RESUMO
Background: Seizure is a commonly encountered problem in pediatric practice. Convulsive disorder constitutes a heterogeneous group with a varied etiology. Arriving at the cause of seizure is important as it plays a vital role in managing the child. Chances of recurrence to be analyzed, after the first episode of seizure for management. The aim was to study the etiology and the causes of recurrence after a first episode seizure.Methods: A prospective observational study was done on 135 children for a period of two months admitted in tertiary care center. Proper history, complete neurological and other systemic examinations was done. Blood investigations and imaging with EEG was done when indicated. All children were classified according to International League against epilepsy and followed up for recurrence rate and history leading to recurrence. Co- relation between recurrence and risk factors was analyzed.Results: Electroencephalogram tracing was abnormal in 62 out of 105 children. 19 out of 62 had recurrence while only 2 among 43 normal EEG had recurrence. This was statistically significant (P value 0.001). Children with remote symptomatic etiology constitutes the majority in those with abnormal EEG tracings. In children with remote symptomatic etiology, only one child had normal EEG. Remote symptomatic had higher number of abnormal EEG when compared to others and was found to have more recurrence.Conclusions: Children with EEG abnormalities after the first episode of afebrile seizure have more chance of recurrence. Children with seizure secondary to remote symptomatic etiology had more recurrences.
RESUMO
Background: Asthma is a chronic inflammatory disease of the lung airways resulting in episodic airflow obstruction. Management of acute pediatric asthma depends on assessment of asthma severity which is difficult in children due to poor coordination. This study is to evaluate the usefulness of a simple yet effective alternative like Pediatric respiratory assessment measure (PRAM) score in assessing the severity and outcome of an acute exacerbation of wheeze in children and to identify the PRAM score predicting the need for hospitalization.Methods: A prospective cohort study was done on 127 children for a period of 2 months in 2018, admitted with acute exacerbation of wheeze using PRAM scores at admission and following each treatment modalities. Usefulness of score in assessing severity was evaluated.Results: Increasing severity was associated with increasing initial PRAM score. Initial mean PRAM score of 11 in severe persistent forms, 7 in moderate persistent, 6.73 in mild persistent and 5.37 in mild intermittent was found. 59.1% of patients had a positive family history. The most common trigger factor according to our study was viral upper respiratory tract infection (50.4%) followed by exposure to dust (13.4%). Patients who were admitted to the Pediatric Intensive Care Unit (PICU) had the maximum number of interventions.Conclusions: In our study, statistically it was proved that PRAM Score is a tool that can be used across different ages and PRAM Score is a tool that can be used to assess severity of asthma.