BACKGROUNDTyphoid fever in children is a common childhood infection in both urban and rural regions in tropical countries. Clinical presentation is varied and overlaps many other acute febrile illness. MATERIALS AND METHODSStudy was a prospective descriptive study. The study was conducted in Institute of Child Health and Hospital for Children, Egmore, Chennai, Tamilnadu during the period of April 2013 to November 2015. Children aged 3-12 years with fever more than 5 days with no obvious focus of infection. Coated tongue, abdominal distension, toxic look, constipation or loose stools, hepatomegaly, splenomegaly, relative bradycardia was included. Children immunised with typhoid vaccine, children already on antibiotics, and children with documented typhoid fever in the past 8 weeks were excluded. It was aimed to analyse the clinical presentation and to compare the Typhidot test and Widal test with the culture positivity in children with typhoid fever. RESULTS167 children fitted into the inclusion criteria, of which 26 (15.6%) children were culture positive. 52 (31.1%) children were Widal positive, 49 (29.3%) were Typhidot test positive. Fever with anorexia was the common symptoms, and toxic look, coated tongue was the common signs in our study group. CONCLUSIONSBlood culture for typhoid fever is the gold standard, but is time consuming. In our study, we conclude that Typhidot shows high sensitivity and low specificity with higher negative predictive value when compared to Widal test. KEYWORDSTyphoid fever, Typhidot Test, Widal Test. Since the clinical features of the common infections like malaria, dengue, typhoid, leptospirosis and scrub typhus are very similar it is difficult for the treating physician to diagnose typhoid fever based on clinical features. (1,2,3) It is then mandatory to have a very valid diagnostic test with good sensitivity and specificity for an earlier diagnosis in children with acute febrile illness. (4,5) With increasing use of antibiotics, the clinical presentation is nonspecific and difficult to diagnose based on clinical features in children. HOW TO CITE THIS ARTICLE:

Background: Acute encephalitis syndrome (AES) is defined as the acute onset of fever and change in mental status (including symptoms such as confusion, disorientation, coma or inability to talk) and/or new onset seizures (excluding febrile seizures) in a person of any age at any time of the year. AES is reported mainly from Assam, Bihar, Tamil Nadu, Karnataka, Uttar Pradesh contributing approximately to 80% cases with case fatality rate of 20-25%. In view of paucity of clinical studies from Tamil Nadu, this study was undertaken to have a better insight on the clinical profile and prognostic indicators of AES in children. Objective of present work was to study the clinical profile and predictors of outcome of Acute encephalitis syndrome patients admitted in PICUMethods: This retrospective study was conducted in children with AES admitted to PICU, Stanley medical college over a period of 1year (May 2015-May 2016). 30 cases were studied. Clinical features, demography, immunisation status, and outcome were recorded. Results of blood investigations, peripheral smear, neuroimaging, CSF analysis and IgM ELISA for HSV, JE, CMV, Dengue were recorded and analysed.Results: Mean age of cases was 3.5±3.3years. Male to female ratio was 1.1:1. Etiology included HSV (6.67%), malaria (3.33%), dengue (3.33%), tubercular meningitis (3.33%), AES of unknown origin (83.3%) 11, Most common presentation was seizures 21 (70%). 17 (56.6%)presented with GCS <8. 11 (36.6%) required inotrope support, 16 (53.4%) were ventilated. Laboratorial findings included, leukocytosis in 17 (66.7%), dysglycemia in 12 children (39.99%), hyponatremia in 10 (33.33%), hypernatremia in 8 (26.67%) Mortality was observed in 11 cases (36.67%). Hyponatremia (p=0.02) and cases requiring ionotrope support on admission (p=0.0003) were significantly associated with mortality.Conclusions: There was no case of Japanese encephalitis. Hyponatremia being significantly associated with mortality among children with AES, warrants detailed evaluation to define the etiology which will aid in appropriate management. Maintaining euvolemia, prompt identification of shock and appropriate use of inotropes is of utmost importance. Varied and changing etiologies of AES poses a diagnostic challenge.

INTRODUCTIONIn the world wide pediatric age group urinary tract infection remains as silent yet very frequently faced infection. It produces significant mortality and morbidity among pediatric population due to inconspicuous clinical manifestations. It results in significant morbidity by producing irreversible damage to renal system that can never be salvaged if not recognized and treated early. Hence early recognition of subtle symptoms and signs will definitely provide good outcome among patients suffering from urinary tract infection.The etiology that predisposes to UTI is not very clear as not much studies are available worldwide to find the exact risk factors.1 If exact risk factors are known knowledge about prevention of risk factors help in the management of urinary tract infection as well as prevent recurrence. The risk factors of UTI depend on socioeconomic status and cultural habits like perineal cleaning methods and diaper usage.2-4 So, it is better to analyse the risk factors in specific cultural groups of different places so that the risk factors which is differing from population to population can be identified and different strategies can be formed for population with Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. ABSTRACTBackground: Urinary tract infection (UTI) is one of the common infections occurring in children causing significant morbidity and mortality. The knowledge about the risk factors helps in the management as well as preventing the recurrence of urinary tract infection. Hence this study aims to assess the various risk factors and profile of UTI. Methods: In this prospective case control study conducted in tertiary care centre between July 2011 to August 2012, children with signs and symptoms suggestive of urinary tract infection and urine culture positive for UTI were included. Age and sex matched asymptomatic children were taken as control. Preformed questionnaire was given to each patient and the results were analysed. Results: Among the 214 cases studied, 111 boys were not circumcised constituting 86.7%. Whereas the other risk factors like recent hospitalisation, recent catheterisation, common toilet usage, cleaning perineum from back to front, constipation, usage of tight underclothing, diaper usage, worm infestation, neurological abnormality, voluntary withholding of urine, reduced water intake constitute 9.3%, 0.5%, 19.6%, 17.4%, 18.2%, 0.9%, 7.9%, 26.2%, 3.7%, 33.6% and 34.6% respectively. Conclusions: Recurrent infection was most often due to unresolved bacteriuria or persistent bacteriuria than reinfection. Signs like supra pubic tenderness and hypertension are very rare. Common organisms causing urinary tract infection in our study population are E. coli followed by Klebsiella, Proteus and Pseudomonas....

Background: Temperature measurement is an important   procedure in the diagnosis and management of childhood illness. Rectal measurement of temperature is often done with resentment from the child, the parents as well as the physician.  Intra aural (Tympanic), temporal artery and axillary measurements are commonly undertaken for temperature recording in children. The aim of the study was to compare the various methods of temperature measurement (intra aural, temporal artery and axillary measurements) in children. This was a hospital based descriptive study (pilot study) from a pediatric tertiary care center.Methods: This was a hospital based descriptive study (pilot study) from a pediatric tertiary care center. 250 children admitted with history of fever in the pediatric ward. All consecutive children with fever were recruited for the study. Children with ear pain, ear discharge and wax in the ear were excluded.Results: Inter-group comparison was performed using student paired t-test. There was no difference in the temperature measured by axillary and temporal artery touch when compared with intra aural. Temperature measured by infra-red temporal at 3 cm showed significant lower temperature.  Temporal artery and    axillary measurements had a correlation coefficient of 0.74 and 0.64 respectively when compared    with intra aural measurement.Conclusions: Temporal artery and axillary measurements are not significantly different from intra aural measurement in children. For the ease of measurement, better correlation, better compliance of the child, temporal artery method   can be a reliable preferred temperature measurement in children with fever.

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