Retropharyngeal abscess with mediastinal extension - A mausoleum of mumps: A case report.

Introduction: Retropharyngeal abscess is a fatal infection that is uncommon, yet serious, especially in young children below 5 years. Oropharyngeal infections, in particular, can cause it as a complication of upper respiratory infections. They can also lead to respiratory depression and acute upper airway blockage and other complications. Case presentation: The unusual case of large retropharyngeal abscess in a 2-year-old child, secondary to mumps infection who presented to us with impending airway compromise is reported. Discussion: Retropharyngeal abscess secondary to mumps is a rare occurrence.The child initially had a bilateral parotid enlargement with fever and upper respiratory tract infection, which was diagnosed clinically as mumps by primary care physician and later confirmed by IgM antibody testing. The child was initially treated conservatively as the symptoms were mild at the beginning, however, the child worsened progressively and presented o our institute with acute retropharyngeal abscess in stridor. Emergency tracheostomy and intraoral abscess drainage were done under general anesthesia followed by appropriate intravenous antibiotics therapy. Conclusion: A dramatic recovery was observed following the treatment approach. Although it is rare to see such a large RPA in this antibiotic era, it is imperative to maintain a high index of suspicion.

Probiotic formulations and gastro-intestinal diseases in the paediatric population: a narrative review.

Background/Aim: Probiotics are live microbial supplements that improve the microbial balance in the host animal when administered in adequate amounts. They play an important role in relieving symptoms of many diseases associated with gastrointestinal tract, for example, in necrotizing enterocolitis (NEC), antibiotic-associated diarrhea, relapsing Clostridium difficile colitis, Helicobacter pylori infections, and inflammatory bowel disease (IBD). In this narrative review, the authors aim to evaluate the role of different probiotic formulations in treating gastrointestinal diseases in pediatric population aged 18 years or younger and highlight the main considerations for selecting probiotic formulations for use in this population. Methodology: The authors searched PubMed and Clinicaltrials.gov from inception to 24th July 2022, without any restrictions. Using an iterative process, the authors subsequently added papers through hand-searching citations contained within retrieved articles and relevant systematic reviews and meta-analyses. Results: The effectiveness of single-organism and composite probiotics in treating gastrointestinal disorders in pediatric patients aged 18 or under were analyzed and compared in this study. A total of 39 studies were reviewed and categorized based on positive and negative outcomes, and compared with a placebo, resulting in 25 studies for single-organism and 14 studies for composite probiotics. Gastrointestinal disorders studied included NEC, acute gastroenteritis (AGE), Acute Diarrhea, Ulcerative Colitis (UC), and others. The results show that probiotics are effective in treating various gastrointestinal disorders in children under 18, with single-organism probiotics demonstrating significant positive outcomes in most studies, and composite probiotics showing positive outcomes in all studies analyzed, with a low incidence of negative outcomes for both types. Conclusion: This study concludes that single-organism and composite probiotics are effective complementary therapies for treating gastrointestinal disorders in the pediatric population. Hence, healthcare professionals should consider using probiotics in standard treatment regimens, and educating guardians can enhance the benefits of probiotic therapy. Further research is recommended to identify the optimal strains and dosages for specific conditions and demographics. The integration of probiotics in clinical practice and ongoing research can contribute to reducing the incidence and severity of gastrointestinal disorders in pediatric patients.

Cotrimoxazole-induced hyperkalemia in renal transplant patient-Case report.

We present the case of a 55-year-old male patient who developed hyperkalemia after using Cotrimoxazole (TMP-SMX). There was a marked increase in potassium levels from 3.3 mEq/L on Day 5 when cotrimoxazole was started to 6.2 mEq/L on Day 11 when the drug was withheld.

CLInical Profile and Side Effects of chronic use of oral Amiodarone in cardiology outpatients department (CLIPSE-A Study)- A prospective observational study.

Background: Amiodarone belongs to Class-III anti-arrhythmic drugs. It is one of the most effective anti-arrhythmic drugs used to treat or prevent several types of arrhythmias including atrial fibrillation, atrial flutter, ventricular tachycardia, and wide complex tachycardia, but unfortunately carries a high toxicity profile. Also, side effects of amiodarone involving various organs can be life-threatening. Materials & methods: This was an observational study carried out for six months i.e from April to September. The study included patients who are on amiodarone for greater than or equal to six months. The required data was collected in-person from the case sheets, treatment charts, and by interviewing the patients. The data for 67 patients was documented in suitable data collection form for analysis. Results: From our study data, it was noted that amiodarone was used for 3 different indications-atrial fibrillation, atrial flutter, and ventricular tachycardia. Among 67 patients enrolled, 38 had no side-effects. Side-effects data in the rest grouped basing on the organ system affected: 9 patients had renal effects, 6 patients had ophthalmic effects, 4 patients had endocrine effects, and 5 patients had hepatic effects. Conclusion: From our study, it is concluded that amiodarone is a safe and effective anti-arrhythmic drug at lower doses i.e. 200-1100 mg/week. When treated in lower doses of 1400-2800 mg/week, many side effects have been incident. Although these effects are mild and develop only after prolonged usage of the drug, it should be used judiciously.

Scleroderma and interstitial lung disease - A case report.

Background: Systemic sclerosis with interstitial lung disease is one of the rarely reported autoimmune disorders. The ILD associated with systemic sclerosis is the most common cause of mortality in these patients. Case presentation: A 37-year-old female patient who is a known case of Scleroderma, Cor pulmonale, and hypothyroidism presented with the exacerbated symptoms of dyspnea and orthopnea. On examination, she had digital gangrene as a dermatological complication of systemic sclerosis. The patient was given medical management and was improving. Discussion: ILD is the dreaded complication of systemic sclerosis. Pulmonary hypertension that developed secondary to the ILD in this patient led to the cor pulmonale. The patient has the exacerbation of the same. Conclusion: Early detection and management of the ILD-SS are very important to prevent progression, exacerbations, and morbidity associated with it.

Contrast induced acute hypersensitivity reaction in a 10-year-old patient: A rare case study.

Background: Immediate skin rashes, flushing, or urticarial pruritus, rhinorrhea, nausea, short retching, and/or vomiting, diaphoresis, coughing, and vertigo are all symptoms of mild hypersensitivity reactions with an incidence of 3%. Case presentation: A 10-year old male child presented with acute hypersensitivity reaction due to the contrast used during the CECT scan. Discussion: Contrast should always be used in caution with children. Although most of them are acute and resolve with minimal treatment but few of these reactions may lead to fatalities. Conclusion: Recognizing the type of contrast reaction is crucial to treating it. Rapid recognition of the signs and symptoms of a contrast response allows radiology personnel to quickly determine the type of reaction, allowing for faster treatment and reversal.