A Case Report Of Paediatric Subacute Sclerosing Panencephalitis

Subacute sclerosing panencephalitis (SSPE) is a devastating disease of the central nervous system (CNS) caused by persistent measles virus infection. The diagnosis of SSPE is based on characteristic clinical and EEG findings and demonstration of elevated antibody titres against measles in cerebrospinal fluid. Subacute sclerosing panencephalitis can have atypical clinical features at the onset.We report a 10 year old boy presented with convulsions and visual disturbances. The disease progressed with behavioural and cognitive disturbances and periodic high amplitude generalised complexes on EEG, and elevated titers of measles antibodies in cerebrospinal fluid leading to the final diagnosis of subacute sclerosing panencephalitis.

A case report of pediatric mog-antibody disease with Bilateral optic neuritis

MOG – Antibody disease is an inflammatory demyelinating condition of the CNS characterized by a monophasic or relapsing course of neurological dysfunction which does not meet the typical criteria for multiple sclerosis or other known neuro inflammatory conditions and occurs in presence of serum MOG antibodies using specific cell based assays. In pediatric patients MOG antibodies are detected in range of relapsing phenotypes including relapsing inflammatory optic neuritis (RION), acute disseminated encephalomyelitis followed by optic neuritis (ADEM – ON), brain stem demyelination and aquaporin P4 antibody negative neuromyelitis optica spectrum disorder (AQP4-Ab negative NMOSD).MOG positive optic neuritis is frequently bilateral and associated with optic nerve head swelling.It is associated with neurological diseases like Multiple Sclerosis, ADEM or Transverse Myelitis.MOG antibody IgG is detected in serum by indirect fluorescence test.IV Methylprednisolone is the treatment of choice, if it fails to improve vision or if optic neuritis is recurring, then a combination of plasma exchange and IV Methylprednisolone should be considered.Long term immunosuppressants used for Prevention include corticosteroids, azathioprine, mycophenolate mofetil and rituximab. The optimal preventive therapy has yet to be determined.Once the disease has been diagnosed, uncertainty remains over the best treatment approach and clinical trials for the pharmacological management of MOG- antibody optic neuritis are still needed

Study of Neuro-developmental Outcome of Preterm Babies Using Risk Stratification Score at a Tertiary Care Hospital

Introduction : Recent advances and improvements in technology in Neonatal Intensive Care Unit (NICU) over the past few decades have increased th survival of preterm infants. India ranks first amongst the number of preterm birth. Though the survival of preterm babies have increased Neuro-developmental morbidity amongst such babies still persist. Through this study we aim to establish a risk stratification tool and predict neurodevelopmental delay at 1 year of age. Materials and Methods : A total number of 77 babies were enrolled in the study after fulfilment of inclusion and exclusion criteria. Follow up till 1 year of age of corrected gestational age was done. Development assessment was done through Child Development Centre (CDC) grading, Amile-Tison Angle, Developmental Observation Card, Trivandrum Developmental Screening Chart and development quotient. Vision and Hearing Assessment was also done. Conclusion : Neuro-developmental outcome prediction at 1 year of age is inadequate and proper long term follow p is needed. Overall preterm babies needing extensive resuscitation and 5 minute APGAR <6 had much poor neurological outcome.

Microbiological profile of diabetic foot ulcers and its antibiotic susceptibility pattern in a teaching hospital, Gujarat.

Background: Diabetic foot lesions are a major medical, social and economic problem and are the leading cause of hospitalization for patients with diabetes worldwide. Infection sometimes leads to amputation of the infected foot if not treated promptly. The present study was conducted to isolate and identify the bacterial pathogens associated with diabetic foot ulcer and to find out its antibiotic susceptibility pattern to reduce the risk of complications. Methods: Total 100 pus samples were collected from patients having diabetic foot ulcer, during July to October 2012. Samples were processed as per standard guidelines. Results: Out of 100 pus samples, 73 (73%) yielded growth of organisms making total of 92 isolates. Out of 92 bacterial isolates, 72 were gram negative and 20 were gram positive. Pseudomonas aeruginosa 25 (27%) was most common isolate causing diabetic foot infections followed by 20 (22%) Klebsiella sp., 17 (19%) E. coli, 15 (17%) S. aureus, 6 (7%) Proteus sp. and 4(3%) Enterococci, 2 (2%) Acinetobacter sp. and 2(2%) CONS and 1(1%) Providencia. Out of 72 GNB, 50 (69.4%) were extended spectrum β lactamase (ESBL) producer. Most gram negative isolates were resistant to levofloxacin, gentamicin, ampicillin-sulbactam and gatifloxacin. All GNB were sensitive to imipenem. Out of 15 S. aureus, 9 (60%) were Methicillin Resistant Staphylococcus aureus (MRSA) and were sensitive to vancomycin and linezolid. Conclusions: Pseudomonas sp. was the most common cause of infections. Most isolates were multi drug resistance.