Clinical profile, etiological factors and outcome of children with status epilepticus admitted in tertiary hospital: a prospective study

Background: Status epilepticus (SE) is a medical emergency, and its neurological outcome is a concern to every pediatrician in developing countries. The incidence of convulsive SE in children is approximately 10�/100,000 per year, with the highest incidence in children less than one year of age. Approximately 30% of patients presenting with status epilepticus are having their first seizure. The objective of the study is to evaluate the clinical and etiological pattern of SE and its outcome in children admitted to PICU.Methods: This was a prospective study conducted among 50 patients aged 1 month to 12 years presenting with status epilepticus. The study was conducted over a period of one year from April 2022 to April 2023.Results: A majority of the patients were in the age group of 1-5 years (64%) and higher incidence of male children was observed (74%). Generalized tonic clonic seizure (GTCS) was predominant in 76% of the children and seizure duration was 10-20 minutes in 44% of the children. The most common etiologies were Meningoencephalitis (44%) and febrile seizures (20%). Nearly 70% of the children showed complete recovery with no neurological symptoms and 5 (10%) children died.Conclusions: Status epilepticus is a life-threatening emergency and timely management is essential to prevent morbidity and mortality. CNS infection is a major etiology and majority of the children showed good response with AED treatment.

A study of clinical profile and outcome of pneumonia associated with traditional child rearing practices in infants

Background: Customs and traditions are strictly followed in many Indian families, both rural and urban. Certain established child rearing practices are being advocated by elders and are being followed traditionally even today. Many of these practices play a significant role in causing pneumonia in children. This study was undertaken to compare and assess the clinical features and outcome of pneumonia occurring in children with traditional rearing practices and in infants without traditional child rearing practices and various factors influencing them.Methods: The present study is a prospective case control study, done in the department of paediatrics, Al-Ameen Medical College and Hospital Vijayapura, in which a total of 220 infants with clinical and/or radiological signs of pneumonia were enrolled during the period of March 2022 to February 2023.Results: 73 out of 220 infants (33%) with pneumonia had history of traditional child rearing practices. Demographic factors like combined families, young and illiterate mothers, lower socioeconomic status, domiciliary deliveries were found to be statistically significant. Increased clinical severity and prolonged outcome (60.4%) and complications (42.5%) were found to be more in pneumonia in infants associated with traditional child rearing practices.Conclusions: This study showed increased clinical severity and prolonged outcome and more complications of pneumonia in infants associated with traditional child rearing practices. High mortality (7.5%) was also seen. Most common traditional child rearing practices influencing outcome in infants are oil bath and blowing into the nose. Thus there is an urgent need to systematically study the utility, futility and possible dangers of a large number of traditional child rearing practices followed in infants.

Neonatal morbidity and mortality patterns in NICU at Al-Ameen Medical College and Hospital, Vijayapura

Background: Despite improvements in perinatal care, there is still a high rate of neonatal morbidity and mortality in developing nations like India. Neonatal period is defined as from birth upto first 28 days of life.Methods: An observational prospective study was done with sample size of 600 babies admitted in NICU at AMCH, Vijayapura during the period from January 2021 to August 2022. During the 18 months period of study, data was collected based on babies admitted with respect to gestational age, weight and day of life.Results: The data analysis for morbidity showed that respiratory distress syndrome 24.6%, birth asphyxia with HIE 18.7%, jaundice 17.5%, sepsis 12.3%, meconium aspiration syndrome 4.7%, major congenital anomaly 3.4%, respiratory distress (other causes) 1.8%, others 17.3%. The disease wise mortality among neonates admitted to nicu was studied and were found that respiratory distress syndrome 35.5%, birth asphyxia with HIE 25.4%, sepsis 23.3%, major congenital malformations 6.1%, meconium aspiration syndrome 5.5%, others 4.1%.Conclusions: The most common causes of admission were respiratory distress syndrome, birth asphyxia, jaundice, sepsis, meconium aspiration syndrome and major congenital anomalies. The most common causes of mortality were respiratory distress syndrome, birth asphyxia, sepsis and major congenital malformations.

A case control study to evaluate the electrolyte abnormalities in asphyxiated neonates

Background: Neonatal asphyxia is a hypoxic condition in new-born and leads to encephalopathy as well as electrolyte disturbances and imposes significant morbidity and mortality. So, the current study was performed to assess the electrolyte abnormalities among asphyxiated neonates as compare to controls.Methods: 50 neonates have beendistributedas2 groups, with case group with 25 cases and 25 cases in neonates group depending on the variables namely Apgar score, fetal heart rates and meconium-stained liquor after baby delivery. Serum sodium, potassium and calcium ranges has been estimated; compared between the groups. In asphyxiated neonates based on the severity the electrolytes levels were also compared.Results: The prevalence of birth asphyxia seems to be higher among male new born (64%). The sodium and calcium ranges has been decreased among asphyxiated babies when associated with control group and it was significant 129.78±4.18 vs 140.76±9.76; 8.12±2.87 vs 10.42±3.12 mg/dl). The electrolyte disturbances were higher in HIE stage 3 of high severity as compared to HIE stage I and II.Conclusions: Electrolyte imbalances namely hyponatremia, hyperkalemia, hypocalcemia were found to be communal in asphyxiated neonates. Thus, proper monitoring is required to prevent the morbidity and mortality among the neonates.

A study of etiopathogenesis, clinical and laboratory profile evaluation of typhoid fever in paediatric age group in Bijapur

Background: Salmonella typhi causes typhoid illness. In India, it is a huge public health issue. Several impoverished nations have endemic typhoid fever. The wide range of clinical symptoms of typhoid fever makes diagnosis difficult. The purpose of this study was to better understand the vast range of clinical symptoms, comorbidities, and drug sensitivity patterns associated with typhoid fever in children.Methods: From March 2021 to October 2022, 100 children hospitalised to the paediatric unit at Al-Ameen Medical College and Hospital in Bijapur with proven typhoid fever were included in the study. Age, gender, presenting complaint, laboratory tests, and antibiotic sensitivity pattern are all gathered and analysed in each patient.Results: There were 58 men (58%) and 42 females (42%) among the 100 cases. The most typical age range was 5 to 15 years. Fever was the most prevalent symptom, occurring in 100% of patients, headache (80%), coated tongue (100%), vomiting (45%), and abdominal pain (70%). In 68% of cases, the most prevalent indication was a toxic look, and hepatomegaly in 44%. In 28% of instances, leukocytopenia was discovered. In every case, the blood culture proved positive. The length of hospital stay ranged from 3 to 10 days. There was no recorded death.Conclusions: Unhygienic habits and consuming meals from the outside are the main causes of typhoid fever. By raising people's understanding of disease transmission and its many preventative methods, this serious public health issue can be resolved.

A clinical study of spectrum of low platelet count to establish etiology, diagnosis, complications and prognosis in newborns admitted in Al-Ameen medical college hospital NICU, Bijapur, Karnataka, India

Background: In the newborn low platelet count is a common finding in both preterm and term newborn. It has been estimated that as many as 22% of all new borns admitted to NICU develop low platelet counts. A platelet count of less than 150,000/mL is defined as thrombocytopenia irrespective of the age of the individual.Methods: All the neonates underwent necessary blood investigations like Complete blood counts, (including platelet counts, HB estimation, Red cell indices and PCV), Capsular Polysaccharide - reactive protein. (CRP), Peripheral Smear study, Blood culture, BT, CT, PT, aPPT, Anti-platelet Antibodies.Results: The prevalence of thrombocytopenia in our study was 28%. The proportion of severe thrombocytopenia among the neonatal thrombocytopenia, 11.2% in our study.Conclusions: It can be concluded that thrombocytopenia is very much common in among our NICU admissions. Septicemia is its most important and most common cause.