RÉSUMÉ
Background: Down syndrome occurs in people of all races and economic levels. Cardiac anomalies with a prevalence of about 50% are the most common anomaly responsible for death during the 1st two years of life in children with down syndrome. Objective of the study was to Assess the incidence and type of congenital heart disease in children with down syndrome presenting to a tertiary care hospital.Methods: Hospital based descriptive study. Participants: All children (0 to 18 years) diagnosed (clinically or on karyotyping) with Down syndrome, presenting in RNT Medical College, Udaipur Each patient was evaluated with a pre-set Performa which contained detailed sociodemographic profile, maternal and clinical history including age of conception, detailed physical examination to look for features of down syndrome. Degree of Intellectual / Developmental retardation was assessed by Vineland Social Maturity Scale. 2D- echo, karyotyping was done in all patient. CBC, thyroid profile, CXR, USG- abdomen, Invertogram were done as per need.Results: Out of 57 Down syndrome children, 32(56.1%) were males and 25(43.9%) were females. Congenital heart defect was found in 35 out of 57 Down syndrome children (61.4%). Among 35 cases 82.2% had Acyanotic CHD and 17.1% had Cyanotic CHD. Ventricular Septal defect (31.4%) was the most common Congenital heart defect followed by Atrial Septal defect in 20% cases. Trisomy 21 was observed among 94.7% cases.Conclusions: More than half of children with Down syndrome have congenital heart disease, mostly Acyanotic, more specifically VSD. Early screening and diagnosis re the key to avoid irreversible hemodynamic consequences.
RÉSUMÉ
Background: Fever is the most common complain of a child presenting to a health care setting. A prolonged fever however, is an intriguing challenge for clinicians and remains overly medicated and inappropriately worked up, provided a systemic approach is not followed. Our study aims to find the etiologic diagnosis in these cases of prolonged fever.
Methods: The present study was conducted in a tertiary care hospital in southern Rajasthan over a period of 12 months from November 2021 to October 2022. Our descriptive, observational study enrolled 150 children who were prospectively followed during their stay in hospital. Each patient was subjected to a set of mandatory investigations followed by other investigations as per the diagnostic clues. Patients were monitored closely during their course of stay until discharge, at which the final diagnosis was charted.
Results: A diagnosis could be reached for 138 patients (92%) and in 12 patients (8%), the cause of fever remained undiagnosed until discharge/death. Out of the 138 patients diagnosed, 118 patients (85.5%, 78.6% overall) had an infection as the cause of fever and 20 cases (14.49%,13.3% overall) had a non-infective etiology.
Conclusions: Infections are the most common cause of prolonged fever in pediatric population - tuberculosis being the most frequent infection. Hematological malignancies were found as an emerging cause of prolonged fever in our study.