ABSTRACT
Background: Foreign Body (FB) aspiration is a life-threatening problem in children. Here the demographic pattern, clinical presentation, type of Foreign Body (FB) and outcome of FB aspiration was examined.Methods: An observational case series study done in Institute of child health and research centre, Government Rajaji hospital, Madurai during November 2015 to June 2018. After a detailed history and clinical examination, children with definite evidence of FB in tracheobronchial tree were subjected to rigid bronchoscopy and with doubtful evidence were subject to FFBS. They were followed up for complications.Results: Of the 136 children, 86.03% (n=117) were under 3 years of age. A positive history of FB aspiration was present only in 51.4% (n=70). Unilateral hyperinflation was seen in 48.53% (n=66) but was normal in 13.97% (n=19). Flexible Fiber Optic Bronchoscopy (FFBS) diagnosed FBs in 61.02% (n=83) which included children with acute onset breathlessness and persistent radiological features. Peanut was the most common FB 64.71% (n=44). FBs were found in the right side in 50% (n=34) and in the left in 38.2% (n=26).' 36% (n=49) developed complications due to the FBs and 2.9% (n=4) due to procedure.Conclusions: FB aspiration is most common in children less than 3 years of age. Positive history of aspiration was seen in only 51.4% and chest X-ray was normal in 13.97%. FFBS diagnosed FB in 61.02%. Peanut was the most common FB. Persistent pneumonitis is the most common complication.
ABSTRACT
Background: Dilated cardiomyopathy (DCM) in children is a serious disorder. Here authors study the risk factors for predicting prognosis of dilated cardiomyopathy in children.Methods: An observational case series study done in Institute of child health and research centre, Government Rajaji hospital, Madurai during September 2012 to August 2014. The diagnosis of DCM was based on clinical examination and echocardiographic evidence. Patients were followed up and grouped according to the outcome as improved or cured (group I), no change in clinical status (group II) and worsened or dead (group III).Results: 31 children less than 12 years of age were diagnosed as DCM. 13 children came under group I with a mean age of 2.15'2.5 and the mean cardiothoracic diameter ratio in chest X-ray was 59.8'3.3. The mean left ventricular ejection fraction at the time of admission was 38.7'3.04 and was 52.1'2.7 on last follow up. 11 children came under Group III with a mean age of 5.35'4.4 and the mean cardiothoracic diameter ratio was 65.3'2.7. The mean left ventricular ejection fraction was 35.8'3.7 at admission and 32.6'2.9 on last follow up. Only two children came under Group II and hence their comparison is negligible.Conclusions: Children with higher age at the time of diagnosis, higher cardiothoracic diameter ratio in chest X-ray and a low left ventricular ejection fraction on serial echocardiogram were associated with a poor outcome.