Adrenaline before Unconventional Therapy for Status Asthamaticus.

How to cite this article: Gohil JR. Adrenaline before Unconventional Therapy for Status Asthamaticus. Indian J Crit Care Med 2019; 23(10):492.

Cardiotoxicity Associated with Midazolam in a Patient with Diphtheria.

BACKGROUND: Adverse cardiorespiratory events are associated with midazolam continuous IV infusion, used for sedation. HISTORY: Here we are reporting a case of 5 year old male child suffering from diphtheria induced airway obstruction, and myocarditis, who received midazolam in the form of IV infusion for sedation while undergoing mechanical ventilation for respiratory failure. Adverse Event: Six hours after starting midazolam infusion he started developing pulsus bigeminus and bradycardia and eventual death after two hours. CONCLUSION: Midazolam, although considered one of the safest drugs, need to be used cautiously in a child with myocarditis, because of the possible cardiotoxic effect in an already affected heart.

Levetiracetam Adverse Drug Reaction: Pancytopenia.

Pancytopenia secondary to levetiracetam administration is infrequent but possible. Here, we report a case of pancytopenia associated with levetiracetam in a 4-month-old infant. However, increased incidence of upper respiratory tract infections (URTIs) has been reported frequently. It appears that URTI is a heralding side effect of pancytopenia and tip of the iceberg.

Headband sign on magnetic resonance imaging: An unusual finding of scurvy in a 5-year-old child described first time.

Scurvy usually presents with tender and painful limbs, swelling of joints, gum bleeding, poor wound healing, and muscle weakness. Here, we report a case of 5-year-old child with global developmental delay who presented with soft swelling of the head over scalp and protrusion of the left eye with extremely irritability. Neuroimaging was suggestive of diffuse extensive soft-tissue swelling involving the entire scalp with large necrotic collections with mild proptosis of the left orbit. It is not mentioned elsewhere, so we are giving name to this magnetic resonance imaging finding as "headband" sign or "turban" sign.

Low molecular weight heparin (enoxaparin) reverses pregangrene in a preterm neonate.

A 34-week-old, 1.6 kg preterm boy was admitted for management of mild respiratory distress syndrome. On the third day of life 1 min after an intravenous cannulation attempt at the right cubital fossa, he developed pregangrene bluish discoloration of all fingertips up to the distal interphalangial joint and pallor of right palm. Pulsations on right forearm were reduced. There was no evidence of sepsis.Enoxaparin, a low molecular weight heparin (1.5 mg/kg (standard dose)) was injected subcutaneously in the abdomen in two doses 12 h apart within 2 h of the event. At 6 h after the first dose, brachial artery pulsation was bilaterally symmetrical. After the second dose, bilateral radial artery pulsation became symmetrical. The pregangrene changes returned to normal within 20 h as the distal phalanges became pink and warm. He was discharged on the eighth day of life. Enoxaparin was safe and effective in this preterm infant for reversal of pregangrene.