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Our last admission day after the OP was going back to ICU to see new cases admitted. I was called by PG to rush to casualty to see a bad case. An adolescent girl, She was in distress. Periphery cold,peripheral pulses not palpable. 13 year old girl was under evaluation by our cardiology colleagues, after ECHO she was sent to radiology was some scanning and she was returning back to cardiology department. On the way back she suddenly became sick and she was bought to our casualty which is on the way to cardiology. She was holding an ECHO report, which the PG read out , dilated cardiomyopathy. She did nt have report of the procedure she underwent in radiology, But the mother said they took a scan after injecting a drug. First possibility considered was anaphylaxis to contrast agent. Oxygen started, IV line secured. But Major question to be answered here. Drug of choice is adrenalin . But the ECHO report with us says DCM, What to do Will it save. OR ... Other possibilities

Four year old boy bought with fever sore throat for the last four days. He was on oral antibiotics. As local doctor noticed this patch in the throat he was referred here Second child, older one is 7 years. Both of them un  immunized. No vaccine taken so far. Many kids in the neighborhood also At the time of admission child was sick, Drooling of saliva and cervical lymph node enlarged odema neck plus In view of unimmunised child developing this typical patch in the throat provisional diagnosis of diphtheria was made. Took a throat swab for gram stain, and culture and patient was put on Crystalline penicillin  Diphtheria antitoxin 80000 unit was planned. While administration rashes and BP fall occurred.Under cover of Adrenalin and supportive measures could give 100000 units of antitoxin. Differential diagnosis  To rule out other possibilities like membranous tonsillitis and Infectious mononucleosis investigations were taken. Peripheral smear taken showed normal distribut

History in short  One year and eight month old girl born to a blind couple were bought with fever and seizure.( Both of them were blind at birth,otherwise intelligent and normal) She developed fever and at the height of fever she developed generalized seizure for which they were hospitalized. Seizure was controlled and she was playful for a while.At night again she developed seizures. lasting for two and half hours which was not controlled with usual anti convulsants and she was referred here. In between the seizures she vomited twice.She was bought deeply comatose, seizing movements controlled but occasional twitching persisting on left side, mother said the movements were more on left side. She was second child was born at term after an uneventful pregnancy. She was normal up to this age gained all milestones normally. Elder sibling born at term was normal. She developed fever,developed seizure and vomiting. Got hospitalized with intractable seizures and coma,she died in h