scholarly journals A Survey of Physicians’ Opinion and Treatment Preferences Regarding Febrile Seizures in Children

Author(s):  
C. Tulasi Priya ◽  
Chaudhary Devand Gulab

Background: Fever of either low or high-grade is a big concern when present in the pediatric age group; it is much more worrisome if children are younger than 5 years of age. Fever can subside on its own or with the help of simple remedies and or medications. However, some children will develop seizures when they have a fever. Febrile seizures are one of the most common presenting complaints seen in pediatric patients in emergency room visits and physician consult. Two different types of seizures are seen in children, simple and complex seizures. Simple febrile seizures are non harming and self-limiting, while, complex seizures are prone to have long-term side effects on children. Febrile seizures can occur with or without a source of an underlying cause. In this study, we aimed to identify physicians’ opinions, knowledge, and suggestions to improve guidelines on current treatment trends for fever and fever’s association with febrile seizures in children less than 5 years of age. Objectives: To determine physicians’ opinion knowledge, and suggestions to improve guidelines on current treatment trends for fever and fever’s association with febrile seizures in children less than 5 years of age.  Methods: A cross-sectional study plan was designed and conducted in June - July 2021 involving general physicians and pediatricians (n = 600). The questionnaire form including 15 closed-end questions was distributed to physicians. Descriptive statistics were used to analyse the data.  Results: 100% of physicians prescribed antipyretics to control fever and or to prevent complications, especially febrile seizures. All participants were aware that axillary temperature of > 37.2 ° C is defined as fever. All most all, general physicians and most pediatricians used antipyretics to treat other associated symptoms and signs, even when the fever was absent. 76.3% believed that high fever might be an indicator of underlying serious occult bacterial infection. Almost all physicians (91.3%) advised parents to switch to the use of alternate medication when the fevers did not subside after initial treatment with paracetamol; everyone recommended that non-medical supportive treatments like tepid sponging along with antipyretics and ibuprofen to reduce the fever soonest possible. 68% of pediatricians and 90% of general practitioners believe that febrile seizures will cause brain damage. 74% of general practitioners preferred to refer children immediately to specialty centers, for further management of seizures. However, Pediatricians at tertiary care centers, as well as those in private practice used diazepam or lorazepam.    Conclusion: Differences are negligible between general physicians and pediatricians while managing fever and fever complications including febrile seizures. Irrespective of the knowledge, awareness and the availability of fever guidelines by many national and international organizations, physicians are leaning towards child and parents comfort in treatment fever. The gap is wider in general physicians’ preparedness than pediatricians. A considerable gap exists to improve physicians' approach, diagnosis, and management of fever in the pediatric population.

2020 ◽  
Vol 7 (9) ◽  
pp. 1906
Author(s):  
Ashna Kumar ◽  
Javid Ahmad ◽  
Pooja Bharti ◽  
Vasundhara Bakshi

Background: India has one of the highest TB burden globally. Children contribute a significant proportion of TB burden, in whom the diagnosis can be challenging because many childhood diseases mimic TB. Therefore, a high index of suspicion is required for early diagnosis of childhood tuberculosis to prevent poor outcome. Objectives was to evaluate the prevalence and profile of childhood tuberculosis cases and to determine the risk factorsMethods: An observational cross-sectional study was conducted over a period of 6 months at a hospital in north India and the prevalence and profile of the children admitted with the clinical suspicion of tuberculosis was studied. Case specific diagnostic approach was used for diagnosis and the appropriate treatment was instituted.Results: The prevalence of childhood TB was 2.3% among hospitalized children. Of these, 66.5% were males and 33.49% were females. The majority of cases were more than 8 years. The history of contact was present only in 31.1%. Tuberculin skin test was positive in 53.11%. Pulmonary tuberculosis was the most common type of childhood tuberculosis (45.45%) followed by neurological tuberculosis (42.8%), abdominal tuberculosis (6.45%), tuberculous lymphadenitis (2.63%), others (2.61%). Malnutrition was a potent contributing factor present in 91.86%. The mortality rate observed in the study was 9.56%.Conclusions: Owing to the high burden of tuberculosis among pediatric population in India, there is an alarming need to develop more economical and advanced diagnostic methods for better patient management and above all there is urgent need of the hour to educate the masses about the transmission and risk factors for this disease.


Author(s):  
S. Dhanya Dedeepya ◽  
Vidhyasagar Krishnamoorthy ◽  
P. Ambikapathy

Aim: To assess the knowledge, attitude and belief of Parents about fever in their children and how they respond to it while at home and when they seek medical attention. Objectives: The purpose of this study is to know the preexisting knowledge of parents about fever in their children and to impart additional knowledge to them. Materials and Methods: A Cross- Sectional study in the form of a questionnaire was conducted at a tertiary care hospital among parents of children visiting the outpatient department and those admitted as inpatient with fever. Children who presented to the emergency room and those with chronic illnesses were not included. Majority of the primary caregivers was the child's mother, and family becomes the 1st point of contact for the intervention, hence we chose family. As per our department that at least 80% of children were primarily brought to OP for fever, and 90% of those admitted in wards were for febrile illnesses, with or without other associated problems, we asked the statistician to come up with an adequate number and we were given.  Results: A total of 100 parents were selected and interviewed. The informants were mostly mothers (83%). Most of the children were brought to outpatient department within the first five days of onset of fever (68%). The parents said that they confirmed the fever by touch(86%)and most of them prefer to consult the pediatrician before giving any medication (56%).The most common symptoms which were seen associated with fever are cough, cold  and  running nose (54%).The most common cause for worry amongst parents are complications like febrile seizures (43%). Conclusion: Fever is one of the most common complaints with which patients come to the hospital. Majority of parents in this study do not have the practice of documenting fever at home with a thermometer. Inadequate parental knowledge about the nature of fever can lead to poor management. Appropriate education helps them to take appropriate measures when their child develops fever.


Author(s):  
Pralhad Sureshrao Potdar

Background: Convulsion is the most common neurologic finding in children (10%). Prevention of febrile convulsions is therefore desirable, and is of particular relevance in children with factors carrying a high risk of recurrence. Aim and Objectives were to study the demographic profile and some risk factors of febrile seizures among children.Methods: A record based descriptive cross-sectional study was conducted at paediatric department of Dr. S.C.GMC, Nanded. Considering inclusion & exclusion criteria all children in the 6 month to 6 year age who were diagnosed as having febrile convulsion admitted during January to December 2015 were included in the study.Results: Of the 288 children 173 (60.1%) were boys and 115 (39.9%) were girls. 46.9% children were in the 1-3 year age group. Mean age of occurrence was 2.8 years (±1.5 years). In this study, 80.2% (231) of the patients had simple and 19.8% (57) had the complex form of febrile seizure. In our study, 51.73% (149) of affected children had positive family history of febrile seizure. URTI (9.7%) followed by AGE (7.3%) was the most common co-morbidity. 54.2% children were hospitalized for 1-3 days.Conclusions: Most of the children had a positive family history and the most common causative factor was URTI, LRTI, AGE etc. are associated with febrile convulsion and these diseases can be managed effectively thereby reducing the occurrence of febrile convulsion. 


2018 ◽  
Vol 25 (03) ◽  
pp. 461-465
Author(s):  
Nathumal Maheshwari ◽  
Om Perkash ◽  
Mehmood Shaikh ◽  
Bilawal Hingorjo ◽  
Yasmeen Kazi ◽  
...  

Objectives: To determine the serum zinc levels in children with simple febrileseizures reporting at a tertiary care hospital of Sindh. Study Design: Cross sectional study.Place and Duration: Department of Paediatrics, Layari General Hospital Shaheed MuhtramaBenazir Bhutto Medical College from January 2015 to February 2016. Methodology: A sampleof 120 children (60 cases and 60 controls) was selected through non- probability (purposivesampling) by pre defined inclusion and exclusion criteria. 3 ml venous blood was taken from aperipheral vein. Blood was process, centrifuged and sera were used for the analysis of serumzinc. Data of cases and controls was analyzed on Statistix 10.0 software (USA). P-value of≤0.05 was considered statistically significant. Results: Age of controls and cases was notedas 13.68±8.74 and 15.75±9.11 months respectively and most common age group was 12 - 24months in the cases. Male children predominated. Means± SD serum zinc was 79.03±24.17and 62.82±14.66 in controls and cases respectively (P=0.0001). Low serum zinc was noted in66.6% of cases compared to 40% in controls (P=0.0001). Conclusion: We noted low serumzinc levels in children with febrile seizures which may provoke febrile seizures. Children with lowserum zinc levels are prone to febrile seizures. 


Background: The bacterium Salmonella enterica serovar typhi causes typhoid fever which is a life-threatening systemic infection that mainly occurs in developing countries of the world and remains a major public health issue. Paratyphoid fever is caused by Salmonella enterica serovars Paratyphi A and B and (infrequently C). Appropriate and immediate antimicrobial therapy is required for the prevention of complications and mortality due to enteric fever. Therefore, this study is designed to investigate the current sensitivity pattern of Salmonella typhi so that appropriate antibiotics can be initiated on time. Objective: To determine the sensitivity pattern of Salmonella typhi in enteric fever among the pediatric population visiting a tertiary care hospital. Methods: This cross-sectional study was carried at the Department of Pediatrics in National Institute of Child Health Karachi from 13-12-2019 to 13-06-2020 after acquiring ethical approval from the hospital committee. There were 149 children aged 3-12 years of either gender diagnosed with enteric fever selected for this study. Patients' information was collected on pre-designed proforma. Blood of five milliliters quantity was drawn and sent to the pathology department within 12 hours of the admission. Salmonella typhi was identified by biochemical testing of the suspicious non-lactose fermenting colonies. Mueller Hinton Agar medium was used for testing antibiotic sensitivity. The sensitivity of the drug was interpreted as Sensitive, Intermediate and Resistant based on inhibition zone size. Results: The average age of the children was 5.56±2.39 years. Sensitivity for meropenem, azithromycin was 100% and 93.3% respectively while the sensitivity of ciprofloxacin was 53.7%. Ampicillin, Co-trimoxazole, Chloramphenicol and Ceftriaxone were more than 80% resistant. Conclusion: Our study confirms the sensitivity for meropenem, azithromycin, ciprofloxacin. Ampicillin, Co-trimoxazole, Chloramphenicol and Ceftriaxone showed higher resistance. This study emphasizes the need for continuous evaluation and judicious use of antimicrobials, considering the ever-changing antibiogram.


Cephalalgia ◽  
2021 ◽  
pp. 033310242198963
Author(s):  
Theodoros S Constantinidis ◽  
Chryssa Arvaniti ◽  
Nikolaos Fakas ◽  
Jobst Rudolf ◽  
Evangelos Kouremenos ◽  
...  

Objective To estimate the prevalence, burden and current treatment of disabling primary headaches in a large sample of the Greek population aged 18–70 years old. Methods This is an observational descriptive study, with cross-sectional design performed by quantitative computer-assisted telephone interviews, using a validated 37-item questionnaire for headaches. The prevalence, burden, and current treatment of primary headaches (ICHD-3) were recorded along with participants’ treatment preferences. Results Out of 10,008 interviewed participants, 1197 (12.0%) reported headaches affecting performance. The annual prevalence of migraine was 8.1% (95% confidence interval, 7.6–8.7, corresponding to 0.6 million Greeks), of chronic migraine 1.0% (95% confidence interval, 0.8–1.2, corresponding to 0.1 million), and of tension-type headache 3.8% (95% confidence interval, 3.4–4.2, corresponding to 0.3 million). The participants with headaches reported 0.5 headache-induced lost workdays per month (corresponding to 5.8 million lost workdays annually) and reductions in performance on 2.8 workdays per month (corresponding to 30.9 million workdays annually). In all, 43.4% of headache participants felt bad/ashamed because of headaches and 21.9% sought professional treatment, most often from a private neurologist. 83.8% of headache participants had never taken pharmacological prophylaxis, and only 5.5% were currently under preventative treatment. For both prophylactic and acute treatment, headache participants prefer oral medication to injection or stimulation devices. Conclusion More than 10% of the Greek adult population up to 70 years old experience disabling headaches, causing a dramatic work loss. More than 80% of these have never taken pharmacological prophylaxis. Thus, enriching the quality of life of people with headaches relies crucially on expanding awareness about headaches and their treatment.


Author(s):  
Muhammad Iqbal Afridi ◽  
Jawed Akbar Dars ◽  
Chooni Lal ◽  
Rakesh Kumar ◽  
. Sadia ◽  
...  

Objectives: To assess the general practitioner's perspective on mental illness in a tertiary health care setting. Study Setting and Duration: Online seminar in March 2020, Jinnah Postgraduate Medical Centre, Karachi. Study Design: Cross-sectional, Observational study Methodology: A total of 152 general practitioners were enrolled in the study. All house officers, psychiatric specialists, staff members, and patients were excluded from the study. An online survey instrument was used to collect data from general practitioners through social media. The questionnaire was related to the biodata of the physicians and their perspective on mental health disorders. Data was analyzed by using SPSS Version 26. Results: A total of 152 general practitioners participated in the study. The mean age of participants was 39.76 (11.540) years. The majority of them were male and married with an average experience of 12.80 (10.90) years. According to the participants, the most common symptoms experienced by patients with mental disorders were loss of appetite, hopelessness, and the loss of interest in day to day activities. The majority of the doctors confessed they find the treatment and management of psychiatric illnesses the hardest. Most of the participants were aware of the diagnostic criteria used for common mental health disorders. Over a hundred (66.4%) participants considered mental health disorders to be a medical disorder while 16 (10.5%) assumed it is the possession by supernatural creatures. 65 (42.7%) of the doctors confessed that they would not feel comfortable having a coworker or befriending a person with a diagnosed mental health issue. Conclusion: Our findings suggest that general physicians had good knowledge about common mental illnesses; however they found the management of these patients difficult. Mental health awareness and training intervention tools are needed to help improve the perspective of health care professionals towards patients with suspected mental illnesses.


2020 ◽  
Vol 24 (3) ◽  
pp. 245-248
Author(s):  
Syeda Mamoona Qudrat ◽  
Najaf Masood ◽  
Ammara Khalid ◽  
Tanzeela Rani ◽  
Mobeen Tabussum ◽  
...  

Objective: To find the association between zinc deficiency and febrile seizures in children of 6 months and 5 years of age. Materials and Methods: Cross-Sectional Descriptive Study was carried out at the Department of Pediatrics, Benazir Bhutto Hospital, Rawalpindi for a duration of six months (From 11th March to 31st August 2017). After taking approval of the Ethical Research Committee of Rawalpindi Medical College and taking informed consent from the parents/ guardians, children selected according to the inclusion/exclusion criteria. Patient profile including name, age, sex, address, hospital number, serial number, date of inclusion in the study was noted. Data was collected from the Patient’s charts and/or by direct interview of the child’s guardian. Using aseptic measures, 2ml of blood from venipuncture utilizing a 22-gauge antiseptic needle, in no more than 24 hours of hospital visitation was reserved. Evaluation of serum zinc was completed in no more than 6 hours of collection. The copy was then given to the lab testing and thus this report was then approved by the physician. Results: In our study, out of 145 cases, 52.41%(n=76) were between 1-3 years of age whereas 47.59% (n=69) were between 4-6 years of age, the mean and standard deviation was calculated as 3.54 + 1.50 years, 50.34% (n=73) were male whereas 49.66% (n=72) were females. Mean serum zinc levels were calculated as 64.28 + 12.13 mcg/dl. The frequency of hypozincemia in febrile seizures among children presenting at tertiary care hospitals was 54.48% (n=79). Conclusion: These analysis outcomes depicted that children with febrile seizures had notably lesser serum zinc measures.


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