Background: Tuberculosis is the second most common cause of death from infectious disease at the global level, being second only to AIDS. Good data on the burden of all forms of TB amongst children in India is not available; most surveys conducted have focused on pulmonary TB. The present study was designed to study clinical profile of various forms of childhood EPTB. Objective of current study was to study clinico-epidemiological profile of various forms of childhood EPTB. Methods: Retrospective analysis of clinical profile of 100 patients of childhood EPTB in the age group of 6 months to 12 years. Results: Age distribution in our study showed that 62% cases falling in the age 0-5 years and 38% cases in 5-12 years (P = 0.041) with male to female ratio of 1.9:1. 96% (P = 0.016) of the patients belonged to the lower socioeconomic class (P = 0.01). The distribution of EPTB was-TBME (46%), disseminated TB (21%), pleural effusion (12%), abdominal TB (10%), TB lymphadenitis (7%), Osteoarticular (4%). 28% of the patients had mild to moderate malnutrition (PEM Grade-I,II) and 46% (PEM Grade-III,IV) were severely malnourished. 66% of the patient were BCG vaccinated & history of Koch's contact were present in 28% of the all cases. In CNS tuberculosis, fever was present in 97% followed by altered sensorium & convulsion in 80%, tonic posturing in 60% & abnormal movements in 4% and in most common sign was tonic posturing in 60%, crack pot sign positive in 41%. In abdominal tuberculosis-fever (100%), anorexia (90%), weight loss (80%) abdominal pain (50%) & hepatomegaly was common finding seen in 100% of abdominal tuberculosis. Conclusion: Childhood EPTB is commonly seen in children age more than 1 year, lower socioeconomic class & in severely malnourished. CNS tuberculosis commonly present with fever, altered sensorium, convulsion, abnormal movements while abdominal TB present with fever, anorexia, weight loss & abdominal pain.
Background: Neonatal septicemia continues to be a major cause of mortality and morbidity in new-borns all over the world. Aim and objectives of the study were determining the risk factors for mortality in neonatal septicemia.Methods: A retrospective observational study of the demographics, clinical features and laboratory parameters of 100 neonates admitted in NICU of a tertiary care hospital from September 2019 to March 2020.Results: 67% of neonates delivered outside centre and 33% of neonates delivered at centre were found to have sepsis exclusively based on culture positivity. A significant association was found between very low birth rate (VLBW) (p value<0.001), prematurity (p value<0.01) and high neonatal mortality. Among the different clinical presentations of neonatal sepsis, lethargy (p value<0.02), apnea (p value<0.01) and hypothermia (p value<0.02) were found to be frequently associated with neonatal mortality. Further, C-reactive protein (CRP) positivity (p value<0.003), hyperglycaemia (p value<0.0009) and thrombocytopenia (p value<0.0009) were also associated with high neonatal mortality. Gram positive bacteria were frequently isolated from blood cultures of deceased neonates, Coagulase negative staphylococci (CoNS) (36.1%), being the commonest bacteria followed by B. subtilis (11.1%), Klebsiella spp. (11.1%) and Acinetobacter spp. (8.3%).Conclusion: Demographic factors like VLBW, prematurity, outborn deliveries, clinical and laboratory parameters like lethargy, apnea, hypothermia, thrombocytopenia and hyperglycemia are strong predictors of mortality in neonatal.
Background: India contributes up to 25% of neonatal mortality worldwide. Most of the times, the patient deteriorates in-transit from periphery to tertiary healthcare facility. There is a need for reliable scoring system in analysis of neonates transferred to tertiary healthcare centers in prediction of in-hospital mortality. The aim of the research was to evaluate the efficiency of extended sick neonatal score in ‘in-hospital’ mortality prediction of neonates referred to tertiary healthcare institutes and to compare it with that of other scoring systems like sick neonatal score and temperature, oxygenation, perfusion and blood sugar (TOPS) score.Methods: The research was a retrospective observational study. All extra-mural neonates admitted over a period of one month at neonatal intensive care unit (NICU) of our tertiary healthcare centre were considered after informed consent and the required parameters for scoring were assessed. Data was collected according to a pre-formed proforma.Results: Over a period of one month, 145 neonates attended on arrival were analyzed according to the mentioned systems. Various cohorts were considered. Of the systems analyzed, extended sick neonatal score had the highest sensitivity and specificity, regardless of the cohort.Conclusions: Extended sick neonatal score was more efficient than sick neonatal score and TOPS score in mortality prediction of sick neonates.
Background: Thousands of people in the world suffer from epilepsy. Inspite of modern advances, it can be controlled in only 80% of treated once. Diagnosis and treatment of epilepsy is still challenged. The present study is attempted to highlight the importance of clinical findings and role of EEG and CT scan and MRI in diagnosis of epilepsy2.Aim:To study the incidence and epidemiological profile, various types of epilepsy and correlation with MRI, CT SCAN, EEG and the effectiveness of various Anti epilepticdrugs in different types of epilepsy. Settings and Design: This is a prospective study carried out at Civil Hospital, Ahmedabad.Methods:All the patients having 2 and/or more unprovoked seizures and already enrolled patients in epilepsy clinic in 1 year duration from January 1,2020 to December 31,2020 were included.Results &Conclusions:Out of 6930 total admissions, 163 patients with epilepsy were enrolled in this study from age group of 1 month to 12 years. Out of 163 patients, 97 were male and 66 were female. Most common age group affected is of 1-5 years. 128 patients (78.62%) were of generalized epilepsy and 35 patients were of partial epilepsy. Most common precipitating factor in epilepsy is inadequate drug dosages (45%). 45 patients (22.7%) have developmental delay. Abnormal EEG findings were present in 123 patients (75.46%). Abnormal MRI findings were present in 37 patients (22.7%). CT scan was done in 56 patients, 20 were abnormal. 107 patients were on monotherapy and 56 patients were on polytherapy. Valproate is most commonly used drug (76.6%).
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