Pediatric Education and Research

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Keywords: Attention; Children; Reaction Speed; Narrative Review; Ruler Drop Method. 

 Background: The present evaluation study has been conducted with the following objectives: (i) To assess the treatment outcomes of Revised National Tuberculosis Control Program (RNTCP) in five microscopic centers of Kangra district under five tuberculosis units and (ii) To identify gaps and underlying contributing factors. Based upon the findings of (i) and (ii) we suggest appropriate measures to narrow down the existing gaps. Materials and Methods: We identified and interviewed health personnel involved, reviewed the documents and records pertaining to evaluation plan/guidelines, training records and reports generated by five tuberculosis units. We assessed the inputs, processes and outputs of the program across five tuberculosis units. We calculated the proportion of staff of various categories trained and internal quality control (case detection); availability of drugs, Directly Observed Treatment Short- course (DOTS) providers and supervision (case management) and Information, Education and Communication (IEC) and funds distribution. (Logic model) Result: Around 60% to 88% of staffs of various categories trained with overall 25% gap of supervisory visits. In Tuberculosis Unit (TU) Nurpur the discordant slides while cross-checking were 8% and 25%. The total proportions of sputum positivity are 5.1%; the highest in Kangra-2.3% (National norms of 10%-15%). There was no full cross checking of the positive slides despite internal quality in place. Increased numbers of the extra pulmonary tuberculosis in young cases (EPTB) are present in all TUs, as high as 61% in TU Dharamshala (Normal range 15%-20%). A gap of 20% DOT centre exists- the least in (58%) in TU Nurpur. The awareness level in the TU Dehra is minimum (51%); more so in adolescent females and rural set up. . Conclusion: RNTCP has successfully achieved all its targets in all the five TUs of Kangra District as per national norms despite several gaps.  We recommend (i) filling of vacancies of medics and paramedics with re-orientation trainings/refresher courses; (ii) conduction of supportive supervision by the seniors; (iii) investigation of cause of increased number of the extra pulmonary cases in adolescent and young ages and (iv) need of aggressive IEC activities.

Background: Seizure is one of the common causes of childhood hospitalization with significant mortality and morbidity. There is limited data regarding the prevalence of seizures in children from the developing countries. Aim & Objectives: To find the prevalence of epileptic and non-epileptic seizures and the common etiology of seizures in various age groups presenting to tertiary care center in Central India. Material &Methods: This was a hospital based observational study carried out in the Department of Pediatrics, Acharya Vinoba Bhave Rural Hospital, Jawaharlal Nehru Medical College, Sawangi (Meghe), Wardha from 1st August 2012 to 31st July2014.  All patients who were fulfilling the inclusion criteria within the age group of  >28 days to 15 years  were enrolled for the study. Results: A total of 169 patients were admitted for seizures with 115 (68%) males and 54 (32%) females. Among these patients, Maximum patients were in the age group between 1.1 year to 5 years of age (41%). the prevalence of epileptic seizures was 6.5/1000 population whereas the prevalence of non-epileptic seizures was 4.1/1000 population. Most common type were epileptic seizures (61.5%) followed by febrile seizures (25.5%) and Acute symptomatic seizures (13%).Generalized tonic-clonic seizures were the most common type of seizure presentation (59.2%). Conclusion: To conclude, with respect to the age and sex of patients, the prevalence of epilepsy in our region is not so much different from that of patients in other parts of the country. 

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