Seizure in children: How important is EEG & Neuroimaging?

Seizure in children are generally indicating a potentially serious underlying systemic or CNS disorders that require thorough clinical examination, investigation and management. It is therefore important to establish accurate diagnosis of seizure and its etiology to manage such patients appropriately. We carried out this study to evaluate different etiology of seizures and its correlation with abnormal EEG & abnormal neuroimaging in the age group of 2mo to 14 years. 200 children presented with seizure to our department from January 2019 to November 2020 were enrolled in this prospective hospital-based study. Detailed history, clinical examination, investigation with special emphasis to EEG & neuroimaging was done and different correlation was drawn by using SSPS 18.0 statistical analysis. Among 200 cases, 6 to 10yr. age group constituted maximum (49%) number of cases. Male to female ratio is 1.5:1. GTCS is the predominant pattern of seizure (60%) in all age groups. EEG abnormality is found in 45%, mostly in focal seizure type. Neuroimaging abnormality found in 29%. Maximum cases (30%) had infectious etiology. Childhood seizure needs detailed history taking and careful examination. Vedio recording shown by parents / caregivers really help towards differentiating seizure from seizure mimics. EEG has a role in specific seizure type; Neuroimaging at times helps in diagnosis. There are few studies that describe neuroimaging [Computed Tomography (CT) and Magnetic Resonance Imaging (MRI)] and Electroencephalogram (EEG) data in children who present with new-onset seizures. The EEG is recommended as a part of the neurodiagnostic evaluation of the child with an apparent first unprovoked seizure.

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Clinical and epidemiological profile of neurocysticercosis in children

International Journal of Contemporary Pediatrics ◽

10.18203/2349-3291.ijcp20204548 ◽

2020 ◽

Vol 7 (11) ◽

pp. 2210

Author(s):

Preeti Lata Rai ◽

Gunjan Kochar ◽

P. L. Prasad

Keyword(s):

Statistical Tests ◽

Age Groups ◽

Uttar Pradesh ◽

Age Group ◽

Inclusion Criteria ◽

Unprovoked Seizure ◽

Focal Neurological Deficit ◽

Female Ratio ◽

Epidemiological Profile ◽

High Index Of Suspicion

Background: This study was done to describe the clinical and epidemiological profile of neurocysticercosis in children of Rohilkhand region.Methods: The study was carried out in the Paediatric Department (Paediatric Intensive Care Unit and General Ward) of Shri Ram Murti Smarak Institute of Medical Sciences, Bareilly, Uttar Pradesh. It was a prospective clinical observational study. After IEC approval and written informed consent, all children between the age group of one month to sixteen years, who fulfilled the inclusion criteria, that is, presented with unprovoked seizure and had evidence of active and ring enhancing lesion or mixed lesion on CT Scan/MRI of brain were enrolled in the study. Detailed history and clinical examination were carried out. Seizures due to any other CNS pathology were excluded. Simple tests for measures of dispersion were the statistical tests that were used.Results: Statistically forty children fulfilled the inclusion criteria. Of the total children enrolled in the study, 63% were males. Male to female ratio was 1.7. Almost three fourths of the population belonged to rural backgrounds. The mean age of studied children was 10.5 years. More than half of the affected children belonged to the school going age group. Generalised tonic clonic seizures were more common in all age groups than partial seizures. Headache (52.6%), loss of consciousness (42.1%), vomiting (31.5%) and focal neurological deficit (15.7%) were the most common presenting complaints in order of decreasing frequency.Conclusions: There should be a high index of suspicion of NCC in any child presenting with unprovoked seizures.

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Ascitic Fluid Cytology Seen in a Tertiary Hospital in Nigeria

Journal of BioMedical Research and Clinical Practice ◽

10.46912/jbrcp.161 ◽

2020 ◽

pp. 345-350

Author(s):

CC Nwafor ◽

K Obioha ◽

TO Akhiwu

Keyword(s):

Sex Ratio ◽

Patient Care ◽

Ascitic Fluid ◽

Age Groups ◽

Tertiary Hospital ◽

Age Group ◽

Malignant Cells ◽

Female Ratio ◽

Male To Female ◽

Fluid Cytology

Ascites is a symptom that can originate due to diverse pathologies. A lot of investigations including ascitic fluid cytology (AFC) can be done on it to help determine its origin. The aim of this study, is to document the findings and highlight the importance of AFC in patient care in Uyo. All AFC reports and slides in the Department of Histopathology, University of Uyo were retrieved, reviewed and used for this study. The age ranged from 1.5 – 80 years with mean age, 41.79 (±17.23) years. About 71.8% of the ascitic fluid (AF) specimens were from patients between the 3rd and 6th decade. Females predominated in all age groups expect 10-19 year's group, with a male to female sex ratio of 1:2.4. Malignant cells were seen in 28.7% of all the samples, while 51.2% were negative for malignant cells. Malignant cells were seen in 4 (6.7%), 11 (18.3%) and 6 (10%) of the AFC performed due to various liver pathologies, ovarian malignancies and intra-abdominal malignancies respectively. Malignant cells were found more in females with a male to female ratio of 1: 3.6. Age group 40-49 years accounted for most of the malignant cases (26.6%). The pattern of AFC in Uyo is similar to the pattern in other parts of Nigeria

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Study of prevalence and clinical spectrum of seizures in children in a teaching hospital in rural Telangana, India

International Journal of Contemporary Pediatrics ◽

10.18203/2349-3291.ijcp20181503 ◽

2018 ◽

Vol 5 (3) ◽

pp. 862

Author(s):

C. P. V. Ramana Sastry ◽

R. Manohar Reddy

Keyword(s):

Clinical Spectrum ◽

Response To Treatment ◽

Age Group ◽

Unprovoked Seizure ◽

Patient Response ◽

Female Ratio ◽

Medical College ◽

Appropriate Treatment ◽

Long Term Follow Up ◽

One Year

Background: To study the prevalence and clinical spectrum of seizures and treatment outcome in children.Methods: A hospital based prospective study was done at Maheshwara Medical College and Hospital, Patancheru, Telangana in the department of Paediatrics over one-year period. A total of 75 cases presenting with seizures were studied for demographics, clinical features, imaging studies where possible and patient response to treatment. Results: T Patient age ranged from one week to 14 years with male to female ratio of 1:4. Majority were in the age group of 1-3 years 25/75 (33.3%). Fever was present on admission in 66.6% of cases in 1 month to 6 years. Unprovoked seizure was common 20/75 (26.6%) in age group 6 to14 years. Neonatal seizures were seen in 6.6% cases. Generalized tonic clonic seizures were common and were seen in 63.3% cases. Only 5 (6.6 %) cases presented with status epilepticus. CT scan was done in 20 cases in unprovoked seizures and showed various etiologies. Conclusions: Seizures in children are a common indication for hospital admission. They can be febrile or unprovoked. CNS infections and space occupying lesions are common causes for paediatric seizures. Early detection of the cause of seizures helps in instituting appropriate treatment. Children with unprovoked seizures should be on regular long term follow up and treatment.

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Gender Differences in Psychiatric Outpatients: A Before and During COVID-19 Pandemic Study in General Hospitals From China

10.21203/rs.3.rs-877877/v1 ◽

2021 ◽

Author(s):

Wenli He ◽

Danhong Xu ◽

Jiafeng Wang ◽

Yuze Shen ◽

Zheng Lin ◽

...

Keyword(s):

Mental Disorders ◽

Virus Disease ◽

Age Groups ◽

Psychiatric Clinic ◽

Age Group ◽

General Hospitals ◽

Female Ratio ◽

Psychiatric Outpatient ◽

Number Of Patients ◽

Male To Female

Abstract BackgroundLittle is known about the gender characteristics and the Corona Virus Disease 2019(COVID-19) impact on psychiatric department outpatients in general hospitals in China. MethodsWe retrospectively collected 225,947 outpatient clinic records before and during COVID-19 pandemic from January 1, 2019 to December 31, 2020 in the psychiatric clinic of 3 general hospitals, gender composition of patients was analyzed in different five age groups and nine diagnostic categories at three levels: total patient visits, number of patients and number of first-visit patients. ResultsThe total male-to-female ratio of psychiatric outpatient records in 3 general hospitals from 2019 to 2020 was 1:1.69. Women were more common in all age groups and the male-to-female ratio of 2020 was expanded compared to that of 2019, especially in age group below 34 years old and anxiety disorders category. Most mental disorders showed higher demands for females than that for males except Mental and behavioral disorders due to psychoactive substance use with the male-to-female ratio was 1:0.05. Compared to 2019, the proportions of women were expanded especially in age group below 34 years old, and anxiety disorder and undetermined diagnosis categories were significantly increased in 2020. ConclusionsThe demand for female psychiatric outpatient services is obviously higher than that for males. It is necessary to pay more attention to explore targeted mechanism or psychosocial service strategy for female patients with mental disorders. Trial registration: ChiCTR2100044894, March 31,2021 retrospectively registered.

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A comparative study on outcome of ileal perforation after primary perforation closure and resection and ileostomy

International Surgery Journal ◽

10.18203/2349-2902.isj20180027 ◽

2018 ◽

Vol 5 (2) ◽

pp. 445 ◽

Cited By ~ 2

Author(s):

Khalilur Rahman A. ◽

Jawahar Krishnaswamy ◽

Muthukumaran G. ◽

Sanjay Prakash J.

Keyword(s):

Wound Infection ◽

Primary Closure ◽

Age Groups ◽

Age Group ◽

Respiratory Complications ◽

Female Ratio ◽

Ileal Perforation ◽

Factors Affecting ◽

Group 5 ◽

Closure Group

Background: Ileal perforations are a common occurrence in our hospital setup with a majority of cases having an etiology of typhoid. The presentation and management of ileal perforation with special reference to typhoid, nonspecific and traumatic perforations and the outcomes in these patients and the factors affecting prognosis are important. Aims and objectives of the study were to study the management of Ileal perforation. To compare the outcome of two different types of treatment for Ileal perforation i.e. Primary Closure (vs) Resection and Ileostomy.Methods: This is a randomized comparative observational study conducted in general surgery department of Saveetha Medical College and Hospital, Chennai between February 2016 to October 2017. A Minimum of 28 patients was included in the study. Diagnosis was made on the basis of the X-ray erect abdomen, ultrasound abdomen, Widal test and intra-operative findings.Results: The common age groups affected was 41-50 years age group (5 patients) and 61-70 years age groups (5 patients). The least affected were 1-10years age group (one patient). The incidence in males was slightly greater than females. Male to female ratio was 2.5:1. Typhoid perforation is the most common case of ileal perforation followed by non-specific perforation. Post-operative complications are more in the primary closure group with 32.14% (9 patients) which is lower when compared to ileostomy group 17.85% (5 patients). Complications of primary closure were wound infection (2 patients), burst abdomen (3 patients), faecal fistula (1 patient), respiratory complications (3 patients). Complications in ileostomy group were wound infection (4 patients) and respiratory complications (one patient).Conclusions: Mortality was more in primary closure group with 21.42% (6 patients) and mortality was less in ileostomy group with 7.14% (2 patients). This study proposes that ileostomy may be given priority over other surgical options in moribund patients.

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Epidemiology of fractures in indoor patients at a tertiary care centre in India: a study of 3000 cases

International Journal of Research in Orthopaedics ◽

10.18203/issn.2455-4510.intjresorthop20214958 ◽

2021 ◽

Vol 8 (1) ◽

pp. 39

Author(s):

Mohan M. Desai ◽

Deven R. Kuruwa ◽

Easwar Elango ◽

Roshan Wade

Keyword(s):

Road Traffic ◽

Tertiary Care ◽

Age Groups ◽

Control Measures ◽

Age Group ◽

Care Centre ◽

Tertiary Care Centre ◽

Treatment Protocols ◽

Female Ratio ◽

Femur Fractures

Background: Implementing appropriate fracture control measures and treatment protocols is crucial to maximizing health and development gains. This requires an in depth understanding of age-specific, sex-specific and cause-specific injury patterns at the national and subnational levels. No such study on fracture epidemiology has been undertaken in the Indian population.Methods: Study was conducted in a tertiary care centre (KEM hospital, Mumbai) which is one of the highest volume trauma centres in the country. Data of 3000 patients was obtained from the medical records department for the year 2016-2019. Patients were segregated with respect to their genders and into three age groups. Etiology of fracture was noted, and fractures classified according to the anatomical area. Whether the patient received conservative or operative management was also recorded.Results: 43.83% of the fractures occurred in 18-50 years age group. 41.33% in the above 50 group and only 14.73% in the below 18 age group. Overall male to female ratio was 1.4: 1. Vehicular accident was the most common mode of injury (47.07%) followed by fall from height (21.03%). Proximal femur fractures were the most common accounting for 19.57% of all fractures followed by forearm (10.53%), tibia diaphysis (8.10%). Talus was the least common. 81.07% cases were managed operatively and 18.93% conserved.Conclusions: Our study highlights that Indian epidemiology is unique from our Western counterparts. Population affected is much younger, old age males are affected more than females. Lower limb fractures are more prevalent and road traffic accidents are responsible for almost half the fractures.

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A prospective study of intestinal obstruction in paediatric age group

International Surgery Journal ◽

10.18203/2349-2902.isj20172395 ◽

2017 ◽

Vol 4 (6) ◽

pp. 1979

Author(s):

Amul Bhedi ◽

Miten Prajapati ◽

Arnab Sarkar

Keyword(s):

Intestinal Obstruction ◽

Prospective Study ◽

Hypertrophic Pyloric Stenosis ◽

Age Groups ◽

Total Mortality ◽

Infants And Children ◽

Age Group ◽

Female Ratio ◽

Paediatric Age ◽

A Prospective Study

Background: Intestinal obstruction can occur at any age in the paediatric population1-4. Bowel obstruction in children differs from that in adults in terms of etiology, presentation and even the management. The aim of the study was to find out various etiologies, clinical features, outcome and mortality of paediatric age groups with intestinal obstruction and their relation to age and sex distribution.Methods: This is a prospective study of 50 cases of paediatric age group with signs and symptoms of intestinal obstruction which were admitted in Sir Sayajirao Gaekwad Hospital, Vadodara, India during period of December 2004 to November 2006. Surgical intervention was carried out where indicated otherwise patients were managed conservatively. Data was analysed in SPSS version 10 statistical software for percentage and frequencies.Results: Total 50 patients were included in the study. Among these 30 were males and 20 were females with M: F ratio of 3:2. Majority of them were 25 neonates of age group of 1-7 days (50%), followed by 7 infants of 1 months- 1 years (14%) and 18 children aged 1 years-12 years (36%). Out of 50 patients, 41 (82%) patients had congenital causes in which 21(42%) patients had imperforate anus followed by Hirschprung’s disease in 8(16%), Meckel’s diverticulum in 6(12%), jejunal atresia in 4(8%), hypertrophic pyloric stenosis in 2 patients (4%) and 9(18%) patients had acquired causes in which intussusception was in 5(10%) patients, abdominal tuberculosis in 2(4%) and gangrenous appendix in 2(4%) patients. Total mortality was 6 out of 25 neonates and there were no mortality in infants and children groups.Conclusions: Majority of patients were neonates than infants and children with slight male preponderance with male: female ratio of 3:2. Congenital causes of intestinal obstruction were more common (82%) than the acquired causes (18%). Postoperative septicaemia was more common and overall mortality was exclusively in neonates.

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Etiological classification of seizures in pediatric age group (6-12years) – MRI study

International Journal of Medical Research and Review ◽

10.17511/ijmrr.2021.i04.08 ◽

2021 ◽

Vol 9 (4) ◽

pp. 257-262

Author(s):

Dr. Nirmalkumar Gopalakrishnan ◽

◽

Dr. Mohammed Ansari Gaffoor ◽

Keyword(s):

Age Group ◽

Section Thickness ◽

Partial Seizures ◽

Mri Findings ◽

Unprovoked Seizure ◽

Pediatric Age Group ◽

Magnetic Resonance Imaging Mri ◽

Mri Study ◽

A Prospective Study ◽

New Onset

Background: A seizure is an occurrence of signs or symptoms due to abnormal excessive orsynchronous neuronal activity in the brain. The present study aims to study the etiological factorsand clinical profile for new-onset seizures in children aged 6-12 years and to determine thefrequency of Magnetic resonance imaging (MRI) abnormalities in the pediatrics age group with new-onset unprovoked seizure and those with inadequately investigated longstanding epilepsy andclassify the etiology based on the MRI findings. Methods: A prospective study involving a total of 50patients was recruited aged between 6 to 12 years. All of them underwent neuro-imaging with MRI.Uncooperative patients were imaged following sedation and monitoring by the anesthetist. Allchildren aged 6-12 years who presented with new-onset seizures were included. All MR images wereobtained at a 3-mm section thickness except magnetization-prepared rapid gradient-echo images,which are obtained at a 1.8-mm section thickness. Results: Of the 50 patients 28 presented withgeneralized tonic-clonic seizures, 12 with simple partial seizures, 10 with complex partial seizures.Generalized seizures were a more common presentation than partial seizures in children 6-12 yearsof age. Conclusion: With the positivity of the MRI in the new-onset seizure in children between 6-12 years in our study gives an important aspect of the essential factor of imaging in pediatric new-onset seizures.

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A study on clinical characteristics of herpes zoster in a tertiary care center

International Journal of Research in Dermatology ◽

10.18203/issn.2455-4529.intjresdermatol20170081 ◽

2017 ◽

Vol 3 (1) ◽

pp. 79

Author(s):

Rachana R. ◽

Shivaswamy K. N. ◽

Anuradha H. V.

Keyword(s):

Herpes Zoster ◽

Clinical Characteristics ◽

Care Center ◽

Tertiary Care ◽

Age Groups ◽

Age Group ◽

Female Ratio ◽

Varicella Zoster ◽

Medical College ◽

Male To Female

Background: Herpes zoster (HZ), also known as shingles, derived from the Latin word Cingulum, for “girdle”. This is because a common presentation of HZ involves a unilateral rash that can wrap around the waist or torso like a girdle. HZ results due to reactivation of an earlier latent infection with the varicella zoster virus (VZV) in dorsal root ganglia. It occurs at all age groups, common over 60 years of age. It is estimated that in non-immune populations, approximately 15 cases per 1000 people occur per year. The objective of the study was to study the clinical characteristics in patients with uncomplicated herpes zoster.Methods: A total of 72 patients attending dermatology OPD at Ramaiah medical college between June 2013 to September 2014 were recruited after obtaining informed consent. A detailed history regarding onset of rash, pain, progression, duration and distribution of the lesions were recorded. Demographic information including age, sex, and any other co morbidities noted. Tzanck smear and serology for HIV was done where-ever necessary.Results: Of the 72 patients, females outnumbered males [M=35(48.61%), F=37 (51.39%)] with male to female ratio of 0.9 to 1. The mean age of presentation was 58±18 years. Majority of the patients (54%) were in the age group of 51 to 70 years followed by 31-50 years (25%). Least number of cases (9%) was in the age group of 21 to 30 years. Of the 72 subjects, thoracic involvement was noted in 30.6%, followed by lumbar (22%), and trigeminal (16%). Cervical (4%) and sacral (2%) involvement was the least. Conclusions: Herpes zoster commonly occurs in old age and the presenting symptom being pain and burning sensation. Thoracic dermatome is the commonest site. Immunocompromised states like diabetes, malignancy and HIV can increase the risk of developing herpes zoster.

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Correlation of patient's mental attitude with age, sex, and educational level: A survey

European Journal of Dentistry ◽

10.4103/1305-7456.175688 ◽

2016 ◽

Vol 10 (01) ◽

pp. 023-028 ◽

Cited By ~ 1

Author(s):

Shweta Choudhary ◽

Ajit Kumar ◽

Himanshu Arora

Keyword(s):

College Graduates ◽

Age Groups ◽

Educational Status ◽

Age Group ◽

Oral Rehabilitation ◽

Mental Attitude ◽

Female Ratio ◽

Patient Cooperation ◽

Male To Female

ABSTRACT Objective: The aim of this study was to determine any relationship, if exists, between the patient's mental attitude with age, sex, or educational qualification. Methods: A total of 200 patients who attended the outpatient department during a span of 1 year, for the fabrication of new complete dentures, were chosen for the study. After completing a routine case history and examination, a questionnaire was filled by the clinician as answered by the patient. Participants were evaluated and categorized based on the questionnaire and clinical experience during treatment according to a predefined classification of determining mental attitudes. Outcomes from the survey were correlated with participant gender, age, and educational status. Results: The male to female ratio was 83:117, out of the 200 enrolled participants. The results from the questionnaire showed that females were found to be more exacting (P = 0.007) in nature, while males, on the other hand, revealed more indifferent attitude (P = 0.02); both differences being statistically significant. Of the three age group categories: Participants in the age group of 45–54 years revealed a significant inclination toward an exacting attitude when compared with other age groups (P < 0.001). In regards to educational status, an illiterate or minimally educated group significantly outnumbered the college graduates in the indifferent attitude group (P < 0.001). Conclusions: Within the limitations of this study, it could be said that the mental attitudes of patients could vary according to gender, age, and educational status, which could affect patient cooperation and satisfaction with oral rehabilitation, eventually manipulating the overall success of the treatment rendered.

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