Introduction: Early intervention services play a pivotal role

Aim:To study the spectrum of neurological complications of diphtheria, timing of onset with respect to respiratory disease, and pattern of recovery.Settings and Design:Prospective, observational, hospital-based study conducted in tertiary care hospital.Materials and Methods:Twenty-eight cases of diphtheria with neurological complications were admitted during the period of study. Demographic profile, age, gender, status of immunization, past history stressing on the severity of the respiratory disease, and complaints regarding diverse complications of diphtheria were recorded. Detailed clinical and central nervous system examinations along with relevant investigations were carried out.Results:Children were in the age group of 3–18 years. All 28 children presented with bulbar symptoms. Isolated palatal palsy was present in 18 children (64%). Third cranial involvement was present in four children. Three children had unilateral lower motor neuron facial palsy and one child had sixth cranial nerve palsy. Nine children developed symmetric limb weakness. Diaphragmatic palsy was present in three children with the onset from 1–3 weeks after pharyngeal diphtheria. Loss of vasomotor tone was present in two children. Recovery was complete in all 28 children.Conclusion:Pediatricians/neurophysicians should have a high index of suspicion to recognize diphtheritic polyneuropathy. It carries good prognosis, hence timely diagnosis and differentiation from other neuropathies is a prerequisite for rational management and contact tracing.

Background: Malaria is a major health problem in tropics with a high morbidity and mortality. Malaria causes wide spectrum of manifestation both clinical as well as hematological. A variety of haematological alterations like progressively increasing anaemia, thrombocytopenia, leucocytosis or leukopenia and rarely disseminated intravascular coagulopathy (DIC) have been reported in malaria. Though clinical manifestation has been widely studied but there is paucity of work in hematological abnormality.Methods: The hospital based observational study was conducted in the Department of Paediatrics, Shri Rammurti Smarak Insitute of Medical Sciences (SRMSIMS), Bareilly. Ninety-eight cases were positive for malaria by peripheral smear or by rapid diagnostic test for malaria or by both.Results: In the present study, prevalence of malaria found to be (11.6 %). Out of 98 cases, 60 were males, majority of cases belonged to 9-12 years of age, followed by 4-8 years of age. Male:Female ratio is 1.57:1. There was neutrophilic predominance and low monocyte count in cases positive for plasmodium falciparum malaria. All the patients had microcytic hypochromic anemia as per mean of MCV. In haematological profiles of malaria neutrophil and monocyte showed statistically significant variations (P value ≤0.001)Conclusions: Anemia is the most common hematological abnormality. There was neutrophilic predominance and low monocyte count in cases positive for malaria which is highly significant. All the patients had microcytic hypochromic anemia as per mean of MCV. Profound thrombocytopenia is very common in malaria.

Background: This study was done to describe the clinical and epidemiological profile of neurocysticercosis in children of Rohilkhand region.Methods: The study was carried out in the Paediatric Department (Paediatric Intensive Care Unit and General Ward) of Shri Ram Murti Smarak Institute of Medical Sciences, Bareilly, Uttar Pradesh. It was a prospective clinical observational study. After IEC approval and written informed consent, all children between the age group of one month to sixteen years, who fulfilled the inclusion criteria, that is, presented with unprovoked seizure and had evidence of active and ring enhancing lesion or mixed lesion on CT Scan/MRI of brain were enrolled in the study. Detailed history and clinical examination were carried out. Seizures due to any other CNS pathology were excluded. Simple tests for measures of dispersion were the statistical tests that were used.Results: Statistically forty children fulfilled the inclusion criteria. Of the total children enrolled in the study, 63% were males. Male to female ratio was 1.7. Almost three fourths of the population belonged to rural backgrounds. The mean age of studied children was 10.5 years. More than half of the affected children belonged to the school going age group. Generalised tonic clonic seizures were more common in all age groups than partial seizures. Headache (52.6%), loss of consciousness (42.1%), vomiting (31.5%) and focal neurological deficit (15.7%) were the most common presenting complaints in order of decreasing frequency.Conclusions: There should be a high index of suspicion of NCC in any child presenting with unprovoked seizures.

Introduction: Evaluation of the effectof educational intervention on early initiation of breast feeding in full term normally delivered baby 1 & 6 months andfactors affectingbreast feeding. Methods: interventional study with subjects as mothers with vaginal delivered newborns excluding preterm, VLBW/ LBW /IUGR babies, newborn with medical or surgical problems and whose child didn't survive Cases were pregnant women attending antenatal clinic of KRH (n=124) and controls were mothersdelivered at government hospital except KRH. (n=120). Mothers counseled antenatally and helped for initiation of breast feeding immediately after birth and again counseled individually at discharge, on follow up at end of1 st and 6months. In control group breast feeding practices were recorded at 1 and 6 months after birth without any counseling. Results: There were 76.8% (n=80) mothers who had early initiation of breast feedingin interventional groupcompared to 10.56% (n=12) in non-interventional group with odds ratio of 32. 93 and 83% mothers in interventional group were practicing EBF (p = 0.01) against only 63%, and 49% mothersat 1 and 6 months respectively in non-interventional group. Effect of counseling in cases for EBF was more in primiparous (70.83% and 91.30%) than in multiparous (29.16% and 60.41%) at 1 and 6 months respectively (p = 0.01and 0.04). Conclusion: counseling antenatally and at regular intervals significantly increase early initiation and sustainedexclusive breast feeding. This influence primiparous mothers more.

Background: Perinatal asphyxia is amongst the common problem of neonates and there exists a significant contribution to the neonatal morbidity and mortality. It is observed as a common and a vital cause of the preventable cerebral injury. The prediction of the perinatal asphyxial outcome is very important but dreadful. There is a limited role for APGAR score to predict the immediate outcome, like HIE and the long-term neurological sequelae observational error may happen in APGAR. But the biochemical parameters can truly be relied upon. This study was done to assess urinary uric acid/urinary creatinine ratio (UA/Cr) as a non-invasive marker for perinatal asphyxia and co-relate its absolute value to the degree of the perinatal asphyxia.Methods: In this prospective case control study conducted in the Pediatrics Department of Shri Ram Murti Smarak Institute of Medical Sciences between Nov 2017 to May 2019, 42 asphyxiated and 42 non-asphyxiated newborns were included. Detailed history and assessment were for all the enrolled newborns. Spot urine samples were sent for the uric acid and creatinine estimation. Results were documented, and statistical analysis was performed.Results: Urinary uric acid to creatinine ratio used as additional non-invasive, early and easy biochemical marker of the birth asphyxia that biochemically supports severity grading and clinical diagnosis of the asphyxia by APGAR score.Conclusions: The ratio of the urinary uric acid and creatinine enables rapid and early recognition of asphyxial injury and also the evaluation of its severity and potential for short-term morbidity or death.

No abstract

Despite the proven benefits of laparoscopic surgery, it is indeed very costly. The aim of our study was to show an effective way to reduce one of the costs. Between January 2012 and December 2018, we used sterile unpowdered latex-free surgical gloves for specimen retrieval in 243 selected cases of laparoscopic cholecystectomy and appendectomy. The mean retrieval time was 6.7 AE 3.6 min. All procedures were performed safely. Minor wound infection was noted in three patients but there was no case of port site hernia in our series. We conclude that specimen retrieval using sterile, unpowdered, latex-free surgical gloves is safe, effective and cheap. No special additional preparation is required.