Gallbladder motility in children with chronic functional abdominal pain

Background: Chronic abdominal pain is a common gastrointestinal symptom in children that significantly lowers their quality of life. In adults, Gall bladder (GB) hypomotility / dyskinesia is associated with many functional abdominal disorders but there is scarcity of evidence on its role in childhood gastro-intestinal disorders. Aim of the study is to evaluate the GB motility in children with chronic functional abdominal pain (FAP).Methods: Children aged 5-15 years with chronic abdominal pain fulfilling ROME-III criteria and healthy controls were included and all study participants were subjected to ultrasonographic evaluation of the gall bladder volume in fasting state and post - Fatty test meal (FTM) and its ejection fraction was calculated.Results: Sixtysix children including 31 with chronic FAP underwent sonographic evaluation for GB motility. The mean ejection fraction (EF) of cases and controls were 51.72'17.76% and 57.3'23.26% (p'value - 0.158). The mean EF of cases with upper abdominal pain and lower/peri-umbilical abdominal pain were 41.7'17.1% and 57.2'15.9% respectively (p'value < 0.0001). Increasing BMI had no significant association with GB motility among the participants.Conclusions: There is lack of significant association between children with chronic FAP and GB hypomotility. Children with upper abdominal pain have lesser GB EF, suggesting a possible abnormal GB motility.

Clinical and laboratory predictors to differentiate severe dengue from scrub typhus in children

Background: Objective of study was to compare the clinical features and laboratory parameters at admission and differentiate severe dengue from scrub typhus in children.Methods: Retrospective analysis of case records and comparison of clinical and laboratory parameters at admission of all children with a diagnosis of severe dengue and scrub typhus was done.Results: A total of 72 children were included (severe dengue =40; scrub typhus =32) during the study period. The mean (SD) age of children with severe dengue and scrub typhus was 7.9(3.8) and 11.8(5.8) years, respectively. Majority of children with severe dengue presented with hypotension, 21(52.5%) vs 3(9.4%) in scrub typhus. Children with severe dengue had a relatively low ANC (2.6'1.97x103/mm3 vs 3.9'2.06x103/mm3), low platelet count (50.23'35.55x103/mm3 vs 140'95.0x103/mm3) and low mean ESR at 1hour (8.1'6.82mm vs 33.88'13.79mm) than scrub typhus.Conclusions: Compared to scrub typhus, severe dengue was significantly associated with hypotension, lower ANC, ESR and platelets.