Prevalence of Seizure Disorder in School Children in Kashmir

Seizure disorder is highly prevalent disorder particularly in developing countries. This study was undertaken to determine the prevalence of seizure disorder of school going children (6-16) years of age in all the six districts of Kashmir. Methods: The selection of schools was done by PPS (proportionate to population size) used in cluster survey. Questioner Performa was given to 60 randomly selected children from each selected school, 30 boys and 30 girls were screened to find out the prevalence of seizure disorder. To give adequate representation to all individuals of various strata both Govt and Private run schools from rural as well as urban areas were selected. Results: A total of 19 positive cases of epilepsy were detected during the survey period, After screening of 5760 children (rural and urban) the crude prevalence of epilepsy was found to be 3.3/ 1000 which is comparable to the other studies in the world. The Male prevalence in school going children was 3.8/1000 while female prevalence of epilepsy was 2.77/1000. Commonest type of seizure was generalized tonic clonic (GTC) 78.9%. Conclusion: The prevalence of seizure disorder in children of lower socio economic class was 3.5/1000.

Nosocomial sepsis-induced late onset thrombocytopenia in a neonatal tertiary care unit: a prospective study

Late onset sepsis [LOS] [onset of sepsis >72 hours of age or nosocomial sepsis] is an important cause of morbidity and mortality in the neonatal intensive care unit [NICU]. Thrombocytopenia is an important complication of sepsis. We investigated the incidence of thrombocytopenia in LOS patients and studied the influence of various parameters on platelet response. Infants born in the level 3 neonatal intensive care unit between January 2002 and December 2006 with documented LOS were included in this prospective study. Multiple hemograms with platelet counts, bacterial blood culture and fungal blood culture were obtained in all patients. Demographic and clinical data were compared between patients without thrombocytopenia and with mild, moderate and severe thrombocytopenia. Duration of thrombocytopenia in relation to type of organism and mortality with respect to degree of thrombocytopenia were also studied. Of 200 patients with culture-proven nosocomial sepsis, 119 [59.5%] patients developed thrombocytopenia [platelet count <150x10[9]/L]. In our series Klebsiella pneumoniae was the most frequently isolated organism [125/200, 62.5%] and the incidence of thrombocytopenia was 60.0% [75/125]. However, the incidence of thrombocytopenia was highest among patients who had concurrent bacterial and fungal sepsis [28/31, 90.3%] Coagulasenegative staphylococcal [CoNS] sepsis was present in 21 [10.5%] patients and the incidence of thrombocytopenia was 33.3%. Isolated fungal sepsis was present only in 6 [3%] patients and the incidence of thrombocytopenia was 66.0%. The incidence of thrombocytopenia was highest among preterm babies and low-birth weight [LBW] babies. Twenty-seven percent [54/200] of babies presented with mild thrombocytopenia, 20% [40/200] presented with moderate thrombocytopenia, and 12.5% [25/200] developed severe thrombocytopenia. Severity of thrombocytopenia was also directly related to the presence of necrotizing enterocolitis [NEC] and disseminated intravascular coagulation [DIC]. The mortality rate was significantly associated with the degree of thrombocytopenia. LOS sepsis is an important risk factor for thrombocytopenia in the NICU. Fungal and gram-negative sepsis are frequently associated with a decreased platelet count. Sepsis-induced thrombocytopenia is more common among LBW babies and preterm babies. The mortality rate is significantly related to degree of thrombocytopenia

Recurrent abdominal pain in children.

Eighty five children with recurrent abdominal pain(RAP) were studied. Organic cause was noticed in 70 cases and non-organic in 15 cases. Giardiasis was the commonest organic cause in 57 (67.0 percent), either alone or with other parasitic infestations. Other organic causes include gallstones (4.7 percent), urinary infections (4.7 percent), esophagitis/gastritis (3.5 percent) and abdominal tuberculosis (2.3 percent). Single parent, school phobia, sibling rivalry, RAP in other family members and nocturnal enuresis are significant factors associated with nonorganic causes