Association between iron deficiency anemia and Febrile Seizures

To find the association between iron deficiency anemia and febrile convulsions among children presenting at the Aga Khan University Hospital, Karachi. Case control study. Paediatric Department of the Aga Khan University Hospital, Karachi, from January 2001 to December 2001. A total of 60 patients fulfilled the study criteria of febrile seizure or any febrile illness. These were divided into two groups with children having febrile seizures comprised the cases while those having only febrile illness with no seizures comprised the controls. Both groups had equal number of children matched for age and gender. Workup for seizures and iron deficiency anemia was done and data was analyzed using SPSS version 10. The mean age for cases [group A] was 22.97 +/- 9.52 months while that for controls [group B] was 22.77 +/- 11.33. There was also no significant difference in the gender distribution in the two groups. Iron deficiency anemia was significantly more frequent among the cases as compared to the controls as evident from parameters studied i.e. hemoglobin <10g/dl [p-value= <0.000], hematocrit <30% [p= <0.01], MCV <70fL [p=<0.002], MCH<24pg [p= <0.001] and serum ferritin <10ng/ml [p= <0.000]. Plasma ferritin level was significantly lower in cases as compared to controls suggesting that iron deficient children are more prone to febrile seizures. A follow-up study of patients found to be iron-deficient at the time of a first febrile seizure to determine the incidence of subsequent febrile seizures after treatment for iron deficiency would be of great interest

Impact of socioeconomic conditions on perinatal mortality in Karachi

OBJECTIVE: To study and compare the perinatal mortality [PNM] in hospitals located in various socio-economic areas of Karachi. DESIGN: A prospective review of all births was done from May 1996 to April 1997. Precoded proformas were provided to each hospital and the birth and details of each mother and baby delivered recorded. SETTING: All mothers and their newborn delivered during the time period mentioned. OUTCOME MEASURES: Comparison of PNM in hospitals located in various socio-economic areas of Karachi. A total of 4957 proformas were filled, 63.5% by doctors, 32% by LHVs, 2.9% by administrator and 2.3% by paramedics. Overall 92.3% mothers were housewives, less than 45% of the mothers received primary/secondary education; 42% mothers were of the age 21 to 25 years. More than 52.3% fathers were unskilled labourers. Only 27% mothers were booked while the rest were unbooked or came to deliver on walk in basis. Majority [62%] of the mothers had a > 37 week duration of pregnancy and 51% newborns were male and 49% female. Twenty three% of the newborns weighed < 2500 grams, remaining weighed > 2500 grams but less than 4500 grams; 24.5% newborns died on day one of birth. The PNM per 1000 births in the high, middle and low socioeconomic hospital was 16.4 +/- 23.6, 24.9 +/- 51.20 and 80.4 +/- 177.78 respectively. A statistical significance [p < 0.0000] by the Chi-square for several proportions was seen between the high middle and low socioeconomic hospitals of Karachi. The present socioeconomic conditions will take some time to change. However, this study indicates that perinatal mortality rate may be changed by an improvement in antenatal care of the mother, hence the fetus

Haematuria in children

Haematuria is a common presenting symptom of urinary tract disease in children. This study was conducted over a period of twelve months in the Paediatric Unit of the Civil Hospital, Karachi to determine common causes and presentation of hematuria in children. All children who came with history of gross hematuria were included in the study. Children admitted to the Paediatric Unite whose urinalysis revealed microscopic hematuria were also selected. Sixty-nine cases of hematuria were assessed to establish the causes. Among the causes of hematuria, acute glomerulonephritis was seen in 39.13%, nephrotic syndrome in 17.39%, renal and vesical calculi in 13.04%, infections like enteric fever in 5.80%, and urinary tract infection [isolated] in 1.45% of cases. Fever, oedema, oliguria, loin pain and dysuria were predominant signs and symptoms in these children. A child with haematuria and proteinuria has renal parenchymal disease until proved otherwise. During urinalysis, particular attention should be paid to the presence of white cells, casts and protein along with red cells

Microcytic hypochromic anaemia: an unusual presentation of gaucher's disease in children

Seven cases of Gaucher's disease presented with moderate to severe anaemia and marked splenomegaly. These children were initially suspected of suffering from haemolytic anemia. Preliminary haematological investigations revealed anaemia to be of the microcytic hypochromic type. Bone-marrow aspiration biopsy was characteristically alike in all cases showing changes due to iron deficiency or acute haemolytic process. Gaucher's cells were seen in the bone-marrow in two cases and in the spleen and/or liver in five cases. We did not find any association between microcytic anaemia and Gaucher's disease reported in the reported in the literature. We suggest that Gaucher's disease should be considered in the differential diagnosis of microcytic anaemia with marked splenomegaly