Evidence-Based Paediatrics & Specialized Paediatric Nephrology

Bedwetting (nocturnal enuresis) is considered clinically significant after age 5. While many children eventually gain nighttime bladder control, a specialist consultation is advised if bedwetting persists beyond age 5–6, if daytime urgency/dampness is present, if bedwetting suddenly reoccurs after months of dryness (secondary enuresis), or if accompanied by painful urination or constipation. We conduct a non-invasive bladder evaluation, assess fluid habits, and offer proven urotherapy, enuresis alarms, or medication (desmopressin) when indicated.

Most pediatric kidney stones can be managed conservatively with adequate hydration and medical expulsive therapy if they are small. However, children who form stones require a metabolic workup: a non-invasive 24-hour urine collection and blood electrolyte panel. We check for excess calcium (hypercalciuria), oxalate, cystine, or low citrate. Identifying the underlying chemical imbalance allows us to prescribe specific dietary adjustments, oral potassium citrate, or hydration schedules that prevent future stones from forming.

Unlike adults whose high blood pressure is often tied to lifestyle, childhood hypertension is frequently 'secondary' — meaning it is caused by an underlying renal problem (such as renal artery stenosis, kidney scarring from past UTIs, or polycystic kidney disease) or aortic coarctation. Routine blood pressure screening from age 3 helps detect elevated readings early. At Pravas Clinic, we interpret BP against pediatric percentile charts and conduct comprehensive diagnostic evaluations to treat the underlying source.

Recurrent UTIs in young children must always be investigated by a specialist. Febrile UTIs (infections reaching the kidneys, known as pyelonephritis) can leave permanent renal scars that cause hypertension or reduced kidney function later in life. We confirm every suspected UTI with a sterile urine culture, initiate appropriate targeted antibiotics, and perform renal ultrasound, and if indicated, an MCU (voiding cystourethrogram) to check for Vesicoureteral Reflux (VUR) or urinary blockages.

We plot weight, height, and head circumference on standardized WHO growth velocity charts. Faltering growth can result from caloric deficit, subtle feeding difficulties, malabsorption (celiac disease, food allergies), or silent chronic illnesses like Renal Tubular Acidosis (RTA) or recurrent urinary infections. We conduct focused, non-excessive laboratory testing, provide structured dietary enrichment plans, and evaluate neurodevelopmental milestones to ensure timely intervention.

Over 80% of common childhood fevers, coughs, and throat irritations are caused by viral pathogens where antibiotics are completely ineffective and can cause side effects like diarrhea and antibiotic resistance. We practice strict antibiotic stewardship: we examine the child thoroughly, explain the natural timeline of the viral illness, provide symptomatic relief, and reserve antibiotics strictly for confirmed bacterial infections such as acute bacterial otitis media, streptococcal pharyngitis, or bacterial pneumonia.

Yes. Before any pediatric elective or emergent surgical procedure (such as hernia repair, orchidopexy, circumcision, or ENT procedures), children require a formal medical fitness clearance. We review their medical history, assess airway and respiratory stability, examine heart sounds to rule out innocent vs. pathological murmurs, review blood counts, and coordinate directly with the pediatric surgical and anesthesia teams.