Background: Children contribute a significant proportion of the tuberculosis (TB) burden in India and suffer severe TB related morbidity and mortality, particularly in endemic areas. Diagnosis and management of pediatric TB especially Extra pulmonary (EPTB) is challenging. The present study was designed to study clinical, laboratory characteristics and outcome of childhood tuberculosis.Methods: A retrospective analysis of 90 cases of TB in children within 2 year period was conducted at Pediatric Department and DOTS center at a tertiary care hospital from January 2015 to December 2016.Results: In the present study 20% of the total TB patients attending DOTS OPD were Children. Most common symptoms were Fever (53.3 %), Cough (46.6%), abdominal pain (18.8%), lymphadenopathy (13.3%), osteo-articular symptoms (13.3%), weight loss (10%), CNS related complaints like convulsions and unconsciousness (6.6%). History of contact was present in 10 cases (11%). Sputum examination was positive in 9 cases (10%) who were predominantly older children above 12 years. Mantoux test was positive in 9 cases (10%). Only one patient was HIV positive. Extra pulmonary tuberculosis (EPTB) patients were more common than pulmonary. 47 out of the 90 cases (52%) were receiving DOTS for EPTB. Out of the 90 cases 84 (93.3%) were on New Category 1 treatment and 6 (6.6%) were on Cat 2 treatment. Out of the total 90 cases 3 defaulted, 3 died, rest completed treatment with good compliance and no side-effects and were declared cured.Conclusions: In present study, it was found that extra-pulmonary tuberculosis (EPTB) patients are more common than pulmonary tuberculosis in pediatric age group. Sputum positivity yield is very low in pediatric age group. Success of treatment with DOTS is good (94.4%). No adverse effects of ATT were observed.
Background: Breastfeeding is known to be central in an infant's nutrition and growth worldwide. However, breastfeeding rates have remained low during this crucial period due to various misconceptions and cultural beliefs. This study was planned to assess the knowledge and practices of breast feeding and identify misconceptions regarding breastfeeding in the postnatal mothers from rural central India. Methodology: A cross-sectional observational questionnaire based study was conducted at a tertiary care teaching hospital in rural part of central India. A total of 100 postnatal mothers attending the pediatric outpatient department were enrolled in the study. Subjects were informed about the study, written consent taken and a structured questionnaire was administered to them. Results: About one third (34%) of the mothers were either illiterate or received only primary education. Only 18% mothers had received antenatal counseling about breast feeding and only 28% had their breast examination done. Although majority of the mothers (86%) were breastfeeding their babies, only 22% had initiated breastfeeding within an hour of delivery. Only 70% mothers knew that exclusive breastfeeding should be given for first six months and only 58% believed that it should be continued till 2 years age. Only 18% mothers knew about the correct technique of breastfeeding. Conclusions: This study reveals that the knowledge and practices of postnatal mothers regarding breastfeeding are far from satisfactory. Our study emphasizes the need for education of mothers especially during antenatal visits and whenever the healthcare providers get an opportunity to sensitize them about the correct technique, early initiation and exclusiveness of breastfeeding for first 6 months.
Background: Acute encephalitis syndrome (AES) is defined as the acute onset of fever and a change in mental status and/or new onset of seizures (excluding simple febrile seizures) in a person of any age at any time of the year.
Aims and Objectives: The objectives of the study were as follows: (a) To study clinicoepidemiological profile and outcome among children with AES admitted at M.Y.H. Hospital and MGM Medical College, Indore, M.P., and (b) to study prognostic factors associated with bad outcomes.
Materials and Methods: This prospective observational study was conducted over 12 months (July 2019–August 2020) at the pediatric department of our hospital. Inclusion criteria: Inpatient children aged 6 months–14 years meeting the case definitions of acute encephalitis syndrome. Exclusion criteria: Simple febrile seizures.
Results: Out of 50 AES cases, majority were between 1 and 5 years of age (40%). There were more males 31 (62%) than 19 (38%) females. Most of the cases were reported during the monsoon period 29 (58%) followed by post-monsoon 13 (26%) and pre-monsoon 8 (16%). Out of 50 cases, all had fever and altered sensorium, 37 (74%) had convulsions, 14 (28%) had vomiting, and 9 (18%) had headache. Out of 50 cases, 42 (84%) had viral etiology including 7 (14%) of dengue encephalitis and 1 (2%) of case of human immunodeficiency virus encephalitis. Only 5 (10%) cases had bacterial etiology. Those who needed inotropes and mechanical ventilation showed significant mortality.
Conclusion: The peak of AES cases occurred during the monsoon period. A higher proportion of such cases had viral etiology on cerebrospinal fluid analysis. Use of inotropes and mechanical ventilation was identified to be associated with significant mortality.
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