 78.41 fl with a S.D. of 5.87. Mean Ferritin in cases was 41.63 ng/ml with S.D. of 35.04 and in controls it was 78.75 ng/ml with S.D. of 51.40. P value was 0.001 indicating a statistically significant decreased ferritin in cases. Conclusion: Iron deficiency anemia was present in 56.6% of the cases on basis of MCV. The high iron requirements of cyanotic heart disease cases due to increased erythrocytosis induces iron deficiency anemia.There was statistically significant difference in Hb and MCV values between cases and controls. The ferritin level was statistically significantly lower between cases and controls suggesting iron deficient state in CCHD patients. Iron therapy in iron deficient CCHD (based on hematological and iron indices) patients might improve clinical outcome in these patients.

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Background: Acute encephalitis syndrome (AES) is defined as a person of any age group, at any time of the year with the acute onset of fever and change in mental sensorium (including confusion, disorientation, coma or inability to talk) and/or new onset of convulsions (excluding febrile seizures). Encephalitis is a inflammation of brain tissue which presents as a diffuse and/or a focal neuropsychological dysfunction and inflammation of adjacent meningitis. Objectives were to determine clinicoepidemiological profile in AES with special to reference cerebral malaria and to study various MRI findings in patients of AES especially in cerebral malaria.Methods: A prospective study of all cases of fever with unconsciousness or altered sensorium with or without convulsions admitted in PICU of MYH and CNBC Indore. Inclusion criteria was all those children who were previously neurologically normal, of age 1-14 years, patients with fever (<15days) with altered sensorium, with or without seizures and who stay in hospital long enough to complete essential diagnostic work up which includes (CBC with peripheral smear, RFT, LFT, MP, S. electrolytes, CSF, MRI brain).Results: The final study group comprised of 60 patients with age group 1-14 yrs and male to female ratio was 1.07:1. Patients with diagnosis of cerebral malaria were 17. High grade fever, headache, altered sensorium, generalized seizures In general examination pallor was present in 52.9%, icterus in 35.29% cases of cerebral malaria. Splenomegaly (70.5%) was more common finding than hepatomegaly (58.8%) in cerebral malaria. GCS was>6 in most cases, fundus abnormality and meningeal irritation was absent in all cases of cerebral malaria. MRI of brain in cerebral malaria was mostly normal, in (47.05%), second most common we get hyperintensity in periventricular and corpus callosum areas (23.52%), hyperintensity in basal ganglia and thalamus was found in17.64% cases and white matter changes in 2 cases. The final outcome of all cerebral cases was good, all were discharged, and there was no mortality.Conclusions: Our result demonstrate that cerebral malaria is a common cause of acute febrile encephalopathy in children. Presence of plasmodium falciparum is essential for diagnosis of cerebral malaria. No specific lesions have been identified in MRI brain.