Warm Greetings from the editorial team of this issue of Chettinad Health City Medical Journal. With immense pleasure we bring out this issue of Chettinad Health City Medical Journal, which has been uninterruptedly growing with contributions from energetic, enthusiastic, qualified and high profile researchers from all over the world.

: Intussusception is one of the most common causes of acute abdomen in infants and preschool children. With the introduction of non-operative enema reduction into practice, the role of surgical management of intussusception in children is becoming narrower. Advantages of ultrasound guided saline enema reduction (USGSER) over fluoroscopic guided pneumatic reduction made it standard first line approach in majority of centers. Aim of this study is to analyze the results of intussusception cases managed by USGSER by a single surgeon. Methods: Retrospective review of all cases of intussusception from February 2010 to August 2016 was done. Demographics, clinical presentation, investigations, management and outcomes were reviewed. Results: Out of 59 intussusceptions managed during the study period, 5 cases taken for upfront surgery were excluded. All the remaining 54 cases have undergone USGSER and 51 (94%) were successfully reduced. Conclusion: In view of high success rate with very minimal complications, non-operative management should be the first line treatment for all uncomplicated cases of intussusception in children.

To assess the association between urinary pH and urinary tract infection (UTI), in children presenting with fever and symptoms of UTI.

Since its invention, electricity has gradually progressed from being a luxury to a necessity. Electricity and electrical appliances are indispensable in today’s life. Industrialization and urbanization have greatly increased the expense of electricity. It is a source of much productivity and enjoyment. When used without adequate care and precaution the same can result in injuries resulting in morbidity and mortality. Accidental electrocution is a frequent mode of potentially preventable death in our modern civilization. Objective : To study the demographic and other features of deaths due to Electrocution, brought for autopsy. Materials and Methods : In this retrospective study done at Government Stanley Medical College, Chennai during a 2year period, we studied 28 cases of deaths due to electrocution.

Assisted reproductive technology (ART) has become most widely used procedure worldwide for the couples with subfertility. Also, predictability for the success rate in ART is challenging and is of paramount importance in counseling and treating the couples. Whether the prolonged period of COS would have an impact on pregnancy outcome is of concern. Hence this study has been designed to compare the number of days of stimulation and ART outcome.

A 15-year-old female patient presented with vomiting and intractable headache for a short duration of time. Neuroimaging of brain showed a single ring - enhancing lesion which could not differentiate between Neurocysticercosis (NCC) and Tuberculoma. Magnetic Resonance Spectroscopy (MRS) helped to delineate the diagnosis as tuberculoma and the girl was treated with antituberculosis drugs when conventional investigations failed to reveal the diagnosis MRS will be helpful.

Tuberous sclerosis complex (TSC) is an inherited genetic disorder that has an autosomal dominant inheritance. It can affect almost all organ systems in the body but manifestations may vary widely among individuals. Here we discuss the case of a 11 month old infant who presented with fever and seizures, initially suspected to be febrile seizures. But a detailed head to toe examination revealed multiple hypomelanotic macules and brain imaging showed subependymal nodules and cortical tubers confirming the diagnosis of tuberous sclerosis. Through this case we would like to highlight the importance of a thorough clinical examination for neurocutaneous markers, having a high index of suspicion and neuroimaging in the early diagnosis of TSC.

Laryngomalacia is a condition where there is intermittent resistance to airflow due to collapse of supraglottic structures. The Anaesthetic management during a Supraglottoplasty or Tracheostomy is quite challenging. Here, we present a case of laryngomalacia in an infant with stridor, managed with intermittent apnoea technique of ventilation for Laser Supraglottoplasty.

Kawasaki disease(KD) though not very common , is a clinical condition which needs a high degree of suspicion for diagnosis. The child presented to our hospital with history of fever of 12days duration and a laboratory evidence of thrombocytosis. Child was afebrile with minimal peeling of skin of both soles. Based on the retrospective history and clinical presence of unilateral cervical lymphadenopathy with a lab evidence of raised ESR , platelet count and CRP child was diagnosed to have KD and started on immunoglobulin. Echo revealed giant coronary aneurysms . Child is on follow up with aspirin, clopidogrel and warfarin.

Accidental ingestion of salbutamol respiratory solution has not been reported in children. The case reported here had junctionaltachycardia,hypertension with wide pulsepressure and hypokalemia following ingestion of 1.25mg/kg of salbutamol two doses at 6 hours interval. The child improved completely with gastric decontamination and oral propranolol.

Terlipressin, a vasopressin analogue, is commonly used to treat oesophageal variceal bleeding . Ventricular Tachycardia, a fatal arrhythmia due to Terlipressin, is a well known, but under reported complication. We report a case of broad complex Ventricular Tachycardia in a 53 year, male patient during treatment with Terlipressin for bleeding oesophageal varices, which reverted to normal sinus rhythm after withdrawal of drug and usage of anti arrhythmic drugs . Electrolyte disturbances, long QT interval as seen in alcoholic liver disease were found to be underlying causes for this.

Advances in obstetric and neonatal care in the recent years has led to increased survival of babies viz preterm, low birth weight, congenital anomalies, metabolic problems, who are prone for developing long-term morbidities such as developmental delay, learning disability and visual/hearing problems. The shrinking size of families with a single child has resulted in increased concern and expectancy of their only child by their parents.

Oskar Minkowski (1858-1931) in 1889, discovered incidentally that removing the pancreas in dogs caused a serious form of diabetes1 . A medical student Paul Langerhans (1847-1888) discovered the islet cells in the pancreas, the secretion of which was thought to be involved in diabetes2 . But as for the discovery of the active component, numerous scientists followed the work of Minkowski but were unsuccessful in their their attempt to extract it. Between 1914 and 1916 it was the Romanian physiologist Nicolas C Paulescu who first extracted a pancreatic anti diabetic agent that healed dogs but these experiments would be overlooked in favour of work by other scientists3 . In 1922, the Lancet expounded that a simpler method of measuring blood sugar might have led to earlier discovery of insulin ; 25-50 ml of blood and 3 hours were required to test sugars then.

Chest pain in children seems to be is one of the most routinely seen presenting complaint that brings lot of anxiety and stress to patients, parents and treating physician, though most of them have a benign cause . A simple history taking and detailed physical examination is sufficient in most of the times to identify the origin as well as the source which causes chest pain and diagnostic testing and cardiologist referral can be reserved for selected cases as routine referral still increases the family concern.

Which is the best cry in humans? The first cry is the best cry. When a baby is born crying it makes all the family members smile. If the baby does not cry immediately blood supply and oxygen to the brain is compromised. The neuron needs glucose as glucose and oxygen as oxygen; Unlike other cells neurons cannot convert other substrates into glucose. Because of this the neurons gets damaged and a lot of problems are produced - Hypoxic ischaemic encephalopathy. This makes the parents cry forever.