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We report an infant with necrotizing pnuemonia and bilateral broncho pleural fistula, who failed on conventional and high frequency ventilation and was managed successfully on Veno-venous Extra Corporeal Membrane Oxygenator (V-V ECMO) with a unique configuration for 12 days, and weaned off successfully.Interstitial lung disease with nephrotic syndrome and junctional epidermolysis bullosa is caused by biallelic mutations in the integrin gene ITGA3 and is associated with death in infancy. We describe a variant of this syndrome with delayed presentation of symptoms and prolonged survival.Esophageal lung is a rare variety of communicating bronchopulmonary foregut malformation with anomaolous communication between an isolated portion of respiratory tissue and esophagus. Veliparib order Children present in early life with recurrent cough and pneumonia. Majority of the reported cases are associated with other anomalies like tracheoesophageal fistula. We report a case of a 7-month-old girl with right sided esophageal lung who was misdiagnosed as dextrocardia with right sided pneumonitis.Diphtheria has had a resurgence in India over the past decade. We present a case of umbilical diphtheria in a neonate, who had a good outcome with administration of anti-toxin and antibiotics.We report our experience of using Audience Response System among 21 pediatric postgraduate residents in pediatrics as a mode of teaching. Apart from significant improvement in test scores, three-fourth of the participants felt it was an interesting way to learn actively and was better than the traditional audio-visual presentation during lectures.The study aimed to explore the perception and knowledge-gain of undergraduate medical students during the Medical Council of India-mandated one month foundation course in August, 2019. A total of 129 consenting students who underwent the foundation course were enrolled and their feedback collected using an email-based structured questionnaire. A majority (>60%) had positive attitudes towards various aspects of the course, with good scores obtained in the post-test by the majority of the students. The information reported will assist in the planning of future foundation course programs.This survey was conducted among 125 pediatricians working in public and private child care facilities of Delhi. Prescription rates of routine vitamin D supplementation varied between 70-100% for various groups of infants, despite non-availability of government guidelines. Pediatricians in private practice more frequently prescribed vitamin D supplementation to term healthy infants as compared to government pediatrician (91.4% vs 71.6%; P=0.005).We observed that 760 (92.1%) out of 825 healthy newborns at our institution had vitamin D deficiency (VDD) at birth. These observations highlight the importance of regular screening and supplementation of vitamin D in the early years of life.CONTEXT Refractory status epilepticus (RSE) and super-refractory status epilepticus (SRSE) are neurological emergencies with considerable mortality and morbidity. In this paper, we provide an overview of causes, evaluation, treatment, and consequences of RSE and SRSE, reflecting the lack of high-quality evidence to inform therapeutic approach. SOURCES This is a narrative review based on personal practice and experience. Nevertheless, we searched MEDLINE (using PubMed and OvidSP vendors) and Cochrane central register of controlled trials, using appropriate keywords to incorporate recent evidence. RESULTS Refractory status epilepticus is commonly defined as an acute convulsive seizure that fails to respond to two or more anti-seizure medications including at least one non-benzodiazepine drug. Super-refractory status epilepticus is a status epilepticus that continues for ≥24 hours despite anesthetic treatment, or recurs on an attempted wean of the anesthetic regimen. Both can occur in patients known to have epilepsy or de novo, with increasing recognition of autoimmune and genetic causes. Electroencephalography monitoring is essential to monitor treatment response in refractory/super-refractory status epilepticus, and to diagnose non-convulsive status epilepticus. The mainstay of treatment for these disorders includes anesthetic infusions, primarily midazolam, ketamine, and pentobarbital. Dietary, immunological, and surgical treatments are viable in selected patients. Management is challenging due to multiple acute complications and long-term adverse consequences. CONCLUSIONS We have provided a synopsis of best practices for diagnosis and management of refractory/super-refractory status epilepticus and highlighted the lack of sufficient high-quality evidence to drive decision making, ending with a brief foray into avenues for future research.OBJECTIVES To evaluate association between total IgE levels and wheezing in preschool children from India. METHODS Data were collected in a prospective birth cohort study related to wheezing till three years of age. Total IgE was measured at enrolment, at one year and two years of age and correlated with wheezing episodes. RESULTS A total of 310 (167 boys) children were enrolled. Total IgE levels increased with age (P less then 0.001). Overall, 101 (32.6%) children had 182 episodes of wheezing. The median (IQR) total IgE levels in children with wheezing and without wheezing were similar at one year [42.1 (12.7, 93.5) vs 41.9 (17.1, 96.7) kU/L; P=0.39] and two years of age [62.8 (32.4, 212.0) vs 75 (25.8, 173.0) kU/L, P=0.92). CONCLUSION Total IgE levels increased with age and were not different in preschool children with and without wheezing.OBJECTIVE To determine if vitamin D status is affected in term neonates with early onset sepsis and its association with outcome. METHODS Study was done at a level 3 neonatal unit on 140 neonates. Term neonates with early onset sepsis (study group, 70 patients) and without sepsis (control group, 70 patients) were enrolled. RESULTS Mean neonatal vitamin D level in the study group was 16.00 (10.49) ng/mL and in the control group, was 29.07(8.36) ng/mL (P =0.061). In the study group 80% (n=56) babies had low vitamin D levels ( less then 32 ng/mL) among whom 51.7% (n=29) had severe vitamin D deficiency ( less then 11ng/mL). In the control group, 58.5% (n=41) had low vitamin D levels of whom, 9.8% (n=4) had severe vitamin D deficiency (P less then 0.001 and P less then 0.001, respectively). Mortality and highly probable sepsis were more common with vitamin D levels less then 11ng/mL in the study group (P= 0.005 and P=0.006, respectively). CONCLUSIONS Vitamin D is deficient in neonates with early onset sepsis and is associated with increased sepsis severity and mortality.