Indian Journal of Trauma and Emergency Pediatrics

Background: Fever and altered sensorium constitute a medical emergency in children. Early recognition, accurate diagnosis and timely management may help in reducing the morbidity and mortality in acute febrile encephalopathy (AFE). Aim: To study etiology, clinical presentation and outcome in children presenting with acute febrile encephalopathy. Methods: This prospective observational cohort study was conducted in a tertiary care centre over the duration of one year (2016 to 2017). Consecutive patients (age group of one month to 12 years) presenting with fever of ≤ 2 weeks duration and altered mental status were enrolled. The clinical features were noted and patients were followed up through the duration of hospital stay (wards & intensive care unit). Etiology and clinical features were listed as percentage of total cases. Risk factors for mortality were determined using chi-square test. Results: 120 children were enrolled. Besides fever and altered sensorium, convulsions (70%) and meningeal signs (38.3%) were common clinical features. Tubercular meningitis (33.3%) was the most common cause followed by viral encephalitis (24.2%), bacterial meningitis (9.2%) and cerebral malaria (5.8%). Mortality was 16.7% with neuro-morbidity seen in 45% of the cases. Longer duration of hospital stay (≥ 28 days), longer duration of PICU stay (> 14 days), longer duration of mechanical ventilation (≥ 7 days) and low Glasgow coma score (GCS< 8) were risk factors associated with higher mortality. Conclusions: Infectious causes were the commonest cause of AFE. AFE has a high rate of neuro-morbidity. Early identification of high risk factors may help to reduce the mortality. Key Message: Most common etiology for children presenting with acute febrile encephalopathy (to our institute) was tubercular meningitis (TBM) followed by viral encephalitis, bacterial meningitis and cerebral malaria. The mortality was 16.7% with 45% neuromorbidity.

India is dedicated to reaching the Millennium Development Goals (MDGs) set through the UN Millennium Declaration in 2000. MDGs ably summarize important in ternational improvement worries, encompassing more than one dimensions of financial and social poverty. As a result, they were integrated easily into the five-yrmaking plans frame work of the United States. Specifically with reference to fitness, the Eleventh Five Year Plan is positive approximately reaching the MDG goals for toddler and maternal mortality rate (IMR and MMR) through the stop of the plan duration. The plan additionally recognizes the want for motion on many fronts to reap this, along with progressed get admission to to fitness centres, institutional deliveries, dietary supplementation, and smoothing esting water and sanitation. However, attainment of those desires with inside the given time body is feasible best via focused awareness on prone corporations that extensively account for the united states’s burden of poverty and deprivation, and lag a long wayin the back of with inside the united states’s march closer to improvement.

Hypokalaemic periodic paralysis is an uncommon but potentially life threatening clinical syndrome. It should consider in any child with recurrent motor paralysis. A positive family history with a low potassium level during attacks, will confirm the diagnosis If recognised and treated appropriately, patients recover without any clinical sequelae. No extensive investigations are needed. KCL, acetazolamide, spiranolactone and life style modificationswill help them to bring to normal activity.