Causes and outcome of antenatal hydronephrosis detected in the third trimester at Queen Alia Hospital

Objective: To determine the clinical features and postnatal outcome of all antenatally detected hydronephrosis cases

Methods: A retrospective review of the collected data for all infants with antenatal hydronephrosis who were seen at Queen Alia Hospital during the period between Feb 2010 and April 2013. The degree of hydronephrosis was defined as mild, moderate, severe, based on the antero- posterior pelvic diameter that was measured after 30 weeks of gestation. Patients were divided into group I [with unilateral hydronephrosis] and group II [with bilateral hydronephrosis and ureteric dilatation]. Post natal evaluation and follow up was uniformly done. Causes and clinical outcomes were compared between the two groups

Results: A total of 80 infants enrolled in this study. Fifty seven [71%] were male and 23 [29%] were female with a male: female ratio [2.5: 1]. The left kidney was more commonly involved [left: 34, right: 18]. Group I had 52 patients, 4 [8%] required surgery. Group II had 23 patients, 7 [30%] required surgery. Transient hydronephrosis was the commonest cause of antenatal hydronephrosis [33%] followed by pelviureteric junction obstruction [PUJO] [31%], and vesicouretral reflux [27%]. Posterior urethral valve and vesicouretral junction obstruction were seen in [4%], [3%] respectively

Conclusions: Antenatal hydronephrosis requires close follow up during antenatal and postnatal period. Patients with mild unilateral and bilateral antenatal hydronephrosis run a relatively benign course and require limited, infrequent ultrasonography follow up. Those with bilateral moderate to severe hydronephrosis require extensive or further work up and close follow up

changing spectrum of end stage renal disease at Queen Rania Al-Abdullah two Hospital of Paediatrics

End stage Renal Disease is a rare condition in children. It is usually the result of slowly progressive irreversible kidney damage. The aim of this study is to determine the causes, outcome and describe the demographic features of all children with end stage renal disease on regular dialysis at Queen Rania Al-Abdullah two Hospital of Paediatrics. This is the referral centre for all pediatric subspecialties in Jordan. A retrospective review of all computerized data for all children with end stage renal disease who were on regular dialysis at Queen Rania Hospital during the period January 2006 to April 2011 were done. The data was reviewed regarding gender, age at the initiation of dialysis, mode of dialysis and primary disease. The outcome of these children was also followed and reviewed. Out of 98 children who were on regular dialysis at Queen Rania Hospital, 90 [92%] were on hemodialysis and eight [8%] were on peritoneal dialysis, 53 [54%] were female, 45 [46%] were male. The mean age at the initiation of dialysis was 8.2 +/- 2.3 years; the commonest cause of end stage renal disease was congenital anomalies of the kidney and urinary tract which occurred in 34 [34.5%] children. However unknown causes were found in four cases [4%]. Thirty-nine children [39.5%] were transplanted and 25 [25.5%] children died while they were on dialysis. The most common cause of end stage renal disease at our center was congenital anomalies of the kidney and urinary tract, which is a preventable cause when detected early. The increased percentage of renal transplants observed among patients with end stage renal disease on regular dialysis at our center is promising as it offers the best choice of renal replacement therapy

Eosinophilic esophagitis among children at King Hussein medical center

Eosinophilic esophagitis is a clincopathologic entity characterized by esophageal symptoms in association with a dense eosinophilic infiltrate, the aim of this study is to describe the clinical presentation, laboratory, endoscopic and histopathologic results in children diagnosed with eosinophilic esophagitis. This is a retrospective review of the medical records for 38 children with histologic diagnosis of eosinophilic esophagitis performed at King Hussein Medical Center, during the period between January 2001 to February 2011, with the cut off biopsy diagnosis >/=20/HPF eosinophilic infiltrate. Patients were excluded if gastric or duodenal biopsies showed prominent eosinophilic infiltrate. Patients medical records were reviewed regarding age at presentation, gender, clinical presentation, associated disease. Laboratory, endoscopic and histologic results were also reviewed. A total 38 patients with histological diagnosis of eosinophilic esophagitis were included in this study. Thirty-one [82%] were males and 7 [18%] were females. Their ages ranged between 2-14 years. Mean age 8 years. The most commonly clinical presentation of eosinophilic esophagitis was vomiting which occurred among 26 children [68%], however, rash was presented in only one child [2%]. Peripheral eosinophilia >[0.5x10/L] was found in 45%. High serum IgE level [>100 IU/ml] was found in 39%. Positive radio allergo sorbent testing in 39%. The most frequent endoscopic findings were loss of normal vascularity found in 19 [50%] children, however, white exudates were found in 2[5%] children. Mean eosinophil count was 70 [20-120], eosinophilic degranulation, and bazal zone hyperplasia reported in 18 children [47%]. Eosinophilic esophagitis in Jordan displays similar clinical, endoscopic and pathologic features to those described in other countries. Endoscopic and histologic feature remain the gold standard for diagnosis of eosinophilic esophagitis