Multiorgan dysfunction (MOD) in falciparum malaria in children: a study from high endemic area of Southern Odisha

Background: To find out the prevalence of multiorgan dysfunction in cases of severe falciparum malaria in children, correlating the organ dysfunction in different age group and relationship with case fatality rate (CFR).Methods: This prospective cross-sectional study was conducted from Jan 2014 to June 2016 in the Department of Pediatrics, Maharaja Krushna Chandra Gajapati medical college and hospital (MKCG MCH), Berhampur, Odisha, India. Total 340 cases belonging to 5yr age group. Hyperparasitemia (>10%) was detected in 12.35% cases. Cerebral malaria was most common organ dysfunction found in 1-5 years, followed by anaemia in 5-10 years, acute renal failure (ARF) in 10-14 years age group. Multiorgan dysfunction (MOD) was detected in 32.94% cases of severe malaria. Overall CFR was 8.82%, being directly proportional to no. of organ involvement, 31.81% with 4 organs and 100 % with five organs involvement respectively which was statistically significant.Conclusions: MOD is of grave outcome in severe Pf malaria increasing the case fatality rate proportionate to number of organs involved

Hyperekplexia in a neonate: a seizure mimicker

Hyperekplexia is an exaggerated startle to external stimuli associated with generalized increase in tone seen in a normal newborn with both sporadic as well as genetic predisposition. This is an uncommon neurological entity that is often confused with seizure in infancy. To date about 150 cases have been reported in the literature. We report a 6-week-old infant with characteristic intermittent generalized tonic spasm misdiagnosed as seizure disorder and was on phenobarbitone. With characteristic stiffening episode and exaggerated startle without habituation on tapping the nose we came to a clinical diagnosis of Hyperekplexia or Stiff baby syndrome or Startle disease. The child was started on Clonazepam to which he responded remarkably with decreased startle reflex. The aim of this case reporting is to through insight to this disease entity when we see an intermittent hypertonic infant

Nephrotic syndrome in a case of Rubinstein Taybi syndrome: a rare case report

Rubinstein Taybi syndrome (RSTS) also known as Broad Thumb Hallux Syndrome characterized by distinct facial features with beaked or straight nose, short stature, moderate to severe intellectual disability, broad thumb and big toe. We report an interesting case of female child with history and examination suggestive of RSTS with Nephrotic syndrome. Investigation revealed presence of albumin in urine with hypercholesterolemia and hypoalbuminemia. Purpose of this case report is to highlight the distinctive presentation of this syndrome and to update the current state of knowledge

Etioclinical profile and outcome of acute bacterial meningitis in post neo natal U-5 children: a study from tertiary care center of coastal Odisha, India

Background: Acute bacterial meningitis (ABM) continues to remain an important cause of morbidity, mortality and handicap in children despite availability of wide range of antimicrobials. The microorganisms vary according to age, socio economic condition and geographical area along with other factors.Methods: A prospective study was conducted over 2.5 years from October 2012 to April 2015 in the department of pediatrics, SVP Institute of Pediatrics, SCB Medical College, Cuttak, Odisha, India. Total 104 subjects were included after taking meticulous inclusion criteria.Results: Out of 104 cases, majority (70.2%) were infants. 60.6% were male with M:F ratio 1.5:1. Fever was the commonest symptom in 69.2% followed by convulsion 61.5%, vomiting 36.5%, altered sensorium 33.7%. On examination 69.2% children were febrile, having bulging fontanelle in 34.6%, pneumonia 31.7%, positive meningeal sign 29.8%, cranial nerve palsies 14.4%, papilledema 12.5% and hemiplegia 11.5% cases. GCS were poor (100/cumm). In 82 cases (78.8%) etiological agents were identified consisting of H. influenzae in 46.4%, S. pneumoniae in 36.6%, E. coli in 8.6% and others in 8.4%. CT scan of brain revealed brain edema in 29.4% followed by subdural effusion 19.6%, hydrocephalus 17.6% and infarction in 5.9%. 63.5% children were recovered completely. Mortality was 16.3% with sequelae in 20.2% cases.Conclusions: Hib and Pneumococci were two most common organisms causing ABM in U-5 children with high mortality and sequelae which can be prevented by early diagnosis, optimum lab diagnostic facility and mass vaccination. There is urgent need to include Pneumococcal vaccine in NIP for substantial reduction of infant mortality

Multiorgan dysfunction (MOD) in falciparum malaria in children: a study from high endemic area of Southern Odisha

Background: To find out the prevalence of multiorgan dysfunction in cases of severe falciparum malaria in children, correlating the organ dysfunction in different age group and relationship with case fatality rate (CFR).Methods: This prospective cross-sectional study was conducted from Jan 2014 to June 2016 in the Department of Pediatrics, Maharaja Krushna Chandra Gajapati medical college and hospital (MKCG MCH), Berhampur, Odisha, India. Total 340 cases belonging to <14 yrs having severe malaria (as per the WHO criteria) were included in the study. Mixed malaria and Plasmodium falciparum (Pf) positive cases having other significant disease e.g. chronic hemolytic anaemia, cardiac, renal or other chronic diseases were excluded. The study subjects were thoroughly screened for presence of organ dysfunction clinically and by appropriate laboratory tests and analysed.Results: Out of 340 subjects, maximum no of cases (56.76%) were found in >5yr age group. Hyperparasitemia (>10%) was detected in 12.35% cases. Cerebral malaria was most common organ dysfunction found in 1-5 years, followed by anaemia in 5-10 years, acute renal failure (ARF) in 10-14 years age group. Multiorgan dysfunction (MOD) was detected in 32.94% cases of severe malaria. Overall CFR was 8.82%, being directly proportional to no. of organ involvement, 31.81% with 4 organs and 100 % with five organs involvement respectively which was statistically significant.Conclusions: MOD is of grave outcome in severe Pf malaria increasing the case fatality rate proportionate to number of organs involved

Hyperekplexia in a neonate: a seizure mimicker

Hyperekplexia is an exaggerated startle to external stimuli associated with generalized increase in tone seen in a normal newborn with both sporadic as well as genetic predisposition. This is an uncommon neurological entity that is often confused with seizure in infancy. To date about 150 cases have been reported in the literature. We report a 6-week-old infant with characteristic intermittent generalized tonic spasm misdiagnosed as seizure disorder and was on phenobarbitone. With characteristic stiffening episode and exaggerated startle without habituation on tapping the nose we came to a clinical diagnosis of Hyperekplexia or Stiff baby syndrome or Startle disease. The child was started on Clonazepam to which he responded remarkably with decreased startle reflex. The aim of this case reporting is to through insight to this disease entity when we see an intermittent hypertonic infant

A STUDY ON PREVALENCE OF METABOLIC SYNDROME AND ASSOCIATED CARDIOVASCULAR RISK FACTORS AMONG DIABETIC PATIENTS ATTENDING A TERTIARY CARE HOSPITAL IN EASTERN ODISHA

BACKGROUND Diabetes, particularly Type 2 greatly increases the risk of heart disease and stroke. Other conditions like high blood pressure, family history, obesity, alcohol, smoking & tobacco consumption contribute to the risk for developing cardiovascular disease. MATERIALS AND METHODS The study was conducted on 608 subjects in Medicine Department of KIMS, Bhubaneswar. Coronary artery disease (CAD) was diagnosed based on a combination of previous medical history, clinical findings and electrocardiogram (ECG) changes. Details of diabetes, hypertension, hypercholesterolemia, low high-density lipoprotein (HDL) cholesterol, hypertriglyceridemia and obesity/alcohol/tobacco/education status/occupation data were also documented. Objectives: The aim of the study was to determine the prevalence of Metabolic Syndrome (MetS) and associated cardiovascular risk factors among diabetics in an urban population attending a tertiary care hospital in Eastern Odisha. RESULTS The prevalence of different components of metabolic syndromes in diabetic and non-diabetic was as follows: (a). Dyslipidaemia (in diabetics 85.6% vs. in non-diabetics 78.3%), (b). Hypertension (in diabetics 73.3% vs. in non-diabetics 34.2%), (c). Obesity (≥90 cm in females/≥ 100 cm in males) (in diabetics 18.7% vs in non-diabetics 8.9%), (d). Raised fasting blood sugar (FBS) (in diabetic group 94.1% vs. in non-diabetic group 7.11%), (e). Raised systolic blood pressure (SBP) (in diabetic group 62.2% vs. in non-diabetic group 58.8%) and (f). Raised diastolic blood pressure(DBP) (in diabetics group 56.8% vs. in non-diabetics 44.2%). CONCLUSION This study has shown an increased prevalence of Metabolic Syndrome (49.5%), and through logistic regression analysis, has delineated the key risk factors driving morbidity. Most of the individual risk factors were more prevalent in women, compared to men; women were more likely to have Metabolic Syndrome. The most prevalent component was hypertension, followed by central obesity, low HDL-C and hypertriglyceridemia. Low educational status and obesity also have greater predictive effects on Metabolic Syndrome in type 2 diabetic