Ischaemic stroke resulting from minor head injury are rare in children, as trauma usually results in intracranial bleed. We report a case who presented with right sided hemiplegic stroke due to trivial trauma. 11 year old girl who was previously healthy, presented with right sided facial palsy and ipsilateral hemiplegia of one day. MRI brain showed left sided middle cerebral artery territory infarct. MR angiography showed left middle cerebral artery territory infarct involving the left gangliocapsular region, left corona radiata and left frontotemporal lobe, suggestive of occlusion. On enquiry mother revealed fall from stairs 3 days back.
Background: Dengue fever continues to be one of the major public health problems in large parts of the world, with an estimated 50 million dengue infections occurring annually. Liver enzyme variation is commonly seen in patients with dengue fever. This study was undertaken to assess the pattern of liver enzyme variation in children with dengue fever and to correlate it with the severity of this disease.Methods: Observational, descriptive hospital-based study involving 100 children who were serologically positive for dengue fever. The cases were classified as Mild, Moderate and Severe Dengue based on National Guidelines of clinical management of Dengue fever, 2015 and severity was assessed in each category. The study assessed the variability of liver enzymes in these children.Results: Aspartate Aminotransferase (AST) was elevated in 56 cases whereas Alanine Aminotransferase (ALT) was elevated in 44 cases. The elevation in liver enzymes in mild cases was 52%, moderate cases was 75% and severe cases was 100%. In cases presenting on day 1 of fever, enzymes were elevated in 0%, on day 2 in 20%, on day 3 in 38%, on day 4 in 51%, on day 5 in 90% and on day 6 in 88%.Conclusions: Liver Enzyme (AST and ALT) elevation in Dengue is a common feature. AST elevation was more common than ALT. Highest elevation in liver enzymes were observed on 5th and 6th day of fever. Liver enzyme elevation was more commonly seen in moderate and severe cases.
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