Seasonal variations among admitted paediatric patients at tertiary care hospital, Gadap Town, Karachi, Pakistan
Nighat SeemaHina KhanAsad. R. JiskaniErum SaboohiYasmeen ChannaSyed Muhammad MaqsoodAnus TariqTooba Jawed Khan
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Background: In pediatrics, the season is one of the elements contributing to the etiological factors of community based diseases. Awareness of this variation can help the physicians for prevention and counseling of the patients. A cross-sectional observational study was designed with non-probability convenient sampling technique to determine the frequency of patients admitted to the paediatric ward of the hospital in a whole calendar year and to ascertain which disease presentation is most common. Methods: Study conducted at paediatric ward of Al-Tibri Medical College and Hospital Karachi, Pakistan having patients admitted during May 2018 to April 2019. After ethical approval and informed consent from their parents/ guardian, a total of 734 paediatric patients that were admitted from paediatric OPD/ emergency were selected for the study. Paediatric patients that were referred, in emergency/ ICU and surgical paediatric patients were excluded from the study. Chi-square test was applied to evaluate the statistical variation among the patients.Results: From the 734 patients, 357 (48.6%) patients were of acute gastroenteritis, 104 (14.2%) of respiratory illness, 86 (11.7%) of viral fever, 67 (9.1%) of urinary tract infection, 36 (4.9%) of neurological illness, 29 (4.0%) of protein calorie malnutrition, 25 (3.4%) of enteric fever, 20 (2.7%) of haematological illness and 10 (1.4%) patients were admitted due to sepsis.Conclusion: Our study concluded that majority of the patients admitted were of acute gastroenteritis / admitted due to gastric issues, therefore further studies in the vicinity would help to better understand the issues and help plan a strategy to combat the diseases.Keywords:
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102 children with uveitis were followed up in both an ophthalmological clinic and in private practice. These cases were studied, using the same criteria for the anatomical and etiological classification. For each etiology arguments for certitude and probability were cautiously defined. The etiology could be ascertained in about 36.5% of the cases. Arguments for a presumptive etiology were found in about 23.1% more cases. The first cause was toxoplasmosis; the second cause was streptococcic hypersensitivity. An etiology was rarely found for intermediate uveitis.
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Toxoplasmosis
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Studies can be observational or experimental. With an observational study, the investigator does not determine the assignment of subjects, and there might not be a control group. If there is a control group, assignment of the independent variable (exposure or intervention) is not under the control of the investigator. Observational studies can be rigorously conducted, but the lack of random assignment of the exposure/intervention introduces confounding and bias. Thus, the quality of evidence resulting from observational studies is lower than that of experimental randomized controlled trials (RCTs). An observational study might be performed if an RCT is unethical, impractical, or outside the control of the investigator. There are many types of prospective and retrospective observational study designs. However, an observational study design should be avoided if an experimental study is possible. Sophisticated statistical approaches can be used, but this does not elevate an observational study to the level of an RCT. Regardless of quality, an observational study cannot establish causality.
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introduction: Seizure is the most common neurological illness in pediatric population, and its risk is highest in the rst year of life. A comprehensive study regarding etiology, clinical prole is required, hence the current study was undertaken. The objective of this work was to study the etiology, clinical prole of seizures in children aged less than 18 years.Objective: Materials and Methods: A descriptive study of children with seizure was conducted at Neurology outpatient department, and references from pediatrics department. All children with seizures were included. Biochemical and haematological investigations, imaging, and electroencephalogram were performed whenever necessary. Simple descriptive statistics were used to analyse the data in the form of frequencies with percentages as applicable. Out of 65 Pediatric patients who presented with seizures were Febrile seizure – Simple 4.6% (3)Results: ,Atypical 29.2% (19),Fever precipitated seizure 32.3% (21), Seizure disorder with developmental delay 20% (13),Unprovoked 6.1% (4),others (5) Seizure was the commonest neurological condition of children presenting to neurology OPD and referred from pediatrics. FeverConclusion: precipitated seizure being the commonest etiology. The prognosis and outcomes were good but there were prolonged days of hospitalization. Children with unprovoked seizures require brain-imaging studies for better understanding of seizure etiology.
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Pediatric Neurology
Tertiary care
Seizure Disorders
Outpatient clinic
partial seizures
Febrile seizure
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Seizure is the most common neurological illness in pediatric population and its risk is highest in the first year of life. Studies regarding etiology of afebrile seizures worldwide and in India are limited; hence, the current study was undertaken.The objective of this work was to study the etiology of afebrile seizures in infants aged 1 month to 1 year.A retrospective study of afebrile infantile seizure was conducted at pediatric neurology outpatient department between January 2015 and September 2017. All children with first episode of afebrile seizures were included. Biochemical and hematological investigations, imaging, and electroencephalogram were performed whenever necessary. Simple descriptive statistics were used to analyze the data in the form of frequencies with percentages and median as applicable.One hundred twenty-one children with a mean age of 8.1 months were analyzed. Of these children, 58% were males. Positive family history was found in 1.65% children, developmental delay in 70%, and dysmorphism in 8%. Presenting seizure type were generalized (74%), focal (21%), and unknown (6%) onset. Etiology was deducible in 92% cases. Structural etiology was the most common (66%), followed by metabolic (12%), infections (7%), and others (6%). In structural pathology, common causes were perinatal insult (38%) and cerebral malformations (18%). Imaging was done in 98 cases and yield was 83% (85 cases).Etiology was deducible in 92% of children. Seizures due to structural etiology, secondary to perinatal insult followed by metabolic and infections, are important causes. Imaging aids are important in etiological diagnosis. Etiological evaluation should be considered in children following first episode of afebrile seizures, especially in developing countries like India.
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Tertiary care
Pediatric Neurology
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Epilepsy is one of the most frequent diseases of the central nervous system (CNS) in children. It is considered that roughly 50% of epilepsies begin during childhood. The Department of Childrens' Neurology of the Medical Academy of Białystok embraces with medical attention over 500 children with epilepsy from the north-eastern region of Poland. The aim of the study was the analysis of etiology, clinical symptoms and treatment of epilepsy in children, who are under the medical attention of our Department. 392 children aged from 7 months to 18 and 2/12 years were included in the study. In the analysed groups were 46.6% girls and 53.4% boys. 44.4% of the children live in cities and 55.6% in small towns or villages. The etiology of epilepsy was established in 48.7% of the children. The most common etiology of epilepsy were hypoxic-ischemic damages in perinatal period, developmental malformation of the brain, craniocerebral injuries and neuroinfections in the neonatal period. In 50.3% of the children the etiology of epilepsy was unknown. The most common types of seizures were primary and secondary generalised tonic-clonic seizures. 92.6% of the patients received the antiepileptic drugs during the study. Monotherapy was administered in 66.0%, politherapy in 26.5% of the children. The results relating to the etiology and clinical picture of epilepsy in our children are consisted with many dates from literature. It is a favourable observation, that in many children monotherapy is an effective treatment.
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Etiology and pathogenesis of MCA/MR in 1,023 patients (618 male; 405 female) with mental retardation were studied. Of 1,023 patients, there were 563 cases (317 male; 246 female) with MCA (55%). Among the MCA patients, there were 303 (156 male; 147 female) whose primary etiology was clarified (53.8%). Among the 260 patients with MCA/MR of unknown etiology, there were 23 with recognizable syndromes of unknown etiology and 7 previously reported by us as possibly having a new malformation syndrome. We had 569 patients with mental retardation of unknown etiology including 236 (41.5%) who were involved with MCA.
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Introduction: Neonatal seizures are significant because most of them are treatable if a specific cause is identified. Prompt diagnosis is important to plan correct treatment. The time of onset of seizures is closely related to the aetiology of seizure Objectives: The objective of the present study is to know the etiology of seizures, the time of onset, relation to the cause and the common types of seizures Methodology: 102 neonates presenting with seizures admitted in the NICU of RMH, Thanjavur Medical College, Thanjavur during January 2014 to august 2014 were taken for study, Detailed antenatal, natal and post natal history were taken and examination of baby done and HIE staged according to Modified Sarnat’s staging. Then relevant investigations were done and etiology of neonatal seizures were diagnosed and staged Results: In the present study, out of 102 neonates studied, 82 were full-term, among these 60 (58.8%) were AGA and 22 (21.6%) were SGA. 19 babies (18.6%) were preterm. Male: Female ratio in our study was 1.5:1. Conclusion: The most common etiology for neonatal seizures is HIE. Onset of seizures during first 3 days of life has significant correlation with HIE as etiology. Subtle seizures is the commonest type of seizures and is difficult to identify. Keywords: Neonatal seizures; Birth asphyxia; HIE; Subtle seizures; Hypoglycemia
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The purpose of this study was to investigate the clinical characteristics of children with mental retardation (MR) of unknown etiology for early recognition and intervention. In this study, we defined children with MR of unknown etiology as those without clear etiologies for MR despite extensive evaluation and were not associated with pathological behavioral problems such as pervasive developmental disorders and attention-deficit/hyperactivity disorder. The clinical characteristics of children with MR of unknown etiology were as follows. 1) MR of unknown etiology was 48.8% of all MR. 2) MR of unknown etiology was more common in males. 3) Delayed language development was a leading factor that made the parents of children with MR of unknown etiology seek help from physicians. However, most of the children with MR of unknown etiology showed a relatively uniform delay in several areas of development. 4) Most children with MR of unknown etiology were delayed walkers. 5) Most children with MR of unknown etiology were mild cases.
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One hundred cases of urticaria were studied to find out the etiology and to detect any co-relation between etiology and clinical manifestation. In 59% cases an etiological factor could be detected and the diagnosis was more certain in acute cases. In more than two-third of cases of chronic utricaria, the etiology could not be detected. Type and distribution of the lesions did not suggest any particular etiology except in the cases of physical and cholinergic urticaria.
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