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1.
Pakistan Journal of Medical Sciences. 2018; 34 (6): 1424-1428
em Inglês | IMEMR | ID: emr-201988

RESUMO

Background and Objective: Infantile spasm [IS] is one of the severe epileptic encephalopathies which affect children in early two years of life. Our objective was to determine the clinical profile, etiology and outcome of treatment in children with infantile spasms attending tertiary care hospital at Karachi, Pakistan


Methods: This is retrospective study of 36 patients out of 94 registered as IS, aged three months to two years, managed and followed up at Aga Khan University Hospital, Karachi, from 2010 to 2015. Data of all children with IS was collected from case record. Details including clinical observations, lab investigations, anti-epileptic medications and treatment outcome was collected and analyzed. Patients who received treatment for six weeks to document response were included. The treatment response was categorized as complete response, partial response [>50% improvement] and no response. Data was analyzed on SPSS using descriptive statistics


Results: Thirty-six patients [38.29%] with IS fulfilled eligibility criteria. The mean +/- SD age at presentation was 4.6 +/- 2.1 months. Male to female ratio was 2:1. Consanguinity and developmental motor delay was observed in 66.6% and 89% respectively. Symptomatic etiology was predominant [61%] and hypoxic ischemic insult [32%] was the commonest underlying cause. EEG and MRI were diagnostic tools whereas metabolic studies were not helpful. Multiple antiepileptic drugs were used for seizure control and vigabatrin was the most frequently used [88%] drug. Short term treatment response was not different in idiopathic or symptomatic infantile spasms


Conclusion: Majority of patients had symptomatic infantile spasms and generalized tonic clonic along with myoclonic jerks were predominant seizure types. EEG and MRI were diagnostic in most of cases. Multiple AEDs were required to control seizures and VGB was most common drug [88%] used. Treatment outcome was not different in idiopathic and symptomatic groups

2.
JCPSP-Journal of the College of Physicians and Surgeons Pakistan. 2015; 25 (4): 301-303
em Inglês | IMEMR | ID: emr-191604

RESUMO

The aim of this study was to describe clinical profiles and outcomes of children admitted directly from the Emergency Room [ER] to the Pediatric Intensive Care Unit [PICU] of academic hospital. The medical records of all children [1 month to 16 years] admitted in PICU from ER, from January 2011 to December 2012 were reviewed. Of the 26, 774 patients seen in the ER during the study period, 468 [1.7%] were admitted to the PICU which constituted about 41.5% [468/1127] of all the total PICU admissions. Sixty three percent [n=294] were under-five; males were 60.9% [285], 82.3% [385] were in medical category. Neurological and respiratory illnesses were the most common groups [> 50% of all ER admissions]. Multi-organ dysfunction syndrome and co-morbidity were present in 25.2% [n=118] and 23.5% [n=110] respectively. The mean length of stay was 5 +/- 3.7 hours. The case-fatality rate was 20.3% [n=95] as compared to the overall PICU mortality rate of 11.9% [n=135]. Key Words: Pediatric intensive care unit [PICU]. Emergency room [ER]. Children. Outcome.

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