This case report highlights that in an older child even longstanding extensive basidiobolomycosis can be safely treated with itraconazole. Surgery is not usually necessary in these patients.
Background: Congenital anomalies of the kidney and urinary tract (CAKUT) are a group of disorders responsible for the majority of pediatric end-stage renal disease cases. There are only a few studies on CAKUT. Objectives: A study was conducted to determine the clinical and biochemical profile of children with CAKUT and to estimate the prevalence and the factors associated with hypertension in CAKUT. Methods: A cross-sectional study was conducted in a tertiary center for 18 months from March 2014 to August 2015. Demographic data were recorded, and clinical examination including blood pressure measurement was performed. Various biochemical parameters including plasma renin activity (PRA), urinary beta-2-microglobulin (B2M), and microalbuminuria were evaluated. Results: A total of 81 patients with CAKUT were studied. Twenty-two (27%) patients were underweight, 4 (5%) patients were stunted, and 26 (32%) were both underweight and stunted. Children with bilateral disease had a higher incidence of underweight (21/44 vs. 8/37; p = 0.04; 95% CI; Fisher exact test), and both underweight and stunted (25/44 vs. 10/37; p = 0.006; 95% CI; Fisher exact test) compared to children with unilateral disease. Hypertension was found in 27% cases. No association was found between hypertension and PRA, BM2, or microalbuminuria in our study. PRA was inversely proportional to the estimated glomerular filtration rate (eGFR) (Pearson test; 95% CI; p = 0.006). Conclusions: Bilateral disease in CAKUT was significantly associated with poor somatic growth. PRA was inversely proportional to eGFR. The prevalence of hypertension was higher in children with CAKUT than in normal children and is possibly multifactorial as it was not associated with elevated PRA, B2M, or microalbuminuria.
Background:Electrical stimulation of fractures has been reported to enhance fracture healing. X-rays are normally used to assess union of fractures. Electrical conduction is not tried as a tool to study fracture healing. The current study focuses on electrical conduction as a diagnostic tool to assess fracture healing and new bone formation. The aim was to find if electrical resistance across the fracture can be used as a tool to study fracture healing which can be verified with simultaneous radiographs.Materials and Methods:A prospective study was conducted where 12 open fractures of tibia, including two with bone defects were evaluated. They were debrided and four-carbon ring Ilizarov external fixators were applied. Their healing was followed with clinical assessment and periodical X-rays till the endpoint of fracture union and then the rings were removed. In addition, all these cases also had application of electrical voltage in the range of 0.1–1.0 V DC in 0.1 V increments, across the two wires on either side of fracture. The output current was recorded by an ammeter connected in series. Resistance calculated for various voltages was plotted as a graph for the period of fracture treatment and the characteristics were studied. This graph was compared with the appearance of new bone in the X-rays.Results:In all cases, when the above graph stabilized, in the consecutive recordings, the X-rays showed healing (bridging callus) matching the curve and the patient was able to load the limb. The time of stabilization of this graph for a specific voltage was different in individual cases. However, for a given case, the resistance characteristics were the same for the entire voltage range of 0.1–1.0 V.Conclusion:If the resistance versus day curve stabilizes on the consecutive recordings, we can predict that the fracture is in the process of healing. This stabilization period also matched the patients’ ability to comfortably load the limb and also the radiographs which showed bridging callus (healing). If this is used as a positive criterion for fracture healing in future, the radiation exposure by X-rays shall be less.
Children with SFK have high morbidity especially when associated with ipsilateral CAKUT. Long-term periodical follow up is essential in these patients to improve clinical outcome.
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