Takayasu's arteritis is a chronic, idiopathic, inflammatory disease primarily affecting aorta and its branches. It mainly affects young females in the age group of 10-30 years. Various atypical presentations of Takayasu's arteritis have been described in children. These atypical presentations can cause delayed diagnosis resulting in increased morbidity and mortality. Posterior reversible encephalopathy syndrome (PRES) is a neuroradiologic condition associated with headache, seizures, altered sensorium, visual disturbances, and characteristic lesions on neuroimaging. We report a child with Takayasu's arteritis who presented a posterior reversible encephalopathy syndrome. He also had associated abdominal tuberculosis for which anti-tuberculous treatment was started. PRES was diagnosed by magnetic resonance imaging with fluid-attenuated inversion recovery sequences. The child was started on nifedipine and propranolol. The child regained his consciousness within 48 h of admission. Prompt treatment of hypertension led to rapid reversal of neurological symptoms. In view of hypertension a computed tomography aortogram was done, which showed features suggestive of high grade (>75%) focal proximal left renal artery stenosis. EULAR (European League Against Rheumatism)/PReS (Paediatric Rheumatology European Society) consensus criteria was used for the diagnosis of Takayasu's arteritis in our patient. Percutaneous transluminal balloon angioplasty of the stenotic left renal artery was performed. Post-angioplasty, nifedipine was gradually omitted and oral propranolol was continued.

We describe a 7-year-old boy with staphylococcal toxic shock syndrome who presented with acute respiratory distress and cor pulmonale. We wish to highlight this unusual presentation as the diagnosis of toxic shock syndrome depends chiefly on a high degree of clinical suspicion. Early diagnosis and prompt institution of appropriate therapy will significantly reduce morbidity and mortality.

Objectives: Materials And Methods: Clinical prole and outcome of neonates with hypernatremic dehydration. Cross sectional study conducted in a tertiary care centre in central India, includes sick neonates aged less than 28 days admitted in hospital for a period from April 2022 to March 2023, who found to have hypernatremic dehydration on admission with serum soidum >150 mEq/L. Clinical and demographic information in relation to mother and baby were recorded. Out of total 2076 neonates admitted during t Results: he study period, 25 babies were diagnosed as a hypernatremic dehydration, showing an institute prevalence of 1.2%. Median age of presentation was 9 days, with female to male ratio 1.03. 92% of the babies were exclusively breast fed.76 % were born via normal delivery. Maximum presented with not accepting feed (96%), along with fever (64%), decreased urine output (52%), convulsions (28%). Admitted babies had a mean serum sodium level of 173.9 mEq/L, with as high as 200 mEq/L. 9 babies (36%) presented with shock,19 (76%) presented with evidence of kidney injury. Statistically signicant correlation was found between percentage of weight loss to mortality and serum sodium levels to mortality. Hypernatremic dehydration is a common Conclusion: medical emergency encountered in neonatal ICU and can be caused by poor feeding. Early diagnosis and appropriate treatment are crucial for survival and better prognosis.

Intracranial subdural hemorrhage is a rare complication of lumbar puncture. Caudal traction and tear of the subdural veins due to negative pressure caused by leakage of cerebrospinal fluid (CSF) following lumbar puncture (LP) is the mechanism. Prolonged headache or neurological symptoms following LP should warrant cross-sectional imaging to rule out subdural hemorrhage as it can be fatal. We report a case of subdural hemorrhage following LP in a patient with suspected meningitis and communicating hydrocephalus.

Electric shock injuries are commonly encountered by emergency physicians. Various systemic complications owing to electric shock injury have been described. It is important to maintain raised awareness of these different complications to ensure that they are recognised and treated early. We describe a rare case of transient quadriparesis following electric shock in a 10-year-old boy.