The diagnostic value of anorectal manometry as a screening test for Hirschsprung's disease.

The diagnostic accuracy of anorectal manometry as a screening test for Hirschsprung's disease (HD) was assessed in 46 children suspected of having HD on clinical grounds. Among 33 children in whom a rectosphincteric reflex (RSR) was not demonstrated on manometric recordings, 31 were later proven to have HD by full thickness rectal biopsy: the remaining 2 children were shown not to have HD. None of the 12 children who had a normal RSR had HD. Thus, two false positive diagnoses were observed in this study, giving an overall diagnostic accuracy by anorectal manometry of 95 per cent and diagnostic sensitivity of 100 per cent. Anorectal manometry is an accurate, non-invasive test which has a place as the screening test of choice for HD.

Incidence and risk factors for carbohydrate intolerance in Thai infants with acute diarrhea: an outpatient-based study.

Until recently, information concerning carbohydrate intolerance complicating acute infantile diarrhea of outpatients in Thailand has been lacking. This prospective study was undertaken to determine the incidence and risk factors of secondary carbohydrate intolerance in outpatients. Of 197 well-nourished infants with acute diarrhea who were seen at the outpatient department of Songklanagarind Hospital between July 1991 and June 1992, 62 infants (31.3%) had carbohydrate intolerance, and 7 of the 62 (3.5%) also had acquired monosaccharide intolerance. The clinical characteristics that predicted infants with carbohydrate intolerance were : a low bodyweight relative to the length, dehydration (OR 4.55, 95% CI 1.1.5-17.9), the presence of mucus in diarrheal stools (OR 2.79, 95% CI 1.23-6.32) and rotavirus infection (OR 3.49, 95% CI 1.20-10.18).

Acute glomerulonephritis in children: a prospective study.

Fifty-six patients with acute glomerulonephritis were studied prospectively during 1984. Their ages ranged from 10 months to 14 years old with the peak age range between 5 to 9 years. Most of them had edema, hypertension, hematuria with or without proteinuria and had low serum complement. Azotemia was found in 45 per cent of the cases. Serologic evidence for streptococcal infection was positive in 68 per cent and only 6 per cent had positive culture. Edema and hypertension were all resolved within 2 weeks. All patients that were followed up had normal serum complement by the 6th week, normal BUN, Scr by one year. The hematuria disappeared by 6 months and proteinuria by 2 months in 50 per cent of the cases. By the 4th year only one patient had microscopic hematuria and mild proteinuria with normal serum creatinine, normotension and no edema. In conclusion, in Thailand AGN is still a common kidney disease in children but with prompt and proper treatment its prognosis is still very good.