Background: Status epilepticus (SE) is a common, life threatening neurologic disorder that is essentially an acute, prolonged epileptic crisis. SE can represent an exacerbation of a pre-existing seizure disorder, the initial manifestation of a seizure disorder, or an insult other than a seizure disorder.Objectives: To study the aetiology, clinical profile, and outcome of SE in pediatric age group.Setting and study design: Prospective study at a tertiary care medical college hospital in Bihar, India. Materials and methods:Study was carried out for a period of one year (from April 2008 to March 2009). Seventy patients of SE in the age group of six month to 12 years were included in the study. Clinical history, general and systemic examination and relevant investigations along with pretested questionnaire were used to categorise different variables. Independent t-test was used for continuous variables and chi-square test for categorical variables.Results: Mean age for the study population was found to be 5.94 years (SD=3.152). Preponderance of male (60%) over female (40%) was observed. Aetiology included Idiopathic (27.14%), remote symptomatic (20%), acute symptomatic (47.14%), febrile (2.86%) and progressive encephalopathy (2.86%) groups. Generalised tonic clonic convulsion (GTC) convulsion was observed in 91.4% of SE patients while 8.6% had partial SE. Eighteen patients (25.7%) had prior history of convulsion whereas 52 patients (74.3%) presented with SE as first episode of convulsion. In our study, mortality rate was found to be 31.4% and acute symptomatic causes were responsible for most of the deaths.Conclusion: SE is a severe life threatening emergency with substantial morbidity and mortality. Patients with younger age and male sex are slightly more vulnerable to develop SE. Longer duration of SE and acute symptomatic aetiologies are independent predictors for poor outcome.

Background: Scrub typhus is an acute febrile illness caused by rickettsia Orientia tsutsugamushi. Rickettsial infections are grossly underdiagnosed in India because of their non-specific clinical presentation, low index of suspicion among clinicians, and lack of diagnostic facilities. Objective: Objective of the study is to study the clinical profile, complications, and outcome of pediatric scrub typhus. Materials and Methods: This prospective observational study was conducted in the Department of Pediatrics, SGRR Institute of Medical and Health Sciences, Dehradun, Uttarakhand, India, over a period of 2 years from November 2013 to October 2015. Children up to 18 years of age with signs and symptoms compatible with scrub typhus along with serological confirmation were included in the study. Serological study was conducted using rapid immunochromatographic assay and/or immunoglobulin M enzyme-linked immunosorbent assay technique. Clinical presentation, laboratory findings, complications, and outcome of these children were recorded on a performa. The data were analyzed using SPSS version 20 for windows. Results: About 115 children were diagnosed as scrub typhus during the study period. All children presented with fever. Other common symptoms were myalgia (56%), vomiting (50.5%), abdominal pain (26%), headache (28%), facial puffiness (15%), and seizures (8.7%). Pallor was present in 48% of children. Other common signs were hepatomegaly (29%), splenomegaly (28%), hypotension (24%), edema (21%), oliguria (17%), maculopapular rash (10%), meningeal signs (10.4%), and conjunctivitis (3%). Thrombocytopenia (67%), anemia (51%), pleural effusion (23%), shock (16%), hepatitis (23%), acute kidney injury (17%), meningoencephalitis (10%), myocarditis (7%), and acute respiratory distress syndrome (7%) were the complications observed. Azithromycin, doxycycline or chloramphenicol were used for the treatment. Overall mortality rate was 12.2%. Conclusion: A high degree of suspicion and knowledge of geographicaldistribution of rickettsial diseases is crucial for its early diagnosis and favorable outcome. The presence of an eschar is a valuable clinical clue in the diagnosis of scrub typhus; however, its absence does not rule out the disease.

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