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.
According to the World Health Organizations' (WHO) estimates for 2002, LRTIs were the leading cause of death among all infectious diseases worldwide, accounting for 3.9 million deaths and 6.8% of all reported deaths that year. Since 1990, when the WHO began compiling and presenting statistics on the burden of lung infections, LRTIs have been found to consistently cause more burden than diseases such as diabetes mellitus, HIV/AIDS, cerebrovascular disease, neoplasms, diarrhoeal disease, ischaemic heart disease, malaria, tuberculosis, chronic obstructive pulmonary disease (COPD) and asthma. 1 Lower respiratory tract infections (LRTIs) including bronchitis (viral and bacterial),pneumonia, bronchiolitis, and pertussis (whooping cough) are among the most ABSTRACT Background: Lower respiratory tract infections are the leading cause of death among infectious diseases and responsible for large burden of avoidable morbidity and mortality in childhood. Inappropriate, economically inefficient use of antibiotics has been observed in health care system. The objective of the present study is to identify various lower respiratory tract disorders, antibiotic prescription patterns, average hospital duration and average direct cost of antibiotic prescriptions. Methods: The present study was an observational study. A total of 110 inpatients fulfilling the inclusion criteria were included. Current diagnosis, treatment chart, length of hospital stay, MRP (INR) of antibiotics on admission to discharge were recorded and analyzed. Results: Males are more as compared to females with similar severity of illness. Study states that Bronchopneumonia is highest in the incidence followed by WALRI. Average duration of patient stay in hospital was 5.71days whereas 62.73% were on monotherapy and mostly prescribed antibiotic was Cephalosporin's. Average cost of antibiotic prescription in bronchopneumonia is INR 1681.94 followed by Walri INR 579.64, bronchiolitis INR 355.68 others INR 1044.9. Majority of drugs were given by intravenous route and Prescriptions are mainly ordered in Brand names. Conclusions: The present study provides an overall pattern of antibiotic usage in patients. Higher generation antibiotic usages and brand name prescription especially in bronchiolitis & WALRI where there is no requirement, adds to the cost of the therapy.
Scimitar syndrome is characterized by partial or total anomalous pulmonary venous return from the right lung along with hypoplasia of the lung. This syndrome has varied presentations, from an asymptomatic state to severe pulmonary hypertension and/or heart failure. Newer diagnostic modalities have improved our understanding of this rare syndrome and hence providing newer treatment options to be tried. Here, we present a case of a 4-year-old child with recurrent pneumonia with Scimitar syndrome. We are reporting this case in view of the rarity of this syndrome and its presentation as recurrent pneumonia.
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