Objectives: To compare the prevalence of psychosocial problems in children with and without epilepsy. Study Design: Comparative Cross Sectional study. Settings: The Children’s Hospital and The Institute of Child Health Multan (CH & ICH). Period: July 2019 to December 2019. Material & Methods: Fifty-nine patients of either gender, 5 -12 years of age, diagnosed as Epilepsy were included in group A. For the group B the patient of same number, age and gender without epilepsy visiting the general outpatient department of the hospital with acute illness were included. The children having known psychiatric disorder, and intellectual disability were excluded. Educational level of parents, socioeconomic status, Time of onset, type, outcome of epilepsy, number of antiepileptic medicines used and EEG findings were noted. Intelligence Quotient of each patient was calculated. A Pediatric Symptom Checklist was used for psychosocial problems in all children. Data was analyzed by using SPSS version 20. Result: Out of 118 patients (59 in group A and 59 in group B), 68% (n=73) were male. Mean age of the participants was 10.2years (st dev.±11.1). Patients age ranging between 5-9 years constituted 32% (n=38) while 68% (n=80) were more than 9 to 12 years. Most of the children belonged to low socioeconomic status 66% (n=78). Educational level of parents was below matric in 67.8% (n=80) and 32.2% (n=38) were above matric. In Group A 64.41% (n=38) patients had generalized tonic clonic type of epilepsy, 28.81% (n=17) partial/focal type and 3.39% (n= 2) myoclonic type. In 42% (n=52) of patient’s epilepsy was controlled while in 58% (n=7) patients it was uncontrolled. Psychosocial problems were detected in 59.3% (n=35) patients in epileptic group A while in 23.7% (n=14) in non-epileptic group B. Single use of antiepileptic was important factor causing psychosocial problems in epileptic children. Conclusion: Psychosocial problems are more common in Epileptic children, so psychological evaluation and management must be integral part of their therapy.
Objective: To determine the role of motivational interviewing in better management of diabetes mellitus in children. Study Design: Observational Cross Sectional Study. Setting: Children Hospital & Institute of Child Health Multan. Period: November 2019 to May 2020. Material & Methods: Fifty-six poorly controlled follow up diabetic children of 8 to 15 years of both sexes, with HBA1c more than 10 %were included. Their social status, educational status whether studying or not was noted. All patients were advised subcutaneous Insulin according to weight. All children were counselled and motivated for self-care, problem identification and solution, and proper diabetic management by a team consisting of an endocrinologist, a dietitian, a psychologist and a nurse. Glycemic control was assessed using HbA1c, at 1st visit, 3rd and 6th month. A decline in HbA1c by ≥1% was considered for good control of DM, while ≤1% decrease was taken as poor control of DM. Data was analyzed by using SPSS version 20. Result: Out of 56 patients. 50%(n=28) were females and ,50%(n=28) were males.42.9 % (n=24) patients were age ranges between 8 to 11.5 years while 57.1%(n=32) more than 11.5 to 15 years, with mean age of 11.8±1.97 years 28.6% diabetic children belonged to lower, 57.1% middle while 14.3% upper socioeconomic status. 69.4%children were going to school while 27.6% were not studying. Good glycemic control was observed in 85.7% diabetic children which is statistically significant (p-value <0.001). Conclusion: Motivational interview proved to be a good tool for the better outcome of diabetic children, who need both knowledge and practical communication for their management regarding behavioral changes, lifestyle issues and self-management. It must be a part of diabetic management programs.
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