Constrictive pericarditis following epicardial pacemaker implant: a diagnostic dilemma.

Constrictive pericarditis is a rare complication after cardiac surgery. It is mostly seen in adults. We report a case of constrictive pericarditis in a 3-year-old child with right ventricular dysfunction after permanent pacemaker implantation during infancy for congenital complete heart block.

Novel Peri-Operative Strategy for Sickle Cell Disease with Tetralogy of Fallot.

Peri-operative management of cyanotic congenital heart disease in a patient of sickle cell disease (SCD) can be challenging. We report a case of Tetralogy of Fallot and homozygous SCD with history of multiple blood transfusions and sickle cell crises who underwent intracardiac repair. Hemoglobin S level was reduced from 75% pre-operative to 21.

Wake Up Safe in the USA & International Patient Safety.

Patient safety is the most important aspect of anesthetic care. For both healthcare professionals and patients, the ideal would be no significant morbidity or mortality under anesthesia. Lessons from harm during healthcare can be shared to reduce harm and to increase safety.

Surgical rescue mitral valve procedure post percutaneous transluminal mitral commissurotomy-a single-center observational study.

Percutaneous transluminal mitral commissurotomy (PTMC) has become the standard of care for severe mitral stenosis with favorable anatomy. Although the complications have reduced over the years, the need for emergency surgical rescue persists. This study evaluates the outcomes of surgical rescue performed within 24 h of undergoing PTMC from 1 January 2013 to 31 December 2019.

One-Bone Forearm Procedure for Severe Recalcitrant Forearm Deformities in Masada IIb Hereditary Multiple Exostoses.

Introduction: Hereditary multiple exostoses (HME) Masada IIB has traditionally been treated by gradual ulnar lengthening with questionable efficacy in reducing the dislocated head. One-bone forearm (OBF) has been used as a reconstructive procedure in forearm deformities with very scarce literature for HME. The study aims to report short-term results of OBF as a definitive procedure for severe forearm deformities in Masada IIB patients with respect to clinical and radiological parameters.

Aortic Uncrossing for Circumflex Aorta.

Circumflex aorta is described as a retroesophageal aortic arch, with opposite-sided descending aorta forming a true vascular ring with ligamentum arteriosum. We report two cases of right-sided circumflex aorta with varied clinical presentation. Computed tomography diagnosed this vascular ring anomaly.

Genetic Disorders in Pediatric Rheumatology Clinic: When to Suspect, and Why?

Just under a decade ago, most children with genetic disorders received a phenotypic diagnosis, often by atlas matching. With advances in genomics (decoding of human genome, easy availability of genetic testing, and reduction in cost of tests), genotypic diagnosis is now a reality. Genetic diseases can lead to non-inflammatory arthritis that can mimic juvenile idiopathic arthritis (JIA).

Absent Superior Vena Cava: An Uncommon Cause of Anomalous Systemic Venous Return.

We report a case of a one-year-old boy with tetralogy of Fallot, who was preoperatively diagnosed to have an associated systemic venous anomaly. Computed tomography confirmed the absent superior vena cava, and the case was managed with an appropriate cannulation strategy. Preoperative diagnosis and thorough planning of this rather benign anomaly were imperative for the successful outcome of this case.

Does Baska mask deserve its own niche among extraglottic airway devices? A prospective, single-arm study.

Background And Aims: A variety of extraglottic airway devices (EADs) are available. Main concerns with EADs are protection against aspiration and ability to ventilate patients with high airway pressures. Baska mask meets these criteria and is the only third-generation device available for clinical use.

Rapid-Onset Obesity, Hypothalamic Dysregulation, Hypoventilation, Autonomic Dysregulation, and Neuroendocrine Tumour: Rare Syndrome with Myriad Anaesthesia Implications.

Anaesthesia management of a child with rapid-onset obesity, hyperphagia, and hypothalamic dysfunction syndrome is complex due to the multisystem involvement, the most important features being morbid obesity, autonomic dysfunction, and dyselectrolytemia due to hypothalamic dysfunction. The acronym of the disease was amended in 2008 to rapid-onset obesity, hyperphagia, hypothalamic dysfunction neural crest tumour to include the risk of ganglioneuroma or ganglioneuroblastoma. Patients usually require removal of tumour in the prone position.

Pediatric cardiac surgery following severe acute respiratory syndrome coronavirus-2 infection: Early experience and lessons learnt.

Background: We evaluated our early experience of cardiac procedures in children with congenital heart defects (CHD) after asymptomatic severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, to understand whether recent reverse transcription-polymerase chain reaction (RT-PCR) positivity had a negative impact on their postprocedural recovery and outcomes.

Materials And Methods: In this retrospective observational study, all patients with CHD who underwent cardiac surgery or transcatheter intervention at our institution between March 2020 and June 2021 who were detected to have asymptomatic SARS-CoV-2 infection on routine RT-PCR were included. Details of the cardiac procedure and postprocedural recovery were reviewed and compared with RT-PCR-negative patients who concurrently underwent similar cardiac surgeries or interventions at our center.

The Preoperative Fasting Conundrum: An Audit of Practice in a Tertiary Care Children's Hospital.

Objective: This article aimed to study preoperative fasting times in children undergoing elective surgery and to analyze the effect of active interventions conducted to promote compliance with current fasting guidelines.

Methods: An initial audit was performed in which 85 children up to 15 years of age posted for elective surgeries were surveyed. A question- naire was circulated among nurses, resident medical officers, and surgeons to assess their knowledge regarding recent fasting guidelines and its importance.

Anomalous right coronary artery from pulmonary artery in aortopulmonary window.

We report a case of a 1-year-old patient with aortopulmonary window, anomalous right coronary artery arising from the pulmonary artery, and a large perimembranous ventricular septal defect. Computed tomography was successful in diagnosing the coronary anomaly and the case was managed surgically with an intrapulmonary baffle, rerouting the right coronary ostium to the aortic root and a fenestrated patch closure of the ventricular septal defect. Pre-operative diagnosis and thorough planning were essential for the successful outcome of this case.

Wide variation in glucocorticoid dosing in paediatric ANCA-associated vasculitis with renal disease: a paediatric vasculitis initiative study.

Objectives: High-dose glucocorticoids for remission-induction of ANCA-associated vasculitis are recommended and commonly used in adults, but recent studies suggest lower glucocorticoid doses can reduce toxicity without reducing efficacy. No paediatric-specific data exists to inform optimal glucocorticoid dosing in paediatric ANCA-associated vasculitis (pAAV). Our objectives were to describe glucocorticoid use in pAAV-related renal disease, and to explore associations between glucocorticoid dose, baseline patient characteristics and 12-month outcomes.

Quality improvement and patient safety in India-Present and future.

India is a vast, populous and diverse country, and this reflects in the state of health care as well. The spectrum of healthcare services ranges from world class at one end, to a dearth of resources at the other. In the rural areas especially, there is a shortage of trained medical personnel, equipment, and medications needed to carry out safe surgery.

Comparison of Bone Age Assessments by Gruelich-Pyle, Gilsanz-Ratib, and Tanner Whitehouse Methods in Healthy Indian Children.

Background: There are several methods of bone age (BA) assessment, which include Gruelich-Pyle (GP), Gilsanz-Ratib (GR), and Tanner Whitehouse-3 (TW-3) methods. Although GP atlas is the most widely used, there are concerns about its accuracy in children of different ethnicities, making the use of the TW-3 method an attractive option in Indian children.

Objectives: 1) To assess the relationship of BA with chronological age (CA) as assessed by different methods (GP, GR, and TW-3) in healthy Indian children 2) To assess which of the three methods of BA assessment is more suitable in Indian children.

Dental Practitioner's Perception of the Compliance of Pediatric Patients to Orofacial Myotherapy Treatment Protocols: A Mixed Methods Study.

Introduction: The success of orofacial myotherapy in children is dependent on patient compliance to treatment protocols recommended by practitioners, such as reporting for regular follow-ups to the clinic, wear of appliances, and practice of orofacial myotherapy exercises at home. Due to the availability of limited literature on the same, this mixed methods study focused on studying the perception of Indian dental practitioners toward pediatric patient compliance to orofacial myotherapy treatment protocols.

Materials And Methods: A self-administered, digital questionnaire was emailed to members of the .

Consensus Statement on Neurorehabilitation during COVID-19 Times: Expert Group on Behalf of the Indian Federation of Neurorehabilitation (IFNR).

The COVID19 pandemic in India is causing significant morbidity and disruptions of healthcare delivery. The rapidly escalating contagion is straining our public health system, which is already under pressure due to a shortage of infrastructure and inadequate workforce. Neuro rehabilitation services that are still in its infancy in our country have been significantly interrupted in the last six months.

Diagnosis and Management of Gastroesophageal Reflux Disease in Children: Recommendations of Pediatric Gastroenterology Chapter of Indian Academy of Pediatrics, Indian Society of Pediatric Gastroenterology, Hepatology and Nutrition (ISPGHAN).

Justification: Gastroesophageal reflux (GER) related symptoms are a major cause of parental concern and referrals at all ages. These guidelines have been framed to inform pediatricians regarding current diagnosis and management of gastro-esophageal reflux disease (GERD).

Process: A group of experts from the pediatric gastroenterology sub-specialty chapter of Indian Academy of Pediatrics (ISPGHAN) discussed various issues relating to the subject online on 25 October, 2020.