Reversible Cerebral Atrophy in Infantile Tremor Syndrome.

Background: We report changes in MRI brain of children with Infantile Tremor Syndrome (ITS) at the onset of illness and following treatment. Case characteristics: Three children with infantile tremor syndrome were assessed for changes in brain neuroimaging at admission and at follow-up visit. On MRI, all children had mild to severe diffuse cerebral atrophy, which reverted back to normal on follow-up visits. Outcome: Children with infantile tremor syndrome have reversible diffuse cerebral atrophy on neuroimaging.

Screw-worm Myiasis of Prolapsed Rectum.

Background: Wound myiasis in the Indian subcontinent is most commonly caused by old world screw-worm (Chrysomya bezziana). Case Report and management: A 4-yearold malnourished girl presented with full thickness rectal prolapse following acute diarrhea with a large wound and screwworm myiasis of the rectum. Turpentine oil was applied to immobilize the maggots followed by manual extraction. Prolapse was successfully treated by manual reduction followed by strapping of the buttocks. Outcome: Child was thriving well and gained 2 kg weight in follow up after two weeks. Message: Parents should be educated about taking care of prolapsed rectum.

Method Development and Validation for Simultaneous Estimation of Ketorolac and Sparfloxacin by RP-HPLC.

A modified simple, selective, rapid, precise reversed phase high performance liquid chromatography method has been developed and validated for the simultaneous estimation of ketorolac and sparfloxacin. The separation was made in a Hypersil-Keystone C-18 column using a methanol: water (60:40, v/v) (pH 3.1) as mobile phase at 308 nm. The mobile-phase flow rate and the sample volume injected were 0.9 ml/min and 20 μl, respectively. Retention time of sparfloxacin and ketorolac was found to be 3.181 and 4.473 minutes respectively. The correlation coefficient of both drugs was found to be 0.999. The accuracy of ketorolac was found to be 99.82% - 100.55% whereas for sparfloxacin, it was 99.76% - 99.89%. Over all % RSD was found to be less than 2%. The method was validated according to ICH guidelines with respect to linearity, accuracy, precision, robustness, specificity, etc. The developed method can be used for routine analysis of ketorolac and sparfloxacin in their pharmaceutical dosage forms.

Intravenous immunoglobulins in severe Guillian-Barre syndrome in childhood.

OBJECTIVE: This is a retrospective analysis of 25 children with severe Guillain-Barre syndrome admitted to our PICU. METHOD: All children were treated with intravenous immunoglobulins (IVIG) in a dose of 2 g/kg body weight over 2-5 days in addition to supportive and respiratory care. Seventeen children were elective admissions to the PICU whereas 8 children were transferred from other hospitals in a critical condition. Five of 8 of the late referrals died as compared to none of the elective admissions. RESULT: All 8 of the late referrals required mechanical ventilation as against 3 of the 17 elective admissions. Mean duration of PICU stay in the late referrals was 27 days as compared to 15 days in the elective admissions. CONCLUSION: The authors concur with previously published reports, that early use of IVIG could reduce the mortality and the need for intubation and mechanical ventilation.

Persistent hyperinsulinemic hypoglycemia of infancy--successful therapy with nifedipine.

Recent studies have demonstrated a role for calcium channel blocking agents in the treatment of persistent hyperinsulinemic hypoglycemia of infancy. We report a 30 day old infant with PHHI whom we successfully treated with oral nifedipine alone.