Our aim was to study the clinical profile, immediate outcome and risk factors associated with poor outcome in critically ill children presenting with seizures requiring PICU admission. As seizures lasting 10 min or more can potentially cause brain damage, we included all children regardless of seizure duration. The records of 157 children aged 1 month to 16 years admitted in the PICU at a tertiary hospital in India with seizures as the presenting symptom during a three-year period were studied retrospectively. Median age of patients was 4 years. 34 (21%) had pre-existing epilepsy and 33 (21%) had previous developmental delay/neuro-deficit. Seizure duration was > 30 min in 75 (47.7%) and 56 (35.6%) required the use of more than 2 antiseizure drugs. 101 (64%) had acute symptomatic seizures, 28 (17%) remote symptomatic and 27 (17.1%) had unknown cause. New onset neurological deficit was seen in 18 (15.6%) and 14 (8.9%) died. Young age, high PEWS score at presentation, prolonged/recurrent seizures, CNS infection, need for multiple antiseizure drugs and ventilation/pressor use were risk factors for poor outcome. Neurological outcome and survival of children in our study were good. Further all-inclusive studies irrespective of seizure duration are needed to obtain a complete picture of critical children presenting with seizures.
Aim
We conducted this study to examine the mid upper‐arm circumference (MUAC) of full‐term infants from birth to 6 months; construct gender‐specific MUAC graphs; and assess the role of MUAC as a surrogate marker for low birthweight and wasting in infants younger than 6 months.
Methods
This is a prospective longitudinal study of 268 (133 female and 135 male) new‐borns in a tertiary care centre in Navi Mumbai, India. We measured weight, length, head circumference and MUAC. We drew the MUAC curves for the first 6 months using the mean MUAC and standard deviation (SD) values and assessed the diagnostic test properties of MUAC at birth as a marker of low birthweight.
Results
The mean (SD) birthweight of the male and female new‐borns was 2756.2 g (368.1) and 2803.8 g (326.2), respectively (P = 0.25). The mean (SD) MUAC at birth was 8.7 (0.3) cm in males and 8.8 (0.2) cm in females, respectively (P = 0.14). The plotted mean MUAC curve in infants who were classified with wasting was between the −1SD and −2SD in both genders. The sensitivity and NPV for detecting low birthweight were 100% at cut‐off of 8.6 cm in females and 8.7 cm in males, respectively (area under the curve: 0.92 (females) and 0.96 (males)).
Conclusion
MUAC may be a good proxy for low birthweight at birth and the curves from our study show that it may also help in the diagnosis of wasting in infants below 6 months of age in the community, particularly in resource‐constrained settings.
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