Background: Childhood poisoning covers the entire gamut from accidental ingestion in toddlers and preschool children to intentional overdosage in adolescents. The poisons range from fuel to drugs and other chemicals. Objective: To determine the epidemiology, clinical profile, and outcome of children presenting with acute poisoning in a tertiary care center in south India. Materials and Methods: All patients from the age of 1 month to 18 years, admitted during the 1-year study period with a history of poisoning, were included. Animalbites, snake, and scorpion envenomation were excluded. The data were analyzed using SPSS software, version 16. A multivariate analysis was also done and a p<0.05 was considerer significant. Results: There were 75 cases of poisoning out of the total 4074 admissions. Accidental poisoning constituted 73.3% cases and the remaining 26.7% were suicidal. In most of the cases, poisoning was due to fuel (28%) or drugs (21.3%), and kerosene oil was the most common causative substance (28.0%) followed by camphor (14.7%). The higher incidence of poisoning was found in lower middle socio-economic class (56.0%). An analysis of the outcome showed that92.0% were discharged home, 4.0% with sequelae, and death in 4.0% cases. Conclusion: The highest incidence of poisoning was observed in the lower middle socio-economic group. Most of the poisons were household products, and the most common nature of exposure was accidental. In most of the cases, recovery was complete.
Background: Scrub typhus, a zoonosis caused by bacteria Orientia tsutsugamushi is associated with varying clinical features and significant mortality due to complication in view of ineffective treatment. Objectives: This study was undertaken to identify the factors for predicting severity in scrub typhus. Methods: This retrospective study was conducted at a tertiary care teaching hospital between January 2015 to October 2016. All children younger than 18 years of age admitted with a history of fever for more than seven days and positive IgM ELISA for scrub typhus were included in the study. Cases of "severe scrub typhus" were identified based on criteria from published pediatric studies. A total of 235 patients tested positive for scrub typhus, out of which 39 patients were in the severe scrub group and 196 in the nonsevere group. Reports were analyzed for the predictors of severity of scrub typhus in both groups. Results: Using multivariate analysis, the factors for predicting severity in scrub typhus were hemoglobin < 10 g/L (OR = 2.8, CI = 1.40 to 5.72), platelet < 150 000 cells/mm 3 (OR = 2.54, CI = 1.21 to 5.30), albumin < 2.5 g/d (OR = 3.18, CI = 1.42 to 7.11), SGOT > 5 fold rise (OR = 49.7, CI = 13.49 to 183.17), prolongation of PT (P value = 0.03), and altered sensorium (P value = 0.016) were correlated with severe disease. Conclusions: We conclude that altered sensorium, anemia, thrombocytopenia, elevated transaminases, hypoalbuminemia, and prolongation of prothrombin time to be predictors of severity of illness in scrub typhus.
We attempted to search all possible sources but were unable to find any randomised controlled trials to address the issue up to 23 January 2017. We concluded that there is no high-quality evidence to support or refute the use of an EEG and its timing a er complex febrile seizures in children. Well-designed randomised controlled trials are therefore required. We intend to update this review regularly with the hope that new randomised studies will be reported in the future. EEG for children with complex febrile seizures (Review)
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