Clinical profile of children with acute post-streptococcal glomerulonephritis.

BACKGROUND: Acute post-streptococcal glomerulonephritis (APSGN) is common in developing countries with a high hospitalization rate. Most patients have acute nephritic syndrome features, although some occasionally present with unusual clinical features. This study aims to describe and analyze clinical features, complications, and laboratory parameters in children diagnosed with APSGN at presentation, 4 and 12 weeks later, in a resource-limited setting. METHODS: This cross-sectional study was conducted among children < 16 years with APSGN between January 2015 and July 2022. Hospital medical records and outpatient cards were reviewed for clinical findings, laboratory parameters, and kidney biopsy results. Descriptive analysis of multiple categorical variables was performed using SPSS version 16.0 and presented as frequencies and percentages. RESULTS: The study included 77 patients. Most (94.8%) were older than five years, and age group 5-12 years had highest prevalence (72.7%). Boys were affected more frequently than girls (66.2% vs. 33.8%). Edema (93.5%), hypertension (87%), and gross hematuria (67.5%) were the most frequent presenting symptoms, and pulmonary edema (23.4%) was the most common severe complication. Anti-DNase B and anti-streptolysin O titers were positive in 86.9% and 72.7%, respectively, and 96.1% had C3 hypocomplementemia. Most clinical features resolved in three months. However, at 3 months, 6.5% of patients had persistent hypertension, impaired kidney function, and proteinuria alone or in combination. Most patients (84.4%) had an uncomplicated course; 12 underwent kidney biopsy, 9 required corticosteroids, and 1 required kidney replacement therapy. There was no mortality during the study period. CONCLUSION: Generalized swelling, hypertension, and hematuria were most common presenting features. Persistent hypertension, impaired kidney function, and proteinuria persisted in a small proportion who had a significant clinical course and required kidney biopsy. A higher resolution version of the Graphical abstract is available as Supplementary information.

Colostrum Feeding among Newborns Visiting the Outpatient Department of Pediatrics of a Tertiary Care Centre: A Descriptive Cross-sectional Study.

Introduction: Colostrum is the thick yellowish breast milk that is produced during the first 3-5 days of childbirth. Feeding colostrum protects the newborn from various diseases, thus promoting the overall well-being of the newborn. The objective of this study was to find out the prevalence of colostrum feeding among newborns visiting the Department of Pediatrics in a tertiary care centre. Methods: A descriptive cross-sectional study was done among infants presenting to the Department of Pediatrics in a tertiary care centre. Ethical approval was taken from the Institutional Review Committee (Reference number: 2078/079/107). The duration of study was six month from 12 February 2022 to 12 August 2022. A pre-designed questionnaire was used for face-to-face interviews. Convenience sampling was done. Point estimate and 95% Confidence Interval were calculated. Results: Among 350 newborns, colostrum was fed to 305 (87.14%) (83.63-90.65, 95% Confidence Interval) newborns. A total of 180 (59.02%) were breastfed within 1 hour of delivery. Conclusions: The prevalence of colostrum feeding was higher in our study than in other studies done in similar settings. Keywords: colostrum; exclusive breastfeeding; newborns; prevalence.