ABSTRACT
Objective: To assess clinical profile and short term treatmentoutcomes of pediatric status epilepticus (SE) at a tertiary-carecenter in northern India.Methods: Prospective cohort study enrolled children aged 1month to 18 years presenting with SE to the emergencydepartment. Enrolled children (109) were treated as per hospitalprotocols. Clinical features during hospitalization were noted.Pediatric overall performance category (POPC) scale was usedfor classification of outcome at the time of discharge.Results: Acute symptomatic etiology was identified in 66(60.6%) cases (CNS infections were predominant). Previousdiagnosis of epilepsy was found in 32 (29.4%) children; andbenzodiazepine responsive SE were seen in 65 (59.6%)children. Predictors of unfavorable outcome were acutesymptomatic etiology (adjusted OR 4.50; 95% CI 1.49, 13.62) andno treatment administered prior to hospital (adjusted OR 3.97;95% CI 1.06, 14.81).Conclusions: Acute symptomatic etiology, mainly acute CNSinfections, is the leading cause of SE in this region. Early and pre-hospital management with benzodiazepines may improve SEoutcome.
ABSTRACT
Objectives: To study the magnitude and pattern of injuries in children with epilepsy. Methods: This prospective cohort study enrolled children with epilepsy (CWE) aged 2-16 years on treatment with anti-epileptics for a minimum duration of one-month and compared them with their own siblings (controls). A semi-structured questionnaire was used to enquire about epilepsy and type and frequency of injuries sustained at monthly follow-up visits. Participants were followed up for 12-months for occurrence of injuries. Results: 208 cases and 212 controls were analyzed. 21 cases (10.1%) and 10 controls (4.7%) had sustained injuries (P=0.03) (RR 2.1; 95% CI, 1.0 - 4.4). Seizure-related injuries were present in 4.3% of cases. Conclusion: Children with epilepsy are at an increased risk of injuries and hence need supervision.
ABSTRACT
Background: In the present study we have done a retrospective as well as prospective studies of patients with carcinoma anorectum undergoing abdominoperineal resection with special emphasis on the role of adjuvant treatment regimens as a complement to surgery. Methods: 75 patients operated for APR were studied retrospectively and 25 patients operated for the same were studied prospectively. Results: It was observed that colorectal cancer is the most common malignancy of the gastrointestinal tract. Rectum remains the most common site affected by it. Carcinoma anal canal is about one tenth as common as rectal cancer. Adjuvant treatment after surgery was studied with respect to the indications, the schedules followed and the subsequent complications. Conclusion: It was concluded that adjuvant treatment, in the form of Radiotherapy and Chemotherapy, has a definitive role in, both locally advanced Carcinoma Anorectum and for Dukes' C stage but it has its own complications which need to be addressed. Nigro's chemoradiation regimen has become the first choice for carcinoma anal canal, ahead of APR.
ABSTRACT
This record review of 82 children with Down Syndrome (DS) between April 2004 and March 2014 who had thyroid dysfunction, showed that majority (76, 92.6%) had subclinical hypothyroidism. Of the 60 patients who underwent radionuclide scan, 63.3% had a normal gland; the rest exhibited only impaired tracer uptake. Ultrasonograms done in 20 patients showed reduction of thyroid gland size in 3 (15%) patients only.