A One and Half Years Old Baby Presented With Urosepsis Following H/O Pyeloplasty

We report a case in which a one and half years old baby presented with frequent loose motion 10 month back.For this her parent put her to a physician and diagnosed as a case of PUJ obastruction(left).She underwent A-H pyeloplasty in India for PUJ obstruction on Dec,16. She developed fever with chills & rigor immediately after removal of D-J stent and referred to DMCH. Open nephrostomy was done in DMCH on March,17. Antegradenephrostogram showed low lying left kidney with moderate hydronephrosis. Reexploration of left kidney was done on oct,17. Left kidney found baggy and distal ureter found atretic. Resection of distal ureter and ureteroneocystostomy with psoas hitch was done.Post operative period was uneventful. Bangladesh Journal of Urology, Vol. 21, No. 2, July 2018 p.172-174

Clinical Profile of Enteric Fever in Children of a Tertiary Care Centre in Kathmandu, Nepal

Background: Enteric fever, commonly known as typhoid fever is a global public health problem. It is one of the common infectious diseases of humans, fever lasting for more than 7 days. It is transmitted by faecooral route and common in the areas with poor sanitation. Globally, majority of the Typhoid fever is caused by Salmonella enterica var typhi, one fifth of the infection is caused by Salmonella enterica var paratyphi. This study was conducted to describe clinical and laboratory parameters among children with enteric fever. Methods: It was a descriptive cross-sectional study conducted in the Pediatric ward and Pediatric Intensive Care Unit (PICU) of Nepal Medical College Teaching Hospital (NMCTH), Atterkhel, Kathmandu, Nepal from 2015 January to 2015 December. Inclusion criteria: clinical details and laboratory parameters of children aged 13 months to 15 years old with diagnosis of enteric fever was obtained in the proforma and descriptive statistics were calculated. Result: A total of 1,020 children with the sign and symptom suggestive of enteric fever were admitted in the inpatient department (Pediatrics) during the study period. All the enteric fever suspected children were tested for blood culture, Widal test and complete blood count, out of them 80 children were diagnosed as enteric fever. Male female ratio is 1.6:1. Fever was the most common clinical feature observed in 95% cases and other common features were loose motion (37.5%), vomiting (33.8%) and abdominal pain (27.5%). Hepato-splenomegaly is common finding of Enteric fever reported in 85.0% and 43.7%. Majority of the patients had normal leucocyte count (71.0%) and leucopenia reported in 20.0%. Conclusion: Fever and hepato-splenomegaly were the major clinical presentation of typhoid fever in our study. Other less common features were loose motion, vomiting and abdominal pain. This finding may be useful for the pediatrician and other health professionals for the early diagnosis of enteric fever.

Study of the efficacy of Pathadi Ghanavati with Lajamanda in the management of Aamatisara

Acute Diarrhoea is an important public health problem worldwide. The World Health Organization estimates that there are more than 1000 million cases of Acute Diarrhoea. Loose motion less than 2 weeks that labelled as Acute Diarrhoea. Diarrhoea is described in Ayurvedic classics with the name of ‘Atisara’. It means passing of excessive flow of watery stool through anus. Most important factor in the pathogenesis of Aamatisara is Mandagni. In present study 50 patients of Aamatisara were selected from OPD and IPD of Kayachikitsa department. For the clinical study Pathadi Ghanavati and Lajamanda was selected as the trial drug which was given for the duration of 7 days in the dose of 1gm twice a day. It was observed that 32% patients were from the age group 51-60 years, 70% were females, 62% were from lower-middle socio economic class. Sama Jivha was found in all the patients. Among results loose motion showed 98.75% relief, 97.82% showed improvement in Udarashoola, 97.43% improvement in Agnimandya and Daurbalya each, 100% relief was seen in Aruchi. All the symptoms showed highly significant results. Hence it can be concluded that Pathadi Ghanavati and Lajamanda is very effective remedy in the patients of Aamatisara.

ACUTE DIARRHEA

Acute diarrhea is the fourth-ranking cause of death in children under the ageof 5 years. after neonatal causes, malaria, and acute respiratory infections. Objectives: Todetermine the role of Saccharomyces boulardii in the treatment of acute diarrhea. Design:Comparative study. Period: Six months, Mar to Aug 2013. Setting: Pediatric Unit II- LiaquatUniversity Hospital Jamshoro/ Hyderabad. Patients and methods: It consisted of 100 patients,of acute diarrhea with age between 3 months to 5 years reported to pediatric unit and fulfilledthe inclusion criteria. Cases were given low osmolar ORS, Zinc & Saccharomyces boulardii250mg twice daily for three days and controls were given low osmolar ORS and Zinc. P-value≤0.05 was considered as significant. Results: The results showed that 51 patients were maleand 49 patients were female. 27 male patients were in control and 24 were in case group. 23female patients were in control and 26 were in case group. The overall mean age of studysubjects was 26.73±12.65 months. Among reported patients most of the patients 84% werereported on 1st day. All reported patients had a complaint of loose motion with 73% also hadvomiting. All patients had watery loose motion. The mean duration was 4.20±1.70 days withthe mean frequency of 9.82±6.16 times. Among the patients 96 patients were hospitalized and97 patients were given I/V fluid. Among reported patients 10 were without dehyderation, 8 hadsome dehyderation, and 82 had severe dehyderation. 52 had acceptability of probiotics. Theresults were evaluated according to 1st, 2nd, and 3rd day post intervention. Among 50 patientsof case group, 18 patients were compliance. 49 patients had decrease in duration. The sameresults were observed in the decrease in frequency. Consistency was improved in 39 patients.The duration of hospitalization was reduced in 36 patients. It was observed that improvement inthe duration, frequency, and consistency was mostly observed on 2nd day of post intervention.Conclusions: The role of S. boulardii as a good biotherapeutic agent allowing to prevent and/ortreat several grastrointestinal diseases. In comparison to probiotic bacteria, the use of probioticyeast is beneficial when the treatment is combined to antibiotherapy.