Management of different nephrotic syndromes is based on the levels of immunoglobulins along with clinical and biochemical parameters. The decrease of IgG level as a predictive marker for unfavorable prognosis of nephrotic syndrome in children needs further evaluation in larger scale studies.

Background: A large number of children with Urinary Tract Infection (UTI) are seen in the community by general practitioners , but there is frequently delay in treatment and not all are referred for further investigations. There is evidence that many cases are misdiagnosed. It is important to optimize diagnostic and management strategies. Result: UTI is an important cause of acute illness, it may be a marker of underlying urinary tract abnormality. Bacteria causes the large majority of UTI in children- Escherichia coli is the most common (90%) bacterial cause. Urine culture & sensitivity is the gold standard for the diagnosis and mandatory for confirmation of UTI. On culture, a colony count of more than 105/ml organisms of a single species is considered confirmatory of UTI. But there is a strong recommendation that , presence of both pyuria and at least 50,000 Colony Forming Unit (CFU) / ml of a single uropathogen in an appropriately collected specimen makes the diagnosis . There is a recommended imaging schedule in childhood UTI to detect anatomical abnormality. Management depends on type of infection. There is no role of prophylactic antibiotics to prevent febrile recurrent UTI without VUR. Conclusion: UTI is a very common disease and may be associated with renal abnormalities and long term squeale. There is debate about best investigation and management strategies. The greatest potential for prevention of renal damage lies in increased awareness, better diagnosis and management of young children with UTI in primary healthcare. DOI: http://dx.doi.org/10.3329/bjch.v36i2.13085 Bangladesh J Child Health 2012; Vol 36 (2): 90-97

The skin is the most commonly affected organ. Wasp venom causes both local and systemic reactions, but acute kidney injury (AKI) is the most serious complication, with a 20% mortality rate. Acute kidney injury can occur from single or multiple stings. Diagnosis depends on history, clinical findings, and investigations. Treatment protocol is same as other causes of AKI, including dialysis, and prognosis is good with early treatment.

Abstract:Background: Systemic lupus erythematosus in children (Paediatric SLE / pSLE)

Acute post-streptococcal glomerulonephritis (APSGN) is characterized by abrupt onset of hematuria, edema, hypertension, oliguria and impaired renal function following streptococcal group A â hemolytic streptococcal throat and skin infection. There is a declining incidence of APSGN worldwide, particularly in industrialized nations because of easier and earlier access to competent medical treatment of streptococcal infections and the widespread use of fluorination of water since virulence factors in streptococcus pyogens are reduced with fluoride exposure. But in the underdeveloped world, global burden of APSGN continues to be significant with lower estimate of 9.3 to 9.8 cases per 1,00,000 population per year to higher estimates as high as three times these values. Furthermore, clusters of cases are more frequently reported in poor communities in industrialized countries while epidemics of more than 100 cases are reported in the middle ranger countries with mean annual health expenditure per capita of about 550 US dollars. APSGN typically follows 1to2 weeks after pharyngeal infection and 2 to 4 weeks after skin infection by nephritogenic strains of group A â hemolytic streptococcus in a range of 5 – 15 years of age. Subclinical cases are 4 – 10 times higher than symptomatic patients. The acute phase generally resolves within 4-8 weeks but microscopic hematuria may persist for 1-2 yr after the initial presentation. Acute complications of symptomatic patients are hypertensive heart failure, encephalopathy and retinopathy. There can be acute renal failure and rarely rapidly progressive ( crescentic) glomerulonephritis, hyperkalemia, hyperphosphatemia, hypocalcemia and acidosis. Treatment is directed towards reduction of hypertension, but prompt address of complications are essential to avoid immediate mortality. Heart failure is treated with diuretic and anti-hypertensive, digoxin is ineffective. Hypertensive encephalopathy is treated by I.V phenobarbitone for convulsion, supportive measures for unconsciousness and blood pressure control. Acute renal failure is managed by supportive measures, rarely requires dialysis. Short and long term prognosis is excellent, with1% mortality during acute stage and 1% ending up with chronic kidney disease, but in higher age group abnormal urinalysis are present in higher number of patients. DOI: http://dx.doi.org/10.3329/bjch.v38i1.20025 Bangladesh J Child Health 2014; VOL 38 (1) : 32-39