Vertical transmission was the major route of HIV infection. Persistent fever, cough, loss of appetite and loss of weight were common presenting clinical features. Tuberculosis was the commonest opportunistic infection.

Background: Epilepsy has been considered as a public health problem by WHO and ILAE. It was felt that there remains considerable scope for the development of better epilepsy services in a developing country like India. Hence we sought to evaluate the drug utilization of antiepileptic drugs. Aim: The study was designed to evaluate the drug utilization of anti epileptic drugs in in-patient admission of medicine and pediatric departments at tertiary care teaching hospital. Methods: The data was obtained prospectively from 132 patients with antiepileptic drug over a period of 6 months. The utilization was assessed based on age, seizure type, therapy, newer and conventional AEDs and rationality of prescriptions. Results: AEDs are highly prescribed for an age group of 0-2 years in the study. AEDs are highly prescribed as monotherapy in 62.12% of the patients. In the study 51.5% of AED were prescribed alone and 40.62% of AED with add-on therapy of benzodiazepine and found statistically significant (P<0.005). Assessment of rationality was done as per ILAE and IAP guidelines of which 64% and 75.7% were found to be rational respectively. Conclusion: In the study, conventional AEDs are used as monotherapy was more effective in terms of reduction of seizures, as they are available at low costs and are more affordable than the newer drugs and polytherapy. The study concludes the effective use of benzodiazepines along with AED. Due to the lack of specific guidelines for the usage of AED in India, the rationality in the prescription is variable and poor.

Background: With advances in neuroimaging, acute necrotizing encephalopathy of childhood (ANEC) is being recognized as an acute encephalopathy with a characteristic rapidly deteriorating neurological course with poor neuro-developmental outcomes with high mortality and morbidity rates. Indian data of ANEC is primitive and hence this study was planned. The objective of the study was to evaluate the clinical, radiological characteristics and its outcomes in children with ANEC.Methods: Retrospective review of 10 infants and children with ANEC at Department of Paediatrics, S.N. Medical College and HSK Hospital, Bagalkot from January 2013 to December 2019. ANEC was suspected based on clinical and radiological characteristics and diagnosis was made based on diagnostic criteria proposed by Mizuguchi et al. Clinical and radiological (Magnetic resonance imaging (MRI) brain characteristics) findings and response to early pulse dose steroid therapy and supportive treatment were assessed in all cases. All cases were followed for evaluation of neurodevelopmental outcome and response to physiotherapy was noted in all the cases.Results: Total 10 cases were analysed (age ranged from 6 months to 11 years). Sex distribution male to female was 3:7. All cases had precedent viral illnesses and had fever, coryza, diarrhoea. The initial neurological symptoms included seizures and status epilepticus (n=7), altered sensorium (n=3), focal neurological signs , gait disturbances (n=2) and diplopia (n=1). MRI brain revealed characteristic thalamus involvement with varied involvement of midbrain, pons, medulla (n=10). Other findings were cavitation (n=5), haemorrhage (n=4), minimal residual lesions (n=4), cerebral atrophy (n=1), normal brain study (n=5) on follow-up. 9 out of 10 cases survived, responded to early physiotherapy and rehabilitation. 6 children had complete recovery with minimal disability in 3 cases.Conclusions: ANEC is a clinico-radiological syndrome. Early detection and appropriate treatment improves outcome in ANEC.

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