Background: Seizures are common in pediatric age group and less than 1/3rd of seizures in children are caused by epilepsy. Aim of present study was to analyze the etiological factors and clinical profile of new onset seizures in children aged 3-12 years.Methods: This was a prospective study done at a tertiary care center of south India. Authors analyzed 98 children aged 3-12 years presenting with new onset seizures. Proper history and investigations including EEG, and CT brain were done to confirm the etiology.Results: Out of 98 children 51 were 3-5 yrs of age and 47 were 6-12 years. 66.3% had generalized seizure and 33.6% had partial seizure. Partial seizure were more common in 5-12 years of age. Intracranial infections were the leading cause (73/98) which included neurotuberculosis (26/73), NCC (20), bacterial meningitis (12), cerebral malaria (8) and viral encephalitis (7). Intracranial infections were the leading cause in both age groups. Space occupying lesions were more common in 6-12 years (46.8%) as compared to 3-5 years (19.6%). NCC and Tuberculoma were the leading CT findings in both age groups. There was significantly high incidence of focal EEG changes in partial seizure group compared to generalized seizure group.Conclusions: Intracranial infections were leading cause of new onset seizures especially GTCS. Good clinical evaluation and judicious use of investigations should be ensured. CT brain and EEG are more likely to be informative in partial seizures than in generalized seizures.
Introduction: Pregnancy-induced hypertension is the general classification for hypertension diseases during pregnancy, which include pregnancy-induced hypertension usually after 20 th week of gestation (without proteinuria), pre-eclampsia (with proteinuria), and eclampsia (pre-eclampsia with convulsions). This disease is responsible for high maternal and perinatal morbidity and mortality rates, and is one of the main public health problems. Material and Methods: It was retrospective study conducted between March 2013 to March 2016 in the department of pediatrics, Chirayu Medical College and hospital Bhopal. A total of 3015 mothers were delivered in department of obstetrics and gynecology. Out of these 180 were identified as having pregnancy induced hypertension. During the same period 100 mothers without any risk factor were included in the study. Results: Out of 180 cases of hypertensive disorders of pregnancy, majority were of preeclampsia (47.22%), then Gestational hypertension 38.88%, percentage of eclampsia (13.88%). Incidence of Pregnancy Induced Hypertension-5.97%. Incidence of low birth weight in PIH is 57.7%, preterm 44.2% and IUGR 20.4%, Still birth 8 (4.4%), early neonatal death 22 (12.2%), Highest incidence of LBW (88%), Preterm (80%), IUGR (12%) is present in eclampsia group. In control group incidence of LBW is 22% (P<.001)**, Prmaturity-18% (P<.001)**, IUGR-6% P(<.05)*. Conclusion: The purpose of this article is to give overview of burden of adverse perinatal outcome in high risk Pregnancy. Thus High risk pregnancy should be identified prospectively and then given special care, perhaps a major impact on overall perinatal loss could be reduced.
Introduction:A large number of babies born in India and many developing countries are born at home and majority of them have no access to scales or other means by which they can be identified as LBW. The aim of our study was to determine the correlation of chest circumference and foot length with birth weight and gestational age and to determine the most sensitive and specific cut-off values for detection of Low birth weight and preterm babies using foot length and chest circumference. Methods: This was a prospective observational study done at a tertiary care centre in south India. We analyzed 1000 newborn babies within 24 hours of birth. For each baby we measured 1. chest circumference (CHC), 2. Foot length (FL), 3. Weight (BW) and 4. Gestational age (GA). Babies were classified according to GA (preterm/term) and BW (kg) as Very Low Birth Weight (VLBW) (<1.5kg), Low Birth Weight (LBW) (1.5-2.5kg) and Normal Birth Weight (NBW) (>2.5kg). Results: Significant positive correlation of 0.921 was found between FL and BW (p<0.001). The two ROC curves for FL and CHC were close to each with AUC 0.982 and 0.969 respectively and difference in the areas was statistically significant (Z = 4.303, p < 0.0001) which suggested that FL was better indicator of BW. FL <= 6.4cm predicts VLBW; between 6.4cm and 7.3cm predicts LBW and > 7.3cm predicts NBW. For estimating preterm birth FL cut off was <=7.1cm. Conclusion: FL and CHC both can be used as predictor for BW and GA estimation and FL was more appropriate than CHC considering its ease of measurement also. Screening of babies who are in need of extra care can be done using our cut off values and this can help in reducing neonatal mortality by early referrals.
Introduction: Anaemia is defined as a decreased concentration of blood haemoglobin. World Health Organization (WHO) estimates that 42% of children less than 5 years of age worldwide are anaemic and prevalence of anaemia in India in children 6-59 months for year 2019 was 53.4%. Childhood anaemia not only affects physical health but cognitive and social development as well. Aim: To determine various causes of anaemia in children in age groups 1-5 years, 6-12 years and 13 to 18 years and to determine clinical features and haematological investigations in moderate to severe anaemia. Materials and Methods: This retrospective, observational study was conducted in Department of Paediatrics, Shri Shankaracharya Institute of Medical Sciences, Bhilai, Charttisgarh, India, from September 2021 to December 2021. The data collection was done retrospectively over a period of 2 years, from September 2019 to September 2021 from patients case records which were available from Medical Record Department. A total of 300 patients from age 1 year to 18 years who were admitted in the paediatric ward with anaemia were included for study. Anaemia was defined and severity categorised based on WHO definition. The aetiology of anaemia was analysed based on Complete Blood Count (CBC) and investigations including serum ferritin, vitamin B12 level, bone marrow examination, High Performance Liquid Chromatography (HPLC) and other relevant investigations. Data was entered in a excel sheet and analysed using software Statistical Package for the Social Sciences (SPSS) version 21.0. Statistical test used was student’s t-test for paired and unpaired data for continuous variables. The p-value <0.05 was considered significant. Results: Out of total 300 patients, 148 (49.3%) were males and 152 (50.7%) were females. Most of the patients were in 1-5 years of age (45.6%), followed by 13-18 years age (29.4%) and 6-12 years (25%). Total 95 (31.6%) patients had mild, 112 (37.3%) had moderate and 93 (31%) had severe anaemia. The three most common causes of anaemia were iron deficiency in 77 patients (37.5%), haemolytic anaemia in 54 patients (26.3%) and vitamin B12 deficiency in 34 patients (16.5%). Mean Red Cell Distribution Width (RDW )(31.1±10.1%) values and mean of Mean Corpuscular Volume (MCV) (98.2±15.2 fL) were higher in vitamin B12 deficiency patients as compared to iron deficiency patients mean RDW (17.2±3.5%) and mean of MCV (58.14±7.3 fL), this difference was found to be significant with p-value <0.001. Conclusion: Most of the patients had moderate anaemia. Iron deficiency was most common cause of anaemia overall in children and especially below 13 years followed by haemolytic anaemia mainly sickle cell anaemia and Vitamin B12 deficiency anaemia. The MCV and RDW values from CBC can be used to identify two most common causes of nutritional anaemia.
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