Bandla. Aswani

Balint syndrome is an uncommon and incompletely understood triad of neuropsychological impairments. Balint syndrome is characterized by dysmetria secondary to visual perceptive defect and inability to recognize more than one object at a time. Balint’s syndrome most often occurs with an acute onset as a consequence of two or more strokes at more or less the same place in each hemisphere, therefore it occurs rarely. Disorders such as tumours, trauma, near drowning, Eclampsia, drug toxicity, HIV encephalitis, Alzheimer’s can also leads to balint syndrome.  It is a strange combination of optic ataxia, Gaze apraxia, Simultanagnosia. Although it has been generally constructed as a biparietal syndrome causing an inability to see more than one object at a time, other lesions and mechanisms are also possible. Key syndrome components are dissociable and comprise a range of disturbances that overlap the hemineglect syndrome. Balint syndrome usually from large and more or less symmetrical lesions involving the posterior parietal region, including extensively the superior parietal lobe, as well as part of the inferior parietal lobe and the superior part of the occipital lobe. Diagnosis of individual components and of the whole syndrome may remain difficult, particularly when elementary motor, sensory, and visual deficits coexist.  Lack of awareness of this syndrome may lead to misdiagnosis and resulting inappropriate or inadequate treatment, therefore clinicians and other healthcare professionals should be familiar with the balint syndrome.  The goal of this review is to explore a range of anatomical and psychological explanations for this disorder.  

Antibiotics are the most commonly prescribed drugs in paediatrics and can be a biggest threat of growing   resistance in children. It is always preferable to choose a single drug with a narrowest spectrum effective for pathogen. Combination antibiotic therapy may provide synergistic effect but there is a chance of getting drug resistance particularly in paediatrics. Paediatrics, a specialized population is at a significant risk for drug related problems in particular when they exposed to multiple drug therapy and complex illness. Monitoring and control of antibiotic usage and detailed knowledge of antibiotic prescribing practice is important now-a-days. The aim of our study was to analyse the Utilization of antibiotics in paediatric department of Sri Venkata Ramnaraine Ruia Government General Hospital (SVRRGGH), Tirupathi. A Prospective observational study was carried out for 3 months using patient data collection proforma and clinical significance of 120 individual cases were recorded.  The data were analysed by descriptive statistics. The utilization of antibiotics in emergency ward, general ward and ICU were observed. More number of prescriptions was observed in the emergency ward (53.33 %).  Most of the paediatric patients receiving parenteral preparations (81.8 %) and 55.62 % of prescriptions were based on empirical therapy. In our study 66.66 % of paediatric patients were on single antibiotic. Cephalosporins (42.2 %) were the most commonly prescribed antibiotics in three departments followed by Pencillins (22.7 %) and least prescribed group was Fluroquinolones (2.13 %). This information was helpful to analyse the clinical judgment on selection of antibiotics in paediatrics of SVRRGGH.