NEUROLOGICAL ABNORMALITIES IN CHILDREN WITH T1DM: NEUROLOGICAL ABNORMALITIES IN CHILDREN WITH T1DM

Objective: To find out the prevalence of neurological abnormalities in children between 5-15 years with type-1 DM of at least 2 years duration and the risk factors associated with the development of neurological abnormalities. Methods:Hospital based cross sectional study on 150 Children of 5 to 15 years age having type I diabetes of at least 2 years duration by simple random sampling fulfilling the inclusion criteria, at Department of Pediatric Medicine, Sardar Patel Medical College and P.B.M. Hospital Bikaner. Results: mean age was 10.9 ± 3.6 years, male to female ratio was 1.63:1. Prevalence of peripheral neuropathy was 42.3% when 1 abnormal attribute in atleast 1 nerve was considered, it was 7.3% when 2 abnormal attributes in 2 nerves was considered, 4.6% had autonomic neuropathy and 4% had cognitive abnormalities. The peripheral neuropathy was subclinical in substantial number of cases as up to 39.4% and 39.3% type 1 DM cases having peripheral neuropathy had normal Neuropathic symptom score and Neuropathic disability score respectively. Female, longer duration of diabetes, higher mean age of diagnosis, higher mean HbA1c level were significantly more likely to develop peripheral neuropathy. Conclusion: neurological complications begin quite early and insidiously in Type1DM patients highlighting the importance of early and regular screening by nerve conduction study

Clinical Profile and Outcome of Patients Presenting with Mushroom Poisoning in a Tertiary Care Center of Eastern Nepal

Introduction: Accidental mushroom poisoning is constantly seen and regularly reported from all over world. Exact magnitude of problem and its clinical profile in Nepal is not well known. This study was done to evaluate clinical profile and treatment outcome of patients presenting with mushroom poisoning in the department of internal medicine, BPKIHS, Dharan. 
 Methods: It is a prospective observational study conducted in department of internal medicine, BPKIHS, Dharan from 1st January 2008 to 31st December 2009. Informed consent was taken. All the patients were subjected to necessary laboratory investigation. They were followed up at 1 week and 1 month after discharge. 
 Results: All together 60 patients were analyzed. Majority of subjects 56 (93.3%) were from rural areas. Vomiting and diarrhea were the two most common presentations seen in 56 (93.3%) subjects. The latent period for the symptoms were > 6 hours in 4 (6.7%) and < 6 hours in 56 (93.3%) subjects. Fulminant hepatic failure was seen in 6 (10%) subjects and among them 4 (66.7%) expired. After admission 3 (5%) subjects developed GI bleeding. Average duration of hospital stay was 4.6 days. In follow up recovery was complete in all subjects who survived the acute phase of poisoning. 
 Conclusions: Especially in patients coming during rainy season mushroom poisoning should be considered in the differential diagnosis of acute gastroenteritis. Mortality is high in subjects with FHF whereas recovery is complete in subjects who survived the acute phase. Keywords: fulminant hepatic failure; gastroenteritis; mushroom poisoning; wild mushrooms