Objective: This prospective study was conducted to evaluate whether a low hemoglobin level, was a risk factor for Acute Lower Respiratory Tract Infections (ALRTI) in children.   Methods: 150 Children of all age groups who came to the outpatient department and those admitted for ALRTI were included in the study. Age and sex-matched 140 children, not having any respiratory illness, were taken as control. The study period was from March 2006 - March 2007. Detailed clinical and laboratory evaluation of the enlisted patients was done. All were subjected to detail investigations.   Results: Radiological evidence of pneumonia was present in 70 (50 %) children.Hyperinflated lungs were seen in 40 (29%) and was normal in 30 (21.4%) cases. Blood culture was positive in 14 (10%) children of study group and none among control group. Klebsiella was the commonest organism isolated 6 (4.2%) in blood culture positive cases. The mean Hemoglobin (Hb) level of study group was 9.88 gm% and it was 12 gm% in control group.96 (68.6%) of study group and 30 (21.42%) of control group had anemia. Of the anemic children, 79 (82.3%) in study group had iron deficiency, and 17 (17.7%) had normocytic normochromic anemia. These values were 18 (33.3%) and 36 (66.6%) respectively for control group. Low hemoglobin level was a risk factor (p<0.001) ALRTI.   Conclusion: Anemic children were 3.2 times more susceptible to ALRTI compared to the control group and and iron deficiency anemia was predominating. Supplemental iron therapy may reduce the incidence of ALRTI. Prevention of anemia, due to whatever etiology is also essential. Key words: ALRTI, anemia, hemoglobin. DOI: 10.3126/jnps.v30i1.2453 Journal of Nepal Paediatric Society Vol.30(1) 2010 1-7

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Backgroud Simian crease is usually associated with some chromosomal anomalies and syndromes but it is also seen in some populations without any chromosomal defects. Objective To see the incidence of simian crease in children without chromosomal anomalies and to detect the Ethnic group variations. Methods A prospective study in children attending the paediatric outpatient department of Manipal Teaching Hospital, Pokhara. –2,067 children were screened randomly from the 1st June 2007 to the 31st December 2007. Palm crease and axial triradius angle were detected in every child. Axial Triradius angle was compared between those who have simian crease to those who do not simian crease.Children who were found with simian crease underwent IQ testing. The exclusion criteria were children with Down syndrome, other chromosomal and minor anomalies, plus or any other chronic disease condition. Results 2,067children (1,084 boys & 983 girls) were screened. Among them four were cases of Down syndrome so were excluded from the study. Finally total of 2,063 (1,082 boys & 981 girls) were the study group. There were a total 14 ethnic groups who attended the outpatient department of Manipal Hospital during a seven months period. Among the seven ethnic groups Brahaman, Gurung, Tamang, Lama, Newar, Chettri and Dalit had single palmar crease. The incidence of simian crease was14.6%.This incidence was highly significant (p<0001) in Lama population (71.2%). In these seven ethnic groups axial triradius angle was compared between those who had simian crease and with those who did not have simian crease. Comparisons were made statistically and found to be significant. ConclusionIncidence of simian crease in Nepalese children was 14.6% and was observed only in certain ethnic groups. It was significantly high in the Lama population (71.2%0.http://dx.doi.org/10.3126/kumj.v8i4.6241 Kathmandu Univ Med J 2010;8(4):410-14

Objective: To determine the current pattern and prevalence of renal diseases in childhood in this region of Nepal. Material and Methods: A retrospective study of the renal diseases in children attending the Pediatric OPD and those hospitalised in Manipal Teaching Hospital, Pokhara was done over a period of 6 years (September 2000- September 2006). A detailed clinical and laboratory evaluation was performed at baseline. The children were managed according to disease diagnosed. These cases are under follow up and some have undergone surgical treatment. Results: 228 children (123 boys & 105girls) were diagnosed to have renal disease. Among them 39.5% had urinary tract infection (UTI), 30.7 % were suffering from acute glomerulonephritis (AGN), 17.5% were cases of nephrotic syndrome (NS) and 12 % had some other problems for example, 6.14% had genetic defects, 2.63% had renal Stone, 2.2% had pre-renal acute renal failure, unexplained recurrent hematuria in 1.3%. All the cases of UTI underwent through investigation and were treated accordingly. All cases of AGN are planned for follow up for 1½ yrs and among them 3 required biopsy till date. All cases of NS are under regular follow-ups and 2 have undergone biopsy. Renal stone was operated successfully. All cases of acute and chronic renal failures had required dialysis. Out of 5 (2.5%) chronic renal failures, 2 with end stage renal disease expired after repeated hemodialysis and three are still requiring dialysis. Among the obstructive uropathies, 43 % had renal stone, 36 % had posterior urethral valve and 21% VUR. Conclusion: It can be concluded that renal disease is not uncommon in children. It can be completely cured with proper and adequate treatment. Sometimes it has a bad prognosis when it reaches end stage renal disease. Early recognition, timely treatment and regular follow up are mandatory in management of children with renal diseases. Key words: Renal disease pattern, UTI, AGN, NS, Obstructive Uropathy, Renal failure   doi:10.3126/jnps.v27i2.1414 J. Nepal Paediatr. Soc. Vol.27(2) p.75-78