A pediatric case series of abdominal epilepsy.

BACKGROUND: Abdominal epilepsy (AE) is an infrequent cause of recurrent abdominal pain in children. It is characterized by paroxysmal episodes of abdominal pain, a variety of other abdominal complaints, electroencephalogram abnormalities, and response to anti-epileptic agents. We described the clinical profile of six patients with AE. METHODS: We conducted a retrospective survey of AE in children from the records of the hospital. The diagnosis of AE was dependent on recurrent abdominal symptoms, subtle central nervous system abnormalities, electroencephalogram abnormalities and response to anticonvulsant agents. RESULTS: The six patients were diagnosed with AE. The incidence of the disease was 0.07% in all admissions to the pediatric ward. Recurrent pain was common in all patients except two who had additional recurrent vomiting. In this series, the boy to girl ratio (1:2) was unequal. CONCLUSION: High suspicion is required for the diagnosis of AE after exclusion of other possible causes.

Clinico-anthropometric profile of children from Darjeeling tea garden.

OBJECTIVE: To assess clinico-anthropometric profile of hospitalized children and their apparently healthy siblings from the Darjeeling tea garden. METHODS: This was a descriptive, cross-sectional study, done at North Bengal Medical College, West Bengal, India over a period of 6 mo. Consecutively admitted 157 children and their 301 apparently healthy siblings were included. Clinical diagnosis, height/length, weight, BMI were recorded. RESULTS: Children (n = 157) were mostly admitted for gastroenteritis (36.3 %), respiratory infections (26.75 %), meningo-encephalitis (14.0 %). Among 301 siblings, 30.56 % had nutritional anemia, worm infestation, giardiasis etc. Severe (< -3 Z-score) stunting and wasting were noted in 10 (6.37 %) and 19 (12.1 %) hospitalized children respectively. A quarter of all siblings suffered from moderate malnutrition (stunting 24.92 %, wasting 29.57 %). Distribution of malnutrition in each anthropometric parameter was statistically significant (p < 0.05) in sick children compared to non-admitted siblings. Intergroup comparisons for both sexes were statistically significant for all parameters except in length/height for age for females. Moderate malnutrition (< -2 Z-score) was related to low BMI in 45 % (n = 71) of sick and 27 % (n = 83) of apparently well children. CONCLUSIONS: The present study, first of its kind, delineated specific pattern of illness in sick and apparently healthy tea garden children. Malnutrition is statistically significant co-morbid associate in both the groups. Public health policy targeting these children is needed.

Acute stress-related psychological impact in children following devastating natural disaster, the Sikkim earthquake (2011), India.

BACKGROUND: Psychological stress following natural disaster is common. Despite several earthquakes in India, data on evaluation of acute stress among the child victims in the early postdisaster period is scarce. Immediately following a devastating earthquake (6.9 Richter) at Sikkim on September, 18 2011, many children attended North Bengal Medical College, the nearest government tertiary care institution, with unusual stress symptoms. OBJECTIVE: Evaluation of acute stress symptoms in children in the immediate postearthquake period. MATERIALS AND METHODS: This was a cross-sectional study done over 4 weeks and includes all the children from 1 to 12 years presenting with unusual physical or behavioral symptoms. Those with major injuries requiring admission were excluded. They were divided into two age groups. For older children (8-12 years) the 8-item Children Impact of Event Scale (CIES) was used for screening of stress. Unusual symptoms were recorded in younger children (1-8 years) as CIES is not validated < 8 years. RESULT: A total of 84 children (2.66%) out of 3154 had stress symptoms. Maximum attendance was noted in first 3 days (65.47%) and declined gradually. In children ≥ 8 years, 48.78% had psychological stress, which was statistically significant on CIES scores without any gender predilection. Static posturing (41.86%), sleeplessness (32.55%), anorexia (9.30%), recurrent vomiting (13.95%), excessive crying (13.95%), or night-awakenings (4.65%) were found in younger children (n = 43) and three required admission. CONCLUSION: This study represent the first Indian data showing statistically significant psychological impact in older children (8-12 years) and various forms of physical stress symptoms in young children (1-8 years) following earthquake.