Aims: The aim was to study the incidence, etiology, clinical features and the antibiotic sensitivity pattern of urinary tract infections (UTI) in children at presentation of nephrotic syndrome (NS) (first or recurrent episodes before starting immunosuppressive therapy). Methods: This was a prospective hospital-based study carried out in Basaveshwara hospital, Chitradurga. Fifty children with a diagnosis of NS were studied from June 2010 to October 2014. The cases with recurrence of NS or those with the first episode of NS were evaluated before placing on immunosuppressive therapy. A clean-catch midstream urine specimen was collected from all children to avoid contamination. For younger children, where collection of urine was difficult in the manner described above, suprapubic aspiration was done. Prompt plating of the urine specimen, within 1-h of a collection, was ensured. Identification of the organism and antibiotic sensitivity patterns was determined.Results: Among the fifty children studied, boys were affected more than the girls with a ratio of 1.5:1. The mean age was 4.75 years. Pyuria was noted in 64% of the patients. The most common organism isolated was Escherichia coli in 10 cases, followed by Klebsiella pneumoniae in 4 cases. About 75% of the organisms were sensitive to third-generation cephalosporins. Conclusions: UTI is a common infection accompanying NS. A high index of suspicion and early institution of appropriate antibiotics will help in attenuating morbidity and mortality.
Hot water epilepsy (HWE) is a type of reflex epilepsy which occurs when hot water is poured over the head. Most cases have been reported from Southern India. Genetic, cultural, and geographical factors can be responsible for HWE. HWE can be treated by clobazam 1–2 h prior to take a bath rather than continuous anti-epileptic therapy. Medication prior to bathing may be useful in treating older children, eliminating the need to be accompanied by an adult during bathing. It can also be treated by reducing the temperature of the water used for bathing. Here, we report three cases of HWE in varying age groups.
Background: There is little information on the clinical profile and outcome of children with diabetic ketoacidosis in India. We analysed the data of children managed by us at a tertiary care hospital in order to study the clinical profile of the children admitted with DKA. Methods: This descriptive retrospective study was conducted in pediatric ICU of tertiary level care hospital at Chitradurga, Karnataka (between June 2011 and May 2014). The case records of 52 children admitted with DKA were reviewed and information with respect to the personal details, clinical features, laboratory parameters, management and outcome was recorded using a predesigned proforma. The data was analyzed using SPSS VS-21. Results: The median age at presentation was 7.52 years (range: 2-14 years) with a male:female ratio of 1.3:1. 80.7% were newly diagnosed type 1 DM. 46(88 %) of the cases belonged to lower socio economic status.41 (78%) were from rural areas. The most common presenting complaints were polyuria and polydipsia in 42 cases (80.7%). Twenty eight children (53.8%) presented with severe DKA. The most common presenting complaints were polyuria and polydipsia (80.7%). The average length of stay in the ICU was 3.5 days. The mortality rate was 11.5% (6 cases). Cerebral edema was the commonest cause for fatality. The prevalence of DKA amongst all pediatric admissions was higher than that estimated in previous studies (1 in 419 cases). Conclusions: The outcome of active management of diabetic ketoacidosis in children is rewarding. Diabetic ketoacidosis is a life threatening complication of diabetes mellitus in children. Boys and girls were equally affected. Early identification and careful monitoring of fluids, electrolytes and renal function are the cornerstones of successful DKA management.
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