Difficult airway foreign body removal.

Foreign body (FB) aspiration in children is a common emergency. Traditionally, rigid bronchoscopy has been considered to be the mainstay for removal. However, in certain cases, flexible bronchoscopy can prove to be a better option and avoid thoracic surgery and unnecessary morbidity.

5% Dextrose in Ringer's Lactate versus 5% Dextrose Normal Saline as Maintenance Intravenous Fluid Therapy in Children - A Randomised Controlled Trial.

Objectives: To estimate the difference in serum chloride levels between children receiving 5% Dextrose in Ringer's Lactate (RLD5) vs. 5% Dextrose Normal Saline (DNS) and to estimate the incidence of dyselectrolytemia, hyperchloremic metabolic acidosis (HCMA), acute kidney injury (AKI) and all-cause mortality in both groups.

Methods: A randomised controlled trial was conducted in non-critically ill children aged 6 mo to 14 y, admitted between August 2021 and July 2022, requiring intravenous fluids.

Human Bocavirus infection in childhood acute respiratory infection: Is it an innocent bystander?

Purpose: Acute respiratory infection (ARI) is one of the major attributing factors of under-five mortality and morbidity all over the world. Viruses are the most common cause of ARI. Due to the availability of molecular techniques, new viruses are getting isolated from children with ARI.

Aggressive vertebral hemangiomas in children.

Background: Aggressive vertebral hemangiomas are rare tumors in children, usually occurring in the thoracic spine that can cause significant neurological morbidity. They are technically difficult to treat with significant risk of blood loss during surgery.

Methods: We describe a case of aggressive vertebral hemangioma managed in our institution.

Eastern India Collaboration on Multisystem Inflammatory Syndrome in Children (EICOMISC): A Multicenter Observational Study of 134 Cases.

Background: Few single center studies from resource-poor settings have reported about the epidemiology, clinical feature and outcome of multisystem inflammatory syndrome in children (MIS-C). However, larger data from multi-center studies on the same is lacking including from Indian setting.

Methods: This retrospective collaborative study constituted of data collected on MIS-C from five tertiary care teaching hospitals from Eastern India.

Clinical Profile and Risk Factors for Severe Disease in 402 Children Hospitalized with SARS-CoV-2 from India: Collaborative Indian Pediatric COVID Study Group.

Introduction: There is a lack of large multicentric studies in children with COVID-19 from developing countries. We aimed to describe the clinical profile and risk factors for severe disease in children hospitalized with COVID-19 from India.

Methods: In this multicentric retrospective study, we retrieved data related to demographic details, clinical features, including the severity of disease, laboratory investigations and outcome.

Vascular access in ECMO.

In critically ill patients, deserving extracorporeal membrane oxygenation (ECMO), choosing the right pattern of cannulation such as veno-venous (VV), veno-arterial (VA), veno-veno-arterial (VVA), and central; selecting the appropriate size cannulae; and good cannulation techniques are all pre-requisites for the successful outcome of ECMO. We are describing the selection criteria for choosing appropriate size cannulae, cannulation configurations, available cannulae, and possible complications. A brief note on anticoagulation was added.

Feasibility of Pediatric Non-Invasive Respiratory Support in Low- and Middle-Income Countries.

Non-Invasive respiratory support can be viewed as mechanical respiratory support without endotracheal intubation and it includes continuous positive airway pressure, bi-level positive airway pressure, high flow nasal cannula, and non-invasive positive pressure ventilation. Over past few years, non-invasive respiratory support is getting more popular across pediatric intensive care units for acute respiratory failure as well as for long-term ventilation support at home. It reduces the need for invasive mechanical ventilation, decreases the risk of nosocomial pneumonia as well as mortality in selected pediatric and adult population.

COVID-19 related multi-inflammatory syndrome presenting with uveitis - A case report.

Multi Inflammatory Syndrome (MIS-C) associated with Corona Virus Disease (COVID) in children and young adults presents with a varied clinical spectrum; from that mimicking Kawasaki disease (KD), Incomplete Kawasaki disease to even Hemophagocytic Lymphohistiocytosis. A 14-year-old girl, presented to us, with headache, fever, bilateral uveitis, unilateral cervical lymphadenopathy, oral mucosal changes and abdominal pain. A disproportionate increase in inflammatory markers and Interleukin - 6, in the setting of a negative COVID real-time reverse transcription polymerase chain reaction (RTPCR) and significantly elevated COVID antibody titre confirmed our diagnosis.

Congenital Lung Malformations: Experience From a Tertiary Care Center in India.

Background: There are limited data on congenital lung malformations (CLM) and their clinical course from developing countries.

Methods: A 10-year retrospective chart review of records of children with CLM attending pediatric chest clinic at an Indian tertiary care center was conducted.

Results: Among the 48 children (24 boys) included in the review, the malformations included congenital lung ypoplasia/agenesis in 24 (50%), cystic pulmonary airway malformation in 9 (19%), bronchogenic/foregut cyst in 8 (18%), and congenital lobar emphysema in 4 (9%).

Dexmedetomidine vs Midazolam for Sedation in Mechanically Ventilated Children: A Randomized Controlled Trial.

Background: There is a paucity of data on use of dexmedetomidine as a sedative agent in mechanically ventilated children.

Objectives: To compare the efficacy of dexmedetomidine and midazolam for sedation in mechanically ventilated children aged 1 month - 15 years. Secondary objectives were to compare the need for top-up doses of fentanyl and paralytic agents, duration of mechanical ventilation, ICU stay and hospital stay, and adverse events.

Risk factors and clinical course of children with cystic fibrosis colonized with Staphylococcus aureus.

Background: The literature is limited on staphylococcal infection in children with cystic fibrosis (CF) from tropical countries. We aimed to study the risk factors and clinical course of children with CF infected with Staphylococcus aureus.

Methods: In this chart review we compared demographic, clinical and spirometry characteristics in CF children with S.

International Guidelines 2020 for the Management of Septic Shock in Children.

The recent version of pediatric septic shock guidelines, 2020 have addressed practical issues pertaining to pediatric septic shock management, which can be applicable to resource-limited setting as well. Supportive aspects in management of septic shock such as ventilation, antibiotic stewardship, and nutrition are addressed compared to previous guidelines that concentrated more on first-hour management. The current guideline needs to be adapted to local clinical practice cautiously in the light of experience, clinical acumen and judgement.

Technology-dependent children.

In recent past, revolution in medical technology resulted in improved survival rates and outcomes of critically ill children. Unfortunately, its impact relating to morbidity is not well documented. Although survival rates of these critically ill children who are medically fragile and technology-dependent have improved, we as health professionals are still in the learning curve to improve the quality of life of these children at home.

Rh Alloimmunisation: Current Updates in Antenatal and Postnatal Management.

In spite of advances in medical science, Rh alloimmunisation remains one of the leading causes of preventable neuro-morbidities and significant neonatal hyperbilirubinemia in lower-middle income countries. Despite availability of effective antenatal preventive strategy (Anti-D), its uptake in antenatal period is low due to ignorance. Further, once diagnosed, there is lack of adequate antenatal follow up in health care facility.