Thirty-eight children, aged 1-15 years, with portal hypertension and recent variceal bleeding, were treated with repeated endoscopic sclerotherapy. Thirty-six of them had extrahepatic portal venous obstruction. Obliteration of varices was achieved in 35 (92%) patients requiring an average of 5.3 sessions per patient. Major complications occurred in seven patients, three of whom had oesophageal perforations and four had oesophageal stricture. Sclerotherapy significantly reduced the rate of rebleeding after the start of sclerotherapy and more so after variceal obliteration.
Objective-To report 10 children younger than 10 years of age with benign cutaneous polyarteritis nodosa (BCPAN). Methods-Ten children aged 1 25-10 years (mean 4-7 years; M:F = 7:3) were admitted with an unusual vasculitis. The clinical features, laboratory investigations, treatment and follow up data were analysed.
Psychosocial problems faced by parents and other family members were studied in 50 families with a physically disabled child (PD group), 50 with a mentally retarded child (MR group) and 50 with a healthy child (control group). A semi-structured questionnaire assisted interview and standardized scales were used to measure social burden, marital adjustment and maternal neuroticism. Families with disabled children perceived greater financial stress, frequent disruption of family routine and leisure, poor social interaction, and ill effects on their physical and mental health as compared to families of control children. The overall social burden scores were significantly higher in both the groups with disabled children as compared to controls (mean scores PD 17.8, MR 14.6, C 0.72, p less than .001), and showed a significant inverse correlation with the socio-economic and educational status of parents. The neuroticism scores were also significantly higher (PD 23.7, MR 19.0, C 9.6, p less than .01), and the marital adjustment scores lower (PD 75, MR 79, C 86, p less than .01) in families with disabled children. Appropriate management of these problems should be part of rehabilitation programmes.
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