Role of zinc supplementation in treating measles pnemonia in children

Objective: To determine the role of zinc supplementation in treating measles pneumonia in children

Methods: This descriptive study was conducted in the department of Paediatric, Services hospital, Lahore. The duration of the study was 6 months from June 2012 to December 2012. 120 cases of children with measles Pneumonia between 9 months to 15 years of age with both genders were included in this study after taking informed consent from parents. An approval was taken by ethical committee of the hospital. All patients received zinc sulphate [1mgkg/day] along with conventional treatment in twice daily doses till resolution of measles pneumonia. Patients were assessed daily for fever, rash and tachypnea and findings were recorded till the resolution of measles pneumonia. All these information were recorded on a pre-designed proforma

Results: In our study, out of 120 cases, 81.67%[n=98] were between 1-10 years of age while 18.33%[n=22] were between 11-15 years of age, mean+sd was calculated as 7.49+3.48 years, 51.67%[n=62] male and 48.33%[n=58] were females, mean duration of illness in children with measles pneumonia receiving conventional treatment with zinc supplementation was calculated as 132.81+8.36 hours

Conclusion: We concluded that that mean duration of illness in children with measles pneumonia receiving conventional treatment with zinc supplementation was similar to previous studies, however, in absence of any local study, there is a dire need for further trials to validate our findings

Hyperimmunoglobulin e [job's] syndrome

Hyperimmunoglobulin E syndrome is a primary immunodeficiency disease characterized by markedly high titers of serum immunoglobulin E [lgE], chronic eczema, recurrent staphylococcal infections and pneumatoceles. There are no clin ical tools for diagnosis and definitive laboratory investigation. Variability of presentation makes it easy to confuse the diagnosis with severe atopy or other rare immunodeficiencies. We report case of a 9-year-old boy with recurrent eczema, mycotic infection of the nails and moderately elevated lgE levels

Frequency of bacterial meningitis in children presenting with seizure and fever diagnosed on Lahore puncture

Objective: to determine the frequency of bacterial meningitis in children presenting with seizure and fever diagnosed on lumbar puncture

Material and Methods: this descriptive study was conducted in the department of Paediatrics, Services Hospital, Lahore. The duration of study was 6 months from June 2012 to December 2012. One hundred and fifty cases with fever and seizures were included in this study. Their demographic information was recorded; lumbar puncture was performed and sent for cerebrospinal fluid analysis in the laboratory. All this information was recorded on a pre-designed proforma

Results: majority of the patients were between 1-2 years of age i.e. 50.6% [n=76], 21.3 %[ n=32] between 3-4 years, 19.3% between 5-6 years and only 8.6% [n=13] were of 7 years of age. Mean +/-. Standard deviations were 3.67+/-2.54 years. Males were 58 %[ n=87] and 42% were females. Frequency of acute bacterial meningitis in children with fever and fits, which were diagnosed on lumbar puncture, reveals 6% [n=9], while 94% [n=141] had no finding on CSF examination

Conclusion: the frequency of bacterial meningitis in children with fever and seizure is considerable but not significantly high

Scurvy

Scurvy is a disease of ancient times. Now-a-days, with advances in the understanding of the disease, improvement in the nutrition and health standard, scurvy is rarely noticed. Very few cases of scurvy occurred in neglected and developmentally delayed children. We present a 9 years old child who was a known case of cerebral palsy and presented with painful swelling of the right knee, with bleeding from the gums. With vitamin C replacement therapy there was a dramatic improvement in his condition. This case serves as a reminder to the clinicians that even though rare in today's practice, ascorbic acid deficiency is still encountered and when recognized, is an easily treatable disease

One stage emergency resection and primary anastomosis of sigmoid volvulus

To evaluate the safety of single stage resection and primary anastomosis [RPA] in cases of viable sigmoid volvulus, in terms of anastomotic healing and complications. Observational study. Surgical Unit, Hayatabad Medical Complex [HMC], Postgraduate Medical Institute, Peshawar, from November 2006 to October 2008. Study included all patients presented and admitted in Surgical Unit, HMC, with sigmoid volvulus during the above mentioned period. Resection and primary anastomosis was done without defunctioning stoma formation or on-table colonic lavage. Manual decompression was carried out pre-operatively. Patients excluded, had serious co-morbid conditions in whom colostomy was done instead of primary anastomosis. Patients were followed-up for one month after surgery. A total of 30 patients were admitted during the study of 2 years duration, out of which there were 21 male and 09 female patients, with male to female ration of 2.4:1. Only 1 patient and anastomotic leak while 4 patients had superficial wound infection. One patient died due to comorbid condition. Abdominal wound dehiscence or postoperative abdominal abscess was not observed in any case. Single stage resection and primary anastomosis is a reliable current treatment modality for the emergency surgical management of sigmoid volvulus and has low morbidity and mortality. On-table colonic lavage and proximal defunctioning colostomies are unnecessary with this technique

Toxic epidermal necrolysis

Toxic epidermal necrolysis [TEN] is a clinical syndrome characterized by severe exfoliative skin changes, erosive mucosal involvement, and potentially life-threatening multisystem involvement. We present a 1 year old boy with recurrent rashes and fever, who turned out to be a case of toxic epidermal necrolysis

Frequency of disorders causing childhood thrombocytopenia

Objective: To study the relative frequency of the disorders causing childhood thrombocytopenia

Patients and Methods: This descriptive study was conducted in the Department of Hematology and Transfusion Medicine Division, the Children Hospital and the Institute of Child Health, Lahore and the Department of Pediatrics, Services Hospital Lahore. The duration of the study was 1 year from March 2005 to April 2006. Two hundred cases having platelet countless than 1, 50,000/mm3 were included in this study. Causes of thrombocytopenia were determined on the basis of history, physical examination and various investigations. The data were collected on a proforma and analyzed using SPSS for Windows version 8. The results were compared with other studies. Chi- Square test was applied to determine P-values

Results: Acute lymphoblastic leukemia was found to be the commonest cause of childhood thrombocytopenia observed in 60 [30.0%] cases, followed by hypoplastic / aplastic anemia 40 [20%] cases, AML in 30 [15%], ITP in 28 [14%] cases and megaloblastic anemia in 20 [10%] cases. Drugs and infections together caused thrombocytopenia in a considerable number of patients. 96 children [48.0%] had platelet count in the range of 11-40 x 10[9]/L. Hemorrhagic manifestations were seen in 123 [61.5%] children. Epistaxis and purpura / bruises were the main presenting bleeding manifestations

Conclusion: Thrombocytopenia is associated with different disorders and acute lymphoblastic leukemia was found be the most common of childhood thrombocytopenia

Primary anastomosis in the management of acute sigmoid volvulus with out colonic lavage

The objective of this study was to evaluate the safety of single stage resection and anastosis for acute left sided colonic obstruction due to sigmoid volvulus. This study was conducted in the department of surgery Hayatabad Medical Complex and Lady Reading Hospital Peshawar Pakistan from January 2002 to Jun 2007. It included cases who presented with sigmoid vulvolus in emergency. All cases were operated by surgeons at senior registrar or above level. Resection of the sigmoid colon followed by primary anastomosis after simple manual decompression with out ontable colonic lavage or diverting stoma were carried out. Total number of patients who underwent bowel decompression, resection and primary anastosis was 80. Superficial wound infections occurred in 20% [n=16]. No death or clinical anastomotic failure was recorded. Hospital stay was 11.4 + 4.3[SD] days. Resection of acute sigmoid volvolus and primary anastomosis after decompression alone can be carried out safely in reasonably fit patients