abdul qader

Bedwetting or enuresis is not uncommon in children, although its prevalence varies by age. Spontaneous remission of enuresis may occur at a rate of approximately 15% per year, but treatment protocols should be carried out because of its significant impact on a child’s family, emotional state, self-esteem, and totally on the quality of life (QoL). Today, non-pharmacological therapy is an initial treatment for enuresis, in which both the parents and children are motivated to take the behavioral management approach. This study was done to determine the effectiveness of non-pharmacological therapy in pediatrics with enuresis.

This prospective observational research was carried out in pediatrics aged 5 to 15 years with bedwetting who visited the outpatient department of Asgar Ali Hospital from January 2021 to December 2021. They were categorized into two groups, primary and secondary (monosymptomatic and non-monosymptomatic) enuresis according to the definition of the international children’s continence society (ICCS). Also, our patients were divided into different age groups: Group A: 5-7 years, group B: 8-10 years, and group C: >10 years, and the response was classified as no response: <50%, partial response: 50-99%, and complete response: 100% reduction in baseline symptom frequency.

Among the 74 patients, 28 cases (38%) were male and 46 cases (62%) were female, with most of them having primary enuresis 72(97%), and only two patients had secondary enuresis. Most patients were monosymptomatic 62(83.7%), and only 12 cases (16%) were non-monosymptomatic. Among 32 patients (43%) of group A, 87.5% had complete response within three months of follow-up, in group B, of a total of 20 patients (27%), 40% had complete and 40% had partial response, and in group C, among 22 patients (30%), only 9% had complete and 46% had partial response.

Non-pharmacological therapy in enuretic patients showed encouraging recovery.

Alkaptonuria is an exceedingly rare tyrosine metabolism disorder of autosomal recessive inheritance. Only a few instances of it have been observed in Bangladeshi children. Here, we talk about a 2-year-old boy who had dark urine and was later found to have alkaptonuria.

Urinary tract infection (UTI) can lead to adverse renal outcomes in the form of renal scarring and its consequences in children. Underlying congenital abnormalities of the kidney and urinary tract (CAKUT) play a crucial role in UTI recurrence and its outcome. 

This study was conducted to evaluate children aged 1 month to 18 years with bacteriuria retrospectively to assess recent trends of antimicrobial resistance, underlying structural abnormalities of the urinary tract, and severity of symptoms associated with it. Ultrasonography was done in children under 2 years with a history of recurrent UTI to exclude associated structural abnormalities of the urinary tract.

Of 255 studied children, 58% were female. Ultrasonography of the kidney and bladder was performed in 116 children, which revealed CAKUT in 38% (n=44). Children with CAKUT commonly presented with fever (36%) alone or in combination with other features. The most common pathogen was E coli (60%), which was very sensitive to intravenous aminoglycosides (95-100%) and carbapenems (96%) but had less sensitive to cephalosporins (43%). E coli showed higher resistance to oral cephalosporins and quinolones (62% and 54%, respectively). E coli had a high (93%) and Klebsiella spp had a low (63%) sensitivity to nitrofurantoin.

This study revealed that about one fifth of the children with bacteriuria had CAKUT. A higher resistance pattern was observed to commonly used oral antimicrobial agents, which eventually narrows down the choice of empirical antibiotic. Keywords: Child; Bacteriuria; Urinary Tract Infection; Urinary Tract Abnormalities.

Renal diseases in children can be congenital or acquired. In Bangladesh, pediatric nephrology care is available for last 2 decades, but there was no epidemiological study to see the pattern of renal diseases in children of the country. So, this study was carried out to observe the pattern of renal diseases in children of pediatric nephrology centers of Dhaka city.
The children aged 1 day to 18 years with renal problems attended at selected four pediatric nephrology centers of Dhaka city (BSMMU, DMCH, DSH and NIKDU).
Among 6453 patients, 1123 were admitted in IPD and 5330 were visited at OPD. Mean age was 5.8±3.5 years in IPD patients and 6.90±1.37 years in OPD patients. In IPD among 1123 patients, 720 (64.1%) were male and 403 (35.8%) were female and in OPD among 5330 patients 3336 (62.59%) were male and 1994 (37.4%) were female. Nephrotic Syndrome (76% in IPD and 74% in OPD) was the most common disease followed by chronic kidney disease (CKD 6%) in IPD and urinary tract infections (UTI 9.4%)in OPD were the next common disease. Common presentations were proteinuria (27.6%), oliguria or anuria (26.2%) and edema (25.7%).
The current pattern of renal diseases shows, that the most common renal diseases are NS followed by CKD and UTI. In the study male patients are more common than female.