Significant advancement has occurred over the years in diagnosis, recognition, intervention and impact of acute kidney injury (AKI) on morbidity and mortality in critically-ill neonates. However an ...increased risk of chronic kidney disease (CKD) is still observed among neonates who survive an episode of AKI. Therefore, preventing and adequately managing AKI in neonates could help in controlling long-term renal morbidity in neonates who develop AKI. Thus, this study was undertaken with the aim of studying the incidence, contributing factors and outcomes of AKI in at-risk term neonates admitted to the neonatal intensive care unit (NICU).
One hundred and ninety-six term neonates admitted to the NICU with sepsis, hypoxic ischemic encephalopathy (HIE), dehydration and respiratory distress were enrolled and evaluated over a period of one year. Detailed maternal history along with neonatal history, anthropometry, vitals and clinical signs of neonates were recorded in a pretested proforma. Urine output was measured in all at-risk neonates. Serum creatinine was estimated to categorize AKI into stages as per modified KDIGO criteria.
Incidence of AKI was 21%, (n = 107 out of 510 admissions) in the study. Mortality was significantly higher in AKI stage III neonates (88.9%) (p < 0.001). Multivariate analysis revealed that hypoxic ischemic encephalopathy (HIE) had 35.293 (p < 0.001) times higher risk, while sepsis had 35.701 (p < 0.001), dehydration had 30.260 times (p < 0.001) and respiratory distress had 10.366 times (p < 0.001) higher risk of developing AKI.
Our study recorded a high incidence of AKI among at-risk neonates. KDIGO criteria for diagnosing AKI is feasible to apply in the at-risk neonates and helps in its early identification. Early diagnosis and timely intervention in neonates with HIE, sepsis, dehydration and respiratory can prevent the progression of AKI and thus improve prognoses.
Quality of life in children with epilepsy Nadkarni, Jayashree; Jain, Arti; Dwivedi, Rashmi
Annals of the Indian Academy of Neurology,
10/2011, Volume:
14, Issue:
4
Journal Article
Peer reviewed
Open access
Epilepsy is a chronic medical condition with many co-morbid features. It has been observed that children with epilepsy (CWE) have a compromised quality of life (QOL).
To assess the QOL in CWE and to ...study the various factors affecting QOL among CWE.
The sample consisted of 102 CWE aged 5-15 years of either sex. QOL was measured by Quality of Life in Childhood Epilepsy (QOLCE) questionnaire, a 76-item, parent-reported questionnaire. Cronbach alpha was used to determine the internal consistency of the subscales and Pearson correlation to determine construct validity. The t-test and analysis of variance were used to compare mean QOLCE scores.
Factors affecting QOL included age, place of residence, socioeconomic condition, maternal education, seizure type and frequency and number of antiepileptic drugs.
CWE have a relatively compromised QOL and comprehensive care needs to go beyond the attempt of controlling seizures.
Introduction: Dengue is a common arboviral infection in tropical areas of world with increased incidence in the past few years. Spread of disease has led to increased recognition of various atypical ...manifestations apart from the classical features. This study was conducted to find out the neurological and cardiac manifestations of dengue in children.
Methods: This observational study was conducted in a tertiary referral centre in Central India. Cases were classified based on the WHO 2009 Dengue guidelines for the diagnosis, treatment, prevention and control. The neurological and cardiac manifestations of dengue were studied and compared with those cases without manifestations.
Results: In this study, a total of 75 dengue cases were included and out of them, five (6.75%) cases presented with CNS abnormalities. The most common neurological manifestations were fever with seizures, altered sensorium, vomiting and headache. Hepatomegaly, hypotension, coagulopathy, and leucocytosis (> 11,000 cells/mm3) were significantly associated with neurological dysfunction (p < 0.05). Ten children out of 75 (13.33%) had cardiac manifestations. They included bradycardia in five cases, tachycardia and signs of CCF in three cases and shock in two cases. Echocardiographic evaluation showed mild pericardial effusion in one patient.
Conclusions: Dengue poses a huge burden to healthcare system with its various atypical manifestations. A better understanding of neurological and cardiac clinical manifestations of dengue will reduce morbidity and mortality in such cases.
Primary central nervous system tumours are a heterogenous group of diseases that are collectively, the second most common malignancy in childhood and adolescence. The overall mortality among this ...group approaches 30%. Despite of high mortality rates, outcomes of these malignancies has improved with neurosurgery, radiation therapy, and chemotherapy as a therapeutic modality. Here authors have reported a 4-year female child who was diagnosed with brainstem glioma in present institute. The child presented with the typical clinical presentations of brainstem glioma.
Background: Dengue is a mosquito-borne viral disease that has rapidly spread in all regions of WHO in recent years. It is an acute febrile illness, caused by infection with any of 4 related ...positive-sense, single-stranded RNA viruses of the genus Flavivirus, dengue viruses 1, 2, 3, or 4. Objective of study was to study the clinical profile of dengue viral infection in the paediatric age group.Methods: This observational study was conducted in a tertiary referral centre in Central India. Cases were classified based on the WHO 2009 Dengue guidelines for diagnosis, treatment, prevention and control and the clinical and laboratory parameters were analyzed for demographic and other correlates.Results: 75 patients met all the inclusion criteria and were analyzed. Most children were in age group 6-10 years. Fever, bleeding, rash, abdominal pain and vomiting were the common symptoms. We noted some atypical symptoms also.Conclusions: When infected, early recognition and prompt supportive treatment in dengue infection can substantially lower the risk of medical complications and death.
This study sought to find out the correlation between serum concentration of thyroid hormones and grade of malnutrition among 60 children between 1-5 year having PEM. With increasing severity of ...malnutrition, the serum concentration of T3 and T4 progressively decreased and that of serum TSH increased.
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