Acute renal failure in non-fulminant hepatitis A infection.

A 7-year-old boy developed acute renal failure during the icteric phase of non-fulminant hepatitis A infection. He needed peritoneal dialysis for 3 days, which was followed by a rapid recovery in renal function which was normal when he was discharged 4 weeks later.     

The management of extensive corrosive esophageal strictures: Do not dilate and procrastinate

Corrosive strictures of the esophagus are difficult to treat, however, prompt and appropriate management of corrosive burns to the esophagus can prevent the formation of strictures. In a developing country like India, where facilities for early treatment are not easily available, strictures are an ineviatable consequence. If the strictures are extensive, dilatational therapy proves ineffective and offers no substantial benefit to the patients. Twenty patients with extensive corrosive strictures of the esophagus were surgically managed; by esophageal bypass in 13 and esophagectomy in 7. Surgical treatment restored normal swallowing in all the patients. The common post-operative complications to occur were: pulmonary complications, anastomotic leak and stricture, gastric outlet obstruction and reflux esophagitis. For extensive corrosive strictures of the esophagus, we advocate early surgical treatment rather than prolonged dilatational therapy.     

Nephrotic syndrome in 1st year of life and the role of unilateral nephrectomy

The study includes 17 infants with nephrotic syndrome. Their ages at the onset of disease ranged from 10 days to 10 months (median 2 months), and included 10 males and 7 females. Ten patients had consanguineous parents and 4 had a history of similar illness in the sibling. Renal biopsy revealed diffuse mesangial proliferation in 10 patients, diffuse mesangial sclerosis in 3, Finnish microcystic disease in 2, and focal segmental glomerulosclerosis and atypical glomerulopathy in 1 each. Unilateral nephrectomy was performed in 8 patients with intractable proteinuria associated with multiple complications. Five are well after 4–36 months follow-up, 1 died of septicaemia soon after the procedure, 1 needed dialysis and is stable at 26 months and 1 showed no reduction in the degree of proteinuria. We conclude that unilateral nephrectomy is a better alternative to bilateral nephrectomy in some infants with severe nephrotic syndrome.     

Health status of school age children employed in carpet weaving in Ganderbal Block.

In a health and morbidity screening among 500 carpet weaving children and 450 children attending school selected at random in a rural field practice area the age group studied was from 6 to 16. Each child was thoroughly interviewed and examined for any deviation from health. The height and weight were taken by standard procedures and clinical assessment of morbidity and nutritional status was also observed. The results showed that the heights and weights of schoolchildren were greater than those of the carpet weaving children in both boys and girls. Clinically, 56% of the schoolchildren as against 41.6% of carpet weaving children had no nutritional defects. The main complaints in the carpet weaving children were in order of descent, headache, blurring of vision, backache, abdominal pain, limb pains, and respiratory tract infection. Both groups of children were later followed up for six months from September 1981 to March 1982. The incidence of subjective and objective deviations from health were higher in the carpet weaving than in the schoolchildren and the first ten major complaints in the carpet weaving children were respiratory tract infection, headache, backache, pain in the abdomen, injuries (major and minor), joint pains, diarrhoea and dysentery, fever of unknown origin, dermatitis, and chilblains.