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 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. 

Abstract P354: Circulating Interleukin 17 A In Patients With Acute And Chronic Coronary Syndrome

2021 ◽  
Vol 129 (Suppl_1) ◽  
Author(s):  
Dinaldo C Oliveira ◽  
Edivaldo Mendes Filho ◽  
Mariana Barros ◽  
Carolina Oliveira ◽  
Joao Vitor Cabral ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Healthy Volunteers ◽  
Clinical Characteristics ◽  
Serum Levels ◽  
Cross Sectional Study ◽  
Interleukin 17 ◽  
Cross Sectional ◽  
Coronary Syndrome ◽  
Artery Disease

Introduction: Interleukin L-17 is produced by Th 17 cells and other cells. There is a debate if IL 17 is atherogenic or atheroprotective. The true role of this interleukin during the development and progression of the coronary artery disease is not known. Objective: To evaluate if there are differences between the IL17 A serum levels according to clinical presentation of the coronary artery disease. Methods: This is a cross sectional study which enrolled 101 patients with acute coronary syndrome (ACS), 100 patients with chronic coronary syndrome (CCS) and 100 healthy volunteers. Blood samples were taken from patients ( at admission) and controls to analysis the level of IL17A. Clinical characteristics were collected through questionnaires. This research was approved by ethical committee. Results: Comparisons of the clinical characteristics between patients with ACS and CCS revealed: mean age ( 62 ± 12.4 vs 63.3 ± 9.8, p = 0.4 ), male (63.4% vs 58%, p = 0.4) hypertension (85.1% vs 79%, p = 0.1) , disyipidemia (48% vs 31%, p =0.01), Diabetes Mellitus (47.5% vs 41%, p = 0.3), previous myocardial infarction (57.4% vs 40%, p = 0,01), smoking (29.7% vs 38%, p = 1). The peripheral concentrations of IL17A according to ACS, CCS and controls were: 5.36 ± 8.83 vs 6.69 ± 17.92 vs 6.26 ± 11.13, p = 0.6. Besides, the comparison between ACS and CCS showed: 5.36 ± 8.83 vs 6.69 ± 17.92, p = 0.3. Conclusion: The main finding os this study was that the circulating IL 17 concentrations were similar in patients with ACS, CCS and healthy volunteers). Besides, there was no difference between patients with ACS and CCS. Therefore, our hypothesis is that in patients with ACS and CCS the circulating IL 17 A concentrations are low or undetectable.

scholarly journals Characterization of depressive syndrome in schizophrenic outpatients

2002 ◽  
Vol 24 (1) ◽  
pp. 18-25 ◽  
Author(s):  
Flávio Soares de Araújo ◽  
Kátia Petribú ◽  
Othon Bastos
Keyword(s):  
Clinical Features ◽  
Clinical Picture ◽  
Depression Scale ◽  
Cross Sectional Study ◽  
Depressive Syndrome ◽  
Psychosocial Stressors ◽  
First Episode ◽  
Psychotic Episode ◽  
Cross Sectional ◽  
Dsm Iv

OBJECTIVE: The authors carried out a cross-sectional study with the aim of characterizing and describing depressive pictures in schizophrenic patients seen at the Psychiatry Outpatient Clinic of the Federal University of Pernambuco (HC-UFPE). The patients had the diagnosis of schizophrenia confirmed on the basis of the operating criteria of the DSM-IV. METHODS: Those who where in the period of stabilization of the clinical picture were selected for the study defined according the following criteria:the last psychotic episode must be happened two months before at least, and during this period the alterations of the antipsychotics doses had been lower than 5 mg of haloperidol or equivalent doses of others neuroleptics. A total of one hundred and four patients took part. Following the identification of the depressive symptoms using the Calgary Depression Scale for Schizophrenia (CDSS), thirty-one patients (29.8%) fulfilled the diagnostic criteria described in the DSM-IV. Of these, 22.1% had the diagnosis of major depression and 7.7% of minor depression according the DSM-IV. Two groups were constituted: Group A, schizophrenics with a depressive syndrome, and Group B, schizophrenics without such a syndrome. An assessment was made of the distribution of the symptoms of the CDSS scores in both groups, the sociodemographic, clinical and therapeutic variables in relation to the frequency of the depressive syndrome, and the patients clinical course. For the investigation of certain clinical features, the following tools were used: problem list (psychosocial stressors) contained in axis IV of the DSM-IV intended to detect the presence of factors triggering the initial episode of schizophrenia and the Global Assessment of Functioning (GAF -- Axis V -- DSM-IV) to characterize the current functioning of the patients. CONCLUSIONS: The results obtained allowed the authors to draw the following conclusions: all the items that comprise the Brazilian version of the CDSS were statistically significant in characterizing the depressive syndrome; a comparison of the sociodemographic and therapeutic variables revealed no statistically significant differences between the two groups, and this was also the case with the majority of the clinical features. Statistically significant differences, however, were found in relation to the greater frequency of life events (psychosocial stressors) in triggering the first episode of schizophrenia and the higher incidence of affective disorders antecedents in family members (first and second degree) among the depressed patients. The mean duration of the depressive syndrome during follow-up of the patients was 5.30 months. The patients in whom there was a recurrence of the psychotic episode presented a delusional-hallucinatory clinical picture. This study seeks to contribute to the inclusion of the Postpsychotic Depressive Disorder (PSD) of Schizophrenia (DSM-IV), in the group of Schizophrenic Disorders.

scholarly journals Clinical Characteristics of Pigment Dispersion Syndrome and Pigmentary Glaucoma Patients: A Cross-sectional Study

2020 ◽  
Author(s):  
Vijay Pratap Singh Tomar ◽  
Sandeep Sharma ◽  
Rahul Bhardwaj ◽  
Sindhuja Singh ◽  
Virendra Kumar Pal ◽  
...  
Keyword(s):  
Visual Field ◽  
Optic Disc ◽  
Clinical Characteristics ◽  
Cross Sectional Study ◽  
Pigment Dispersion ◽  
Pigmentary Glaucoma ◽  
Spherical Equivalent ◽  
Sectional Study ◽  
Cross Sectional ◽  
Pigment Dispersion Syndrome

Introduction: Pigmentary Glaucoma (PG) and Pigment Dispersion Syndrome (PDS) are two different spectrums of a single disease. Since the disease is seen in younger population and is rapidly progressive blinding disease, therefore early diagnosis and treatment will reduce the burden of the disease and improve the quality of life. Aim: To evaluate clinical characteristics of PDS and PG patients in eastern part of Uttar Pradesh. Materials and Methods: This was a two years (1st January 2018 to 31st December 2019) hospital‑based retrospective cross‑sectional study of patients who attended the glaucoma clinic. Diagnosis of PDS was made when they had normal optic disc, normal visual field {with or without increased Intra Ocular Pressure (IOP)} and at least two of the following three signs were found clinically: Krukenberg spindle, homogenous moderate‑to‑heavy (≥Spaeth 2+) Trabecular Meshwork (TM) pigmentation, and any degree of zonular and/or lenticular pigment granule dusting. Patients with PDS were diagnosed with PG, if they had two or more of the following findings: initial IOP >21 mmHg, glaucomatous optic nerve damage or glaucomatous visual field loss. Various parameters such as influence of demographics, IOP, Best‑Corrected Visual Acuity (BCVA), Central Corneal Thickness (CCT), Mean Deviation (MD), Visual Field Index (VFI %), spherical equivalent and clinical finding of anterior segment of study patients were analysed. Mean, standard deviation and percentage were calculated using GraphPad Instat version 3.0. Results: Among 40 patients, nine eyes of the six patients had myopia of ‑0.5D or greater, with mean refractive error of ‑3.55±4.72 spherical equivalent. The average baseline IOP in study patients (PDS+PG), was 30.21±11.42 mmHg. Twenty four (60%) patients, either in one or both eyes had glaucoma, secondary to PDS at the initial diagnosis. Thirty three (82.5%) patients had Krukenberg spindles. Homogeneous TM pigmentation was seen in all patients. Typical spoke‑like radial Iris Transillumination Defects (ITDs) were not observed in any of the patients except in one patient, who had isolated short slit‑like trans‑illumination defects in iris crypts. Conclusion: PDS patients with normal optic disc and visual field and raised IOP, should be started prophylactic treatment and needs to be monitored more closely. Thus, the finding of PDS in Indians should alert the ophthalmologist to look for glaucoma during the initial examination.

scholarly journals Clinical characteristics and outcome of vasculitides

2016 ◽  
Vol 3 (2) ◽  
pp. 3-9
Author(s):  
Buddhi Prasad Paudyal ◽  
Anjana Education Rajbhandari
Keyword(s):  
Medical Records ◽  
Clinical Characteristics ◽  
Cross Sectional Study ◽  
Health Sciences ◽  
Small Vessel ◽  
Small Vessel Vasculitis ◽  
Cross Sectional ◽  
The Mean ◽  
Schonlein Purpura ◽  
Overall Mortality

 Introductions: Vasculitides can cause significant morbidity and mortality if not treated on time. There is lack of data locally. This study aims to define the pattern, clinical characteristics, and outcome of vasculitides.Methods: This was a cross sectional study between January 2011 and December 2015 at Patan Hospital, Patan Academy of Health Sciences, Lalitpur, Nepal. The medical records of patients diagnosed with vasculitides in adults rheumatology service of the hospital were reviewed.Results: Ninety six patients were diagnosed with vasculitides during the study period. The mean age was 42.2 years. Sixty nine (71.8%) patient had small vessel, 20 (20.8%) large vessel and five (5.2%) had variable vessel vasculitides. Seventy five patients (78.1%) had primary and 21 (21.8%) secondary vasculitides. Cutaneous leucocytoclasticangitis was seen in 27 (28.1%), Takayasu arteritis in 17 (17.7), Henoch-Schonlein purpura in 11 (11.4%) and Rheumatoid arthritis associated vasculitis in nine patients. Purpura was present in all 96 (100%). The overall mortality was 9 (9.3%).Conclusions: Primary vasculitides were more common than secondary forms. Small vessel vasculitis was the most common. Cutaneous symptoms were predominant features. The mortality was attributed to active disease, sepsis, and complications of the primary disease. Journal of Patan Academy of Health  Sciences. 2016 Dec;3(2):3-9

scholarly journals The association between serum uric acid and diabetic complications in patients with type 2 diabetes mellitus by gender: a cross-sectional study

PeerJ ◽  
2021 ◽  
Vol 9 ◽  
pp. e10691
Author(s):  
Yimeng Hu ◽  
Qinge Li ◽  
Rui Min ◽  
Yingfeng Deng ◽  
Yancheng Xu ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Risk Factor ◽  
Clinical Characteristics ◽  
Independent Risk Factor ◽  
Binary Logistic Regression ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional

Background The relationship between serum uric acid (SUA) and several diabetic complications or co-morbidities remains a matter of debate. The study aims to explore the association between SUA levels and the prevalence of non-alcoholic fatty liver disease (NAFLD), diabetic retinopathy (DR), diabetic nephropathy (DN) and diabetic peripheral neuropathy (DPN) in patients with type 2 diabetes mellitus (T2DM). Methods A total of 2,809 participants (1,784 males and 1,025 females) were included in this cross-sectional study. Clinical characteristics and the prevalence of each of the four diseases were analyzed based on gender-specific quartiles of SUA levels. The Pearson correlation analysis and linear-regression analysis were used to access the correlation between SUA levels and clinical characteristics. Furthermore, a binary logistic regression analysis was carried out to determine whether SUA was an independent risk factor for each of the four complications. Results SUA levels were positively correlated to BMI, BUN, Scr and TG, but negatively associated with eGFR, HDL, FBG, 2h-PG and HbA1c% for the patients with T2DM. The prevalence of NAFLD and DN, but not DR or DPN, were increased with SUA levels from the first to the fourth quartile. Binary logistic regression further disclosed that SUA was an independent risk factor for NAFLD (ORs Male = 1.002, ∗P = 0.0013; ORs Female = 1.002, ∗P = 0.015) and DN (ORs Male = 1.006, ∗P < 0.001; ORs Female = 1.005, ∗P < 0.001), but not for DR and DPN. After adjustment for the confounders, SUA levels were significantly associated with NAFLD within the 3rd (ORs = 1.829, P = 0.004) and 4th quartile (ORs = 2.064, P = 0.001) for women, but not independently associated with SUA for man. On the other hand, our results revealed increased prevalence of DN for SUA quartile 2 (ORs = 3.643, P = 0.039), quartile 3 (ORs = 3.967, P = 0.024) and quartile 4 (ORs = 9.133, P < 0.001) in men; however, SUA quartiles were significantly associated with DN only for quartile 4 (ORs = 4.083, P = 0.042) in women Conclusion For patients with T2DM, elevated SUA concentration is an independent risk factor for the prevalence of NAFLD and DN after adjustment for other indicators, but not DR or DPN.

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