scholarly journals The rationality behind performance of routine lumber puncture in simple febrile seizure in 6-18 months old children

2021 ◽  
Author(s):  
Sarful Ali ◽  
Kalpana Datta ◽  
Balai Chandra Karmakar
Keyword(s):  
Febrile Seizure ◽  
Prospective Observational Study ◽  
Normal Limit ◽  
First Episode ◽  
Medical College ◽  
Serious Infection ◽  
History Of ◽  
Meningitis In Children ◽  
Current Guidelines ◽  
Rule Out

Background: Pediatrics seizures can be either due to febrile seizure or underlying serious infection such as meningitis. It is important to rule out meningitis in children presenting with fever and seizure. The aim of the study was conducted to assess the necessity of routine lumber puncture and to determine the incidence of meningitis among children aged 6 to 18 months presenting with first episode of febrile seizure.Methods: This prospective observational study was conducted among 47 children with first episode of simple febrile seizure presenting to emergency in Medical College Kolkata, West Bengal from April 2018 to September 2019.Results: Total 47 children were studied among 32 (68%) children were between 6-12 months and 15 (32%) were between 12-18 months of age. Only 1 child (2.1%) diagnosed as meningitis. Clinically 7 children (14.9%) showed signs of sepsis and meningitis like picture and 6 children (12.8%) were in 6-12 months of age and only 1 child (2.1%) was in 12-18month of age. Only 1 child in 6-12 months of age showed CSF positive and all other CSF studies were within normal limit. A significant association was seen between age group and hyponatremia and family history of febrile seizure (p<0.05). There was no statically significant between clinical diagnosis and CSF results (p=0.15).Conclusions: The risk of meningitis in children presenting with simple febrile seizure between 6-18 months of age is very low, specially in 12-18 months of age. Therefore, current guidelines regarding lumber puncture in simple febrile seizure should be reconsidered. 

scholarly journals Use of Lumbar Puncture for First Episode of Febrile Seizure among Children 6 Months to 18 Months of Age: A Cross Sectional Study

2018 ◽  
Vol 3 (2) ◽  
pp. 399-402
Author(s):  
Nirajana Kayastha ◽  
Ganesh Kumar Rai ◽  
Subhana Karki
Keyword(s):  
Lumbar Puncture ◽  
Febrile Seizure ◽  
Clinical Characteristics ◽  
Cross Sectional Study ◽  
First Episode ◽  
Cross Sectional ◽  
Serious Infection ◽  
Meningitis In Children ◽  
Complex Features ◽  
Seizure Episode

Introduction: Febrile seizure accounts for the majority cases of the pediatric seizure. Fever with seizure can be either due to febrile seizure or underlying serious infection as meningitis. As seizure may be the only manifestation of meningitis it is important to rule out meningitis in children presenting with fever and seizure.Objective: The objective of this study was to determine the incidence of meningitis among children aged 6 to 18 months presenting with first episode of febrile seizure.Methodology: A prospective observational study was conducted among 94 children with first episode of febrile seizure presenting to the emergency and observation wards of Kanti Childrens' Hospital and subjected to lumbar puncture (LP) as per the American Academy of Pediatrics (AAP) recommendations. The proportion of children with meningitis and no meningitis among the study population was determined, clinical characteristics were compared among these groups and the incidence of meningitis in simple febrile seizure and complex febrile seizure was calculated. The collected data was analysed using SPSS.Results: Twenty (21.3%) cases were diagnosed with meningitis among 94 children enrolled in our study. Meningitis was detected in 38.1% of the cases of complex febrile seizure and 7.7% of cases of simple febrile seizure. In the age group 6 to 12 months, 11 (17.4%) had meningitis while in 12 to 18 months of age, 9 (29%) were detected with meningitis. Meningitis was 7.38 times more likely in cases presenting with complex febrile seizure than simple febrile seizure (OR=7.58; 95% CI 2.24-24.4; p<0.001). Regarding the clinical characteristics, vomiting, fever of more than 48 hours duration prior to onset of seizure, impaired consciousness and complex features of seizure were found to be significantly associated with meningitis in our study.Conclusion: The probability of meningitis among children aged 6 to 18 months presenting with first episode of febrile seizure episode is high. In febrile convulsing children less than 18 months of age, meningitis should be considered even in the absence of signs of meningeal irritation.  BJHS 2018;3(2)6:399-402.

scholarly journals Predictors of meningitis in children presenting with first episode of febrile seizure

2016 ◽  
Vol 4 (1) ◽  
pp. 136
Author(s):  
Suresh Reddy D. ◽  
Habib Khan S. ◽  
Pavan Hegde
Keyword(s):  
Bacterial Meningitis ◽  
Lumbar Puncture ◽  
Febrile Seizure ◽  
Febrile Seizures ◽  
Good Prognosis ◽  
Acute Bacterial Meningitis ◽  
First Episode ◽  
Medical College ◽  
Csf Analysis ◽  
Meningitis In Children

Background: Febrile seizure is the most common cause of seizures in infants and toddlers presenting to the paediatric emergency department. Two to five percent of children experience at least one or more episodes of febrile seizures. Simple febrile seizures are benign and self-limiting. They have good prognosis and carry very low risk for epilepsy. Probability of acute bacterial meningitis presenting as fever with seizures varies from 0.6% to 6.7%. The American Academy of Paediatrics (AAP) strongly recommends lumbar puncture (for CSF analysis) in the work up of every child under 18 months of age with a first episode of febrile seizure to rule out acute bacterial meningitis. The objective of this study was to determine the occurrence of meningitis in children who presented with first episode of seizure and fever and also the predictors of meningitis among them.Methods: The records of children admitted to Father Muller Medical College and Hospital between 1st January 2014 to 31st December 2015 were reviewed. All children between 6 months to 6 years of age having first episode of convulsions, associated with fever were included in the study and subjected to retrospective analysis of data collected from the case sheets. Results: Our study included 105 children with febrile seizures, 49 children had simple febrile seizures (SFS) and 56 children presented as atypical febrile seizures (AFS). Lumbar puncture was performed in 43 children (15 with SFS and 28 with AFS). The CSF analysis was normal in all the children who presented as simple febrile seizures. There was 25.87% prevalence of meningitis in children with atypical febrile seizures who underwent lumbar puncture. The CSF yield suggestive of bacterial meningitis was as high as 50% in children below 1 year in whom lumbar puncture was done.Conclusions: Children presenting with Atypical/Complex febrile seizures who were treated with antibiotics have more likelihood of having meningitis rather than those presenting with simple febrile seizures. 

scholarly journals Clinical, epidemiological and laboratory characteristics of children with febrile seizures

2020 ◽  
Vol 7 (7) ◽  
pp. 1598
Author(s):  
Poornima Shankar ◽  
Shajna Mahamud
Keyword(s):  
Family History ◽  
Febrile Seizure ◽  
Monsoon Season ◽  
Febrile Seizures ◽  
First Episode ◽  
Upper Respiratory Tract ◽  
History Of ◽  
Upper Respiratory ◽  
One Year ◽  
Tract Infections

Background: Febrile seizure is the most common type of seizure disorder that occurs in children aged 6-60 months. Recurrences are common. This study was conducted to evaluate the epidemiology, clinical profile and laboratory parameters of children presenting with febrile seizure in a teaching hospital.Methods: This was a descriptive retrospective study among children presenting with febrile seizure admitted to KIMS, Bengaluru from March (2018-2019). Children between six months to five years were included in the study while patients with prior episodes of afebrile seizures, abnormal neurodevelopment and not meeting the age criteria were excluded. Patient’s demographic and clinical data were collected from the in-patient records and analysed.Results: Among 60 children with febrile seizures were enrolled in our study with highest prevalence in males (58%) and amongst 13-24 months age group (37%). Majority (20%) presented in the monsoon season (June) and in the morning hours (43%). Simple febrile seizures and complex febrile seizures were observed in 60% and 40% respectively. Majority (73%) who developed first episode of seizure were below 24 months ago with mean age of 18.71±11.50 months. 42% had recurrence and was significantly associated with first episode of febrile seizures at age ≤1 year and family history of seizures. Upper respiratory tract infections were the commonest cause of fever. Anaemia and leucocytosis were seen in 72% and 70% cases respectively.Conclusions: Febrile seizure was observed predominantly in children below two years, simple febrile seizure being the commonest. Recurrence was common and significantly associated with the first episode of febrile seizure at the age one year or below and family history. Majority had anaemia which showed that iron deficiency anaemia could be a risk factor. Leucocytosis was present in most which could be either due to underlying infection or due to the stress of seizure itself.

scholarly journals Evaluation of post sterilization ectopic gestations

2017 ◽  
Vol 6 (4) ◽  
pp. 1503
Author(s):  
Lavanya K. Sarella
Keyword(s):  
Andhra Pradesh ◽  
Tubal Sterilization ◽  
Medical College ◽  
Ectopic Gestation ◽  
Government Hospitals ◽  
History Of ◽  
Correct Technique ◽  
Living Children ◽  
Permanent Method ◽  
Rule Out

Background: Tubal sterilization is considered a permanent method of contraception. The risk of failure of tubectomy is only 0.1-0.3%. Most often the pregnancy following tubal sterilization is ectopic gestation.Methods: 35 cases of post sterilization ectopic gestation were evaluated during a period of January 2014 to December 2015 at Government General Hospital, Rangaraya Medical College, Kakinada, Andhra Pradesh, India.Results: Number of post sterilization ectopic gestation were (n=35) 33%, in 105 ectopic gestations during this period. 93% were in the age group of 20-30years with a mean age of 30.5years. 82% were gravida three who underwent sterilization with two living children. 62% of women presented with 4-6 weeks of amenorrhoea. 97.14% underwent minilaparotomy and out of which 74% were performed in Government hospitals. Puerperal sterilizations constituted 85%. In all cases ectopic gestation occurred within 10years of undergoing sterilization and all cases presented with hemoperitoneum. Site of rupture is ampulla in 31.4% of cases. Length of remaining tube is 7-8cm in 60% of cases.Conclusions: History of tubal sterilization does not rule out the possibility of ectopic gestation even when many years after the tubectomy. Adopting correct technique can reduce the failure rates. Woman should be counselled about the possibility of intra and extra uterine gestation at the time of performing tubectomy.

scholarly journals Association of thyroid dysfunction with abnormal uterine bleeding

2018 ◽  
Vol 7 (6) ◽  
pp. 2388
Author(s):  
Lakshmi Manjeera M. ◽  
Prabhneet Kaur
Keyword(s):  
Thyroid Dysfunction ◽  
Endometrial Thickness ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Thyroid Function Tests ◽  
Medical College ◽  
History Of ◽  
Hormonal Steroids ◽  
Thyroid Abnormalities ◽  
Rule Out

Background: Abnormal uterine bleeding is a common complaint for women being referred to the gynaecologist and is associated with an array of symptoms. The objective of this study was to detect association of thyroid dysfunction in patients with menstrual irregularitiesMethods: This non-interventional prospective study was done over a period of one and half years in a private medical college in Mangalore. All patients in age group of 15-55 years who presented with history of menstrual disturbances were enrolled and evaluated in the study. Patients with structural causes of AUB or using IUCDs or hormonal steroids were excluded. Total of 85 patients were hence evaluated. These 85 patients were subjected to routine investigations like Hb, BT, CT and platelets (to rule out coagulation defects) along with TSH, T3, T4 estimation. Ultrasound abdomen and pelvis with endometrial thickness was done to rule out structural causes.Results: The most common menstrual disturbance was menorrhagia (47 patients: 55.3%). Thyroid abnormalities were found in 29 of the 85 patients with AUB (34.11%). Of the 29 patients with thyroid dysfunction, 24 were hypothyroid and 5 patients were found to be hyperthyroid.Conclusions: Thyroid abnormalities are frequently associated with menstrual irregularities. Hence Thyroid Function Tests are extremely valuable in patients with provisional diagnosis of AUB and should be made mandatory to avoid unnecessary hormonal or surgical treatment in such patients.

scholarly journals Utility of Lumbar Puncture in the first episode of Simple Febrile Seizure in Children between 6 to 18 months of age

2021 ◽  
Vol 8 (1) ◽  
pp. 45-53
Author(s):  
Dr. Pradeep Kumar Jena ◽  
Keyword(s):  
Lumbar Puncture ◽  
Febrile Seizure ◽  
Febrile Seizures ◽  
Pediatric Emergency ◽  
First Episode ◽  
Common Symptom ◽  
Upper Respiratory Tract ◽  
Neuro Imaging ◽  
Time Of Admission ◽  
Rule Out

Introduction: Febrile seizures are the most common seizures occurring in children and areexclusive to childhood. It is the most common pediatric emergency and the most common type ofseizure every pediatrician is dealing with. It accounts for 2.5% of all seizures in children. Despiteprogress in the understanding of febrile seizure and development of consensus statement aboutdiagnostic evaluation and management there exists a diversity of opinion regarding bloodinvestigations, neuro-imaging, Electro Encephalogram (EEG) and the need for routine lumbarpunctures (LP)during a febrile seizure. Aim & objectives: To determine the utility of lumbarpuncture in identifying the group of children aged 6 to18 months having the first episode of feverwith seizures that would benefit from the procedure. Observation: Most common cause of fever infebrile seizures was found to be upper respiratory tract infection (38%) in children followed byAGE(15%). Family history was present in 12.77% of cases of SFS. The most common symptom iscough and cold apart from fever and seizure saw in children. Most common clinical sign wastransient lethargy lasting less than <15 minutes seen in 18% of cases. In 11.7% of cases of SFS adiagnosis of meningitis was made at the time of admission. Out of these only 1 case (2.4%) wassuggestive of meningitis in the age group of 6 to 12 months. Conclusion: Lumbar puncture isnecessary to rule out meningitis in all children between the ages of 6 months to 12 monthspresenting with the first episode of fever with seizure to rule out meningitis.

scholarly journals Incidence and maternal outcome of twin pregnancy

2018 ◽  
Vol 7 (11) ◽  
pp. 4506
Author(s):  
Bharti Sahu ◽  
Pooja Jain Jain
Keyword(s):  
Twin Pregnancy ◽  
Prospective Observational Study ◽  
Preterm Labour ◽  
Reproductive Technology ◽  
Age Group ◽  
Common Complication ◽  
Common Indication ◽  
Medical College ◽  
Risk Pregnancy ◽  
History Of

Background: Twin pregnancy is a high-risk pregnancy with different prevalences in different regions of world which is on the rise due to growing use of assisted reproductive technology. The objective of this study is to determine the incidence and maternal complication and outcome of twin pregnancies.Methods: This is a prospective observational study conducted in 2016-2017 in NSCB medical college and hospital, Jabalpur on 67 twin deliveries. Final outcome was given in terms of percentage and ratio.Results: After assessment of 5995 deliveries during the period 2016-2017 the incidence of twin pregnancy was 1.12 percent. In present study 83.6% of patients were in the age group of 21-30 years. Majority 56.7% were unbooked. 50.7% were primipara. Family history of twin pregnancy was found in 31.3% cases and 17.9% cases have history of ovulation inducing agent. Maximum 65.7% delivered between the gestational age 29-37weeks. Mostly 59.7% were dichorionic-diamniotic twins. Preterm delivery occurred 72.5% in Diamniotic Dichorionic and 85.7% in Monoamniotic Monochorionic. 49.3% cases were having both babies with cephalic presentation. 29.9% twins delivered by cesarean section. most common indication for LSCS in twin pregnancy was malpresentation. Most common complication was preterm labour (52.2%) followed by anaemia and preeclampsia.Conclusions: Twin pregnancy had higher likelihood of maternal adverse effect. The higher morbidity and mortality is due to high percentage of patient being unbooked and majority receive no therapeutic intervention until admission. So all efforts should directed towards better quality antenatal care of twin carrying mother.

PROGNOSTIC SIGNIFICANCE OF GLYCAEMIC STATUS AND ELECTROCARDIOGRAPHIC CHANGES IN ORGANOPHOSPHOROUS POISONING AND ITS SEVERITY USING PERADENIYA SCORE

2021 ◽  
pp. 7-8
Author(s):  
Divya Singh ◽  
Rakesh K Yadav ◽  
Anubha Srivastava ◽  
Rajpal Prajapati
Keyword(s):  
Prospective Observational Study ◽  
Prognostic Significance ◽  
Mortality And Morbidity ◽  
Medical College ◽  
Organophosphorus Poisoning ◽  
History Of ◽  
Electrocardiographic Changes ◽  
Prolonged Qt Interval ◽  
Time Of Presentation ◽  
Severe Grade

OBJECTIVE: To correlate the documented Random Plasma glucose level and ECG ndings with the severity in Acute Organophosphorus poisoning. METHOD: A prospective observational study of 80 patients with alleged history of OP poisoning within 24 hours and fullling inclusion and exclusion criteria in MLN Medical College, Prayagraj from Jan 2019 to March 2020 irrespective of age and sex were included. The glycemic status, ECG ndings at the time of presentation was documented and same was correlated with severity using Peradeniya score and relevant statistics. RESULT:In present study, 16.7% of hypoglycemics and 10.3% of hyperglycemics had severe grade of poisoning based on POP scoring while none of the euglycemic had severe grade of poisoning and this was statistically signicant. Prolonged QT interval was the most common nding seen in 59 (73.8%) subjects. CONCLUSION: ECG can be used as a simple and effective method in predicting mortality and morbidity. RPG at admission in acute OPpoisoning patients is a simple, inexpensive tool that may help to predict the clinical outcome.

scholarly journals Role of serum sodium levels in recurrence and recurrent episodes of febrile seizure

2020 ◽  
Vol 7 (7) ◽  
pp. 1606
Author(s):  
Sara Benny
Keyword(s):  
Family History ◽  
Serum Sodium ◽  
Febrile Seizure ◽  
Febrile Seizures ◽  
Febrile Child ◽  
First Episode ◽  
Total Study Population ◽  
History Of ◽  
Low Serum

Background: Simple febrile seizures are the common childhood seizures, usually affecting 1 in 20 children between the age group of 6 months to 60 months. Earlier studies have shown an association between low serum sodium as a cause for febrile seizures and its recurrences. The present study was to determine the role of serum sodium in predicting febrile seizure recurrence within 24 hrs and recurrent episodes.Methods: Children aged between 6 months to 60 months with first episode of febrile seizures, admitted to the Paediatric ward of MOSC medical college Kolenchery, were recruited in the study. Inclusion criteria were demographic data, family history, clinical examinations, and laboratory investigations (serum sodium and hemoglobin).Results: Of the total study population of 100 children 33 had recurrences in 24 hours and 16 had recurrent episodes. About 57 children had a family history of febrile seizures, out which 28 children had recurrence of febrile seizure within 24 hours. 26 children had family history of epilepsy, of which only 8 had recurrences in 24 hours and 5 had recurrent episodes. Serum sodium levels of 69 children was above 130 mmol/l and 31 children had sodium level below 130mmol/l. Of 31 children, with low serum sodium levels (<130mmol/l), 29 had recurrence within 24 hours, which was not statistically significant. The sodium levels of 16 children who had recurrent episodes of seizure, was also between 130.1-135mmol/. No significant differences were seen between the serum sodium levels in simple febrile seizures and recurrent episodes.Conclusions: Study showed low serum sodium is not statistically significant to predict a recurrence within 24 hours, but a relative hyponatremia can predispose, a febrile child to occurrence of simple febrile seizure.

scholarly journals SERIAL CRP EVALUATION FOR THE DIAGNOSIS OF NEONATAL SEPSIS: A PROSPECTIVE OBSERVATIONAL STUDY.

2021 ◽  
Vol 5 (1) ◽  
Author(s):  
Ved Prakash Gupta ◽  
Rizwan Haider ◽  
Binit Singh
Keyword(s):  
Birth Weight ◽  
Observational Study ◽  
Neonatal Sepsis ◽  
Prospective Observational Study ◽  
Clinical Presentation ◽  
Medical College ◽  
Study Population ◽  
Turbidimetric Immunoassay ◽  
Rule Out

Aim: to evaluate the role of serial CRP evaluation in the diagnosis of neonatal sepsis. Materials and Methods: The present prospective observational study was conducted in the Department of Pediatrics, Darbhanga Medical College and Hospital, Bihar for the period of 1 year.  A total of 97 neonates suspected of sepsis having birth-weight >1,500 g constituted the study population. CRP was measured from the serum by quantitative turbidimetric immunoassay. The CRP 1 level was measured at the time of clinical presentation; CRP 2 and CRP 3 were measured at 24 and 48 hours respectively. Results: In the present study out of total 97 subjects, there were 59 (60.8%) males and 38 (39.2%) females. CRP was found positive in 60 cases. In the present study, lethargy (100%), decreased activity (100%), poor feeding (94.7%), poor cry (94.7%), tachypnea (89.5%), hypotonia (47.4%), hypothermia (31.6%), convulsion (26.5%), prolonged CFT (21.1%) and fever (10.5%) were the various symptoms observed. Conclusion: Serial CRP measurements are useful in the diagnosis of neonatal sepsis. CRP 3 level may virtually rule out or rule in the diagnosis of neonatal sepsis, and has very good correlation with blood culture. Keywords: CRP, Sepsis, Neonates

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