ABSTRACT
Seizures can be defined as transient alteration in consciousness which generally manifests as specific behavioral and motor activity. Seizures are one of the common causes of admissions to pediatric intensive care units. Though seizures can start at any age and no age is an exemption to the onset of seizures, it usually occurs in early childhood or late adulthood. We undertook this prospective study to analyze clinical presentation and etiological profile of children presenting with first onset seizures before 12 years of age. Methods: This was a prospective study in which children between the age group of 1-12 years and presenting with new onset seizures were included on the basis of a predefined inclusion and exclusion criteria. Detailed history was taken and through clinical examination was done in all the cases. Routine investigations such as complete blood count, serum electrolytes and random blood sugar was done in all the cases. Neuroimaging was done in selected cases. SSPS 21.0 software was used for statistical analysis. Results: Out of 60 cases there were 34 boys (56.67%) and 26 girls (43.33%) with a M:F ratio of 1:0.76. Most common affected age group was less than 5 years of age (40%) followed by 5-8 years (35%) and 9-12 years (25%). Most common type of seizures seen in studied cases were generalized tonic clonic seizures which were seen in 45 (75%) cases followed by generalized tonic seizures which were seen in 10 (16.67%) cases. After convulsions lethargy was found to be the most common accompanying clinical feature in studied cases which was seen in 27 (45%) patients. most common cause of convulsions in the studied cases was febrile seizures which was seen in 22 (36.67%) patients followed by pyogenic meningitis (20%) and cerebral palsy (11.67%). EEG and Neuroimaging abnormalities were seen in 12 (20) and 14 (25%) patients respectively. Conclusion: Seizures are one of the common emergencies faced by pediatricians. Its correct etiological diagnosis is important from the point of view of proper management.
ABSTRACT
Background:Polyhydramnios is diagnosed if on ultrasound the deepest vertical pocket is more than 8 cm or amniotic fluid index (AFI) is more than 95th percentile for the corresponding gestational age. Approximately 0.5%-1.5% are complicated by polyhydramnios. Polyhydramnios adversely affect fetomaternal outcome in many cases hence it is important to diagnose it in time so that further evaluation and appropriate management steps can be taken. Methods: This was a prospective observational study comprising of 60 pregnant women included in this study on the basis of a predefined inclusion and exclusion criteria. A detailed history was taken in all the cases and detailed clinical examination was done. Polyhydramnios was diagnosed on the basis of amniotic fluid index. Presence of fetal anomalies detected on antenatal ultrasound were noted. Postnatally a pediatrician examined all the newborn babies and presence of any congenital anomaly was also noted. Maternal and fetal complications were studied. Perinatal and neonatal mortality and its causes were analyzed. Data analysis was carried out using Minitab 17 version software. Result: Amongst the studied cases 34 (56.67%) patients were primigravida while rest of the patients were multigravida (43.33%). Mean age of the patients was found to be 26.15 +/- 5.07 years. The risk factors such as maternal anemia, pre-eclampsia, gestational diabetes and Rh isoimmunization was present in 9 (15 %), 8 (13.33%), 6 (10%) and 5 (8.33%) patients respectively. No identifiable risk factor was found in 32 cases. Most of the patient diagnosed with polyhydramnios were between 37-42 weeks (76.67%). The most common gestational age when congenital anomalies were detected was between 27-42 weeks (20%). Fetal congenital anomalies were seen in 11 (18.33%) patients. Maternal complications were seen in 27 patients (55%). There was no maternal mortality in any case. Perinatal deaths were seen in 8 cases while Neonatal Deaths (excluding deaths in perinatal period) were seen in 4 cases. Conclusion: Polyhydramnios adversely affect fetomaternal outcome. Moreover, there is increased incidence of congenital anomalies in cases with polyhydramnios. Proper antenatal diagnoses of these congenital anomalies is essential part of management and helps prospective parents in taking informed decision.