1Urinary tract infections include 10% of all febrile children, 13.6% of febrile infants and 7% of febrile newborns.2 Among the children younger than five years of age, most urinary tract infections lead to scarring or diminished kidney growth and mainly seen in infants in the first year of life. 3It is crucial to recognize urinary tract infections in febrile children and a slip in diagnosis could have long-term consequences like renal scaring with its adverse effects. 4 Fever and significant bacteriuria and pyuria in children should be suspected of pyelonephritis, since acute ABSTRACT Background: In children less than five years of age, fever is the most common reason to visit emergency/outpatient pediatric departments. Quite often, the child receives antibiotics empirically, without adequate evaluation for urinary tract infection. The objectives of this study were to evaluate the prevalence of urinary tract infection (UTI) in febrile children, less than 59 months of age. Methods: Records of 370 children between 1 to 59 months of age, attending the department of paediatrics with febrile illness were reviewed. Data related to age, gender, socioeconomic status, nutritional status, clinical diagnosis, abdominal ultrasound, urinary microscopy and urine culture were analysed. Results: Records of 370 children were evaluated, among them, 240/370 (64.86%) children were below two years, and 130/370 (35.13%) were above two years. 165/370 (44.6%) were males, and 205/370 (55.4%) were females. The overall occurrence of urinary tract infection as defined by significant pyuria was 48/370 (12.9%) in children less than five years of age. The prevalence of UTI in children less than one year of age was 26/370 (7%), whereas it was 15/370 (4 %) in less than two years of age and 7/370 (1.8%) between two to five years. Among pyuric patients, 13/48 (27%) had a urine culture positive reports. The positive urine culture was seen in 6/13 (46%) of children with pus cells> 5/HPF and remaining 7/13 (54%) in children with pus cells >10/HPF. E. coli was the predominantly [9/13 (69%)] seen organism in urine cultures. Conclusions: In present study, the overall occurrence of UTI in children less than five years was 13%. Only 3.5% of children had culture-positive UTI. 46% of positive cultures were found in children having urine pus cells > five /HPF in the centrifuged sample, it is recommendable that children with pyuria should be evaluated thoroughly to initiate prompt treatment and have a successful outcome.

Background: A febrile convulsion is linked with high temperature but without significant underlying health issues. These occur most often in children aged six months to five years. Most of the convulsions last less than five minutes, and within an hour of the occurrence, the child is entirely back to normal.Methods: Sixty children aged 3 months to 5 years admitted to the emergency pediatric ward with a history of convulsion fever with convulsions, in Narayana Medical College and Hospital were taken up for the study with clinical history, clinical examination, laboratory Investigations.Results: Among 60 children in the study group, 15 (25%) of them were aged between 3 months to 12 months, 21 (35%) of them were between 13 months to 24 months. Gender 36 (60%) are male children. 24 (40%) are female children. Family history of convulsions was positive in 18 (30%) of the 60 (100%) cases, and 7 had family history of epilepsy. 42 (70%) are negative. Most of the cases (85%) showed no growth in blood culture.Conclusions: Blood culture should be performed in all children by febrile convulsions, especially those under the stage of two years. Streptococcus pneumonia was the organism isolated from respiratory tract infection in a child with febrile convulsion with significant bacteremia. The symptoms that present can be as harmless as rhinorrhea or cough. Children with a positive family history of afebrile convulsion should be closely monitored and test, as they can develop epilepsy later.

Background: The term malaria (meaning bad air of the marsh and swampland) first originated in the 17th century. Malaria is one of the most serious medical conditions, Malaria causes symptoms which usually include fever, fatigue, vomiting, and headaches. It may cause yellow skin, seizures, coma, or death in extreme cases. The population of tribal areas of Andhra Pradesh, Tamilnadu, Karnataka, Chhattisgarh, Gujarat, Bihar, Orissa, Northeastern states are contributing 50% of cases of Plasmodium falciparum.Methods: All the clinically suspected cases of Malaria, ‘The optiMAL’ test was done at the bedside and simultaneously thick and thin smears are prepared and sent for microscopic examination. Study was carried out at Narayana Medical College, Nellore, Andhra Pradesh, India. The total number of patients in our study was 150. 1-14 years of age were included in the present study after applying the inclusion and exclusion criteria.Results: The ‘OptiMAL’test method had excellent sensitivity and specificity (100%) for detecting plasmodium vivax, very good sensitivity, and specificity (98.57%, 100%) for detecting plasmodium falciparum. The optimal test had a positive predictive value of 100%, the negative predictive value of 98.61% with p-value <0.001.Conclusions: Our study has shown that the 'OptiMAL' test is an easy and successful diagnostic test that can be performed at the bedside for malaria diagnosis. This is very similar to traditional microscopy and do not need highly qualified workers to conduct experiments or interpret.

Background: Bronchiolitis is a predominant cause of respiratory insufficiency and hospitalization in infants during the first year of their life. Respiratory syncytial virus (RSV) has been the major causative virus; other viruses also cause bronchiolitis. Some are activated in winter while another virus in non-winter seasons. This seasonal trend affects the morbidity in infants. In the Indian context, data regarding seasonal influence on the severity and complications of acute bronchiolitis is less. Hence, this study was undertaken to assess the influence of season on morbidity on mortality in acute bronchiolitis.Methods: Infants or children <2 years of age, with the first episode of acute bronchiolitis diagnosed clinically, were evaluated. Clinical, demographic, radiological and risk factors were recorded and correlated with seasons.Results: The age of the infants was 4.0±2.9 months. Peak occurrence (87.7%) was within six months of age. 78/105 (74.3%) of bronchiolitis occurred during July to December. 22/105 (20.9%) were mild, 43/105 (43.9%) were moderate, and 40/105 (38.9%) were severe. The order of chest X-ray findings are consolidation <atelectasis <normal <pulmonary infiltrates <bilateral Hyperareation. Apnea was seen in 2.9%, Otitis media in 7.6% and seizures in 3.8% of infants. The season did not show statistically significant trend on the severity of bronchiolitis. There were no infant deaths due to bronchiolitis in the present study.Conclusions: In the present study, the season did not show statistically significant trend on the severity of bronchiolitis. Studies with more extensive population are needed to reassess the seasonal effects on morbidity of acute bronchiolitis.