Telemedicine is the delivery of health care services using information or communication technology. In the current pandemic scenario, telemedicine can supplement health-care delivery in the absence of in-person visit. The Government of India has recently launched the e-sanjeevani OPD, a National teleconsultation service, which has been adopted by many state governments as mandatory for health-care providers. With Indian Medical Association issuing an advisory against the use of telemedicine except in few situations, a lot of confusion exists in the mind of a pediatrician. Despite the uncertain situation, we have to remember that other diseases shall not stall in the face of a pandemic. Since telemedicine is an evolving subject, training of medical professionals, clear guidelines and good quality internet service systems will go a long way in increasing the acceptability of telemedicine in the Indian population. We herein discuss issues related to using telemedicine during the SARS-CoV-2 pandemic.
Monotherapy was the preferred treatment. Phenytoin was the most common ADR causative agent. Female sex, symptomatic epilepsy, and older age (> 5 years) were found to be associated with higher probability of ADR development.
Snake bite is a common condition in tropical countries. Neurotoxic features of snake bite vary from early morning neuroparalytic syndrome to various cranial nerve palsies. Locked in syndrome (LIS) is a rare presentation. We present four children that had LIS; three patients had total and one had incomplete LIS. All patients made successful recovery with polyvalent anti-snake venom and supportive management. This case series highlights the importance of early diagnosis of LIS in snake bite.
Diabetic ketoacidosis (DKA) can present with various neurological complications, but stroke is rare. Here, we present three children with recent-onset diabetes with DKA, two of them had deep coma not responding to standard DKA regimen and the third one had seventh nerve palsy noted after recovering from coma. Computed tomography scan of head showed hemorrhage in the area of midbrain in one patient and infarcts in two patients. In any child of DKA with severe neurological impairment, possibility of stroke should be entertained.
Acute onset of multiple organ dysfunction syndrome (MODS) is a well-known complication following multiple wasp stings. However, MODS after a single wasp sting has been rarely reported in children and acute pancreatitis have probably never been observed before. Herein we describe the case of a 12-year-old boy who had urticaria and abdominal pain after a single wasp sting. The child gradually developed MODS while his abdominal complaints were worsening. Despite aggressive supportive management, the child did not survive. Afterward, the cause of the acute abdomen was finally diagnosed as acute pancreatitis. Both MODS and pancreatitis following a single wasp sting are very unusual. Thus, although pancreatitis is rarely manifested, it should be suspected after a wasp sting if there are predominant abdominal symptoms.
Background/aim: Children with epilepsy have reduced health-related quality of life (HRQOL) due to disease and medications. We aimed to assess child-reported HRQOL in Indian children with epilepsy and compare it with that in healthy children.
Materials and methods:A cross-sectional study of 256 children with epilepsy aged between 5 and 18 years on antiepileptic drug (AED) treatment for at least 3 months was performed and 125 age and sex matched healthy children were included. A generic version of the Pediatric Quality of Life (PedsQL version 4) scale was used to assess HRQOL.Results: Children with epilepsy had diminished scores in total score and all subdomains of PedsQL as compared to healthy children. Children with epilepsy on polytherapy had diminished HRQOL compared with those on monotherapy. Children with generalized seizures or with symptomatic epilepsy had diminished HRQOL. Significant predictors of poor HRQOL were adverse drug reactions (ADRs) to AED, polytherapy, longer duration of epilepsy, shorter seizure-free interval, and seizure frequency.
Conclusions:Children with epilepsy have diminished HRQOL than healthy children in all subdomains of PedsQL. Significant predictors are ADRs to AED, polytherapy, longer duration of epilepsy, shorter seizure-free interval, and seizure frequency. Comprehensive management of children with epilepsy must go beyond seizure control.
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