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Introduction Magnesium is a less frequently monitored electrolyte in critically ill patients. Hypomagnesemia is associated with increased need for mechanical ventilation, mortality and prolonged ICU stay. The present study was undertaken to identify the proportion of children with abnormal magnesium levels and correlate it with disease outcome. Methods This observational study included children aged 1 month to 12 years hospitalized at the emergency room. Heparinized blood was collected for determination of ionized magnesium, ionized calcium, sodium, potassium and lactate using Stat Profile Prime Plus (Nova Biomedical, Waltham, MA, USA). Clinical outcomes for duration of hospitalization, and death or discharge were recorded. Results A total of 154 (102 males) children with median (IQR) age of 11 (4, 49.75) months were enrolled. Sixty one (39.6%) had ionized magnesium levels below 0.42 mmol/l, 63 (40.9%) had normal levels and 30 (19.4%) had hypermagnesemia (>0.59 mmol/l). Hypomagnesemia was associated with hypocalcemia (p < 0.001), hyponatremia (p < 0.001) and hypokalemia (p < 0.02). A higher proportion of children with hypermagnesemia required ventilation than hypomagnesemia (26% vs. 9%) and succumbed (35% vs. 20%), respectively; p > 0.05. Ninety-three (60.3%) had hypocalcemia and 10 (6.5%) children had hypercalcemia. There was good correlation between ionized calcium and magnesium values (r = 0.72, p < 0.001). Conclusion Both hypomagnesemia and hypermagnesemia were seen in critically ill children. Patients with hypomagnesemia had significantly higher proportion of other electrolyte abnormalities.

We present a male stillborn baby, born with disproportionate body and omphalocele. The infantogram revealed the absence of mineralization of all the bones, except for a minimal ossification of the ribs and spine. The possibilities that can be considered in such a case of absent mineralization at birth are very few. A definite diagnosis can be made on detailed clinical examination and the specific pattern of bone mineralization. The classical phenotypic features, associated anomalies, and the pattern of mineralization facilitated in diagnosing the rare entity, boomerang syndrome. Although the diagnosis should be confirmed by genetic studies, it is important to know the classical phenotypic and radiological features of boomerang dysplasia as it is often mistaken as achondrogenesis.

Cardiomyopathies are a group of diseases of the myocardium associated with mechanical and/or electrical dysfunction that usually exhibit inappropriate ventricular hypertrophy or dilatation. Neonatal CMs account for about 1% of childhood cardiac disease, with an estimated incidence of 10:100,000 live births, and are responsible for 10% of all paediatric cardiac deaths [1]. Among this, transient right ventricular hypertrophy (RVH) is a rare anomaly that is seen during the neonatal period. The various causes associated with right ventricular hypertrophy are maternal diabetes, metabolic causes, NSAID use and premature constriction of ductus. Present case is interesting as no cause could be found in this case of transient RVH.

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