Serum ferritin levels in children of simple febrile seizures in tertiary institute

Background: Seizure onset is impacted by a number of variables, including genetics, diet, geography, concurrent illnesses, metabolic state, history of head trauma, and blood levels of particular minerals. Due to the fact that iron is required for the proper functioning of a number of enzymes and neurotransmitters in the central nervous system, low blood ferritin levels may lower the seizure threshold. The aim of the study was to determine the association between serum ferritin levels and simple febrile seizures.Methods: The present observational study was conducted in department of pediatrics of a tertiary institute and included a total of 200 study subjects who visited to pediatric OPD/emergency room with febrile illness. The data was collected with the help of a structured clinical proforma. The collected data was recorded in Microsoft Excel sheet and statistical analysis was done with the help of SPSS version 21.0.Results: In our study, the maximum number of the study subjects were between 13 and 24 months (35%) with male to female ratio 1.2:1. In patients with simple febrile seizure the mean Hb level was 9.1�4 gm/dl, the mean MCV was 72.6�4 f1, mean MCH was 23.73�2 pg and mean serum ferritin was 13.4�5 ng/ml as compared to those patients with febrile illness without seizure the mean Hb level was 11.5�2 gm/dl, mean MCV was 82.1�5 f1, mean MCH was 29.6�9 pg and mean serum ferritin was 33.6�.2 ng/ml.Conclusions: It is concluded that the low serum ferritin level is a risk factor of simple febrile seizure.

Cutaneous findings in neonates and their socio-demographic profile: a prospective observational study

Background: A wide range of disorders can manifest as skin lesions due to the great difficulty the skin encounters while transitioning from an aqueous to a dry environment in a neonate. Among the skin conditions commonly seen in neonates are temporary benign lesions, atopic dermatitis (and associated disorders), bullous dermatoses. Aim was to study the various patterns of skin lesions in neonates and to estimate the prevalence of physiological and pathological skin lesions.Methods: This prospective observational study was conducted in the department of pediatrics at Acharya Shri Chander College of Medical Sciences and Hospital (ASCOMS) a tertiary care hospital in Jammu. A total of 300 neonates (day 1 to day 28 of life) and having any skin lesions or manifestations born at the hospital or visiting out patient抯 department were included in the study. The data collected was compiled on excel sheet and was analyzed statistically by using statistical package for the social sciences (SPSS) software version 21.0.Results: It was found that the most of the skin manifestations were observed in neonates born to multiparous mothers at term gestation and having average weight. The male to female ratio was 1.3:1. The frequency of the cutaneous manifestations were seen more in neonates born via the caesarean section.Conclusions: It is concluded that the most common skin lesion was erythema toxicum followed by icterus neonatorum.

Parental perception of neonatal care in urban slums of Jammu city

Background: India is undergoing rapid urbanization and many rural residents relocate to urban regions in search of employment, better living conditions and access to education and health care facilities. Neonatal morbidity and mortality are attributed to misperceptions in the community about newborn care. In many parts of urban slums in India, care seeking from multiple providers and use of traditional/home remedies hampered appropriate and timely medical care seeking. Aim was to study awareness, knowledge and practice of newborn care among postnatal mothers in Urban slums of Jammu city.Methods: This observational study was conducted in Urban slums of Jammu city. A total of 100 mothers of newborns residing in urban slums participated in the study after taking Informed Consent from them. A self-structured proforma was used to collect data.Results: Most of the deliveries were conducted in hospital (82%) and 18% were home deliveries. Regarding newborn care practices 88 % had wrapped the newborn with clean cloth immediately after birth. 58% of newborns were given first bath within 2-7 days. 39% of mothers-initiated breast feeding within 6-24 hours. Majority (68%) newborns were fed with colostrum. Regarding cord cutting procedures among home deliveries, it was observed that clean blade was used in 15 newborns while in 3 cases aseptic practice for cord cutting was not followed.Conclusions: Good newborn practices like promotion of warmth, cord care, hygiene and early breastfeeding should be the main focus of community-based health workers. The present study concluded that some unhealthy neonatal care practices were still found to be prevalent which can be mitigated by increasing awareness among parents through IEC activities.

Umbilical hernia in pediatric patients attending outpatient department in tertiary care centre

Background: Umbilical hernias are estimated to affect 15% of children. Age, race, gestational age, and coexisting disorders are some of the variables that affect it. In comparison to the general population, there are greater incidences of connective tissue illnesses in children, premature delivery, low birth weight, syndromic newborns, black children, and children with pathologies that raise intraabdominal pressure. To determine the prevalence and to assess the risk factors of umbilical hernia in pediatric patients attending outpatient department (OPD) in tertiary care centre.Methods: The present observational study was conducted in paediatric OPD, of a tertiary care centre over a period of one year. A total of 100 study subjects were enrolled with suspected umbilical hernia. The data was collected with the help of a structured clinical proforma and analysed with SPSS version 20.0.Results: In our study the most prevalent age group involved being 0-1 years (6%) followed by 8-10 years (3%) and 2-4 years (2%). Umbilical hernia was seen more in males (64%) than females. Low birth weight (81%), premature delivery (54.54%), and undernutrition (90.9%) were the risk factors that were observed to be associated with the development of umbilical hernia.Conclusions: The study concluded that the overall prevalence of umbilical hernia was 11% and the associated risk factors were premature delivery, low birth weight and poor nutrition.

Neurotuberculosis as a Cause of Obesity.

Childhood obesity, taking the form of pandemic in the present era owing to the food habits, lifestyle etc, is the main cause of adult onset diseases. Obesity is the major risk factor for insulin resistance and diabetes, hypertension, cancer, gall bladder disease, and atherosclerosis in adulthood. Obesity being multi-factorial various genetic, anatomic, environmental factors are implicated to its etiognesis. While evaluating the causes of obesity in a child, in addition to the common causes, diseases involving hypothalamus should not be overlooked. We are discussing here a 9 year male child who reported to us for obesity and neurotuberculosis as the etiology was established.

Colloidion Baby.

A two day old male baby, third issue of a second degree consanguineously married couple with clinical features of colloidion baby is being presented. Early recognition of this clinical entity and early institution of appropriate therapy can definitely reduce morbidity and mortality in neonates.

Pattern of Congenital Anomalies in Newborn : A Hospital Based Prospective Study.

This hospital based prospective descriptive study highlights the point prevlance of congenital anomalies in one year. The number of congenital anomalies were more in males (M: F = 1.6:1.4), in neonates of young (= 20 years) and elderly mothers (= 35 years). The pattern of congenital anomalies included musculoskeletal (30.6%), CNS (20.5%), GIT (18.5%), skin (7.6%), genitourinary (4.7%), CVS (4%) etc. In musculoskeletal group, telipes was most common malformation followed by spinabifida and polydactyly. In CNS, group meningomyeleceole was the most common malformation followed by anencephaly and hydrocephalus. Frequency of congenital anomalies were more common in muslims as compared to hindus (1.77% vs. 1.4%), in cesarean born babies as compared to vaginally delivered (1.96% vs. 1.48%), in LBW babies (4.95%) and still born as compared to live born babies (4.46% vs. 1.39%). Present study stress upon the importance to carrying out a thorough clinical examination of neonate at birth.

Bilateral Pulmonary Cyst in a Child.

A four year old male child presented with history of cough for last six months. Chest skiagram and CT scan of mediastinum revealed bilateral pulmonary hydatid cyst. Serology did authenticate diagnosis. The child was prescribed albendazole for 6 months and was advised to come for follow up. The case of bilateral pulmonary hydatid cyst is being presentated because of rarity.

Turner Syndrome

Turner Syndrome is one of the important chromosomal disorders characterised by loss (total or part) of sex chromosome. The manifestations being peripheral edema, short stature, extra skin fold, webbing of neck, renal and cardiovascular anomalies, sexual infantilism, learning disability etc. We present here a one month female baby who had classical features of Turner Syndrome. The karyotape analysis was consistent with the diagnosis.

Sturge Weber Disease in a Child

Sturge Weber Disease is one of the important neurocutaneous syndrome characterized by abnormities of both the integument and central nervous system. We present here a classical case of Sturge Weber Disease. This 16 month male child had facial angioma and seizures. CT Scan head was consistent with the diagnosis.

Clinical Profile of Pica in Childhood

The various aspects of clinical profile in 200 children (18 months to 10 years) with pica have been highlighted. There was a definite male predominance and majority of children belonged to 2– 4 year age group. Direct history of pica was given by 32% mothers. Cough, pain abdomen, poor appetite, increasing pallor, abdominal fullness etc were other presenting features. Clay, sand, mud, plaster, uncooked rice, paper, clothes etc were material used for pica. Intestinal parasites were quite common

Tuberous Sclerosis in a Child

Tuberous sclerosis is one of the important neurocutaneous syndrome chracterized by abnormalities of both the integument and central nervous system. We present here a classical case of tuberous sclerosis. This is a three year female child who had myoclonic seizures, delayed milestones and had hypopigmented skin lesions. MRI brain and EEG were consistent with the diagnosis.

Home Related Accidents During Infancy

A profile of two hundred infants who had met with an accident at home was studied. The most common type of accident observed was fall (53%). The fall was either from walker, furniture/bed, stairs, roof and from attendant's lap. Injuries due to sharp edge instruments (23%) aspiration of parts of toys, marbles, coins (11%), burns / scalds (9%) etc. were other type of accidents encountered. Most of the accidents occurred between 9 AM to 9 PM.

Recurrent Abdominal Pain in Preschool Children

One hundred fifty preschool children with recurrent abdominal pain (RAP) were studied. Organic cause was observed in 135 (90%) and non-organic in 15 (10%). Giardiasis was the commonest organic cause in 81 (60%) either alone or with other parasites followed by ascariasis 27 (20%) alone. Other cause of organic pain were urinary tract infection (UTI) 9 (6.7%), abdominal tuberculosis 9 (6.7%), eosophagitis/gastritis 4 (2.9%) and gall stones 2 (1.4%). School phobia, sibling rivalry, unpleasant relations among parents and nocturnal enuresis were significant factors associated with non-organic causes.