Each institution should use a pre-determined protocol for management of status epilepticus; pre-hospital management and early stabilization is the key to a satisfactory outcome of status epilepticus. Pharmacotherapy should not be delayed for any investigations; the initial management should consist of a parenteral benzodiazepine by any route feasible. Subsequent management has been detailed. The group also felt the need for more epidemiological research on status epilepticus from India, and identified certain research areas for the purpose.
Context: Intelligible speech and language is a useful marker for the child's overall development and intellect. Timely identification of delay by primary care physicians can allow early intervention and reduce disability. Data from India on this subject is limited. Aims: To study the prevalence and risk factors of speech-language delay among children aged 1-12 years. Settings and Design: A cross sectional study was conducted at the Pediatric outpatient department of a teaching hospital. Materials and Methods: Eighty four children (42 children with delayed speech and 42 controls) aged 1-12 years were included. The guardians of these children were requested to answer a questionnaire. History of the child's morbidity pattern and the risk factors for speech delay were recorded. The child's developmental milestones were assessed. Statistical Analysis Used: Data entry was analyzed using SPSS software, version 16. Standard statistical tests were used. A p value of less than 0.05 was taken as statistically significant. Results: Speech and Language delay was found in 42 out of 1658 children who attended the OPD. The risk factors found to be significant were seizure disorder ( P =< 0.001)), birth asphyxia ( P =0.019), oro-pharyngeal deformity ( P =0.012), multilingual family environment ( P =< 0.001), family history ( P =0.013), low paternal education ( P =0.008), low maternal education ( P =< 0.001), consanguinity ( P =< 0.001) and inadequate stimulation ( P =< 0.001). Conclusions: The prevalence of speech and language delay was 2.53%. and the medical risk factors were birth asphyxia, seizure disorder and oro-pharyngeal deformity. The familial causes were low parental education, consanguinity, positive family history, multilingual environment and inadequate stimulation.
A 12-day-old neonate presented with ill-defined dark pigmentation over the centrofacial area with flagellate pigmentation on the trunk and patchy pigmentation on the extremities. The mother had a history of fever starting a week before delivery and continuing for 3 days in the postpartum period. Together these led to consideration of a possible diagnosis of congenital chikungunya, which was confirmed according to the immunoglobulin M antibodies to chikungunya in the mother and child. The rare occurrence of cutaneous pigmentation was the only clue to the retrospective diagnosis of neonatal chikungunya. Chikungunya is an emerging viral disease that can be transmitted maternally during pregnancy and in the peripartum period. It can be added to the list of viral infections that can lead to fetal demise or, when present during labor and delivery, can cause neonatal disease with cutaneous signs.
Context:Majority of epilepsy begins in childhood. Twenty to thirty percent of patients may not respond to antiepileptic drugs. Yoga as a complementary therapy has been found to be beneficial in adults, but has not yet been studied in children with epilepsy.Aim:To study the effect of yoga on seizure and electroencephalogram (EEG) outcome in children with epilepsy.Setting and Design:A randomized controlled trial was conducted in the pediatric neurology outpatient department of a tertiary care teaching hospital.Materials and Methods:Twenty children aged 8–12 years with an unequivocal diagnosis of epilepsy on regular antiepileptic drugs were enrolled. Yoga therapy was provided to 10 children (study group) and 10 children formed the control group. Yoga therapy was given as 10 sessions of 1h each. We compared seizure frequency and EEG at baseline, 3, and 6 months. Statistical analysis was carried out using standard statistical tests. A P value of <0.05 was considered significant.Results:No children had seizures at the end of 3 and 6 months in the study group. In the control group, at 3 and 6 months, four and three children, respectively, had seizures. Eight children each in both the groups had an abnormal EEG at enrollment. At the end of 6 months, one EEG in the study group and seven in the control group were abnormal (P = 0.020).Conclusion:Yoga as an additional therapy in children with epilepsy leads to seizure freedom and significant improvement in EEG at 6 months.
In utero exposure to diclofenac may be associated with neonatal renal failure that may be transient or irreversible. We recommend that the use of diclofenac during pregnancy be avoided.
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