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Tuesday, December 22, 2009

40 - Treatment of Vesicoureteral reflux in children


Grade I
Reflux into a non-dilated ureter
Grade II
Reflux into the upper collecting system without dilatation
Grade III
Reflux into dilater ureter and/or blunting of calyceal fornices
Grade IV
Reflux into a grossly dilated ureter
Grade V
Gross dilatation of the ureter, renal pelvis and calyces: Calyces
show loss of papillary impression



*TREATMENT RECOMENDATION FOR VUR diagnosed following a UTI :


GRADE
AGE(YRS)
SCARRING
INITIAL TREATMENT
FOLLOW-UP
I-II
Any
-
Antibiotic prophylaxis
-
III-IV
0-5
-
Antibiotic prophylaxis
Surgery
III-IV
6-10
-
U/L: Antibiotic prophylaxis
Surgery
III-IV
6-10
-
B/L: Surgery

V
<1
-
Antibiotic prophylaxis
Surgery
V
1-5
No
U/L: Antibiotic prophylaxis
Surgery
V
1-5
No
B/L: Surgery

V
1-5
Yes
Surgery

V
6-0
-
Surgery

Sunday, November 15, 2009

39 - Live and Killed vaccines


*All the live attenuated vaccines are contraindicated in pregnancy.
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