No abstract

Steroid-resistant nephrotic syndrome (SRNS) patients are candidates for other alter-native drug regimes, and the non-responsiveness to steroid is more common among glomerulo-nephritides other than minimal change disease. Without performing biopsy and proper renal histology, progression of the disease cannot be assessed. Fractional excretion of magnesium (FE Mg) has been found to correlate directly with various renal histologies. The aim of this study is to evaluate the relationship of FE Mg in children with the histological pattern in SRNS. In this prospective observational study, 40 children of nephrotic syndrome, both with the first episode as well as relapse, aged 1-12 years were included in the study. Of them, 20 were steroid-responsive cases and 20 were steroid-resistant cases. FE Mg was determined in all the patients and renal histology was performed in the steroid-resistant cases. A correlation was found between FE Mg and renal histology. Data were analyzed in SPSS program version-16. Comparison of two groups was performed by the Fisher exact test and unpaired t test. P-value less than 0.05 were considered to be significant. The results of histo-pathology showed that the mean difference in FE Mg was significant (P <0.001), as FE Mg was 7.0 ± 2.3% in mesangiocapillary glomerulonephritis, 6.9 ± 1.3% in focal segmental glomerulosclerosis, 4.7 ± 0.6% in immunoglobulin M nephropathy, 4.5 ± 1.2% in focal segmental proliferative glomerulo-nephritis, 4.4 ± 1.6% in minimal change disease, 4.2 ± 0.4% in diffuse mesangial proliferative glome-rulonephritis and 3.8 ± 1.3% in mesangial proliferative glomerulonephritis. There was a statistically significant difference between FE Mg in steroid-resistant nephrotic syndrome (4.9 ± 1.9) and steroid-responsive syndrome (1.2 ± 0.3). FE Mg is a simple, minimally invasive screening marker for SRNS, and is an early predictor of clinical outcome. It can be considered as an initial investigation where biopsy cannot be performed or indications are not clear.

Background and Objective: Dengue has emerged globally as the most relevant viral infection transmitted by a mosquito bite and represents a major threat to public health. Dengue-related renal manifestations such as proteinuria, hematuria, acute kidney injury (AKI), and rhabdomyolysis are not uncommon, and acute kidney injury (AKI) is a serious complication of dengue fever. There is relatively few data on the renal manifestations of dengue fever in children. Hence, this study was conducted to evaluate the incidence, characteristics, and clinical outcome of dengue fever with renal manifestations. Method. This prospective cross sectional study was conducted in Dr. M R Khan Children Hospital and Institute of Child Health, Dhaka, over a period of 1 year from January 2018 to December 2018. The study was approved by the ethical committee of the institute. A total number of 316 patients were admitted with the diagnosis of dengue fever either NS1 positive or antibody IgM positive or both IgM and IgG positive. Data were collected in a structured questionnaire form and were analyzed by SPSS version 20.0. The disease severity was classified according to the World Health Organization criteria. Renal manifestations were divided into AKI groups using pRIFLE criteria. Proteinuria was defined as urinary protein >1+ (30 mg/dL) by dipstick test. Hematuria was defined as red blood cell (RBC) >5/μL in a fresh uncentrifuged urine specimen. Result. Among 316 dengue patients, thirty-one patients (9.8%) had renal involvement. Most of the patients (54.83%) with renal manifestations were aged between 1 and 5 years. A total of 14 patients were found to have proteinuria (4.4%). Nephrotic-range proteinuria was seen in only one patient (0.3%). AKI was defined by pRIFLE criteria and was seen in 13 patients (4.1%); among AKI 6 (46.15%) had risk, three patients (23.07%) had injury and 4 (30.7%) had failure and needed peritoneal dialysis. Death occurred in 3 patients (9.6%) in dengue with AKI who had failure. The incidence of renal manifestations (proteinuria, hematuria, and AKI) is as high as 9.8% among patients with dengue, and those with AKI had significant morbidity and mortality. Conclusion. Renal involvement in children with dengue is not uncommon. Dengue associated with AKI had significant mortality and morbidity.

Background: Proper feeding practices during the first two years of life is essential for growth nutrition and development of young children. Optimum infant and young child feeding can reduce childhood mortality and morbidity significantly. Present study was done to know the infant and young child feeding pattern in the children of 0-23 months of age attending out patient department of an urban hospital.Methods: This cross sectional study was conducted among 314 mother/child pair attending the outpatient department of an urban hospital during the period of September 2014 to December 2014.Result: 68.5% children had early initiation of breast feeding and exclusive breast feeding among children below 6 months was 66.8%.Continued breast feeding among the children of 12 to 15 months was 80.4% and 84.2 % children were given solid food at 6 months of age. Adequate minimum dietary diversity, minimum meal frequency and minimal acceptable diet among children 6-23 months were 61.4%,57.3% and 39.4% respectively.64.5%% children were taking iron rich food or supplementation.Conclusion: Early initiation of breast feeding(0-23mo) and Exclusive breastfeeding(0- 6mo) were satisfactory in the study children but IYCF practice in children of 6-23 months was not optimum and far away from the HPNSDP 2011-2016 target of 52% of children to be fed with minimum acceptable diet.Bangladesh J Child Health 2016; VOL 40 (2) :92-97

Cystic Fibrosis (CF) can involve multiple organs although the most commonly affected systems are respiratory and gastrointestinal ones. In infancy it can also present as Pseudo Bartter Syndrome which is characterized by hyponatremic, hypochloremic, hypokalamic metabolic alkalosis without renal tubular pathology. We report a 5 month old boy who had history of recurrent episodes of dehydration due to vomiting and recurrent respiratory infection. His biochemical parameters suggestive of Pseudo Bartters Syndrome. Initial sweat chloride test was normal 16 mEq/L whereas the repeated test revealed Sweat chloride concentration of 107 mEq/L. The cystic fibrosis mutation analysis revealed F508 del homozygosity for the Cystic Fibrosis Transmembrane Regulator (CFTR) gene. Cystic fibrosis should be always considered in any infant with metabolic alkalosis and hyponatremic hypochloremic dehydration, whether or not there are association with pulmonary and /or gastrointestinal symptoms. Early diagnosis is essential in improving the prognosis and long term survival of these children.

Background : IgA nephropathy (IgA N) is one of the most common primary glomerulonephritis worldwide. Although there is paucity of data on the clinical spectrum and outcome of childhood IgA nephropathy in India as well as South Asia.

Dapsone is a sulfone group of antibiotics that works as anti-inflammatory and immunosuppressive agents. It is widely used in many diseases like Acne vulgaris, leprosy, dermatitis herpetiformis, thrombocytopenic purpura, and pemphigoid. Though it is a very cheap drug it has life-threatening side effects like Methemoglobinemia. We hereby report a case of dapsone-induced Methemoglobinemia in an adolescent girl who used dapsone for the treatment of acne vulgaris. She presented with hypoxia, cyanosis, and fatigability. Treatment should be initiated as early as possible otherwise it could be fatal. Here, in this case, immediate treatment was started with vitamin C and N Acytyle cystine as the most effective antidote Methylene blue was not available. As the patient’s condition did not improve with pharmacological treatment so exchange transfusion was done from 2nd day. This case report aims to enhance awareness among physicians about the life-threatening adverse reaction to Dapsone and also the importance of prompt management. Bangladesh J Child Health 2020; VOL 44 (2) :109-113