Role of Imaging in Identifying Various Renal Lesions in Children Less Than 5 Years Presenting with First Febrile Urinary Tract Infections

Febrile Urinary Tract Infections (UTI) is one of the common causes of infections in children. Unrecognized and untreated UTIs may lead to renal scarring of the growing kidneys with subsequent renal failure. Objectives: To compare the effectiveness of USG to detect vesicoureteric reflex confirmed by micturating cystourethrogram (MCU) and renal parenchymal abnormalities confirmed by dimercaptosuccinic acid scan (DMSA) between 1 month to 59 months of age. Methods: A prospective observational study was done at a tertiary care centre to study the imaging correlation in children with the first episode of febrile UTI. Ultrasonography Kidney-Urinary-Bladder (USG-KUB), MCU, and DMSA were done according to the Indian Academy of Paediatrics protocol after getting informed consent from parents. Results:  USG showed a perfect concordance with MCU in detecting VUR (100% sensitivity and specificity) and had a high sensitivity (94.1%) and specificity (100%) in detecting renal parenchymal abnormalities when compared to DMSA in less than 1 year old. It also showed a sensitivity of 85.4% and specificity of 100% in detecting renal parenchymal abnormalities when compared to DMSA in children aged 1-5 years. Conclusion: Overall, the results of this research article indicate that USG shows promising diagnostic accuracy as a non-invasive imaging modality in detecting VUR and renal parenchymal abnormalities across different age groups presenting with febrile UTI.To study the effectiveness of USG in detecting vesicoureteric reflex confirmed by micturating cystourethrogram and renal parenchymal abnormalities confirmed by dimercaptosuccinic acid scan (DMSA) in children with first episode febrile UTI. Short title: Role of imaging in children with first episode febrile UTI

Religious restrictions and cultural taboos related to menstruation in adolescent girls: A school-based cross-sectional observational study

Introduction: The period of adolescence needs special attention because of the turmoil an adolescent faces at different stages ofdevelopment, different circumstances and needs, and diverse problems. In India, there are multiple restrictions and taboos related tomenstruation. In many communities, the mention of the topic is taboo even today. Objective: To evaluate the religious restrictions andother taboos practiced during menstruation by adolescent school girls. Methods: A cross-sectional observational study was conductedin four schools. Girls in the age group of 13-18 years, who have attained menarche and gave verbal consent to participate, were includedin the study. A pre-designed, validated questionnaire that captured information on the cultural taboos practiced during menstruation wasadministered to the participants. The data were analyzed using SPSS version 15 and the percentage of menstral taboos that were practicedon average was determined. Factor analysis was done to determine the most practiced taboo. Results: A total of 1522 adolescent girlsparticipated in the study. The average age of attaining menarche was 13.08±3.5 years. 81.2% (n=1236) of the participants, predominantlyfrom the Hindu community, did not attend religious functions during menstruation. More than half of them (56.6%) did not sleep intheir usual place during menstruation. 40.1% of them (n=611) were not allowed to enter the kitchen. 69.3% (n=1054) of the participantshad restrictions on certain food items. Only 5.4% (n=82) of them did not go to school during menstruation. Factor analysis showed thatthe two most important factors contributing to the taboos were restrictions on religious functions and on sleeping in the same place.Menstrual taboos were prevalent more in younger and less-educated girls (p=0.037 and 0.000, respectively). Conclusion: Restrictionsduring menstruation are still prevalent in many communities. The two most important cultural taboos are sleep restrictions and religiousrestrictions. Cultural taboos are prevalent more among less-educated and younger adolescent girls

Pleural Effusion- An Unusual Cause

Hepatitis A (HAV) infection is one of the most common forms of hepatitis in the paediatric age group in developing countries. It is usually self-limiting and rarely accompanied by extra hepatic complication. In this article, we report two children with hepatitis A who had associated issues of pleural effusion and ascites. Both issues improved with resolution of hepatitis after symptomatic treatment. Although uncommon, extra hepatic manifestations can occur with hepatitis A. However, they resolve completely. Paediatricians in developing countries should be aware of this rare association to avoid unnecessary investigations

Vitamin B12 deficiency presenting as pancytopenia in a young boy--Helicobacter Pylori, a novel causative agent

Deficiency of vitamin B12 (cobalamin) is a well-known cause of megaloblastic anemia. It is a reversible cause of bone marrow failure and demyelinating nervous system disorder, hence early detection and prompt treatment of vitamin B12 deficiency is essential. After diagnosing vitamin B12 deficiency, tracking down its root cause is important in individualizing the treatment approach. Helicobacter pylori-related (H. pylori) B12 deficiency presenting as pancytopenia in pediatric age groups has been reported. However, vitamin B12 deficiency presenting as retinopathy in pediatric age groups has been rarely reported in the medical literature. We herein present the case of an adolescent male with pancytopenia  and retinopathy, secondary to vitamin B12 deficiency-associated H. pylori infection