Background: Cerebral malaria (CM) is a potentially fatal condition encountered in all age groups and if not treated timely can cause mortality. Objective: to evaluate the clinical features of cerebral malaria in children at a tertiary care Hospital of Telangana. Methods: This was a prospective study carried out from January 2013 to December 2014 at a tertiary care hospital of Telangana. Clinical profile, treatment and outcome of all the children diagnosed with CM aged between 5 months to 12 years were assessed. Results: There were a total of 65 patients with CM of which 40 (74.7%) of them were girls and 20 were boys (25%). P. falciparum was the main infecting species in both uncomplicated malaria and severe malaria cases. The clinical features noted were seizure (39.62%), anemia (84.9%), icterus (16.98%), hypotension (13.2%), bleeding (3.7%), hepatomegaly (5.66%), splenomegaly (5.66%), pulmonary edema (16.98%) and renal dysfunction (37.36%). Treatment received included artesunin compounds or quinine. Complete recovery was achieved in 53 (81%) of them. Three (6.1%) of them died. Conclusion: CM considered being a fatal disease has shown remarkable improvement in the outcome with the wide availability of artesunin and quinine components. The key to management is early diagnosis and initiation of treatment based on a high index of suspicion.
Background: Dysglycaemia (hyper-or hypoglycaemia) in critically ill children has been associated with poor outcome. Objective: comparison of clinical outcomes in children admitted to Emergency unit of MGM Hospital, Warrangal for acute medical conditions and presenting with euglycaemia or dysglycaemia. Methods: Five hundred and twenty five subjects aged between 4 months and 12 years were screened out of whom 330 (205 with euglycaemia and 125 with dysglycaemia) were enrolled. Results: In the dysglycaemia group, 28 (13%) subjects had hypoglycemia and 97 (87%) had hyperglycemia. Overall, there were 101 complications in 125 subjects. The number of subjects with complications was significantly higher in dysglycaemia group (46%) compared to euglycaemia group (8%). Fifty subjects died out of whom 30 had dysglycaemia. Subjects with dysglycaemia were 3 times (95% CI: 1.5-6.0) more likely to die and 4.8 times (95% CI: 3.1-7.5) more likely to develop complications. Conclusion: Dysglycaemia is associated with increased morbidity and mortality in children with acute medical conditions.
Background: The impact of endocarditis in childhood accompanies many cardio-vascular disorders. Infective endocarditis (IE) is the most frequently occurring form of endocardium inflammation. Prevailing among the agents are Str. Viridans, Str. Haemoliticus, Staph. Aureus, Staph Epidermidis, Enterococcus, etc. Objective: This study will explore the outcome of children diagnosed with infective endocarditis for a better guidance in management. Methods: This was a prospective study from warrangal from January 2013 to December 2015. 50 patients with definite IE based on modified Duke's criteria were recruited into the study. Clinical presentation, risk factors, echocardiography and outcome were obtained. Results: A total of 50 IE patients were included within the study. The mean age was 6 ± 5.45. Most patients (80.39%) were diagnosed within the first week of admission. Staphylococcus aureas was the most common pathogen (38%) and the mitral valve was predominantly affected (68%). Complication were common and in hospital mortality remains high (27.3%). Conclusions: Mortality remains relatively high in children with infective endocarditis. The most common complication is cardiac deficiency (70%), and pleuropericardial effusions and lung embolism
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