Introduction: Vitamin D is an important micronutrient having crucial role in calcium and phosphate homeostasis but there is emerging evidence to suggest its role in prevention of infectious, inflammatory and neoplastic diseases. The vitamin D insufficiency/deficiency is a widely recognized problem among children in developed as well as developing countries.Objective: To find out the prevalence of vitamin D deficiency/insufficiency among children aged 2 months to 13 yrs and its correlation with serum calcium, phosphate and demographic factors.Methodology: Prospective, cross sectional, hospital based study conducted at Birat Medical College Teaching Hospital for a period of one year among children presented to pediatric OPD in whom pediatrician had a suspicion of Vitamin D Insufficiency /Deficiency. Venous blood Samples were taken for the estimation of 25(OH) Vitamin D, Calcium and Phosphate. Statistical analysis was done using SPSS software version 16. Results Among 174 children aged 2 months to 13 years, the prevalence of vitamin D insufficiency at the cutoff of <30ng/ml was 82.75% where as no cases of vitamin D deficiency was noted at cut off level of < 10 ng/ml. Children residing in urban area, samples taken in the winter season had higher prevalence of vitamin D insufficiency (p value <0.05). Serum calcium and phosphate level were found positively correlated with Vitamin D level (p<.05). However the relationship was very strong between Vitamin D and Calcium (r=0.402, p-value <0.001) and weak positive correlation was noted with phosphate(r=0.155, p value <0.05).Conclusion: There is very high prevalence of Vitamin D insufficiency among children. The vitamin D insufficiency was significantly higher in winter season as compared to summer. Children living in the urban area are more prone to Vitamin D insufficiency. Moderately strong positive correlation was observed between Vitamin D level and calcium but weak correlation existed with phosphate. BJHS 2018;3(1)5 : 381-384
Introduction: Urinary tract infection (UTI) is among the commonest bacterial infections in infants and children that warrants early detection and management to prevent long term consequences in kidney causing significant morbidity. The prevalence of UTI varies according to age, gender, race, circumcision status of children but it occurs in 1% of boys and 1 to 3% of girls. There have been studies that have highlighted the importance of C-reactive as an inflammatory marker involved during urinary tract infection in children.Objectives: To find out how Quantitative C-reactive protein level, white blood cell count and pus cells in urine are associated in febrile infants and children with UTI. To find out the antibiotic sensitivity pattern of UTI.Methodology: A prospective cross sectional study was conducted to evaluate febrile infants and children of 2 months to 13 years of age with suspected UTI for a period of six months. Venous blood samples were sent for Quantitative estimation of CRP, White blood cell count and urine samples were sent for urine microscopy and culture sensitivity. Statistical analysis of data was done using SPSS software version 16.Results: Among 210 infants and children enrolled in the study, 62 (29.55%) had positive urine culture, representing 31.2% and 28.6% of female and male populations respectively. The sensitivity, specificity, positive predictive value(PPV) and negative predictive(NPV) value of CRP (with cut off of 1mg/dl) was 77%,81%, 63% & 90% respectively and that of WBC Count (with cut off of > 12000/ml ) were 56%, 88%, 66% & 83% respectively. Similarly for pyuria (with cut off of >10/HPF) using urine culture as gold standard were 63%, 91%,74% and 85% respectively. The most common organism found in urine culture was E. coli 49(79%). Highest number of isolates were sensitive to Nitrofurantoin(96%) and Amikacin(94%) whereas Amoxycillin was resistant to all the organism tested that was the resistance of 100%.The next common antibiotics found to be resistant was cotrimoxazole (70%).Conclusion: Quantitative C- reactive protein and White blood cell count in blood are very useful markers to predict UTI in febrile infants and children. E coli is the commonest pathogen to cause UTI and Pyuria(pus cells > 10/HPF) has high predictive value for UTI. Birat Journal of Health SciencesVol.2/No.3/Issue 4/Sep- Dec 2017, Page: 296 - 299
Introduction: Ultrasound (USG) is the most commonly used imaging method to evaluate thyroid nodules. The sonographic features of thyroid nodules are very important to determine whether the nodule is benign or malignant. Fine Needle Aspiration Cytology (FNAC) is the gold standard to determine whether the nodule is benign or malignant. Objective: The purpose of this study was to compare ultrasound and color Doppler features of thyroid nodules with ultrasound-guided FNAC results to determine the relative importance of these features in predicting the risk of malignancy. Methodology: This prospective cross-sectional study was conducted in Birat medical college teaching hospital in Tankisinuwari, Morang, Nepal. The study was conducted from September 2019 to April 2021. In total sixty-one patients with thyroid nodules were evaluated for sonographic characteristics. Finally, USG guided FNA for cytopathological examination was performed. Both descriptive and inferential statistics were used to analyze the result. Results: Out of the 61 patients, 34 (55.7%) were females and 27 (44.2%) were males. Majority of the malignant nodules were solid 11 (91.6%), whereas cystic and mixed nodules were predominantly seen in benign nodules 18 (36.7%) and 30 (61.2%) respectively. In malignant nodules 10 (83.3%) were heterogeneous and 2 (16.6%) were isoechoic. In benign nodules 29 (59.1%) were heterogeneous and 15 (30.6%) were anechoic with comet-tail artifact and 5 (10.2%) were isoechoic. Among 12 malignant cases, internal and peripheral vascularity were equally present in six cases each. Benign nodules showed peripheral vascularity in 48 (97.9%) and internal vascularity was noted in only one nodule. All of the malignant nodules showed calcification. None of the benign nodules showed micro-calcification. In malignant cases, cervical lymph nodes were present in 7 (58.3%) and absent in 5 (41.6%). In benign cases, cervical lymph nodes were present in 4 (8.1%) and absent in 45 (91.83%). Conclusion: The ultrasound features associated with malignancy in thyroid nodules are predominantly solid component, presence of micro-calcifications and internal vascularity. Enlarged cervical lymph nodes are good predictors for malignancy. USG guided FNAC confirms the suspicious features of thyroid nodules seen on USG.
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