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ustification: A number of guidelines are available for management of congenital heart diseases from infancy to adult life. However,these guidelines are for patients living in high income countries. Separate guidelines, applicable to Indian children, are required whenrecommending an intervention for congenital heart diseases, as often these patients present late in the course of the disease and mayhave co-existing morbidities and malnutrition. Process: Guidelines emerged following expert deliberations at the National ConsensusMeeting on Management of Congenital Heart Diseases in India, held on 10th and 11th of August 2018 at the All India Institute of MedicalSciences, New Delhi. The meeting was supported by Children’s HeartLink, a non-governmental organization based in Minnesota, USA.Objectives: To frame evidence based guidelines for (i) indications and optimal timing of intervention in common congenital heartdiseases; (ii) follow-up protocols for patients who have undergone cardiac surgery/catheter interventions for congenital heart diseases.Recommendations: Evidence based recommendations are provided for indications and timing of intervention in common congenitalheart diseases, including left-to-right shunts (atrial septal defect, ventricular septal defect, atrioventricular septal defect, patent ductusarteriosus and others), obstructive lesions (pulmonary stenosis, aortic stenosis and coarctation of aorta) and cyanotic congenital heartdiseases (tetralogy of Fallot, transposition of great arteries, univentricular hearts, total anomalous pulmonary venous connection, Ebsteinanomaly and others). In addition, protocols for follow-up of post surgical patients are also described, disease wise.
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Background: natural background radiation of a particular region is one of the distinctive factors defining the status of environment. Eloor Island is an industrial area in Ernakulum District of the state of Kerala, India. The indoor and outdoor gamma level measurements have been carried out for the region for evaluating the annual effective dose to the population residing in this area
Materials and Methods: measurements of indoor gamma dose were done for a whole year using Thermo Luminescent Dosimeters [TLDs] and GM tube based survey meters in forty five selected locations. The activity concentration of [232]Th, [238]U and [40]K in the samples were analyzed using gamma spectrometry. The outdoor external gamma ray dose rates were evaluated from the activity concentration of [40]K, [238]U and [232]Th in the soil samples collected from the study area
Results: the average indoor gamma dose measured using TLDs were found to be 1219 microGy y[-1]. The measured activity in the soil samples had range from 92.5 Bq kg[-1] to 792.8 Bq kg[-1] for [232]Th, 9.2 Bq kg[-1] to 114.6 Bq kg[-1] for [238]U and 265.9 Bq kg[-1] to 851.9 Bq kg[-1] for [40]K. From the observed mean dose levels, the annual effective dose equivalent to population residing in the island has been estimated and is found to be 0.68 mSv y[-1] for indoors and 0.32 mSv y[-1] for outdoors
Conclusion: the annual effective dose equivalent to population estimated for indoor is found to be higher as compared to the global average the same for outdoor was found to be less when compared with the natural background gamma level reported by UNSCEAR for normal background areas
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In this report, we describe the Computerised Tomographic findings of the small bowel in an immunosuppressed patient with Strongyloides stercoralis infection. To our knowledge, this is the first report of the Computerised Tomographic appearance in this condition