Clinical Profile and Short-Term Outcome of Neonatal Seizures in a Tertiary Care Hospital, Kuppam – A Retrospective Study

2021 ◽  
Vol 8 (27) ◽  
pp. 2381-2386
Author(s):  
Poojitha Kancherla ◽  
Harsha P.J. ◽  
Gowtham R. ◽  
Dowlath Anwar Basha ◽  
Chandran G.P ◽  
...  

BACKGROUND Neonates presenting with seizures require long term stay in hospital and have higher chances of neuro-developmental delay later. Seizures in neonates are mostly subtle and difficult to diagnose. We wanted to study the clinical profile and short-term outcome on term and later pre-term neonates presenting with seizures. METHODS The study was a retrospective observational study done from November to December 2020 at PES Hospital, Kuppam. Retrospective data of neonatal seizures from May 2019 to April 2020 was considered for study. Details from the case records of neonates with seizures was collected. RESULTS Neonatal seizures (NS) were most common in females (53.8 %, 72/134). Subtle seizures were most common form of seizures in neonates which was seen in 64.2 % (86/134) babies followed by tonic seizures in 22.4 % (30/134). Neonatal seizures were most commonly seen in babies with hypoxic ischemic encephalopathy in 63.4 % (85/134) followed by metabolic disturbances in 15.6 % (21/134) and meningitis in 13.5 % (18/134). In babies with hypoxic ischemic encephalopathy, metabolic and meningitis subtle seizures were observed to be more common. Seizures were seen most commonly in first 72 hours of life (82.85 %, 111/134). Seizures in babies with hypoxic ischemic encephalopathy, metabolic causes most commonly occurred within first 24 hours of birth. Seizures in babies with meningitis most commonly occurred after 7 days of birth. Babies with neonatal seizures with sequelae was seen in 17.96 % (24/134) and 11.94 % babies died (16/134). CONCLUSIONS Subtle seizures were most common form and hypoxic ischemic encephalopathy was most common risk factor. Most neonatal seizures present within 72 hours of birth. Babies with meningitis presented with seizures most commonly after 72 hours of birth. KEYWORDS Hypoxic Ischemic Encephalopathy, Neonatal Seizures, Newborn, Aetiology, Outcome

2021 ◽  
Vol 71 (1) ◽  
pp. 24-28
Author(s):  
Hafsa Niaz ◽  
Jawad Jalil ◽  
Qamar Zaman Khan ◽  
Faisal Basheer ◽  
Shahzad Akhtar ◽  
...  

Objective: To determine the clinical profile, selected antepartum and intrapartum risk factor for adverse shortterm outcomes of hypoxic ischemic encephalopathy in babies with birth asphyxia. Study Design: Cross sectional study. Place and Duration of Study: Neonatal Intensive Care Unit of Pak Emirates Military Hospital, Rawalpindi, fromJan to Dec 2018. Methodology: This study including all birth asphyxiated babies born who fulfilled the inclusion criteria.Following data was collected prospectively regarding gender, gestational age, birth weight and mode of delivery, maternal age, antenatal follow up, history of premature rupture of membranes and meconium stained liquor. Babies were categorized into different stages of hypoxic ischemic encephalopathy according to Sarnat and Sarnat staging. Selected antepartum and intrapartum risk factors leading to hypoxic insult at birth were studied and short-term outcome was recorded in the form of need of mechanical ventilation, mortality and discharge from the hospital.Results: The frequency of birth asphyxia turned out to be 122/5986 (2.03%) at our center. Thirty four (27.87%)required mechanical ventilation, mortality was recorded at 20/122 (16.39%). While 61 (50%) babies suffered from stage I hypoxic ischemic encephalopathy, 13/20 (65%) of newborn who expired were suffering from grade III hypoxic ischemic encephalopathy. Conclusion: The severity of hypoxic ischemic encephalopathy affects the outcome of newborns having birthasphyxia with hypoxic ischemic encephalopathy grade III associated with maximum mortality. Early identifycation of pregnancies at risk for asphyxia, with appropriate intervention in selected cases is the key to prevent birth asphyxia and its ensuing neonatal complications.


2015 ◽  
Vol 30 (6) ◽  
pp. 593-598 ◽  
Author(s):  
Rahul Choudhary ◽  
Ashish Goel ◽  
Sonal Pruthi ◽  
Sarathi Kalra ◽  
Sunil Agarwal ◽  
...  

AbstractIntroductionWith an increasing number of sicker patients, limited hospital beds, and an emphasis on day care, the profile of patients hospitalized to medicine wards has undergone a radical re-definition. The increasing share of patients hospitalized through the emergency department for acute care to medicine wards has left little space for hospitalization through the outpatient department (OPD). There are some global data available on the profile of patients presenting to the emergency rooms (ERs) and their subsequent outcome. Data from developing countries, especially India, in this regard are lacking.MethodsThis cross-sectional study included all patients hospitalized to the medicine ward through the medical emergency services, provided by the Department of Medicine, each Wednesday and every sixth Sunday for the entire year (a total of 62 days), from November 2010 through October 2011, and followed their outcome up to seven days after hospitalization.ResultsOf the 3,618 cases presenting to medicine emergency on these days, 1,547 (42.3%) were advised admission. Nine hundred sixty-seven reported to the medicine wards. One hundred eleven (7.73%) expired within 24 hours; others absconded, were lost in transit, did not consent to participation, or were discharged. During the next seven days, 452 (46.7%) recovered sufficiently and were discharged to go home. Two hundred thirty (23.8%) left the hospital without informing the medical staff. Fourteen (1.4%) patients were transferred to other departments. One hundred thirty-seven (8.8%) patients died during the next six days of hospitalization. After Multivariate Logistic Regression analysis, abnormal Glasgow Coma Scale (GCS) score, high systolic blood pressure (BP), age, increased total leucocyte count, increased globulin, low bicarbonate in arterial blood, low Mini Mental Status Examination (MMSE) score, and a raised urea >40 mg/dL were found to be associated significantly with mortality.ConclusionOf the 1,547 patients who needed urgent hospitalization, 248 (16%) died within the first week, one-half of them within the first 24 hours. An advanced age, abnormal GCS score, low MMSE score, increased systolic BP, leukocytosis, acidosis, and uremia were found to be associated with a fatal outcome. Therefore, nearly one-half of the patients who would have a fatal short-term outcome were likely to do so within the first 24 hours, making the first day of presentation “the golden day” period.ChoudharyR, GoelA, PruthiS, KalraS, AgarwalS, KalraOP. Profile of patients hospitalized through the emergency room to the medicine ward and their short-term outcome at a tertiary care hospital in Delhi. Prehosp Disaster Med. 2015;30(6):593–598.


Renal Failure ◽  
2016 ◽  
Vol 39 (1) ◽  
pp. 26-31 ◽  
Author(s):  
Vina Tresa ◽  
Afshan Yaseen ◽  
Ali Asghar Lanewala ◽  
Seema Hashmi ◽  
Sabeeta Khatri ◽  
...  

2021 ◽  
pp. 004947552110162
Author(s):  
Ashish Garg ◽  
Renu Suthar ◽  
Venkataseshan Sundaram ◽  
Praveen Kumar ◽  
Suresh K Angurana

Neonatal seizures are common manifestations of several neurological or systemic disorders and associated with high morbidity, mortality and poor short- and long-term developmental outcomes. It is important to determine the aetiology and factors that determine the poor outcome, more so in a newly developed setting. The early detection of predictors of poor outcome will help in planning acute management, counselling, follow-up and rehabilitation services. In this prospective observational study, we looked at the clinical profile, aetiology, short-term outcomes and predictors of poor outcome of neonatal seizures among out-born neonates. The common causes were hypoxic ischaemic encephalopathy, sepsis and metabolic disturbances. One-third of neonates had poor outcome. Abnormal neurological and cardiorespiratory examination at admission; low oxygen saturation, glucose and pH; and hypoxic ischemic encephalopathy-III were predictors of poor outcome.


2020 ◽  
Vol 57 (3) ◽  
pp. 213-217 ◽  
Author(s):  
Chinmay Chetan ◽  
Suvasini Sharma ◽  
Surendra B. Mathur ◽  
Puneet Jain ◽  
Satinder Aneja

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