Background:To compare the efficacy and safety of intravenous levetiracetam and phenytoin in status epilepticus.Methodology:A prospective, randomized controlled, nonblinded study was conducted in children 1 month to 12 years of age with active seizure and with status epilepticus. A total of 104 children were randomly allocated to either group 1 (levetiracetam) or group 2 (phenytoin) on the basis of computer-generated random number table. Children already on antiepileptic drugs, very sick children with shock, impending respiratory failure, or head injury, and children hypersensitive to phenytoin or levetiracetam were excluded. Data analysis was done by IBM SPSS statistics.Results:The mean age was 4.09 years with a male preponderance with the most common type of seizure being generalized type (74%). The seizures were controlled in all 104 patients initially within 40 min. Seizure control for 24 h was significantly better in group 1 (96%) when compared with group 2 (59.6%) (P = 0.0001). Minibolus of drug was given in 28.8% in group 1 and 46.2% in group 2 (P = 0.068). The seizure recurrence in groups 1 and 2 in the first hour was 1.9% and 5.8%, respectively (P = 0.61), whereas the recurrence between 1 and 24 h was significantly more in group 1 (34.6%) when compared with group 2 (3.8%) (P = 0.0001). The mean time to control seizure was comparable between both the groups (P = 0.71). There was no significant adverse effect in both the groups.Conclusion:Levetiracetam is more effective than phenytoin for seizure control for 24 h in children with status epilepticus, and it is safe and effective as a second-line therapy.

Background:As there is paucity of data on Scrub typhus from Garhwal belt. So, to bridge this gap we conducted this study and tried to bring awareness about Scrub typhus. Methods: This is a descriptive study of 40 patients who were ELISA positive for Scrub typhus. A detailed history, demographic details, clinical features, complications, routine laboratory parameters and their relation with and without eschar was noted. Results: On analysis of demographic details, majority of scrub typhus patients belonged to Hilly district, Rudraprayag of Garhwal region. Common signs included fever (100%), lymphadenopathy and splenomegaly (70%), hepatomegaly (55%), rash (37%), eschar (35%), meningitis (20%), hepatitis and epistaxis (5%), pleural effusion, sub-conjunctival hemorrhage and ARDS (2.5%). Presence of eschar was strongly associated with abdominal pain, facial edema, meningitis and ARDS.Conclusion: Early diagnosis with high index of suspicion and timely treatment in children from hilly area with acute febrile illness decreases the mortality and leads to better prognosis.

Background: Dengue is rising globally. It presents with varied clinical manifestations. This study was done to describe the salient clinical as well as laboratory findings of serologically confirmed cases of dengue fever.Methods: This was a prospective study conducted at Government Multispeciality Hospital-16 Chandigarh from July 2017 to December 2017. All children below 17 years of age that had clinical features of dengue and who were antigen or antibody positive were included in this study.Results: Age group most commonly affected was 5-10 years with maximum number of dengue cases with warning signs(72.94%). Fever was present in all cases followed by headache(89.41%) and myalgia(78.82%). Thrombocytopenia was the commonest hematological abnormality(97.6%).Conclusions: Dengue presents with varied clinical features. Community awareness, early diagnosis and management and vector control measures needs to be strengthened in order to reduce the increasing number of dengue case.