Introduction: Acute glomerulonephritis includes renal diseases in which immunologic mechanism triggers inflammation and proliferation of glomerular tissue that can result in damage to the basement membrane, proliferation of mesangium, capillary endothelium. Objectives: The objective of this study is to know the clinical profile and immediate outcome of acute glomerulonephritis in hospitalized children. Material & Methods: The study was done in Chittagong Medical College Hospital Pediatric Unit during the period of June 2007 to February 2008. All patients admitted with AGN, with or without complications were included in this study. Diagnostic criteria were scanty urine (infrequent and less than normal in amount as stated by the parents), swelling, high colored urine with or without albuminuria, no past history of similar attack and microscopic or naked eye haematuria. Criteria of discharge from the hospital were absence of puffiness and oedema, adequate urine formation, absence of heart failure and hypertensive encephalopathy. These were taken as clinical recovery. No long-term follow up was done. Results: Seventy-eight cases of acute glomerulonephritis (AGN) in children under 12 years of age were studied. Male to female ration 3:2. Scanty urine (84.0%), puffy face (88.5%) h, haematuria (80.0%), hypertension (82.5%), heart failure (11.5%) convulsion (14%) anuria (3.8%), RBC (92.3%), RBC cast (41%), albumin one (+) (52.6%) two + (14.1%) three + (14.1%), raised s. creatinine was (25.6%), blood urea (26.9%). Four patients were died. Among them three was due to hypertension and heart failure. One due to the development of acute renal failure. History of skin infection like scabies was present in 61.4% patient. Conclusion: Skin infection is the commonest cause of acute glomerulonephritis. Nephritic presentation (scanty urine oedema, haematuria, hypertension and heart failure) was the commonest mode of presentation. Immediate prognosis was excellent-Long term follow up is recommended.
Introduction: Acute bronchiolitis is a condition where patients are presenting with breathing difficulties, cough, poor feeding, and irritability. Treatment of bronchiolitis have many controversies. Most trials of bronchiolitis treatment suffer from 2 constraints: possible inclusion of patients with asthma and inconsistent outcome measures. The aim of the study was to determine the efficacy of prednisolone in recovery from acute bronchiolitis who have a family history of atopy. Material & Methods: This randomized double blind placebo controlled trial (RCT) was conducted in the department of pediatrics Dhaka Medical College Hospital (DMCH) from July 2008 to June 2010. Sixty (60) bronchiolitis patients having family history of atopy were included in his study. Prednisolone and placebo were packaged in identical envelops with separate code number given by the guide and the code number were recorded in a preformed questionnaire. The trial was so planned that neither the parents nor the investigator were aware of group allocation. The collected data were analyzed thoroughly by SPSS program version of 16.0 software. Informed written consent from parents or legal guardians was taken and ethical clearance was obtained from the ethical review committee of Dhaka Medical College to conduct the research works. Results: In our study, mean age of the patients of this series were 3.68 months (±1.29SD) and 3.52 month's (±1.1SD) in prednisolone and placebo group respectively. Use of accessory muscle score was assessed twice at 8 am and 8 pm each day for three days. On first assessment at day 1 the score was similar in both the treatment groups (P>.05). More people in Prednisolone arm recovered within 3 days then the placebo group. The difference is statistically significant (P<.01). Conclusion: Three-day oral prednisolone treatment was effective in accelerating clinical recovery (Fast breathing, use of accessory muscle, wheezing) in acute bronchiolitis cases who had family history of atopy.
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