A rare cause of recurrent pneumonia: Scimitar syndrome

Scimitar syndrome is characterized by partial or total anomalous pulmonary venous return from the right lung along with hypoplasia ofthe lung. This syndrome has varied presentations, from an asymptomatic state to severe pulmonary hypertension and/or heart failure.Newer diagnostic modalities have improved our understanding of this rare syndrome and hence providing newer treatment options tobe tried. Here, we present a case of a 4-year-old child with recurrent pneumonia with Scimitar syndrome. We are reporting this case inview of the rarity of this syndrome and its presentation as recurrent pneumonia

Hot water epilepsy: A form of reflex epilepsy - from infancy to adolescence

Hot water epilepsy (HWE) is a type of reflex epilepsy which occurs when hot water is poured over the head. Most cases have been reported from Southern India. Genetic, cultural, and geographical factors can be responsible for HWE. HWE can be treated by clobazam 1–2 h prior to take a bath rather than continuous anti-epileptic therapy. Medication prior to bathing may be useful in treating older children, eliminating the need to be accompanied by an adult during bathing. It can also be treated by reducing the temperature of the water used for bathing. Here, we report three cases of HWE in varying age groups

Open-label randomized controlled study comparing continuous infusion versus intermittent bolus dose of atropine with or without pralidoxime in the treatment of organophosphorus poisoning in a teaching hospital

Background: Severe organophosphorus (OPC) poisoning is one of the serious problems in developing world, taking great toll on life. Though Atropine is used as an antidote, there are no clear guidelines. We conducted an open label randomized controlled clinical study to compare the efficacy of continuous infusion of atropine to that of intermittent bolus dose in the treatment of OPC poisoning. Methods and Material: Patients aged above 12 years with clinical evidence of OPC poisoning were studied. Both the groups received initial bolus of 1to3 mg of atropine. Then, Group-A received intermittent bolus and group-B, continuous infusion, until adequately atropinized. Results: Out of 743 patients (group-A: 356 and group-B: 387), females were 54%. 83% had suicidal intent. Mean atropine dose was 126.6mg in group-A and 78mg in group-B (P < 0.0001) . 21.07% (group-A) and 12.92% (group-B) developed intermediate syndrome (P = 0.003) , mortality was 27.25%(97) in group-A v/s 13%(50) in group-B (P < 0.0001) . Ventilator support needed in 36%(group-A) against 17% in group-B (P < 0.0001) and duration of ventilation was 1.5 days lesser in group B (P < 0.0001) . 23.03% had atropine toxicity in group-A as compared to 8% in group-B (P < 0.0001) . Hospital stay was 1.67 (P < 0.0001) days shorter for group-B. Conclusion: Continuous atropine infusion should be standard of care in treating OPC poisoning