Risk Factors of First Episode Simple Febrile Seizures in Children Aged 6 Month to 5 Year: A Case Control Study

Objective: To study the risk factors of first episode simple febrile seizures in children. Methods: This case control study was conducted at the pediatric department of our tertiary care hospital. Cases were children of age group 6 months to 5 years presenting with first simple febrile seizures (n=214), and Controls were children of same age group presenting with short febrile illness but without any seizures (n=214). Blood investigations were done to diagnose iron deficiency, which was diagnosed by adopting cut off of hemoglobin value <11 g/dL, serum ferritin < 12 ng/mL and red cell distribution width >15%. Other risk factors studied included age, gender, socioeconomic status, prematurity, family history of febrile seizure and epilepsy in first degree relatives, consanguinity, neonatal hospital admissions, day care attendance (for >1 mo), under nutrition, and immunization status of the child. Univariate analysis for crude odds ratio and multivariate analysis (logistic regression) was performed to study the adjusted odds ratio and independent risk factors. Results: The significant risk factors for first episode simple febrile seizure were iron deficiency [OR (95% CI) 5.78 (3.56-9.38); P=0.001], family history of febrile seizure [OR 4.31 (2.37- 7.83), P<0.001] or epilepsy [OR 4.25(2.21-8.19), P<0.001] in first degree relatives, day care attendance for >1 month [OR 4.81 (2.41-9.59), P<0.001], and prematurity at birth [OR 5.18 (2.48-10.84), P<0.001]. Conclusion: Iron deficiency, family history of febrile seizure and epilepsy in first degree relatives, day care attendance and premature birth are the risk factors for first episode simple febrile seizures in children.

Safety-pin Induced Hemopericardium and Cardiac Tamponade in an Infant

Background: Safety-pin ingestion causing cardiovascular complications are very rarewith high risk for mortality. Case characteristics: A 10-month-old child who presentedwith persistent irritability and intermittent fever of 1 month duration. The child hadtachypnea and mild subcostal retractions. Observation: Investigations revealed opensafety-pin in lower esophagus, and pericardial effusion that later progressed to cardiactamponade during handling of the safety pin by endoscope. Message: It may be safer todrain pericardial collection before handling sharp foreign bodies in lower end of esophagusas it can worsen cardiac complications.