ABSTRACT
Background: Malaria is one of the major vectors borne disease globally responsible for 1 million deaths a year. Changing trends in the causative species and epidemiological distribution have identified icterus and renal involvement as an emerging complication associated with severe mortality in children. The objectives of this study were aimed to study the clinical profile of malaria cases admitted in a pediatric ward. The study also highlights the involvement of renal manifestations in the cases with regard to species distribution and associated complications in the study group.Methods: A prospective study for 14 months was conducted, and all positive cases of malaria admitted in paediatric unit were enrolled and socio demographic data, clinical history were collected, and biochemical investigations were performed and analyzed. SPSS software version 12 was used for analysis. Statistical significance was set at p ?0.05.Results: About 278 subjects with 55.4% males, 44.6% females and with 5-10 years was most common age group. 102 cases of vivax malaria, 152 cases were falciparum and 24 were mixed cases. Cerebral malaria, hyperparasitemia was identified in 28 cases, DIC in 5.04% of cases. Renal involvement was observed in 38.16% of falciparum infections and 27.45% of vivax infections. 68 cases developed acute renal failure as a severe complication.Conclusions: 'Renal involvement is more in falciparum and mixed infections than vivax malaria. Early diagnosis and prompt treatment help in early recovery of cases and halts to progression to renal failure. An urgent need for a biomarker for early identification of renal involvement in malaria before biochemical involvement is detected.
ABSTRACT
Background: Diarrhoea is one of the commonest clinical entities encountered regularly in clinical practice. In India, at least 1.5 million children die due to acute diarrhoea per year. Timely recognition, high index of suspicion and thorough understanding of various clinical signs in different types of dehydration is necessary in preventing the deaths. The present study focuses on the different types of biochemical alterations and electrolyte disturbances in cases of acute diarrhoea among children.Methods: A prospective study with ethical committee consent was done at a tertiary care hospital for two years in department of Paediatrics. All cases of acute diarrhoea attending with signs and symptoms of moderate and severe dehydration were included. Clinical history and necessary biochemical investigations including serum electrolytes were performed. The results and data were entered in an excel sheet and analysed.Results: 250 cases were enrolled in the study with males (57.6%) and females (42.4%). 1month to 5 years with 84 cases (33.6%) was the most common age group with mean age of 11.48' 2.4 years. History of passage of loose motions was with a frequency ranging from 6-12 /day with a mean frequency was 8.12/day. 80.8%cases had some kind of electrolyte abnormality with majority having isolated Hyponatremia and a combined Hyponatremia and Hypokalemia (33.6%) each.Conclusions: Diarrhoeal disorders can be easily prevented with proper hand hygiene practices, health awareness programmes, increased breast-feeding practices and proper disinfection of water. Hyponatremia, hypokalemia, combined Hyponatremia and hypokalemia are major electrolyte abnormalities in cases of diarrhoea.