A prospective study was conducted to evaluate the demography, clinical profile and outcome of JE in children. A total of 57 hospitalized AES cases were enrolled from April 15 to August 16. Serum and cerebrospinal fluid were tested for presence of JE specific IgM antibody. 8 cases (14.03 %) were found to be JE positive. The most common presenting symptoms were fever 57(100%), altered sensorium 46 (%), seizure 28 (80.70%), headache 28 (49.12%) and signs of meningeal irritation in 12 (21.05%) cases. 27 cases (47.36%) had GCS ≤ 8. Among unknown AES cases, 19 out of 49 (38.77%) and among JE patients, 3 out of 8 cases ( 37.5%) died before discharge. Among 57 AES patients, 17 (29.82 % ) recovered completely (GOSV), while 12 (21.05%) cases had neurological sequelae (GOS II –IV) varying from mild to severe at the time of discharge. 22(38.59%) patient died in hospital (GOS I). Use of mechanical ventilation, lower Glasgow coma score, shock and aspiration on admission and prolonged seizures were found to be predictors for a poor outcome. These significant findings thus seek attentions of the global community to combat AES in children, particularly the eastern India, where the problem is disturbing.

Hydrocephalus has been recognized as a clinical and pathological entity since the days of Hippocrates. There occurs dilatation of the cerebral ventricular system, which leads to corresponding compressive effects on the parenchyma. It can be either communicative or obstructive. The incidence of congenital hydrocephalus in the newborn has been reported to be 0.2 to 5 per 1000 births. Ultra-sonography (USG) is increasingly becoming the imaging modality of choice for many CNS abnormalities, including hydrocephalus, especially in infants (0-2 years). Different treatments options have been advocated but ventriculo-peritoneal shunt is the gold standard of treatment. Methods: This study is an effort to evaluate the results of USG of hydrocephalus in children under 2 years of age via a case study of 50 cases of hydrocephalus. Inclusion criteria consisted patients with signs and symptoms of increased intracranial tension, hydrocephalus detected on clinical examination, suspected cases of hydrocephalus on antenatal USG, treated cases of hydrocephalus coming for follow up. Children with closed anterior fontanel and children of age more than 2 years were excluded from the study. Results: In this study, 84% patients belonged to 0-12 months of age. 52% belonged to the acquired group and 48% belonged to the congenital group. Non- communicating hydrocephalus was observed in most of the patients (76%). Aqueductal stenosis was seen as the most common (40%) associated congenital anomaly. Diagnostic accuracy of ultrasound was as high as 88%.

Background: Surveillance of intussusceptions was initiated nationwide after introduction of monovalent rotaviral vaccine (RV1) in national immunisation schedule. The objective is to access epideimiology, clinical presentation and outcome of intussusception cases in pre-vaccination era. Methods: This is a retrospective hospital based analysis in a tertiary care hospital of eastern India. We reviewed medical records of intussusception (Among 0-2 years of age) for 4 years from March 2012 to February 2016. For diagnosis of intussusception, definition developed by Brighton Collaboration working group were used. The base-line demographic data, clinical signs and symptoms, vaccination status as-well-as diagnostic and treatment procedures were extracted and captured for analysis. Observation: There were 51 confirmed cases of intussusception; with median age at diagnosis was 8 months. Male to female ratio remained 2.9:1. The mean time of presentation to hospital from onset of symptoms was 38.4 hours. Vomiting (84.3%), blood in stool (82.4%), abdominal pain (72.5%) and diarrhoea (51 %) were the most common symptoms. The classical triad of abdominal pain, vomiting and blood in stool was found in (56.8%). The commonest type of intussusception was Ileo-colic (82.3%), followed by colo-colic (11.8%). Out of the 51 confirmed cases, 7.8% had spontaneous resolution. 9.8% had undergone surgery. The majority (82.3%) was managed with hydrostatic reduction under ultrasound guidance. The mean hospital stay was found to be 3.4 days. Conclusion: The study provides the baseline data of childhood intussusceptions prior to introduction of monovalent rotavirus vaccine. Aprospective surveillance using standardized case definition is highly essential to access the scenario change in post vaccination era.

Diastrophic dysplasia is a rare form of short limb dwarfism recognizable at birth, characterized by amalgamation of features like Short tubular bones (Specially first metacarpal), joint limitation with talipes equinovarus, hypertrophied auricular cartilages. In 1960, Lamy and Maroteux reported their first three cases.¹ Major abnormalities are related to growth, limbs, spine and pinna although other abnormalities may co-exist. We came across two classic cases of this form of short stature in last one and half years.

Dengue fever presents with a wide spectrum of clinical presentation ranging from minor illness to dengue shock syndrome with multisystem involvement. We encountered a case of dengue in eleven year old girl without any prior illness who presented with fever of 15 days and sudden onset hemorrhagic rash with acute liver injury. She did not have very low platelet count but had prolonged prothrombin time since admission which remained abnormal for more than a week. Child was evaluated for possible occult liver disease or co-infections and no underlying abnormality was detected. This is unusual presentation of Dengue fever with probable direct effect on liver or immunologic phenomenon.