Indian journal of pediatrics
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Swyer James syndrome (SJS) is a rare disorder. It is generally discovered on a chest radiograph as increased translucency involving one hemithorax with diminished vascular markings. ⋯ She was diagnosed as having Swyer James syndrome from the results of CT scan and ventilation perfusion scintigraphy, which revealed unsuspected bilateral involvement. This condition should be considered as a differential diagnosis in a patient with Swyer James (Macleod's) syndrome without an obvious etiology.
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Congenital heart defects (CHD) remain a significant cause of death in children, though the etiology remains unknown. One third of all patients born with CHD become critically ill during the first year of life, often within the first month. The reason for consulting a pediatric cardiologist may be urgent or elective and varies with different age groups, and on availability of health care resources. ⋯ In the older child, referral is more likely to be related to acquired disease or genetic abnormalities resulting in systemic and cardiac manifestations. A careful history and physical examination will often determine the need for referral. Because many defects can now be successfully treated surgically, it is important to determine prior to referral what resources are locally or regionally available, and what the family's perspective on aggressive therapy is.
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Comparative Study
Interleukin-8 levels in children with bacterial, tuberculous and aseptic meningitis.
lnterleukin-8 (IL-8) is produced in monocytes and vascular endothelial cells in response to stimulation with bacteria or lipopolysaccharides, and is released from these cells into blood stream or tissue fluid. ⋯ The results suggest that determining IL-8 levels may be useful in the differential diagnosis.
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Case Reports
Chemotherapy related fatal neurotoxicity during induction in acute lymphoblastic leukemia.
Neurotoxicity is a common complication during cancer chemotherapy. It is estimated that 3-10% of children with acute lymphoblastic leukemia (ALL) experience acute, transient neurotoxicity during induction chemotherapy. ⋯ Neurological evaluation of children with ALL at diagnosis and during treatment is of value in order to diagnose neurological complications early so that appropriate intervention can be adopted. This communication describes the profile of two children with unexpected, acute fatal neurologic toxicity during induction chemotherapy for ALL.
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Upper gastrointestinal bleeding is a potentially fatal condition at times due to loss of large volumes of blood. Common sources of upper gastrointestinal bleeding in children include mucosal lesions and variceal hemorrhage (most commonly extra hepatic portal venous obstruction) and, in intensive care settings infections and drugs are other etiological factors associated with bleeding. Massive upper GI bleeding is life threatening and requires immediate resuscitation measures in the form of protection of the airways, oxygen administration, immediate volume replacement with ringer lactate or normal saline, transfusion of whole blood or packed cells and also monitoring the adequacy of volume replacement by central venous lines and urine output. ⋯ Based on studies among adult patients, presence of shock, co-morbidities, underlying diagnosis, presence of stigmata of recent hemorrhage on endoscopy and rebleeding are independent risk factors for mortality due to upper GI bleeding. Rebleeding is more likely to occur if the patient has hematemesis, liver disease, coagulopathy, hypotension and or anemia. There is a great need for conducting therapeutic trials as well as identifying predictors of outcome of upper GI bleeding in children to develop evidence based management protocols.