Background: Fever and significant bacteriuria and pyuria in children with undocumented sources of infections must be presumed to be symptoms of pyelonephritis, an invasive infection of the renal parenchyma requiring prompt treatment. The present study is undertaken to study of clinical, etiological and radiological profile of children with culture positive UTI.Methods: This study is being performed on children with culture positive Urinary tract infection admitted or attending OPD at department of Paediatrics during the study duration were included in the present study.Results: The highest incidence of UTI in present study was found to be 52.25% in the age group of children below 2 years. E-coli (75%) was the commonest organism found in urine culture in all age groups. Sensitivity, negative predictive value and positive predictive value of renal ultrasonography in detecting VUR was very poor, supporting the impression that renal USG is deficient in accurately excluding VUR. VUR are common in Culture positive UTI, milder grade are more common which are more likely to be missed by renal USG, thus stressing the need of MCU in children of culture positive UTI.Conclusions: Urine examination and culture and sensitivity must be a part and partial in evaluating child with fever without focus. As the scope of USG in detecting VUR is low, MCU must be done in all cases of UTI -5years irrespective of USG finding.
Background: Nocturnal enuresis or bedwetting is a common health problem in children in the age group of 5 to 15 years. In India the prevalence of nocturnal enuresis ranges from approximately 7% to 12.6%. The prevalence from other parts of the world ranges from 6% to 42%. This study was planned to find the prevalence and determinants of nocturnal enuresis in school going children.Methods: This cross-sectional study was conducted in four primary and secondary schools in Solapur. A predefined questionnaire, prepared in English and translated to local languages, Marathi and Kannada, was handed over to all the children attending the selected schools. Children were asked to hand over the questionnaire to their parents and return with the filled questionnaire. The questionnaire was prepared to obtain the information related to the socio-demographic factors of the family and child, frequency of enuresis and information related the risk factors. Nocturnal enuresis was defined if the frequency of enuresis was more than twice per week.Results: The overall prevalence of nocturnal enuresis was 11.4 %. The maximum prevalence was found in the age group of 8 -9 years (22.96 %). The prevalence of nocturnal enuresis in boys (14.34 %) was significantly more than the prevalence in girls (8.31 %). The study showed that nocturnal enuresis was significantly associated with stress, poor school performance, sleep pattern (hard to awaken), family history, burning micturition etc. But it was not associated with maternal or paternal education, birth order, type of family.Conclusions: The prevalence of nocturnal enuresis is 11.40 % in school going children and it is associated with age, sex, stress, family history, burning micturition, hyperactive child, poor school performance, sleep pattern (hard to awake) avoidance of going to micturate before sleep etc.
Background: There are three main causes of anemia, decreased production of RBCs, and excessive destruction of RBCs or Excessive blood loss. In India, the main reason of anaemia is the decreased production due to nutritional deficiency. The main nutrients required in the process of haemoglobin production are iron, folic acid and cyanocobalamine. The objective of the present study was to find the clinical presentations and hematological changes in children with nutritional anaemia. . Children visiting the paediatric OPD due to any illness and having clinical suspicion of anemia were initially screened for inclusion in the study. Detailed laboratory investigation such as CBC, peripheral blood for Leishman's stain and reticulocyte count were performed. Serum Ferritin, vitamin B12, folic acid levels were also done to ascertain the cause of anemia. World Health Organization recommended criteria were used to diagnose and grade the anemia. Results: A total of 405 anemic children were included in the study. Out of that 213 were boys and 192 were girls. A total of 226 children presented with mild anemia. The most common clinical presentation was respiratory tract infection, found in 62.22 % of children followed by fever in 53.09 % of children. Maximum numbers of patients were suffering from iron deficiency anemia, followed by folic acid deficiency. Deficiency of both of these nutrients was also common. Vit B12 deficiency was found in only 5 children. Conclusions:The study concluded that iron deficiency anemia was the commonest nutritional anemia in children in the age group of 5 to 15 years. Second most common deficiency was of folic acid. Majority of the anemic patients presented with respiratory tract infection and fever.
Introduction: Rickettsial fever has been reported to be endemic in the Himalayan belt, Maharashtra and Karnataka in India among the adult population. Pediatric data on the same is limited in developing countries. Recently, the profile of rickettsial fever has been described in children in South India with similar clinical features. Material Methods: This study was conducted from the patients admitted in our hospital, Ashwini Rural Medical College, Hospital & RC, Solapur, from the month of January 2014 to June 2015. The inclusion criteria were, clinical suspicion & supportive lab evidence-Weil Felix, positive leucocytosis, thrombocytopenia. Results: In our study age of presentation ranged from 6 months to 12 years, with mean age of 7 yrs, there was no statistically significant sex difference. All patients presented with fever & purpuric rash was seen in 82%, altered sensorium was seen in 58%, seizures were seen 34% & Hepatosplenomegaly was seen in 65% of cases. Other investigations: In our study CSF examination was done in 25 patients of which 10 had abnormal findings, 6 showed low sugar and 8 high protein. In our study according to the Weil Felix titers, most probable disease would be tick borne spotted fever or epidemic typhus, since no louse infestation (the scalp and body infestation, lymphadenopathy) was seen in any of the patients, and most of them were from rural areas more chances of tick infestation. Conclusions: The diagnosis of rickettsia should always be kept in mind for workup of exanthematous fever. High index of clinical suspicion and good laboratory co-relation are helpful in detection of more no of cases. Early diagnosis and treatment with doxy and chloramphenicol can reduce the hospital stay and cost. Associated mixed infections may mislead diagnosis and are more fatal. Weil Felix test is not diagnostic standard. It should be interpreted in good clinical context, still it is easily available to all & remains good screening test.
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