ABSTRACT
TB remains a leading cause of morbidity and mortality in developing countries. The incidence of congenital TB is underestimated. Current recommendations regarding the management of neonates of mothers with tuberculosis are variable and no tangible guidelines have been advised. Congenital TB is fatal if untreated, moreover the mortality and morbidity is increased if the diagnosis and treatment is delayed. Therefore, the treating clinician should be aware of the unusual presentation of congenital TB. A high suspicion and good screening of mothers and neonates is of paramount importance. Congenital tuberculosis is diagnosed by Cantwell criteria. Isoniazid prophylaxis for 6 months is recommended in neonates born to mothers with TB who are infectious. Breastfeeding should be continued, and isolation is recommended only in certain circumstances such as mother is infectious, has multidrug resistant tuberculosis or non-adherent to treatment. BCG vaccine is recommended in all neonates however, the timing of administration varies according to various guidelines. Neonate diagnosed with congenital TB should be treated with anti-tubercular drug regimen.
ABSTRACT
Background: Febrile seizures (FS) are the commonest cause of seizures in children, with 2-5% of neurologically healthy children experiencing at least 1 episode. Iron deficiency is reported to be one of the most prevalent nutritional problems in the world today, especially in developing countries, with an estimated 46%-66% people affected. Our study is an attempt to clarify the relation between iron deficiency and first febrile seizure.Methods: The present study was a case control study carried from December 2016 till June 2018 in a tertiary care hospital at Aurangabad, Maharashtra, India. The study was done after obtaining approval from Institutional ethical Committee.Results: 77 cases and equal number of controls were included. Males were most commonly affected (>50%) as compared to females in both groups. Highest number of cases and controls were in the age group 0.5 to 1 year group, followed by 1-2 and 2-3 years group. Upper respiratory tract infection was most common etiological factor. Anemia (Hb<11 gm/dl) was seen in in 84% of the cases and 65% of the controls. Serum iron and total iron binding capacity (TIBC) was reduced in cases as compared to controls and this difference was highly statistically significant.Conclusions: Iron deficiency is a modifiable risk factor for first episode of febrile seizures in Indian children of age group 6 months to 5 years its early detection and timely correction may be an important determinant for prevention of febrile seizure in children.