Indian journal of pediatrics
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To evaluate the outcome and prognostic factors for oncology patients in the PICU of a tertiary care centre in a developing country. ⋯ The mortality in children with cancer in PICU in the present study is comparable to previous reports and is related to higher PRISM III score, presence of multiorgan dysfunction syndrome and use of ICU therapies.
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Randomized Controlled Trial Comparative Study
Hypertonic versus normal saline as initial fluid bolus in pediatric septic shock.
To compare the efficacy of 3% saline and 0.9% saline infusion as initial resuscitative fluid therapy in children with septic shock. ⋯ Both normal saline and hypertonic saline were equally effective as resuscitation fluid with respect to restoration of hemodynamic stability, average duration of ICU stay and mortality. Hypertonic saline appears to be a promising fluid for resuscitation of septic shock.
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Anemia is common during adolescence. However, severe anemia is uncommon and can have varied etiology. This study was conducted to find out the profile of adolescents (10-18 years) admitted for severe anemia. ⋯ Mean age of these patients was 12 (+/-2.5) years and mean hemoglobin at admission was 3.6 (+/-1.4) g%. Megaloblastic anemia was most common type of anemia (42.5%) followed by aplastic anemia (27.5%) and 15% cases were due to severe iron deficiency anemia. Although iron deficiency anemia is the most common type of anemia, but in adolescents megaloblastic anemia and aplastic anemia should be looked for whenever the adolescents present with severe anemia.
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Case Reports
Indian carp (Labeo rohita) gall bladder poisoning-report of four cases in a single family.
The ingestion of Indian carp gallbladder may result in transient hepatitis with subsequent acute renal failure. This case series also illustrates the importance of understanding the use and potential serious complications of alternative medicines. So fish gallbladder poisoning should be considered in unexplained acute renal failure in Chinese and Asian patients. We report four family members who developed acute renal failure and toxic hepatitis at the same time following ingestion of raw Indian carp (Labeo rohita) gall bladder.
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Septic shock is an important cause of mortality in children with sepsis. The incidence of septic shock is 2-4% of admissions in western pediatric intensive care units and 40%-67% for Indian PICUs. Early goal-directed resuscitation that includes aggressive fluid resuscitation of up to 60 mL/kg as boluses of 20 mL/kg by IV push, to achieve desired heart rates and blood pressure, has emerged as mainstay of treatment in the initial stage. ⋯ Inodilators such as milrinone are also useful in this situation. Targeting clinical therapeutic end-points assists the management. Good supportive care is also essential for improving the outcomes.