Recurrent urinary tract infection in children. a clinician's approach

Urinary tract infection is one of the most common infections of childhood standing second to respiratory tract infection. Recurrent urinary Tract infection [RUTI ] seen in 30 to 50 % of children, more commonly in infants

The dilemma that a clinician faces is how to manage recurrent Urinary tract infection [RUTI] as a febrile illness in the midst of child hood febrile pathologies of which viral illnesses account for the most?. Who to investigate and which child will need observation only? Consequences of recurrent febrile episode presenting as UTI may lead to renal scarring, compromised renal function and later hypertension due to loss of nephrons in adulthood

The National Institute of Health and Care Excellence [NICE] guidelines 2007 focus more on Urinary Tract Infection [UTI] diagnosis in general with details towards diagnosis and management. In clinical practice this is helpful in investigating and managing any case of UTI

The NICE guidelines comment on RUTI prevention and prophylaxis however, the details of approach for case of RUTI in detail are not present

Guillain barre syndrome; clinical feature in children

Background: Guillian Barre Syndrome is a polyradiculopathy characterized by symmetric ascending paralysis and areflexia. It affects all age groups and both sexes with an unpredictable outcome

Objectives: The aims of this study were to identify the various diseases presenting as Acute Flaccid Paralysis and notice clinical features and outcome of cases of Guillian Barre Syndrome

Materials and Methods: Retrospective analysis of 53 patients presenting as Acute Flaccid Paralysis was done. Clinical features and laboratory investigations of 39 patients of Guillian Barre syndrome were reviewed

Results: Among all cases of Acute Flaccid Paralysis, Guillian Barre syndrome formed the bulk of the cases [73.6%].It was more common in females and in age group of 10 years or below. In majority of the cases, rapid onset of weakness was the initial symptom. Mortality was 100% in patients who had respiratory muscle involvement and who required mechanical ventilation

Conclusions: In our study the main factor causing death in a case of Guillian Barre syndrome was bulbar involvement requiring mechanical ventilation. Early recognition of the prognostic factors may lead to decreased mortality in case of Guillian Barre syndrome

Aluminium phosphide poisoning: a case report

This paper reports the case of a family in which three children were presented at Emergency Room [ER] with poisoning after the use of a pesticide at home. Initially, the cases were managed as routine cases of organophosphorus poisoning; however, the death of two children made the health team members realise that the poison's effects were delayed and devastating. Later, the compound was identified as Aluminium Phosphide [ALP], and the life of the last surviving child in the family was saved

Rosai Dorfman disease

We report an unusual presentation of sinus histiocytosis with massive lymphadenopathy [SHML], also called Rosai Dorfman disease. The child presented with bilateral proptosis with massive cervical lymphadenopathy. The patient had fair response to steroid therapy but relapsed during the course of the disease