ABSTRACT
Background: Fever, the most common complaint that led patients to seek healthcare, indicates an underlying infection which could either be simple self-limiting viral infections or life threatening bacterial infections. It's greatest challenge is the risk of occult bacteraemia, for which blood culture is the gold standard for the diagnosis. Objectives was to determine the proportion of blood culture positives among febrile children and to describe the bacteriological profile and antibiogram of blood culture isolates.Methods: A cross sectional study was done in the Department of Paediatrics and Microbiology, RIMS Hospital, Imphal. After obtaining consent (verbal assent in >7 years), blood culture samples were drawn from 200 children aged between 3 months to 12 years. The data was analysed using descriptive statistics. Chi square test was used and p-value of less than 0.05 taken as statistically significant.Results: Culture positivity was seen in 17 cases (8.5%) of which, participants who were less than 1 year of age and without proper immunisation record showed the highest positivity rate. It was higher in fever with localizing signs (9.2%) than those with fever without focus (7.8%). Gram positives constituted 11 (64.7%) of the isolates while 35.3% were Gram negatives. Staphylococcus aureus was the only Gram positive isolate. Of them, 4 were MRSA but all the strains were sensitive to Vancomycin and Linezolid. The most common Gram negative isolate was Acinetobacter spp and 80% of them were sensitive to Aminoglycosides while most of the Gram negatives were resistant to Ampicillin and 3rd generation Cephalosporins. All Acinetobacter spp were sensitive to Carbapenems but the only Pseudomonas spp isolated was sensitive only to Colistin.Conclusions: Blood culture positivity rate is relatively low in this study. However, studies with larger sample sizes are recommended to validate the findings. We emphasise the need for antibiotic stewardship
ABSTRACT
Background: Wheezing is common throughout infancy and childhood except in the neonatal period where it is relatively rare. By 10 years of age, about 19% of children experience wheezing with an average onset at 3 years of age. This study was aimed to identify the diverse factors associated with wheezing in children aged 2 months to 60 months and to study clinical profile along with short term outcome of the same.Methods: It was a hospital based cross-sectional study carried out in the Department of Paediatrics, Regional Institute of Medical Sciences Hospital (RIMS), Imphal, Manipur. The Study population consisted of randomly selected 131 children aged 2 months to 60 months who were admitted in Paediatrics ward with the symptom of wheezing.Results: Authors found that age below 12 months, male sex, low socioeconomic conditions and artificial breastfeeding practices were important risk factors for wheeze.Conclusions: Wheezing is accountable for a high demand of medical consultations and emergency care services with relatively high rates of hospitalization. Along with ARI, it plays an important role in infant mortality. In Manipur, it is being observed that increasing number of children with wheezing are attended by paediatricians in ED, OPD and ward, thereby proving an added burden to the younger age group. Therefore proper health education and counselling of parents, promotion of exclusive breast feeding and improvement of socioeconomic status can play a vital role in preventing occurrence of wheeze among the children.
ABSTRACT
Hypothalamic Hamartoma (HH) may have diverse clinical manifestations. Its hallmark association is with gelastic seizures. Gelastic epilepsy is characterized by episodes of loud, hollow, mirthless, stereo-typed, forced laughter. The patient may stare and giggle briefly without any other motor manifestations. Hypothalamic hamartoma is most often the cause of gelastic seizures. Here, authors report a case of gelastic seizure with hypothalamic hamartoma in a 14-month-old boy with an associated tonic clonic seizure.' This case highlights the possibility of underdiagnosed hypothalamic hamartoma in younger age groups among pediatric population.