PICU 5 8y/F /18 kg admitted with C/o alterd sensorium with H/O GTCS episode and fever since 5 days with cold and cough ,pain in abdomen O/E I•P•Ln•Cy•Cl• CVS CNS wnl Urine stool Wnl P/A: soft with hepatospleenegalae Temp :afebrile Cracked pot sign -ve Neck rigidity -ve Babinski sign abscent PR 118 bpm SpO2 95% RR ~ 26 bpm

A 24 yrs old female was found in a State that she only was arousable to DPS at 6am today morning. Clinching of teeth was present. Had history of fever from last 2 days,after she returned from a village.she was brought to casualty with same complaints - Alterd consciousness, intermittently arousable to DPS and moving limbs during external stimulus, no neck rigidity, no head injury, no any other significant history. Plantars flexor P-104,bp- 110/70 ,rr-24 Within 2-3 hrs of admission she was tachypnic, tachycardia with hypoxia on ABG so was intubated. MRI with MRV revealed no abnormalities. All labs normal ,ECG normal Kindly give your expert opinions regarding DD for this case.

Today a middle aged,Male patient with h/o fever since seven days and h/o abnormal behaviour (shouting continuesly since evening).On examination vitals normal.But investigations report shows following findings. Kindly diagnose and advice further management.

PICU 1 25092017 9yr female 22kg GTCS episode f/b prolong loss of conciousness f/b alterd sensorium(at 22 september 2017)sunken eyes with hepatomegalae Neck rigidity abscent Pupils normaly reactive non photophobic Cracked pot sign negative At present sensorium allert H/o intermittent fever without chills NCCT wnl reports attached Our ddx dengue fever with viral encephalitis vs hepatic encephalopathy 1.Kindly Add ddx 2.what is the cutoff size of the sludge ball within gb as shown in USG 3.what are causetive aorganism possible and what should be DOC and preventive measures according to you Thank you

A 27 year male patient admitted with high grade continues fever for 9 days with headache and nausea . Not responding to antibiotics . Started on acyclovir and doxycycline after 5 days of no response . Being managed with iv fluids and antipyretics.