Study the iron status in children with febrile seizures: a hospital based cross sectional study

Background: Febrile seizures are most common among childhood seizures, accounts to 2% to 5% in children below 5 years of age. Iron deficiency can cause many neurological deficits and may lower the seizure threshold. The present study was conducted to determine the iron status in children with febrile seizures.Methods: The present cross-sectional study was conducted in the Department of Pediatrics, HIMS, Dehradun, over a period of 12 month from January 2018 to December 2018. A total of 105 children of age group 6 month to 5 years, coming to pediatrics department were included in the study. Total study subjects were divided into two groups, Group I (febrile seizure) and Group II (other than febrile seizure).  A consecutive sampling method was done for selection of study subjects.Results: In Group I (febrile seizure), the number of males were 71.7% while females were 28.3% with male: female ratio of 2.5:1. In Group I (febrile seizure), 61.7% of subjects had deficient iron level while 38.3% of subjects had normal serum iron level. Our study shows significantly low mean serum ferritin and mean serum iron level in subjects with febrile seizures.Conclusions: We concluded that iron deficiency is more common in febrile seizures and there is a positive association between serum iron level and febrile seizures.

Quality of prescriptions in hospitalized children suffering from acute and persistent diarrhoea

Background: Diarrhoea is a major public health problem in children worldwide. It continues to be a major health challenge, especially in developing countries, despite the availability of regularly updated standard treatment guidelines. Non-compliance to such guidelines by the physicians has been a long standing story. The treatment is often marred with incapacitating prescription of drugs besides neglecting even the basic tenets of good prescribing. As a result, the quality of such prescriptions for diarrhoeal disorders in children remains poor. To gauge the magnitude of this problem in this setup towards possible corrective measures, the study was aimed to audit prescription practices in the management of acute and persistent diarrhoea in hospitalised children up to five years of age.Methods: An observational study was conducted in 100 patients of either gender in the age group up to 5 years admitted with acute and persistent diarrhoea. A detailed medical history from the parents/guardians and the details of prescription from the time of admission till the discharge of the patient were obtained. Quality of prescriptions was analysed using prescription quality index (PQI) tool, a validated comprehensive tool described by Hassan et al in 2010. Based on this tool, prescription with the total PQI score of ? 31 were interpreted as poor quality, scores with 32 to 33 as medium quality and scores 34 to 43 as high quality with a possible maximum score of ��.Results: Based on the PQI tool for 100 children, 60 prescriptions were found to be of poor quality. Only 2 prescriptions were of medium quality, whereas 38 prescriptions were in high quality range. Average mean盨D score of prescriptions with poor quality was 25.2�48, ranging from 21 to 31. The mean盨D of prescriptions with medium quality was observed to be 32�and for prescriptions of high quality was 38.07�28. The total average mean score of all prescriptions was 30.23�50. Poor quality prescriptions were particularly observed for the patients with the diarrhoea with No dehydration.Conclusions: Prescription appropriateness in spite of available guidelines continues to be a big challenge in the adequate management of patients with diarrhoeal disorders under the age group of five years in a tertiary care centre in India.

Clinico-epidemiological profile of hepatitis A virus and hepatitis E virus co-infection in pediatric age group: a hospital based retrospective study

Background: Hepatitis-A virus (HAV) and Hepatitis E virus (HEV) are two major hepatotropic viruses of great public health importance in the developing countries like India. Both HAV and HEV are enterically transmitted and there are speculations that their co-infection might be associated with a more severe clinical course and increased rate of mortality. The objective of this study is to determine the prevalence, clinical features and biochemical parameters of Hepatitis A and Hepatitis E co-infection in hospitalized patients at a tertiary care centre in Uttarakhand.Methods: It is a retrospective study, covering a period of 4years and conducted in Himalayan Institute of Medical Sciences, SRHU Jolly Grant, Dehradun. Records of the patients with Hepatitis A and Hepatitis E co-infection were retrieved and analyzed.Results: Out of total 125 patients of acute viral hepatitis, 13 patients had HAV and HEV co-infection. 100% of the patients with co-infection presented with complaints of fever and jaundice, followed by 76.92% with vomiting, 69.23% with pruritis, 61.53% with pain in abdomen and 23.07% with altered sensorium. Mean Bilirubin, ALT, AST were 8.69'7.27 mg/dl, 2030.69'1726.93IU/L and 1880.07'1881.11IU/L respectively. Average duration of stay was 8.2 days. Encephalopathy was seen in 2 patients. However, no mortality was reported.Conclusions: Co-infection of HAV and HEV is not rare in pediatric age group. Knowledge about this will be of immense help for planning of future vaccination strategies and for better sanitation program in developing countries like India.

Megaloblastic anaemia in hospitalised children.

Objective: To study the profile of megaloblastic anaemia in hospitalised children. Study design: Prospective study. Setting: Tertiary care hospital in Uttarakhand. Subjects: 53 children between 6 months and 14 years of age were studied for megaloblastic anaemia. Result: Majority of patients (48.8%) were in the older age group, and only 11% were seen in infancy. Folate and vit B12 deficiency was seen in 55% and 88% cases respectively. 44% had combined deficiency of folate and vitamin B12.11% had pure folate and 44% had pure vitamin B12 deficiency. 66% cases with microcytic blood picture, 70%with dimorphic picture, and 90% of pancytopenia patients on marrow examination had a megaloblastic picture. 60% had malnutrition, and majority belonged to the lower socio-economic strata of society.

Aphallia:A Rare Congenital Anomaly.

Aphallia or absence of penis is a very rare congenital anomaly. Clinical presentation is diagnostic, but immediate and long term management poses great dilemma. The issue like gender reassignment needs parental counseling. Due to social reasons parents have difficulty in giving consent for the classical management of gender reassignment. However with better penile reconstruction techniques, now there is hope for such parents who want to bring up their child as a boy.We present such a rare case with associated dilemmas.

Female Epispadias

Female epispadias is a rare congenital anomaly occuring in 1 in 484,0000 female population. Clinical course, management is discussed in the present case report to stress upon careful diagnosis and to decrease chances of mismanagement in highly morbid condition “urinary incontinence”.