Risk Factor for Relapse in Childhood Nephrotic Syndrome - A Hospital Based Retrospective Study.

Nephrotic Syndrome (NS) is a common childhood illness characterized by massive proteinuria, hyperlipidemia, hypoalbuminemia & edema. NS is a disease of relapse and it is a major problem to manage the cases with frequent relapse. So it is very important to find out such children who are prone to develop frequent relapse. This retrospective study was conducted in the paediatric department of Dhaka Medical College Hospital (DMCH) from January to December 2005.Total 100 children with relapsed NS of them 50 had Frequent Relapse NS (FRNS) and 50 had Infrequent Relapse NS (IFRNS) were included in the study with a view to find out the risk factors for relapse. Data were collected from previous medical and hospital records. Data were analyzed by using SPSS program. Chi-squared test and Student's t-Test were used as statistical test and p value < 0.05 was taken as significant. NS was more common among 2-6 years of age (67%) with male to female ratio roughly 2:1. Most of patient with frequent relapse had age <5 years, came from rural area and belongs to poor social class compared to that of infrequent relapse. The mean age at first onset was significantly less in frequent relapse group than that of infrequent relapse group. Majority of atopic child belongs to frequent relapse cases. Low serum albumin level, low serum total protein level, culture positive Urinary Tract Infection (UTI) at initial attack were observed to be statistically significant in case of frequent relapse group.

An urban, water-borne outbreak of diarrhoea and shigellosis in a district town in eastern India.

Background. In September 2007, the Gayeshpur municipality reported a cluster of cases with diarrhoea. We aimed to identify the causative agent and the source of the disease. Methods. We defined a case as the occurrence of diarrhoea (>3 loose stools/day) with fever or bloody stools in a resident of Gayeshpur in September–October 2007. We asked healthcare facilities to report cases, collected stool specimens from patients, constructed an epidemic curve, drew a map and calculated the incidence by age and sex. We also conducted a matched case–control study (58 in each group), calculated matched odds ratio (MOR) and population attributable fraction (PAF), as well as assessed the environment. Results. We identified 461 cases (attack rate: 46/1000 population) and isolated Shigella flexneri (serotype 2a and 3a) from 3 of 4 stool specimens. The attack rate was higher among females (52/1000) and those in the age group of 45–59 years (71/1000). The outbreak started on 22 September, peaked multiple times and subsided on 12 October 2007. Cases were clustered distal to a leaking pipeline that crossed an open drain to intermittently supply non-chlorinated water to taps. The 58 cases and 58 controls were matched for age and sex. Drinking tap water (MOR: 10; 95% CI: 3–32; PAF: 89%), washing utensils in tap water (MOR: 3.7; 95% CI: 1.2–11.3) and bathing in tap water (MOR: 3.5; 95% CI: 1.1–11) were associated with the illness. Conclusion. This outbreak of diarrhoea and Shigella flexneri dysentery was caused by contamination of tap water and subsided following repair of the pipeline. We recommended regular chlorination of the water and maintenance of pipelines.

Effect of ammonia-stress on the total autolytic levels of proteins in tissues of an air-breathing fish, Channa punctatus (Bloch).

G season-specific effect of a sub-lethal ambient ammonium chloride concentration on the total autolysis of protein in different tissues of the Indian air-breathing murrel, Chauna punctatos (Bloch), has been demonstrated. While its effect on the autotytie levels of protein of different tissues (except white muscle) was marginal in the winter-adapted fish, the same in the summer-adapted fish was more pronounced. In general a reduction in the autolysic levels of the tissue protein of the ammonium chloride-stressed fish was observed. In certain tissues like white muscle of an ammonium chloride-stressed fish and gill of the ammonium hydroxide-stressed fish, augmented levels of autolysis were noticed. The present findings suggest that the accumulation of amino acids in different tissues of the ammonia-stressed fish, as observed earlier, can be explained best by mechanisms other than ammonia induced increased breakdown of proteins.