Profound hypernatremia due to central diabetes insipidus

Diabetes insipidus is a rare endocrine disorder in paediatric patients. Polyuria is a cardinal manifestation that is extremely difficult to recognize in diapered infants. Careful urine quantification is the key to diagnosis in appropriate clinical setting. We report a case of a 4 months old infant presenting with an acute life threatening event following an episode of vomiting and decreased oral intake. She had profound hypernatremia which persisted after stabilization. Polyuria unrecognized by the mother was revealed by 24-hour urine output measurement. A diagnosis of diabetes insipidus was made after appropriate laboratory investigations including serum and urine osmolality. The central nature of the disease was confirmed by neuroimaging which showed holoprosencephaly

Moyamoya disease

A 4 years old boy presented with acute left hemiplegia. Preliminary neuroimaging suggested an arterial ischemic process. Clinical and laboratory evaluation excluded haematologic, metabolic and vasculitic causes. Cerebral angiography confirmed the diagnosis of Moyamoya disease. Treatment included physiotherapy and close follow-up for recurrence

Evaluation of zinc status of preschool children as assessed by hair zinc level in Punjab province

To determine status of zinc in healthy children in some parts of Punjab province by estimation of hair zinc levels. Descriptive study [cross sectional survey] The study was organized at KRL Hospital from August 2004 to January 2005. Study samples were selected randomly from a larger study [To evaluate vitamin A status] carried out in 6 districts of Punjab. This community-based study was done in 6 districts of Punjab including Mianwali, Jhang, Attock, Multan, Pak Pattan and Faisalabad. The population selected was 1-5 yr old healthy children. Both male and female healthy children were included. Malnourished children with mid arm circumference <12 cm, children with skin and hair disorders, liver disease and prolonged illness were excluded from the study. After parental consent and filling up of questionnaire data, hair samples were collected. Relevant features like age, sex, dietary history and previous illnesses were recorded. Hair samples were taken, sealed in dry plastic bags and dispatched to Dr A Q Khan Research Laboratories [KRL] Kahuta where they were analyzed using atomic absorption spectrophotometery. Data analysis was performed through SPSS-10.0. Mean age of study population was 37.5 +/- 13.39 months and male to female ratio was 1:1.32. Hair zinc levels ranged from 69 to 227 micro gm/gm of hair. Mean hair zinc level was 164.79 +/- 53.7 micro gm/gm of hair. Majority of children [62] had an adequate zinc level, while 13 were identified with low zinc status [<100 micro gm/gm]. Hair zinc was not significantly higher in children with adequate dietary habits, similarly there was no association with age and gender. Majority of healthy pre-school children in the sampled districts of Punjab did not have zinc deficiency as assessed by hair zinc level. However about 1 in 10 children was deficient in zinc even in the healthy population

Birth weight pattern of newborns in hospital setup

The objectives of the study were to determine the distribution of the birth weight of the newborns and identify the effects of gender, parity and socioeconomic status on it. CMH Thai [Kohat], KRL Hospital Kahuta and POFs Hospital Wah Cantt from Jun 2002 to Sep 2005. All the live born singleton normal babies born between 37-42 weeks of gestation were included. Premature babies, babies with congenital anomalies and those born to the mothers with malnutrition, obesity, anemia, chronic illnesses and obstetric complications were excluded from the study. Birth weight of each baby was measured to the nearest 100 gram on a baby weighing scale. Infants having birth weight of 2.5-4.0 kg were termed as normal birth weight, those less than 2.5 kg as low birth weight and more than 4.0 kg as large weight babies. Data was analyzed using SPSS v.10. The total number of babies was 1026. Males were 54% and females were 46%. Mean birth weight was 3.08 kg. Birth weight ranged from 1.6 kg to 5.0 kg. Mean birth weight of male babies and babies of higher socioeconomic group was higher than that of the females and the babies of lower socioeconomic group. Seventy nine percent of the neonates had a normal birth weight. Sixteen percent had low birth weight and only 5% were large babies. There was no significant difference in the mean birth weights of the babies of mothers with different parities. This study revealed that majority of analyzed population had normal birth weight. Male neonates and babies of higher socioeconomic group were heavier as compared to females and those of lower socioeconomic group. Parity however did not have any significant affect on the birth weight