Relationship between Clinical Profile, Severity and Outcome of Community Acquired Pneumonia with Hyponatremia in Children Aged 2-60 Months.

Hyponatremia is the most common electrolyte imbalance seen in clinical practice and a common laboratory findings in children with community acquired pneumonia. This study aimed to find out relationship between clinical profile, severity and outcome of community acquired pneumonia with hyponatremia in children aged 2-60 months. This descriptive cross-sectional study was done in pediatrics department of Mymensingh Medical College Hospital, Bangladesh. Study period was 6 month from November 2016 to April 2017. Data were collected from 2 months to 60 months old children who fulfill the selection criteria. In this study sampling technique was purposive. Detailed history was taken, and meticulous examinations and relevant investigations were performed. 100 patients with community acquired pneumonia were enrolled, 34.0% patient had hyponatremia and 66.0% patients had no hyponatremia. Hyponatremia is more marked (45.5%) in severe pneumonia followed by moderate pneumonia (33.3%) and no hyponatremia found in mild pneumonia. Mean temperature, respiratory rate, heart rate, head nodding, nasal flaring, grunting, stridor, cyanosis, convulsion, feeding problem, Poor air entry were significantly higher in patient of pneumonia with hyponatremia when compared to patient of pneumonia without hyponatremia. Mean duration of symptoms and mean duration of hospital stay were also significantly higher in patient of pneumonia with hyponatremia. The mean serum sodium concentration was 132.18±1.51mmol/L in hyponatremic patients and 137.91±1.94mmol/L in normonatremic patients. Mean values of total leucocyte count, ESR, and C-reactive protein were significantly higher in patient of pneumonia with hyponatremia. Serum hemoglobin was significantly lower in hyponatremic patients than normonatremic patients. Maximum (55.9%) patients of community acquired pneumonia (CAP) with hyponatremia had patchy opacity, 26.5% had consolidation, 11.8% had interstitial opacity and 5.9% had pneumatocele. All the patients were treated with appropriate antibiotics and fluid and discharged after complete recovery without any complication. There was no death in the study population. From this study we can conclude that, hyponatremia is directly related with the severity of community acquired pneumonia (CAP). The intensity of clinical profile and investigation findings are also directly related with the severity of pneumonia.

Study on Blood Pressure Profile in School Children of Mymensingh City.

High blood pressure and its related problems are progressively assuming public health dimensions in developing countries like Bangladesh. There was a suggestion that hypertensive process can be aborted in its early stages. But it is poorly understood in its early stages. So, early natural history of hypertension and its evolution from the youth needs to be investigated. Objective of this study was to determine blood pressure distribution in school children aged 6-15 years. This descriptive cross-sectional study was conducted in the Department of Paediatrics, Mymensingh Medical College, Mymensingh, Bangladesh from November 2014 to October 2015. The sample was collected by simple random sampling from five different schools of Mymensingh after applying inclusion and exclusion criteria. After taking proper history and doing relevant examination, both systolic and diastolic BP was recorded by auscultatory method. Out of 994 children, 480(48.29%) were boys and 514(51.71%) were girls. In boys, the mean±SD of systolic and diastolic blood pressure (BP) were 105.9±10.8 mm of Hg and 67.4±6.7 mm of Hg and in girls it was 106.1±11.8 and 67.5±6.9 mm of Hg respectively. Systolic BP was found higher in girls belongs to 10-13 years. The study has shown that BP rises linearly with age and both systolic and diastolic BP has a significant positive correlation with age, sex, height and BMI in both sexes. This study also showed, 46(4.6%) children were hypertensive and 89(8.9%) were pre-hypertensive. Hypertension was found more in girls but there was no significant difference between two sexes. Hypertension was found more in relation to overweight, obesity and family history of hypertension. Hypertension is not uncommon in children. Routine blood pressure measurement should be conducted in all children.

Comparative Study of Serum IgE Level in Frequent Relapse and Infrequent Relapse Nephrotic Syndrome in Children.

Nephrotic syndrome (NS) represents a heterogenous group of glomerular disorders occurring mainly in children. Accumulated data suggest that patient with NS have an immunological basis. This cross-sectional comparative study was conducted in the Department of Paediatrics, Mymensingh Medical College Hospital (MMCH), Mymensingh during the period of March 2018 to October 2019 to determine the relationship of serum IgE level in frequent relapse and infrequent relapse nephrotic syndrome in children. Thirty cases of frequent relapse and 30 cases of infrequent relapse idiopathic nephrotic syndrome who were admitted in Department of Paediatrics, MMCH were included in this study by purposive sampling technique. After admission written informed consent from parents or guardians obtained. Serum IgE level was measured in all patients of idiopathic nephrotic syndrome during relapse and again four weeks after steroid therapy when patient was in remission. Serum total IgE levels were measured by ADVIA centaur CP immunoassay system. Most of the patient's age was within 2-6 years in both groups. Male children were predominant in both groups. Most of the patients came from rural area. Frequency of relapse per year was significantly higher and 24 hours urine output was significantly lower in frequent relapse nephrotic syndrome than that of infrequent relapse nephrotic syndrome. Significantly higher mean IgE was found in children with frequent relapse nephrotic syndrome (1439.8±388.5 IU/ml during relapse and 852.3±103.7 IU/ml at remission) than infrequent relapse nephrotic syndrome (1109.5±248.3 IU/ml during relapse and 776.6±108.5 IU/ml at remission) at both relapse and remission state. A linear, positive, significant correlation was found between rate of relapse and serum IgE level (Pearson correlation coefficient, r=0.674). Based on results it is concluded that serum IgE is high in relapsing nephrotic syndrome and it is persistently and significantly higher in frequent relapse nephrotic syndrome than infrequent relapse nephrotic syndrome.