Estimation of Prevalence of Thrombocytopenia in Cyanotic Congenital Heart Disease: A Cross-Sectional Study Among the Pediatric Population.

Background Congenital heart disease (CHD) is one of the leading causes of mortality in India, with the majority being attributed to cyanotic conditions. Hence, it is crucial to assess the factors that play a significant role in patient prognosis in heart defects of a child. The present cross-sectional study assessed the prevalence of thrombocytopenia in patients with cyanotic congenital heart defects (CCHD). The objectives of our study were to assess the levels of platelets in various cyanotic congenital heart defects and then infer the prevalence of thrombocytopenia in these patients as a whole.  Methodology The study population comprised children aged fifteen days to twelve years with two-dimensional (2D) echocardiography confirmation of CHD; those who were critically ill, had proven sepsis, and were not willing to participate in the study were excluded. Blood samples of enrolled patients were obtained and collected in ethylenediamine tetraacetic acid (EDTA) tubes for assessment. The prevalence was then calculated. Results were obtained and interpreted based on these observations. Result Out of 268 children with CHD, 52 reported thrombocytopenia, and the prevalence rate was found to be 19.4. The comparative analysis of thrombocytopenia showed a significant p-value only in cases with total anomalous pulmonary venous connection (TAPVC). Conclusion Patients with cyanotic congenital heart defects are often diagnosed with various hematological derangements, and while hemoglobin levels are usually seen to rise, significant thrombocytopenia is reported in these patients. The low platelet counts often pose a risk peri-surgically and can also affect the surgical outcomes of the patient. Therefore, it is imperative to study further the relationship between thrombocytopenia and an independent risk factor for patient prognosis in patients of CCHD.

The Early Presentation of a Classic Case of Tuberous Sclerosis: A Case Report.

Tuberous sclerosis (TS) is a potentially severe medical disorder that poses a life-threatening risk and can lead to drastic lifestyle changes. In infants and young children, the typical diagnostic criteria for this condition encompass cutaneous manifestations and seizures, and the development of cellular growths termed hamartomas, astrocytomas, myolipomas, and even carcinomas observed within the cardiac, cerebral, renal, and retinal tissues. The usual age of presentation varies widely, which affects the prognosis. We report a case of a four-month-old male patient who presented with early signs of TS. The patient showed signs of infantile spasms and seizures. On further examination, he had neurological, cutaneous, cardiac, and retinal manifestations, which pointed toward the diagnosis of TS. This case report emphasizes the importance of screening for TS at an early age due to the possibility of patients presenting earlier than the usual age of presentation. To the best of our knowledge, there is scarce data on this kind of early-onset signs of TS; therefore, we feel that it is imperative to start screening infants earlier to improve the prognosis and decrease the complications of this disease. The screening tests and the incidence of screening will vary based on the cost and availability of proper diagnostic and screening tests and the accessibility of efficient treatments.

Posterior Epidural Migration of Lumbar Intervertebral Disc Fragment Mimicking an Epidural Mass.

Acute and chronic lower back pain can be commonly caused by intervertebral disc prolapse. This prolapse usually occurs in the dorsal direction and towards the anterior epidural space. In extremely rare cases, this migration/herniation can be seen approaching the posterior epidural space. One such rare instance has been recorded and described in our patient, a 53-year-old with a history of hypertension who presented with persistent lower back pain, radicular in nature, and recent acute aggravation, leading to mobility impairment. The patient experienced numbness in the lower limbs, urinary incontinence, and irregular bowel movements. Sensory deficits were noted along the L3 dermatome. The patient underwent an L3 laminectomy, revealing extruded disk fragments causing the compression. After surgery, the patient's power in the lower limbs began to improve, with significant recovery by discharge and complete resolution of bowel and bladder incontinence. This case highlights the diagnostic and therapeutic challenges of posterior epidural mass-like lesions in the lumbar spine, emphasizing the importance of prompt surgical intervention in restoring neurological function. The successful outcome underscores the significance of early diagnosis and intervention in such cases, ultimately improving the patient's quality of life.

Assessment of the Impact of a Short-Term Intervention on Menstrual Hygiene Practices of Adolescent Girls in Rural Parts of Central India.

Introduction Menstruation affects many young girls in a negative way in relation to their physical and psychological health despite being a reasonably common issue in daily life. Their health relies on their learning about fundamental menstruation hygiene. They have a significant risk of developing ailments due to their lack of education in this area. Young girls can avoid several preventable illnesses by being educated about menstruation hygiene and practices. Therefore, our study aimed to assess the impact of a health education intervention on the knowledge, attitude, and practice of teenage girls about menstrual hygiene. Materials and methods The current educational interventional study design evaluates the impact of an educational intervention on menstrual hygiene in teenage females. Adolescent girls were educated about the practices and taboos related to menstruation. They were assessed using a pretest and post-test after the intervention. The results of the pre- and post-study tests were compared, and the effect of the intervention was determined. Result A noteworthy observation of the study was that only 87 (34.8%) teenage girls were aware of hygienic practices before menarche. The didactic lecture had a favorable impact, and after two months, 2.40% of the 6.80% of females who changed their reusable pads just once a week began replacing them every two days. Additionally, a shift in hygiene behaviors was noted; 17.20% of the 33.60% of individuals started washing their hands with soap and water after changing their menstruation pads, which was significant (p=0.05). Conclusion The study assessed the impact of a short-term intervention on the menstrual habits practiced by adolescent girls. We concluded that an intervention in the form of educational counseling can significantly impact the menstrual hygiene practices of adolescent girls. Teaching teenage females resulted in a considerable improvement in their menstruation habits, which has a beneficial overall effect.

Delayed Neurological Manifestation in Krait Bites Despite Anti-snake Venom Therapy.

A severe medical emergency that poses a life-threatening risk is envenomation from a snake bite. Among the several snake families, krait bites are known to result in neurological symptoms, including ptosis, headache, and sweating. A 12-year-old adolescent boy who had been bitten by a krait appeared in this instance. The patient showed neurological symptoms after receiving anti-snake venom (ASV). He had three rounds of ASV and made a full recovery. To the best of our knowledge, there have not yet been any reports of this kind of delayed neurological signs after a krait bite, despite getting ASV in the adolescent population.