The aim of this study was to assess the clinico-laboratory parameters, complications and therapeutic responses in children with scrub typhus in Eastern India. In this prospective, observational study, all children (age, 48 h) Scrub meningoencephalitis, with a notably higher incidence, showed favorable therapeutic response. Prompt and empiric doxycycline therapy could be lifesaving.

Background: Hereditary angio-oedema (HAE) is a rare autosomal dominant disorder characterized clinically by recurrent episodes of nonpruritic subcutaneous and/or submucosal oedema. Laryngeal oedema is the commonest cause of mortality in patients with HAE. Prior to the availability of first-line treatment options for the management of HAE, mortality was as high as 30%. Mortality has significantly declined in countries where first-line treatment options are available and patients can access these therapies. There is a paucity of literature on the outcomes of patients with HAE in developing countries where availability of and access to first-line treatment options are still a challenge. Objectives: To report our experience on mortality in patients with HAE and to report factors associated with the death of these patients. Methods: We carried out a record review of all patients diagnosed with HAE between January 1996 and August 2022. Families with HAE who had reported the death of at least one family member/relative from laryngeal oedema were studied in detail. Results: Of the 65 families (170 patients) registered in the clinic, 16 families reported the death of at least one family member/relative from laryngeal oedema (total of 36 deaths). Of these 16 families, 14 reported that 1 or more family members had experienced at least 1 attack of laryngeal oedema. One patient died during follow-up when she was taking long-term prophylaxis with stanozolol and tranexamic acid, while the remaining 35 patients were not diagnosed with HAE at the time of their death. At the time of death of all 36 patients, at least 1 other family member had symptoms suggestive of HAE, but the diagnosis was not established for the family. Conclusions: To our knowledge, this is the largest single-centre cohort of patients with HAE in India reporting mortality data and factors associated with death in these families. The delay in diagnosis is the most important reason for mortality.

Introduction: Pericardial effusion may be due to various causes. With the changing scenario of newer generation antibiotics and robust immunization program our aim is to identify the change, if any, in etiology and disease menifestations. Methodology: This is a hospital-based uni-center prospective study with a population of 30 children for a period of 1½ year. Clinico-epidemiological features, investigations, complications and short-term outcome were assessed. Results: We found 13 (43.33%) patients having mild, 11 (36.67%) had moderate and 6 (20%) had severe pericardial effusion. Cardiac tamponade was present in six cases. Among the study population 9 (30%) patients were diagnosed as having pyogenic pericardial effusion and 8 (26.67%) had tubercular effusion. The predominant symptoms of pericardial effusion in our children were fever and tachycardia (83.33%).Other symptoms at presentation were tachycardia (76.67%), cough (63.33%), chest pain (50%), orthopnea (43.33%) and skin rash (16.67%). Pericardiocentesis was done in 14 cases (46.67%) of which 4 patients (13.33%) required pig tail catheterization. Discussion: Infectious etiology still remains the primary cause of pericardial effusion in our country. The presenting clinical signs are very much nonspecific and also not so prominent unless hemodynamic compromisation occurs. Conclusion: This study showed that bacterial and tubercular pericardial effusions are still two most prevalent etiological diagnosis in this part of country. Early diagnosis and treatment has good outcome.

Only limited information exists regarding the epidemiology of Kawasaki disease (KD) in low-income and middle-income countries. The present study provides the incidence of KD during 2015–2019 in Chandigarh, north India. Our centre follows the largest KD cohort in India. Children with KD at Chandigarh diagnosed during January 2015–December 2019 were enrolled in the study. Annual incidence rates were determined using decadal growth rates of the National Census 2011. We computed the incidence of KD in children aged <5, and <15 years. We also undertook linear trend analysis using our incidence data from 1994 to 2019. During 2015–2019, 83 patients (66 males, 17 females) were diagnosed with KD in Chandigarh. Incidence rates during these 5 years were 5.64, 9.25, 9.11, 9.87, and 9.72/100,000 in children aged <5 years, and 2.65, 4.44, 3.86, 5.07, 4.74/100,000 in children aged <15 years. The median age at diagnosis was 48 months (range: 12 days to 15 years). Compared to previous data (2009–2014), there was a 53.1% increase in annual incidence of KD in children aged <5 years, and a 53.7% increase in children aged <15 years. Coronary artery abnormalities during acute phase were noted in 16.9%, and in 7.2% of patients at 6 weeks of follow-up. The trend analysis indicated a monthly rise of 0.002 cases per 100,000 children aged <5 years, and 0.0165 cases per 100,000 children aged <15 years. The incidence of KD has continued to show an upward trend in Chandigarh over the period 2015–2019. This may indicate a true rise in the occurrence of KD or may reflect better disease ascertainment as a result of greater awareness about KD amongst healthcare professionals. None.