Ruptured baker's cyst in a 15-year boy

Baker's cysts or popliteal cysts are common cystic lesions surrounding the knee joint. These are prevalent among the adult population but rare in children. These are asymptomatic in majority of cases, and are identified incidentally by the parent or physician. We report a case of 15-year boy who presented to the emergency room with symptoms of calf pain and swelling for two weeks. He was in good health previously, and had no underlying knee pathology. Prior to presenting in emergency department [ED], he was suspected as deep vein thrombosis [DVT], and referred for evaluation and management. During his evaluation for DVT, the diagnosis of ruptured Baker's cyst was made on ultrasound. This was further confirmed with magnetic resonance imaging [MRI] of knee joint. He responded to conservative management and was discharged home after reassurance

Subacute sclerosing panencephalitis: clinical and demographic characteristics

To determine the clinical and demographic characteristics of children diagnosed with Subacute sclerosing panencephalitis [SSPE]. Case series. The Aga Khan University Hospital, Karachi, from January 2000 to June 2012. A retrospective analysis was done, regarding medical charts of 43 children under the age of 16 years with a discharge diagnosis of SSPE. Demographic and clinical characteristics were recorded. Results were expressed as percentages. Most of the 43 patients were male [72%]. The average age at presentation was 8.7 years with average duration of symptoms being 100.6 days. History of measles was present in 17 patients [39.5%]. All children had seizures at presentation and 65% had cognitive impairment. Most patients required poly therapy for control of seizures. Sodium valproate was the most commonly used anti-epileptic agent; Isoprinosine was tried in 22 [51%] patients. CSF for antimeasles antibodies was positive in approximately 86% of the 40 [93%] children. EEG showed burst suppression pattern in 36 [83.7%] cases. Forty-two patients [97.6%] were discharged home in a vegetative state. SSPE is progressive neurodegenerative disorder. It can be prevented by timely immunization against measles. Measles antibody in the CSF is diagnostic for SSPE and is helpful in early diagnosis. Most patients experience a gradual but progressive decline in motor and cognitive functions

Histopthological spectrum of renal biopsies in pediatric population: an update

To determine the histological spectrum and indications of renal biopsies in pediatric population from birth to 16 year of age and to delineate any change in histological pattern with time and age at tertiary care hospital in Karachi. Cross sectional study. This study was carried out at Aga khan University Hospital Karachi over a period of 7.5 years from January 2006 to July 2014. A retrospective review of the computerized database of the histopathology department of Aga khan University hospital [AKUH] was carried out on children from birth to 16 years of age who underwent renal biopsy. All renal biopsy specimens were processed, cut and stained and evaluated under light microscopy and immune fluorescence technique. The indication and findings of these biopsies and demographic data such as age and sex were identified. Frequencies and percentages were used for categorical variables and mean +/- standard deviation for quantitative variables. SPSS version 19.0 for statistical analysis. Mean age was 11.5 years +/- 3.5years with an age range from 3 months to 16 years with majority of the patients over 10 years of age. Out of 128 patients 79[61.7%] were male and 49[38.3%] were female with a ratio of 1.6: 1.The most common indication observed for renal biopsy was Nephrotic syndrome seen in 75[58.6%] cases with 36 [28.1%] being steroid resistant variety followed by steroid sensitive 25 [19.5%]. Other indications observed were Nephritic syndrome 16 [12.5%], renal failure 13[10.2%] and lupus nephritis for classification 11[8.6%]. The most frequent renal disease observed was focal segmental glomerulosclerosis [FSGS] 38[29.7%]. Others being minimal change disease 19[14.8%], membranous glomerulonephritis 12 [9.4%]. The most frequent biopsyfinding in all age group was FSGS. The distribution of renal diseases in pediatric age group described is similar to that described in national and international literature with some differencesobserved.This study provides updated epidemiological information on childhood renal diseases