Issue 9

Congenital Adrenal Hyperplasia (CAH) is managed with long term corticosteroid and is suggested to higher dose, based on the general sick day principles. I presented a 5-year-old CAH case by pneumonia managed in our pediatrics department. Consider ing stress doses of cortisone in management of CAH patients with COVID19 should be considered.

Lymphangiomas are rare slowly growing benign tumors derived from lymphatic vessels. They occur in various anatomical loca tions of body like head, neck and abdomen. Abdominal cystic Lymphangiomas are rare intra-abdominal masses affecting the in fants and young children, these may be detected incidentally on radiological investigations or present with abdominal distension, vague abdominal pain and life threatening emergencies like bowel obstruction and torsion of cystic masses.

Patients with Parkinsonism may present acutely to the ED with serious and even life-threatening conditions. Although falls are a common presentation in advanced Parkinsonism, early presen tations with falls should alert the clinician that the patient might have a Parkinson syndrome other than Parkinson’s disease itself, including autonomic neuropathy causing orthostatic hypotension. Patients may present with neuroleptic malignant syndrome, acute psychosis, marked hypokinesis, freezing gait, aspiration pneumo nia, dysphagia, serotonin syndrome, dopamine dysregulation syn drome and intestinal pseudo-obstruction. An inpatient admission is necessary for investigation and observation of these patients.

V-P shunt is the most common surgery done in paediatric hydro cephalus. Though the surgery remains as ‘minor’ in the arena of Neurosurgery, its complication surpass any boundary. Here we discuss a case of shunt complication which had malfunctioning shunt with both end malposition, cranial end occluded by septum and cortex and peritoneal end invading bowel. Surgery was taking a new course for dramatic appearance of COVID 19.