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NEW DELHI, July 12 (Xinhua) -- Indian Prime Minister Narendra Modi returned home Tuesday after wrapping up a five-day tour of four African nations.

"After a vital Africa tour which witnessed key talks, interactions & agreements, PM @@narendramodi reaches Delhi," the Prime Minister's Office tweeted.

Modi flew back to the Indian capital this morning from Kenya, his last stop on his four-nation tour that also included Mozambique, South Africa and Tanzania.

In Kenya, the Indian prime minister held talks on Monday with President Uhuru Kenyatta and both sides inked seven pacts, including in field of defense and security and double taxation avoidance.

Modi had gone to Kenya from Tanzania, where he held talks with the country's leadership and offered 92 million U.S. dollars Line of Credit for a key water supply project and signed five pacts.

In South Africa, the Indian premier met South African President Jacob Zuma and discussed a wide range of issues, particularly in the economic arena.

His first stop was Mozambique where Modi held talks with President Filipe Nyusi and oversaw signing of three pacts, including one under which India will buy pulses from this African nation.

Modi's tour of Africa -- his first to the continent though he had gone to the Indian Ocean islands of Mauritius and Seychelles earlier -- was aimed at bolstering ties with Africa.

Refractory Status Epilepticus Treatment Health Articles | July 12 Wholesale Washington Nationals Jersey , 2017

Refractory status epilepticus is a potentially life threatening medical emergency. It requires early diagnosis & treatment.聽

There is a lack of consensus upon it’s semantic definition of whether it is status epilepticus that continues despite TT with benzodiazepine. One epileptic medication is lorazepam plus phenytoin. Others regard refrectomy status epilepticus as a feature of benzodiazepine and antiepileptic medication i.e. lorazepam plus phenytoin plus phenobarb. All patient of refractory status epilepticus require continuous EEG monitoring. There are three main agents used in the treatment of Refractory Status Epilepticus (RSE). These include thiopental midazolam and propofol. RSE was shown to result in mortality in 35 % cases, 39.13 % of patients were left with severe neurological deficits while another 13% had mild neurological deficits.

A Case Study

A 3 year old boy with history of regression of milestones was referred to Shalby Indore聽with a prodrome of headache, vomiting and swelling all over body for 5-6 days. He was admitted in other setup with status epilepticus Wholesale Toronto Blue Jays Jersey , but seizures were not controlled at the time of admission and the child was in comatose state with refractomy multifocal and generalized seizure, which required admission to intensive care unit & administration of antiepilepticus and general Anaesthetics. The child was intubated, was given ventilator support with IV midazolam and IV thiopental infusions were started along with blood investigations. The patient was intitally treated with acyclovir and antibacterial. A provisional diagnosis of inborn error of metabolism *mitochondirial encephalopathy) was made. Due to acute onset of infection mitochondrial cocktail therapy was started i.e. high dosage of Vitamins Wholesale Texas Rangers Jersey , Coq, Carnisure and Ketogenic diet. The patient was also given packed cell and FFP due to severe anemia and deranged coagulation profile.

Gradually the child started becoming neurologically and thermodynamically stable after 10 days of ventilator and lonotropes support were gradually withdrawn. IV anticonvulsant (thiopental & Midazolam Infusion) were tapered & shifted to IV gardenal, IV fosdin Wholesale Tampa Bay Rays Jersey , IV levipril & also tablet toperamade, which later changed to anticonvulsants. Clinically & EEG wise , the convulsions were stopped completely and he is now being discharged with oral antiepilepticus and Mitochondrial cocktail therapy.

The plan of workup for the etiology of status of epilepticus was undertaken which had been normal so far which comprises of TMS and MR spectroscopy TPO antibody. The parents have been advised to follow-up regularly with pending reports of urinary organic acid.

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