Reversible posterior leukoencephalopathy syndrome is characterized by an acute, usually reversible encephalopathy, with radiological findings that mainly involve the white or grey matter of the parieto-occipital lobes. We report a case of post streptococcal glomerulonephritis presenting as reversible leukoencephalopathy syndrome. Immediate control of hypertension resulted in rapid and complete neurological recovery.
Background: This study was conducted to find out whether high dose hydroxyurea is an effective and safe modality, in inducing haemoglobin synthesis to decrease blood transfusion requirement in transfusion dependent thalassemics.Methods: This quasi experimental un-control before and after comparison study was conducted in Thalassemia Day Care Centre, Department of Pediatrics over a period of six months after obtaining an approval from the Institute’s ethical committee. Fifty transfusions dependent thalassemic children belonging from 2 to 18 yrs were given hydroxyurea in dose of 20mg/kg after getting consent. Pre and post intervention haemoglobin and HbF levels were obtained using Hb electrophoresis by HPLC. Paired t test was applied to find out statistical significance and p value <0.05 was taken as significant.Results: Significant rise in haemoglobin pre and post intervention (p<0.001) but the rise in HbF was not significant (p=0.110). One patient had bone marrow depression which was reversible with drug withdrawal and one patient had rise in s. creatinine.Conclusions: High dose hydroxyurea is an effective and safe drug in inducing Hemoglobin synthesis in transfusion dependent thalassemics.
Objective:This study was conducted to validate the use of Acute Physiology and Chronic Health Evaluation II (APACHE II) scoring system in pediatric population in predicting the risk of mortality and to compare the predicted death rate (using APACHE II) with the actual death rate of the patients.Design:Hospital-based prospective study.Setting:Tertiary care Pediatric Intensive Care Unit (PICU) in Western Rajasthan, India.Methods:A total of 100 critically ill children between 1 and 18 years of age admitted to PICU and fulfilling the inclusion criteria were enrolled. APACHE II score was calculated in each patient on the day of admission. The predicted mortality was calculated on the basis of this score.Results:The mean APACHE II score was 21.35 ± 5.76. Mean APACHE II score among the survivors was 16.60 ± 6.12, and mean APACHE II score among the nonsurvivors was 26.11 ± 5.41, and the difference was statistically significant (P = 0.00). The area under the receiver operating characteristic curve for APACHE II score was found to be 0.889 (P = 0.008) indicating good discrimination.Conclusion:APACHE II scoring system has a good discrimination and calibration when applied to a pediatric population.
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