Clinical Profile and Lab Findings of Dengue Fever in Children Admitted in a Tertiary Care Hospital.

Dengue is an arboviral infection dengue virus (DENV 1-4) transmitted by Aedes mosquito. It shows a wide range of clinical presentation from asymptomatic cases to undifferentiated fever, dengue hemorrhagic fever (DHF) or dengue shock syndrome (DSS) or non-severe and severe dengue. Most cases of dengue are self-limiting; however, severe dengue has high mortality if not diagnosed and managed early during the disease. Dengue virus (DENV) infection is a serious global public health challenge resulting approximately 200 million cases of morbidity and 50,000 cases of mortality annually. Management is based on clinical and lab parameters with certain lab tests aiding in the early forecast of severe dengue. While serological tests (detection of nonstructural protein 1 [NS1] antigen, immunoglobulin IgM and IgG antibodies aid in diagnosis of dengue, simple, cost-effective, easy tests such as hematocrit and platelet counts have great utility in resource-poor healthcare systems for predicting onset of severe dengue. To determine the clinical profile and lab findings of different varieties of Dengue fever in children admitted in a tertiary care hospital. This retrospective observational study was designed to collect data from the medical records of children of both sexes, aged up to 12 years old. The study was conducted from April 2019 to September 2019 in pediatrics department of BSMMU, Dhaka. A total of 50 children who were admitted with the complaints of fever and were found positive for either NS1 antigen or dengue IgM or IgG antibodies were included in the study. Patients with chronic diseases or any concurrent infections were excluded. Samples were collected from hospital record and kept in a separate management system only for dengue patients. The demographics, clinical and laboratory findings were recorded via structured data collection sheet. Among 50 cases, 22 were dengue fever, 17 were dengue hemorrhagic fever and 11 were dengue shock syndrome. The mean age of study participant was 6.95. Out of 50 patients, Male 62.0% were predominant over the female 38.0% and majority 74.0% came from urban area. Fever (95.5%) was mostly the presenting feature in dengue fever. Bleeding (29.4%) and tourniquet test positive (47.0%) were most in DHF. Hypotension (90.0%), tachycardia (90.9%), edema (18.2%), shock (90.9%) and hepatomegaly (72.7%) were mostly present in DSS. Neutropenia (72.7%) was significant in DSS. Platelet count (32,588.24±22,335.67) was significantly low in DHF. Albumin count (27.82±5.25) and TCO2 (18.27±1.8) were significantly low in DSS. Statistical analysis was done by Kuskalwallis test for categorical data analysis and one way ANOVA test for comparison of continuous data. P value <0.05 is considered as significant. This time it was seen that bleeding, tourniquet test positivity with low platelet count is seen in DHF. But DSS was marked by hepatomegaly and hypoalbuminaemia.

Ganglioneuroma Mimicking Nephroblastoma: A Case Report.

Ganglioneuroma is an uncommon benign, slow-growing tumor arising from the neural crest. It rarely turns malignant even after decades of benign existence. Imaging modalities give a definite clue to the existence of a neurogenic mass but it is finally diagnosed on histopathology examination. Here, a 3-year-old girl presented with ganglioneuroma that mimicked renal mass on imaging in a tertiary care hospital, Dhaka, Bangladesh on January, 2016. Later on, it was confirmed as neuroganglioma by histopathological examination. As treatment differs widely between ganglioneuroma and nephroblastoma, a minor mistake in the accurate diagnosis may endanger the life of a patient through potential adverse effects of therapy. So, we should keep in mind about ganglioneuroma regarding evaluation of any kidney or abdominal masses.

Serum Na+ Level in Children Suffering from Acute Bronchiolitis: A Review.

Bronchiolitis is the leading cause of lower respiratory tract infection (LRTI) in infants. Respiratory syncitial virus (RSV) is the most common cause of bronchiolitis in infants and young children. Hyponatremia is a commonly overlooked important extrapulmonary manifestation of bronchiolitis. It is now known that the syndrome of inappropriate anti diuretic hormone secretion (SIADH) occurs frequently in several pulmonary conditions including bronchiolitis which may lead to hyponatremia. In many studies,a good number of patients admitted with bronchiolitis were found to have hyponatremia e.g. Wilson et al. A high index of suspicion with prompt diagnosis and treatment can save life and prevent handicaps. Serum electrolyte level should be measured in all children hospitalized for bronchiolitis. Neurological complications may occur in hyponatremia and fluid therapy in vulnerable infants should be appropriately planned to reduce this risk.

[Medical care of adolescents]. / Meditsinskoe obespechenie podrostkov.

The authors discuss staged transfer of adolescents aged 15-17 years to pediatric outpatient institutions by discontinuing their transfer to general therapeutic and prophylactic institutions and thus initiate continuous medical services for children till the age of 18 years within the framework of pediatric service. Experience gained in the Ryazan region is presented and the basic features in organization of public health organs and institutions of the territory in this direction are described; the role of complex prophylactic measures and inter-departmental approach to solution of this problem are discussed.