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Background and Aim: Hypertension (HTN) has become more prevalent among youngsters. It is frequently under-recognized due to a lack of routine blood pressure measurement in many health centers, partly owing to a shortage of devices and possibly because of the notion that it is not the foremost disease in children. In Bangladesh, there is a scarcity of data on how doctors view childhood HTN and their practice of measuring blood pressure in children. We aimed to conduct this survey among pediatricians and healthcare providers to determine the perception and knowledge about childhood HTN and their practice of measuring blood pressure in children, which can be served as a baseline for future reference. Methods: This cross-sectional mailed-based survey was done on pediatricians and approved by the institutional review board of Dr. Khan Shishu Hospital & the Institute of Child Health from June to December 2021. We obtained the email addresses of all pediatricians from the Bangladesh Pediatric Association. The survey instrument/questionnaire was developed based on the 2017 clinical practice guideline. The data were analyzed and expressed as frequency and percentage. Results: Of the 536 pediatricians in the mailing sample, 257 cases responded and the response rate was 47.9%. The majority of respondents (62.4%) were general pediatricians and only 12.2% were pediatric nephrologists. This survey revealed that 77.2% of pediatricians did not measure blood pressure routinely among children 3-18 years of age, whereas 66% reported measuring blood pressure if children had risk factors. The majority of pediatricians (92.8%) had blood pressure machines at their clinic and only 60% had blood pressure cuffs available for children. Most of the pediatricians (68.7%) did not use a blood pressure chart for labeling blood pressure and only 35.7% reported that they repeated auscultatory blood pressure measurements three times to diagnose HTN. Conclusion: The findings of our study point to a knowledge and practice gap among pediatricians, who are primary health care providers, when diagnosing hypertension in children. For children aged 3 to 18 years, most pediatricians reported no regular assessment of blood pressure. Most pediatricians did not repeat blood pressure measurements for diagnosis, nor did they often use blood pressure cuffs or charts for children. These issues need to be addressed for better diagnosis and treatment of childhood HTN. [ABSTRACT FROM AUTHOR]

Frasier syndrome is a rare genetic disorder characterized by the association of progressive renal glomerulopathy and 46, XY complete gonadal dysgenesis with a high risk of developing gonadoblastoma. Mutations in the Wilms' tumor suppressor gene (WT1) located in 11p23 are responsible for this syndrome. Patients with this syndrome commonly present with normal female genitalia, streak gonads, and a 46, XY karyotype. Nephropathy in Frasier syndrome is in the form of nephrotic syndrome (NS) with proteinuria that begins early in childhood and progressively increases with age, mainly due to nonspecific focal segmental glomerular sclerosis (FSGS). We herein present a 4-year-old girl who presented with steroid-resistant nephrotic syndrome and was later diagnosed with Frasier syndrome. [ABSTRACT FROM AUTHOR]

Background and Aim: Immunoglobulin A vasculitis (IgAV), formerly known as Henoch-Schönlein purpura (HSP), is the most common vasculitis in children with multiorgan involvement. Renal involvement is one of the important causes of morbidity and mortality. The objective of this study was to evaluate the frequency, clinical profile, and outcome of IgA vasculitis nephritis (IgAVN) in children. Methods: This prospective cross-sectional study was conducted in Dr. M R Khan Children Hospital & Institute of Child Health, Dhaka, over a period of 5 years from January 2015 to December 2019. Data were collected using a structured questionnaire form and analyzed by the SPSS software version 20.0. Results: A total of 57 cases of IgA vasculitis were admitted of whom 16 (28%) had renal involvement. The mean age was 7.7 years. Regarding renal involvement, the majority of the patients (56.25%) had isolated hematuria. All nephritis patients (100%) had purpura and 75% of the patients had severe abdominal pain. The mean hematocrit and the mean platelet count were significantly higher in the nephritis group compared to patients without nephritis (41.49±4.47 vs. 39.98±5.16, p-value <0.005 and 485.51±58.29 vs. 293.89±65.15, p-value <0.001, respectively). The level of complement C3 was significantly lower in the nephritis group compared to patients without nephritis (0.85±0.4 vs. 1.5±0.3, p-value <0.01). The majority (68.75%) of the patients recovered and 18.75% were in remission with immunosuppressant. None of the cases progressed to ESRD. Conclusion: Severe abdominal pain, high platelet counts, high hematocrit levels, and low C3 concentrations are common findings in nephritis. Nephritis resolve spontaneously in most cases but severe nephritis requires treatment with immunosuppressive drugs for remission. [ABSTRACT FROM AUTHOR]

Background and Aim: Despite several studies about COVID-19, many factors remain unknown. Apart from pulmonary involvement, the other systemic association needs to be explored. Since information is lacking this study was conducted to see the impact of COVID-19 infection in children with kidney diseases. Methods: This retrospective study was carried out at Dhaka Shishu (children) Hospital and Square Hospitals Ltd from April 2020 to August 2020. All the admitted children below 18 years who had renal diseases and tested RT PCR positive for the SARS-COV-2 virus were included in the study. Data regarding patient's demography, clinical presentation, hospital course, and outcome were collected from the hospital database and were analyzed. Results: Among the COVID-19 positive pediatric patients, the proportion of patient with a history of kidney disease were 12%. The commonest age group belongs to 6 -10 years with a female predominance. Nephrotic syndrome (50%) was the commonest primary renal etiology followed by acute kidney injury (26%). Along with COVID-19 related symptoms like fever (38%) and respiratory tract infection (31%), a good number of them remain asymptomatic (27%) during diagnosis. Hypertension (50%) and hematuria (35%) were the two prevailing clinical findings. Moreover, anemia (65%), and elevated creatinine (50%) were found surprisingly higher irrespective of the primary etiology. A better outcome was observed in children under 5 years. Conclusion: Covid -19 is frequent in patients with a history of kidney diseases and it may present with an atypical presentation like hypertension and or hematuria. Hence, clinicians should increase their awareness and concern to deal with COVID-19 infection among renal patients. [ABSTRACT FROM AUTHOR]