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Background: Neonatal seizure is a common neurological problem in the neonatal period with a frequency of 1.5 to 14/1000 neonates1. Neonatal seizures have always been a topic of particular interest because of their universal occurrence. A varied number of conditions are capable of causing seizures in the neonatal period. The presence of a seizure does not constitute a diagnosis but is a symptom of an underlying central nervous system disorder due to systemic or biochemical disturbances. This study aims to study the various clinical types of seizures and the biochemical abnormalities associated with them.Methods: This prospective study was conducted in the neonatology unit, department of pediatrics, C.S.I. Holdsworth Memorial Hospital, Mysore. Details of history, examination and investigations were recorded on predesigned proforma.Results: Out of total 54 cases, 47(87%) cases had seizures during first 3 days of life and hypoxic ischemic ' encephalopathy (HIE) remains the main etiological factor in 20 (37.04%) cases. More than one metabolic abnormality was present in 6 cases. Hypoglycemia & hypomagnesemia were the commonest abnormality in neonates having seizures.Conclusions: A biochemical work up is necessary for all cases of neonatal seizures. The type of seizure does not give much information as to whether the seizures are purely metabolic or organic or about the type of biochemical abnormality.
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Objective: To examine the validity of accelerometers for characterizing habitual physical activity patterns in Indian children. Design: Cohort study. Setting: Holdsworth Memorial Hospital, Mysore. Subjects: Children (N=103, mean age 6.6 years) selected from an ongoing birth cohort study. Methods: Physical activity was measured over 7 days using accelerometers (MTI Actigraph) and concurrent parent-maintained activity diaries. Actigraph counts per minute representing sedentary (<10), light (<400), moderate (<3000) and vigorous (≥3000) activity were determined using a structured activity session in a separate group of 10 children. In 46 children chosen for validating accelerometers, time spent in different activity levels according to diaries was determined. Energy Expenditure (EE) was calculated from diaries using a factorial method. Results: Ninety-eight children wore the monitor for ≥4 days. Total counts and time spent in different activity levels were similar in boys and girls (P>0.2). Among 46 children chosen for comparisons, time spent in sedentary (r =0.48, P=0.001), light (r=0.70, P<0.001) and moderate activities (r=0.29, P=0.054) according to diaries correlated with those derived from counts, and total Actigraph counts correlated with EE (r=0.42, P=0.004). Bland-Altman analysis showed systematic bias, and wide limits of agreement between these methods for time spent in different activity levels. Conclusions: Accelerometers are a well tolerated and objective way of measuring activity behavior in free-living children. Though accelerometer counts correlate with time spent in activity of varying intensity and energy expenditure derived from parent-maintained diaries, wide limits of agreement show that the limitations of accelerometers need to be recognized in interpreting the data that they generate.
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Background: Prevalence studies on Congenital heart Diseases (CHDs) have been done several times world wide and such studies are very limited in Indian populations. A few earlier studies in India have reported an increased prevalence of CHDs ranging from 2.25 to 50.89 per 1000 live births. Aims and Objective: To study the prevalence of congenital heart diseases in Indian population. Materials and Methods: Data on the prevalence of CHDs were collected and analyzed from the three major hospitals of Mysore, Cheluvamba Hospital, CSI Holdsworth Memorial Hospital and J.S.S Hospital from the year 2000 to 2004. Results: The prevalence of CHDs for five years in Mysore hospitals ranges from 6.6 to 13.06 per 1000 live births. The most frequent type of CHD was found to be VSD (40.47%) followed by ASD (19.06%), TOF (13.38%) and PDA (9.53%). It is clear that the maximum CHDs were detected in the first year of life when compared to the later years of life. The prevalence of CHDs in Mysore is increasing from 2000 to 2004 which might be due to the improvement of diagnosis, attention or awareness among the medical authorities on the disease. Conclusion: The prevalence of CHDs in Mysore is not very high as reported in other parts of the country, however; it is an important disease which needs an immediate medical attention.
ABSTRACT
OBJECTIVES: Muscle-thin but adipose ('thin-fat') body composition of south Asian adults contributes to their high risk of type 2 diabetes. Studies in Pune, India showed that this phenotype is present at birth. We aimed to determine if south Indian babies have a 'thin-fat' phenotype and if this persists in childhood. DESIGN: Prospective cohort study. SETTING: Holdsworth Memorial Hospital, Mysore, India. SUBJECTS: Children (n = 663) whose mothers were recruited from the antenatal clinics. METHODS: Weight, length, head, mid-upper-arm, abdominal circumferences; triceps and subscapular skinfolds were measured at birth, one and four years, and compared with white Caucasian babies born in Southampton, UK (birth), and UK and Dutch growth standards (one and four years). RESULTS: Mysore babies were lighter (2983 g vs 3472 g; -1.10 SD, CI -1.16, -1.02) and smaller in all body measurements than UK neonates (P < 0.001). The deficit was greatest for mid-upper-arm (-1.07 SD), head (-0.89 SD) and abdominal circumferences (-0.73 SD), and least for length (-0.25 SD) and subscapular skinfold thickness (-0.19 SD). Predictors of skinfold thickness were maternal body mass index (P < 0.001) and socio-economic status (P = 0.05). At four years, subscapular skinfold thickness was larger than UK (+0.18 SD, CI +0.11, +0.25; P < 0.001) and Dutch standards (+0.61 SD, CI +0.51, +0.71; P < 0.001), despite all other body measurements remaining smaller. Predictors of 4-year skinfold thickness were neonatal skinfold thickness (P = 0.001) and maternal insulin concentrations (P = 0.05). CONCLUSIONS: Mysore newborns have a 'thin-fat' phenotype. This may reflect the action of genes and/or the 'maternal environment'. The phenotype persists in childhood, and may be the forerunner of a diabetogenic adult phenotype.