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Background: Nephrotic syndrome is a common renal disease in children, associated with high risk of death, most commonly from infections, if not identified and treated promptly. It is a disease that not only affects the physical health but also psychology of the child and that of the family and there is lack of information on nephrotic syndrome in children in a rural setup. Methods: This hospital based observational study was conducted from September 2020 to December 2021, in department of pediatrics in KIMS, Narketpally. A total of 40 eligible children diagnosed with nephrotic syndrome between 3 months to 12 years were taken up for this study. Detailed information of the patient, including thorough history, clinical examination, investigations, response to treatment and complications of the disease were recorded in a pre-designed proforma and the data was analyzed. Results: It was observed that out of 40 subjects, the most common age group affected was 6-9 years (42.5%), majority of which were male children (72.5%). Most common presenting symptom was edema seen in 100% patients, followed by oliguria in 50%. Most common complication noted was ascites (62.5%) followed by hypertension (42.5%). UTI was observed in 52.5% of cases. 75% of the patients were newly diagnosed and 25% were relapses. Conclusions: In the present study, clinical and demographic profile of nephrotic syndrome was congruent with nephrotic syndrome in children in other studies. The response to treatment and associated complications did not differ significantly in a rural center when compared to other studies.

Background: Febrile thrombocytopenia is platelet count <1,50,000/mm3 associated with fever irrespective of age and gender. There is an increasing trend in the incidence of febrile thrombocytopenia with varied etiology. Though infections are the most common cause in tropical countries like India, sometimes non-infectious conditions like primary haematological disorders and malignancies can also present as febrile thrombocytopenia. Hence it is essential for the treating physicians to be fully aware of etiological factors for febrile thrombocytopenia and how to approach to the condition. Methods: A hospital based observational study done at Kamineni Institute of Medical Sciences during the study period October 2020 to December 2021 by collecting and analysing details of 100 patients between 1 month-12 years of age who presented with fever and thrombocytopenia at admission. Patients on drugs causing thrombocytopenia were excluded from the study. Results: Majority of the cases (51%) belonged to the age group of 1-6 years. Out of 100 subjects, 60% of them had dengue fever, 12% of cases had malaria and 10% of cases had enteric fever. Bleeding manifestations were seen in 12% of cases and blood product transfusion was done in 30% of the cases. 98% of cases had recovered and 2 deaths were reported. Conclusions: Febrile thrombocytopenia is a common clinical presentation in children. Majority of the dengue cases responded well to treatment given as per WHO guidelines. In most of the other infections, thrombocytopenia was transient and asymptomatic with lesser severity and resolved with the treatment of underlying condition.

Sickle cell disease (SCD) is a term used for a group of genetic disorders characterized by production of Hb “S”. Sickle cell hemoglobin opathy occurs due to mutation of beta-globin gene situated on short arm of chromosome 11, where adenine is replaced by thymine in base of DNA coding for the amino acid in the sixth position in beta-globin chain. This leads to an amino acid change in beta chain of Hb molecule, from glutamic acid to valine. The result is profound change in the molecular stability and solubility of Hb “S”. Authors are reporting a 8-year-old girl who is a known case of sickle cell disease presented with complaints of intermittent pain abdomen and vomiting since 30 days. Investigations revealed elevated pancreatic enzymes with radiological evidence of pancreatitis. Packed red blood cell transfusion and appropriate supportive therapy given and child recovered well.

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