not available DS (Child) H J 2021; 38(1): 56-60
Background: Upper gastrointestinal endoscopy is an essential, safe and sensitive investigation for diagnosing pediatric gastrointestinal diseases. In resource-limited countries like Bangladesh, the practice of pediatric endoscopy remains rudimentary, lacking in trained pediatric endoscopists and appropriate-sized endoscopes. There is limited study on paediatric upper GI endoscopy in our country. Objectives: The aim of the study was to find out the indications, common endoscopic findings and immediate post procedure complication of UGI endoscopy in children. Methods: This is a retrospective study; the records of all the patients whose age is less than 18 years and who underwent endoscopy in the last 6 years were studied. Results: Among the total of 384 children (age <18 years), the most common indications were recurrent abdominal pain in 133 (34.7%) patients followed by hematemesis±melena in 99 (25.8%), esophageal varices (follow up with eradication) in 67 (17.5%), recurrent vomiting in 31 (8.1%), foreign body, CLD screening, suspected celiac disease, isolated splenomegaly, corrosive injury, and weight loss. The most common abnormal findings were gastritis in 103 (26.9%) children followed by esophageal varices in 73 (19.2%), duodenitis in 26 (6.8%), foreign body, esophagitis, hiatus hernia, esophageal stricture, esophageal ulcer, gastric ulcer, duodenal ulcer etc. Minor adverse events occurred in 7.0% of children. Conclusion: The commonest indication for Pediatric UGI endoscopy was recurrent abdominal pain and the commonest endoscopic feature was gastritis. No significant post procedure complication was noted in the study. DS (Child) H J 2021; 37(2): 123-128
Background Wilson disease (WD) is an inherited disorder of copper metabolism commonly involving the liver, cornea, and brain. Its incidence is increasing day by day worldwide. Early diagnosis and prompt treatment are the key for best outcome. Material and methods A cross-sectional descriptive study was done from January 2014 to December 2019. Sixty children of both genders between 3 and 18 years were diagnosed by clinical and laboratory profile meeting selected criteria. Results Mean age was 8.42 ± 2.6 years and male female ratio was 1.5:1. Consanguinity of marriage was found in 38.3% cases. Seventy percent of cases were hepatic, 16.7% were neuropsychiatric, 5.0% were hepatic with neuropsychiatric, and 8.3% cases were manifested asymptomatically. Asymptomatic and hepatic WD were reported between 3 and 10 years and most of the neuropsychiatric and hepatic with neuropsychiatric manifested after 10 years of age. More than 50% cases improved, a little more than 20% children died, 18.4% were unchanged and 6.6% were hepatic added neuropsychiatric manifestations. Most of the asymptomatic (100%) and hepatic (61.9%) cases improved. High mortality was found with 76.9% cases of acute liver failure (ALF), 7.7% case of chronic liver disease (CLD) and 25% cases of CLD with portal hypertension (CLD and PH). Most of the neuropsychiatric cases (90.0%), and approximately two-third (66.6%) of hepatic with neuropsychiatric cases remained unchanged. Neuropsychiatric manifestations were added in 15.4% cases of CLD and 25% cases of CLD with PH patient. The treatment was well tolerated in 66% children without any side effects. Low WBC (6.3%) and platelet count (4.3%), vomiting (6.3%), anorexia (4.3%), loss of taste (4.3%), rash (4.3%), and proteinuria (2.1%) were found in few cases. Conclusion Majority of the children were presented with hepatic manifestations. More than half of patients with WD treated by D-penicillamine (DP) were improved. Significant mortality was found in acute liver failure whereas neuropsychiatric presentations had persistent abnormalities. No major side effects of DP was observed in most of the cases. Early diagnosis and prompt treatment were crucial for better outcome.
Background: Pediatric colonoscopy is a safe, sensitive and crucial tool for diagnosing as well as treating children with lower gastrointestinal diseases. In resource-limited countries like Bangladesh, the practice of pediatric colonoscopy remains rudimentary, lacking in trained professionals and appropriate instrumentation. Objectives: The aim of the study was to find out the indications, common colonoscopic findings along with histopathologic evaluation and immediate post procedure complications of colonoscopy in children. Methods: This was a retrospective study; the records of all the patients whose age was less than 18 years and who underwent colonoscopy from January 2017 to December 2021 were studied. Results: Among the total of 196 children (8.23±4.12), the most common indications were lower gastrointestinal bleeding (LGIB) in 107 (54.6%) patients followed by chronic diarrhea in 33 (16.8%), recurrent abdominal pain (RAP) in 16 (8.2%), follow up Inflammatory bowel diseases (IBD) in 14 (7.1%), chronic constipation, weight loss, recurrent oral ulcer, intestinal tuberculosis (TB) and melena. The most common pathologic findings were polyps in 81 (61.4%) children followed by non-specific colitis in 19 (14.4%), IBD in 17 (12.9%) and infectious colitis in 09 (6.8%) cases. Minor adverse events occurred in only 2.0% of children. Conclusion: The commonest indication for pediatric colonoscopy was LGIB and the most common findings were colonic polyps. Pediatric colonoscopy is safe and effective diagnostic as well as therapeutic option for lower GI diseases. DS (Child) H J 2021; 38(1): 8-16
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