ABSTRACT
Background: There has been a little attention to pediatrics esophagus problems until recent years. The term esoghagitis can be used to described chemical, infectious, inflammatory, ischemic, immunologic and degenerative abnormalities. Prevalence of reflux esophagitis varies between 2 to 5 percent of general population but little data about its incidence in pediatric age groups. The aim of this study was to evaluate the epidemiology and prevalence of esophagitis and study of symptom, diagnostic measures, therapeutic intervention and prevention of its complication
Materials and Methods: In this prospective and cross sectional study 500 patient under16 years with upper digestive complaints or alteration of their state of health under went upper endoscopy, with special attention paid to esophagus
Results: Among 500 children [205 male, 207 female], pathology reported esophagi is in 325 cases. Majority of the patient were 8 to12 years. Most common complaints was abdominal pain [45/7%] and the second complaints was vomiting [13%], but most common complaints in severe esophagitis was melena [66%] and hematemes [18/8%]. Most of patient [63%] had a mild grade of esophagitis. When difference between endoscopy and pathology compared: Mild esophagitis in endoscopy [67%], but in pathology was [63%], moderate esophagitis [14/7%] in endoscopy was [17%] in pathology and severe form 2/8% in endoscopy but [4/9%] in pathology
Conclusion: According to results of our study in children age group with chronic abdominal pain, vomiting, excessive regurgitation, failure to thrive, we noticed that esophagitis is common etiologic factor. Histological esophagitis frequently occur in the absence of gross endoscopic findings and we need biopsy and histological examination to confirm diagnosis
ABSTRACT
Side effects of steroid therapy of autoimmune hepatitis are seen more frequently with prednisolone only regimen. However, the question of efficacy restrains the broad use of prednisolone in combination with azathioprine. To compare biochemical responses to the two standard immunosuppressive drug regimens [prednisolone alone and prednisolone in combination with azathioprine] in children with autoimmune hepatitis. The study was performed on 42 children with autoimmune hepatitis. Patients were attributed to two groups, with group A receiving prednisolone alone and group B receiving prednisolone in combination with azathioprine, using simple random attribution unless there was a contraindication to azathioprine. The patients were evaluated for treatment response on three occasions: short term [one month after starting therapy], intermediate term [four to six month after starting therapy], and long term [one year after starting therapy]. Chemical response was defined as decrease in aminotransferases to a level below two times the normal values and gamma globulin to lower than 2.8 g/dL. Clinical response was defined as improvement in the initial clinical signs and symptoms [jaundice, hepatomegaly, splenomegaly, fever, and edema/ascites]. There were no differences in chemical and clinical response rates between the two groups. Both clinical and chemical response rates in intermediate term were significantly higher than short term. However, clinical and chemical response rates in long term did not significantly differ from intermediate term. The study shows that some patients need time to respond to therapy. Nonetheless, it seems that whenever there is no improvement after six months of therapy, it is prudent to change the treatment regimen rather than waiting for response. With the same efficacy and less side effects, the combination regimen must be preferred as the standard regimen, unless there is a contraindication to azathioprine