Association of literacy of mothers with malnutrition among children under three years of age in rural area of district malir, Karachi

To determine the association of literacy of mothers with malnutrition among children under three years of age in rural area of district Malir, Karachi. A cross-sectional study was conducted on four hundred children under three years of age, residing in the rural area of district Malir, Karachi. The selection of the children was irrespective of gender, ethnicity and religion.Three hundred nineteen mothers [79.75%] were illiterate and 81 [20.25%] were literate. In the latter group, three mothers could read or write only, 38 had primary, 10 middle, 15 matric, 12 intermediate and 3 mothers had education upto graduate level. Maximum malnutrition regarding stunting [40.75%] was seen in children who's mothers were illiterate and maximum underweight [57.89%] was seen in children who's mothers had education up to primary level and maximum wasting [33.33%] was seen in children who's mothers [only 3 mothers out of 400] were graduates.There was a significant difference regarding underweight between the children who's mothers were illiterate or had education up to primary level in comparison to the children who's mothers had education to more than primary level [P<0.016], but in significant difference regarding stunting and wasting was found.Overall a total of 217 [54.25%] children were underweight, 156 [39%] were stunted and 86 [21.5%], had wasting. Mother's literacy status has a definite association with the malnutrition of the children <3 years of age regarding underweight. In order to combat this an uplift of mother's literacy status is badly needed especially in the rural areas

Clinical pattern of heart diseases in children

This study was done to determine various causes and clinical presentation of heart disease in children. It was a prospective hospital based study conducted in Department of Paediatrics Civil Hospital, Karachi from August 1995 to February 1996. In this study, 70 patients of heart disease upto 12 years of age were inducted. There were 33 [47.14%] cases of congenital heart diseases and 37 [52.85%] cases of acquired heart diseases. The age distribution showed that heart disease was more frequent between 0-11 months of age [41.42%]. Congenital heart diseases were also frequent between 0-11 months [28.57%]. On the other hand acquired heart diseases were more common between 6-12 years [22.85%]. In this study the males were predominantly involved, the male to female ratio was 1.05:1. In congenital heart diseases it was 1.3:1 and in acquired heart diseases it was 0.85:1. Ventricular septal defect was the commonest congenital lesion reported [20%]. Rheumatic fever and viral myocarditis were two frequently occurring acquired heartdiseases 17.14% each. The common presentation of heart diseases were respiratory distress [94.28%], fever [90%], feeding difficulty [57.14%] and failure to thrive [34.28%]. In case of rheumatic fever, chorea was present in 8.57%, arthritis in 11.42% and S/C nodules [2.85%] cases respectively. The early management of the problem may help in decreasing morbidity and mortality due to these diseases in children. Prenatal detection of congenital cardiac lesions by fetal echocardiography in high risk pregnancies,early intervention in neonatal period and counselling of the parents may help in prevention of congenital heart diseases in children. Primary prevention of rheumatic fever can be achieved by early diagnosis and treatment of streptococcal throat infection

Risk factors of persistent diarrhoea in children below five years of age

Persistent diarrhoea has been identified as a major source of morbidity in the developing world. This study was conducted to evaluate the risk factors of persistent diarrhoea in children below five years of age. The data used is from a prospective analytical case control study carried out in the Department of Pediatrics, Dow Medical College and Civil Hospital, Karachi, during 1993-94. A total of 50 cases of persistent diarrhoea and 50 acute diarrhoeal controls [matched for age and sex] under 5 comprised the study subjects in this analysis. The maximum incidence of persistent diarrhoeal episodes occurred in children below one year of age. Male to female ratio was 3:2. The seasonal variation showed a peak incidence in summer rainy season. Risk factors for persistent diarrhoea recorded were young age, poor nutritional status, irrational use of antibiotics during acute diarrhoea, lack of exclusive breast feeding, incomplete vaccination, lack of tap water supply and sanitation facility at home and income < Rupees 2000/month of the earning members of the family. Thus, it is concluded that discouraging the irrational use of antibiotics and other drugs for the treatment of diarrhoea, promotion of breast feeding and Expanded Programme of Immunization [EPI], Standard Diarrhoea Case Management courses for doctors, medical students and paramedical staff and provision of safe drinking water and sanitation facility are important for the prevention of persistent diarrhoea