Psychiatric Comorbidities in Children With Epilepsy.

OBJECTIVE: To evaluate the prevalence of psychiatric comorbidities in children with epilepsy (CWE) and to assess their impact on the Quality of life (QOL). METHODS: All CWE with a normal Intelligence Quotient (IQ) were assessed for Psychiatric co-morbidities using the Revised Child Anxiety and Depression Scale (RCADS) for anxiety and depression, and Strengths and Difficulties Questionnaire (SDQ) for behavioral and emotional problems. Quality of life in Children with Epilepsy (QOLCE-31) scale was used to assess the quality of life at enrolment and was repeated again after appropriate intervention for comorbidities at 3 months. RESULTS: Twenty-two (24.4%), 18 (20.0%), 35 (38.9%), 32 (35.56), 26 (28.89), and 12 (13.34) children met the clinical threshold for social phobia, major depression, generalized anxiety, separation anxiety, conduct problem and peer problem, respectively. After appropriate intervention for the co-morbidities, improvement was noted in the quality of life. CONCLUSION: Psychiatric co-morbidities are common in children with epilepsy and these contribute to the poor QOL.

Phlegmasia cerulean dolens: complication of femoral vein catheterization.

There are three less frequent manifestations of acute massive venous thrombosis and obstruction of the venous drainage of an extremity. They are phlegmasia alba dolens, phlegmasia cerulean dolens (PCD), and venous gangrene. The term PCD differentiates ischemia-associated massive venous thrombosis from phlegmasia alba dolens, which describes fulminant venous thrombosis without ischemia. We present a 55-year-old hypertensive, who presented with paedal oedema and breathlessness at rest. About a month prior to this admission, she suffered dislocation of left patella. She was treated with a plaster cast and immobilization for 3 weeks. Her serum creatinine was 8.8 mg/dL. She was initiated on haemodialysis via two single-lumen catheters placed in left femoral vein. The femoral vein catheters were removed after third session of haemodialysis. On fourth day, the patient complained pain and blue discolouration of left toes. On examination, the left lower limb was swollen, discoloured, and cold with blebs up to upper one-third of left leg. The left dorsalis pedis and posterior tibial arteries were not palpable. A Doppler of veins of lower limb revealed, thrombosis of deep, and superficial venous system of left lower limb. As there was no response to anticoagulation below, knee amputation was performed.