Echocardiographic recognition of a criss-cross heart with double outlet right ventricle

Crisscross heart (CCH) is a rare cardiac malformation characterized by crossing of the inflow streams of the two ventricles due to an apparent twisting of the heart about its long axis. The developmental mechanisms and causes of CCH are remaining unknown. Neonates mainly presents with cyanosis and a systolic murmur. This article presents a case of CCH with concordant atrioventriculo connections with double outlet right ventricle (DORV), which was diagnosed by echocardiography.peer-reviewe

Double orifice mitral valve associated with Ventricular Septal Defect in an infant : case report

Double orifice mitral valve (DOMV) is an uncommon anomaly characterized by a mitral valve with a single fibrous annulus with two orifices opening into the left ventricle. Here we present a rare case of DOMV with ventricular septal defect (VSD) which was detected by 2-D echocardiography.peer-reviewe

Cor triatriatum sinister with situs inversus totalis in an infant.

Cor triatriatum sinister is a rare congenital cardiac malformation characterized by a membrane in the left atrium which separates the left atrium into the proximal and distal chambers.Association of cor triatriatum is extremely rare with situs inversus totalis. This article reports a rare case of cor triatriatum sinister with situs inversus totalis in a 5 month old female infantpeer-reviewe

Accuracy of pulse oximetry screening for detecting critical congenital heart disease in the newborns in rural hospital of Central India

Congenital cardiovascular malformations are the most common category of birth defects and responsible for mortality in the first twelve months of life. Critical congenital heart disease (CCHD) will be present in approximately one quarter of these children, which requires catheter or surgery intervention in the first year of life. The aim is to determine the accuracy of pulse oximetry for detecting clinically unrecognized CCHD in the newborns. This article reports the following methods : Pulse oximetry was performed on clinically normal newborns within first 4 hours of life. If screening oxygen saturation (SpO2) was below 90%, echocardiography was then performed. Inclusion criteria: All newborns who were admitted in postnatal ward & NICU. Exclusion criteria: Out born babies and babies with a prenatal diagnosis of duct dependent circulation.peer-reviewe

An update work of pulse oximetry screening for detecting critical congenital heart disease in the newborn

Background: Congenital Heart Disease (CHD) is the commonest group of congenital malformations and affects 7-8 per 1000 live born newborns. Nevertheless, it is estimated that more than 50% of babies with undiagnosed CHD are not detected by routine neonatal cardiac examination. Aim: To find the incidence of CHD in newborns and to determine the accuracy of pulse oximetry for detecting clinically unrecognized critical congenital heart disease (CCHD) in the newborns. Methods: Pulse oximetry was performed on clinically normal newborns within 4 hours of first day of life. Inclusion criteria: All newborns who were admitted in postnatal ward & Neonatal Intensive care unit (NICU). Exclusion criteria: babies and neonates with a prenatal diagnosis of duct dependent circulation. If oxygen saturation (SpO2) was below 90%, then echocardiography was performed. Results: During the study period, 4926 live born neonates were examined. Nine out of 12 neonates with SpO2<90% had CCHD. Four neonates had tetralogy of Fallot (TOF), two had tricuspid atresia, two had transposition of great arteries (TGA) and one had truncus arteriosus. The incidence of CHD was 33.49 per 1000 live births and CCHD was 1.82 per 1000. A pulse oximetry cut-off value of below 90% for detecting CCHD showed 90% sensitivity, 99.94% specificity, 75% positive predictive value (PPV) and 99.98% negative predictive value (NPV). Conclusion: Pulse oximetry is safe, feasible and noninvasive and also used to screen for CCHD. It is the nice method to detect the CHD along with the physical examination of neonates by medical personal.peer-reviewe

Risk factors of Acute Respiratory Infection (ARI) in under-fives in a rural hospital of Central India

Introduction: Acute Respiratory Infection (ARI) is a major cause of morbidity and mortality in developing countries in children especially in under-fives. Every year in the world, about 13 million under-5 children dies, 95% from developing countries; one third of total deaths are due to ARI. The aim of this study was to identify the significant risk factors for ARI in children less than five years of age living in rural areas of Central India. Methods: A hospital based case control study was undertaken to determine risk factors associated with respiratory tract infections in children. Children less than 5 years admitted in a pediatric ward with diagnosis of ARI were enrolled in the study as cases (n = 300) while the same number of controls (n = 300) were selected from neighborhood and were matched for age, sex and religion. Details of risk factors in cases and controls were recorded in pre-designed proforma. Results: A significant association was found between ARI and lack of breastfeeding, nutritional status, immunization status, delayed weaning, prelactal feeding, living in overcrowded conditions, mothers’ literacy status, low birth weight and prematurity. Among the environmental variables, inadequate ventilation, improper housing condition, exposure to indoor air pollution in form of combustion from fuel used for cooking were found as significant risk factors for ARI in under-fives. Conclusions: ARIs are affected by socio-demographic and socio-cultural risk factors, which can be modified with simple interventions. The various risk factors identified in this study were lack of breastfeeding, undernutrition, delayed weaning, overcrowding and prelactal feeding

A case report of ectopia cordis and omphalocele

A rare congenital defect in fusion of the anterior chest wall resulting in an extrathoracic location of the heart. Cantrell′s pentalogy is a congenital anomaly resulting from embryologic development defect and consists of the following: A deficiency of the anterior diaphragm, a midline supraumbilical abdominal wall defect, a defect in the diaphragmatic pericardium, congenital intracardiac abnormalities, and a defect of the lower sternum. Here we report a rare case of ectopic cordis with omphalocele

Is it reliable to measure the forearm blood pressure in children?

Background: When the upper arm (UA) is inaccessible or a standard-sized blood pressure (BP) cuff is unavailable, some healthcare workers use the forearm (FA) to measure BP with a mercury sphygmomanometer. Objective: The objective was to determine the accuracy of BP measurement in the arm and FA. Design: Prospective, randomized study. Setting: Department of Pediatrics, JNMC, Sawangi (Meghe) Participants: A total of 72 children aged 5-15 years. Measurements: Mercury and Automatic (OMRON Tokyo, 108-0075 Japan) BP measurements were recorded from the arm and FA at 2 min intervals. Results: In our study, 72 children of both sexes were enrolled. The mean age of the children was 10.13 ± 2.82 years, and 48% were females. Pearson′s correlation coefficient between FA and UA systolic BP (SBP) measured by mercury was 0.782, and for diastolic BP (DBP) it was 0.824. Similarly, Pearson′s correlation coefficient between FA and UA SBP measured with an automated device (OMRON) was 0.843, and for DBP it was 0.846. The average readings for the SBP and DBP were higher in the FA than in the UA by approximately 3 mmHg. There was a statistically significant difference in both SBP and DBP. Conclusions: The FA is an acceptable method of BP monitoring when the UA cannot be accessed. The pressure from FA is probably higher than it would be from UA