Urinary screening for detection of renal abnormalities in asymptomatic school children.

BACKGROUND: Urinary screening tests for early detection of renal diseases in asymptomatic school children and adolescents are important in the detection of silent renal diseases. OBJECTIVES: The purpose of the study was to determine the prevalence of occult renal diseases by dipstick test (reagent strips) in asymptomatic Nepalese children. PATIENTS AND METHODS: A total of 2,243 school children, aged 5-15 years, were screened for urinary abnormalities using dipstick test screening. The children who tested positive in the first screening were re-tested after 2-4 weeks. RESULTS: In the first screening, 123 children (5.5%) tested positive for isolated hematuria and proteinuria and for combined hematuria and proteinuria. Of these children, 16 (0.71%) cases tested positive in a second screening. Subsequently, 1 child from the secondary screening group was lost to follow up, 5 tested normal and 10 revealed abnormalities. Glomerulonephritis was the most commonly detected disorder (50%). CONCLUSIONS: Urinary screening was found to be useful in identifying occult renal diseases in asymptomatic children. Urinary screening would therefore not only help in early detection but also in the prevention of the deterioration of renal function later in life.

Perinatal characteristics and outcome of VLBW infants at NICU of a developing country: an experience at eastern Nepal.

OBJECTIVE: To evaluate the perinatal chracteristics and mortality pattern as well as to correlate mortality with perinatal characteristics in very low birth weight (VLBW) infants. METHODS: This was a retrospective study. Chi square tests, Fisher Exact tests, Log rank tests and Pearson correlation coefficient were used for analysis of different parameters using SPSS 10.0 statistical software. RESULTS: Among 125 VLBW infants, 76 survived. Survival improved with increasing birth weight (BW) and gestational age (GA). Most deaths occurred within 5 days. Duration of hospital stay increased with decreasing BW among survivors. Perinatal risks of mortality included history of abortion, no use of antenatal steroid, GA <32 weeks and Apgar score

Systemic lupus erythematosus in childhood--a review of 11 patients at a single center in eastern Nepal.

We retrospectively evaluated the clinico-laboratory features of 11 children and adolescents with Systemic Lupus Erythematosus between the period of 2001 and 2006. All of them (100.0%) had renal involvement at the first visit in the hospital. Female to male ratio was 10:1. Skin and or mucosal involvement (90.9%), periorbital puffiness and or pedal edema (81.8%), fever (72.7%), hypertension (72.7%), and reticuloendothelial involvement (72.7%), were the commonest presentations. All patients had anemia (8.6 +/- 1.5 gm/dl), raised ESR (46.7 +/- 9.4 mm in first hour), proteinuria, and in disease activity as evident by raised ESR and positive anti-dsDNA antibody at the first visit. The mean duration of disease was 7.6 months and the average duration of disease activity was 63.18 days. Renal biopsy was performed in 8 patients: class IV lupus nephritis in 4 patients (50.0%), class II in 2 patients (25.0%), class III and V in patient (12.5%) each. Nephrotic range proteinuria and hypertension was observed in all patients of class IV and V of lupus nephritis. Class II and III lupus nephritis patients' were normotensive and had non-nephrotic range proteinuria. Three out of 11 patients (27.2%) expired. The commonest primary determinant of mortality was uncontrolled disease activity in 2 patients (66.6%). The third one had infection and developed disseminated intravascular coagulation. The mean duration of disease activity in patients who died (mean 30 days) was statistically lower than the survival group (75.6 days) (p < 0.01). Renal involvement during first visit and mortality could be attributed by late referrals and diagnosis at hospital.