Introduction: Hepatitis A is one of the most frequent infectious liver diseases affecting children worldwide. The disease is usually mild and self-limited, and complications are very rare. But sometimes hepatitis A can cause acute liver failure (ALF), a severe, life-threatening condition. The objective was to do clinicoepidemiological evaluation of hepatitis A patients who were admitted to the In patients department of our hospital along with analyze the complications seen in the disease.Materials and Methods: It was a prospective study, done in Department of paediatrics, Maharaja Krushna Chandra Gajapati from May 2014-April 2016. Total number of patients was 80. Patients having history or features of prodromal symptoms like fever, nausea, vomiting, anorexia, yellowish discoloration of urine and body, pain abdomen, change in mental status and coagulopathy with suspicion of acute hepatitis (within 8 wks) with positive IgM for hepatitis A were included in the group. Statistical analysis was done by SPSS software version 20.Results: Total number of patients was 80. Mean age of hospitalisation was 5.5 years. 90% children were having jaundice. 85% patients were having liver enzyme high. Most common complication was gallbladder wall thickening followed by ascitis, pleural effusion etc. Encephalopathy was observed in three patients. Total three patients died. Maximum death was seen in infancy with delay in hospitalisation.Conclusions: Viral hepatitis due to hepatitis A is a benign disease. But fulminant hepatic failure due to it is not uncommon. The lesser the age, presence of cardinal features like jaundice may not be apparent. So clinicians must be conscious of these lethal complications while managing a child of probable viral hepatitis. This study will raise the consciousness of urgency of vaccination for hepatitis A, which is thought to be sparingly optional for many parents as well as doctors.
Background: Antiphospholipid syndrome (APS) is one of the important treatable causes of bad obstetric history (BOH). The literature on the association between the presence of antiphospholipid antibodies (APLA) in patients with BOH and clinical parameters is limited. Aims and objectives:(1) To estimate the prevalence of APLA in patients with BOH and (2) To determine the association of APLA with various clinical parameters in patients with BOH. Materials and methods:A total of 80 patients with BOH of unknown etiology and 40 age-matched controls with at least 1 successful pregnancy outcome were clinically assessed and screened for the presence of APLA {anti-β2 glycoprotein-1-IgG (ABGP1-IgG); anticardiolipin IgG and IgM [anticardiolipin antibodies (ACLA), ACLA-IgG and -IgM)]; and lupus anticoagulant (LAC)}. The clinical parameters of APLA-positive and APLAnegative cases were compared.Results: Antiphospholipid antibodies were detected in 12 of 80 cases (15%) compared with none among controls [odds ratio (OR) = 29.38; 95% confidence interval (CI) = 1.71-505.4; p = 0.0199]. The antibody ABGP1-IgG was the commonest one (n = 7, 58.33%) followed by LAC (n = 4, 33.33%) and ACLA-IgG and -IgM (1 each). Patients with APLA-positive BOH had significantly increased incidence of thrombotic episodes (p = 0.01), hypertension (p = 0.05), thrombocytopenia p <0.01), and anemia (9.67 ± 1.75 vs 11.04 ± 1.37 gm/dL; p <0.01). Second-trimester abortion was significantly higher (p = 0.03), and first-trimester abortions were significantly lesser (p = 0.02) compared with patients with APLA-negative BOH. Third-trimester adverse obstetric events were comparable between the two groups. Conclusion:Antiphospholipid antibodies are present in 15% of patients with BOH of unknown etiology. History of thrombosis, hypertension, thrombocytopenia, anemia, and second-trimester abortions were significantly associated with the presence of APLA in BOH. Clinical significance:The findings from this study will help in determining the subset of patients with BOH who have higher likelihood of presence of APLA and therefore increase the chances of treatment and a successful pregnancy outcome.
Introduction: Poisoning is a major problem in children. The aims of this study were to determine the pattern of poisoning in children along with seasonal incidence, duration of treatment and outcome in referral centre of eastern India.Materials and Methods: All the children admitted to paediatric ward of MKCG Medical college and hospital from 1st April 2015 to 31st March 2016 (1 year) with history or suspicion of poisoning and animal bites were included in the study. Brought dead patients and the children with side effects due to ingested drugs in prescribed amount were excluded from the study.Results: Total 530 cases were documented with highest incidence in rainy season. 1-6 years children were mostly vulnerable (42.6%). Accidental mode was the major cause in small children and suicidal, in older. Animal bites and stings (n=241) were the commonest followed by chemical poisonings. Kraits were commonest culprit in snake envenomation group. Alprazolam was most common drug causing drug overdose. Total numbers of death were 27. Major cause of death was organo- phosphorus poisoning (OP) and snakebite. Mean days of hospitalization was 2.5 days and death after hospitalization was 1.8 days.Conclusion: Most of the childhood poisonings were due to accidental cause. Animal bites were mostly due to snakes. Maximum numbers of deaths were due to OP poisoning. Watchful observation, clean and clear environment, understanding the problems of adolescence, friendly atmosphere in home can prevent most of the poisonings and animal bites in children.
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