ABSTRACT
Objective: To make a comparison between standard doses of theophylline and caffeine for the treatment of apnea of prematurity
Methods: A randomised control trail was conducted in Department of Pediatrics Medicine Govt. Khawaja Muhammad Safdar Medical College and Govt. Allama Iqbal Memorial Teaching Hospital, Sialkot over duration of one year from August 2017 to August 2018 after approval from the hospital ethics committee. An informed consent in the form of written document was also taken from the parents of each infant participating in the study. Data was analyzed by using SPSS version 24. Mean and SD was calculated for numerical data like gestational age and mean concentration of caffeine and theophylline. Frequency and percentages were calculated for categorical data like nasal continuous positive airway pressure [CPAP], supplemental oxyen and intrventricular hemorrhage [IVH] grade I. Student t-test was applied in order to determine the significance of results. P value ? 0.05 was considered significant
Results: A total of 100 infants were enrolled in this study. This study was further divided into two equal groups by lottery method i.e. 50% in each, treated with Theophylline and Caffeine respectively. Mean apnea events/day in neonates administrated by theophylline was 1+/-0.1, 2+/-0.12, 2+/-1.1, 1+/-0.10 and 2+/-o.12 for 0, 1-3, 4-7, 8-14 and 15-21 days respectively. While, the mean apnea events/day in neonates administrated by Caffeine was 2+/-0.3, 1+/-0.22, 2+/-1.5, 1+/-0.13 and 2+/-0.14 for 0, 1-3, 4-7, 8-14 and 15-21 days respectively. The differences were statistically significant for 1-3 days and 4-7 days p<0.05 according to student t test
Conclusion: Results of our study revealed that caffeine being more effective than Theophylline for treating apnea of prematurity
ABSTRACT
Objectives: Comparison of effectiveness and cost of transcatheter occlusion of patent ductus arteriosus [DA] with surgical ligation of PDA
Methods: This retrospective comparative study was conducted in the pediatric cardiology department of Ch. Pervaiz Elahi Institute of Cardiology Multan, Pakistan. Data of 250 patients who underwent patent ductus arteriosus [PDA] closure either surgical or trans-catheter closure using SHSMA Occluder having weight >5 kg from April 2012 to October 2015 were included in this study. SPSS version 20 was used for data analysis. Quantitative variables were compared using independent sample t-test. Chi-square test and fishers exact was used for qualitative variables. P-value <0.05 was considered statistically significant
Results: There were one hundred and twenty [120] patients who underwent transcatheter occlusion of PDA using SHSMA occluder [PDA Device Group] and one hundred and thirty [130] patients who underwent surgical ligation of PDA [Surgical Group]
Incidence of residual shunting was two [1.5%] in surgical group and 0 [0.0%] in PDA Device group for one month follow up period
There were 4 [3.1%] major complications in surgical group. The rate of blood transfusions were high in surgical group [p-value 0.04]
Hospital stay time was significantly less in PDA Device group [P-value <0.001]
Total procedural cost was 110695+1054 Pakistani rupees in PDA Device group and 92414+3512 in surgical group [p-value <0.001]
The cost of PDA device closure was 16.52% higher than the surgical ligation of PDA
There was no operative mortality
Conclusion: The transcatheter closure of PDA is an effective and less invasive method as compared to the surgical ligation. There is a lower rate of complications and the cost is not much high as compared to surgical PDA ligation
ABSTRACT
"To assess the frequency of serum electrolytes [Na[+], K[+] and Ca[+]] disturbances in malnourished children with diarrhea". Cross-sectional. Pediatrics Department Nishtar Hospital Multan. 01-07-2013 to 31-12-2013. Approval from the institutional ethical committee was taken. Malnourished children with diarrhea admitted to Pediatrics Department Nishtar Hospital Multan were registered. Children meeting the inclusion and exclusion criteria enrolled in the study. In this study there were 90 patients which were found to be malnourished and having diarrhea. The average age of patients was 3.28 +/- 1.2 years and the average duration of diarrhea was 4.67 +/- 0.821 days. There were 58[64.4%] males and 32[35.5%] female patients. Hyponatremia was present in 28[31.1%] patients, Hypokalemia was present in 55[61.1%] while Hypocalcemia was present in 12[13.3%]. Serum electrolyte disturbances in malnourished children are obvious during diarrheal illness particularly in those patients with Grade III malnutrition and measurement of these Serum electrolytes is helpful for immediate therapy to avoid serious life threatening situations
ABSTRACT
To describe the clinical presentations of hepatitis B virus infection in children. Children presenting with symptoms of liver diseases and other diseases who were found to be HBsAg positive by screening or ELISA method were enrolled. Children suffering from thalassemia, hemophilia and hemolytic anemia, which need multiple transfusions, were excluded. On the basis of history, examination and investigations the clinical presentation of the patient was categorized. Basic demographic data, relevant clinical history, physical examination, lab investigations and clinical presentations category were entered in the predesigned proforma. As this is the descriptive study, no hypothesis were required. Descriptive case series. Paediatric unit-2 Nishtar Hospital Multan. 16[th] May 2012 to 15th November 2012. Study results consist of relative frequencies of different clinical presentations of HBsAg positive patients. Fifty children who were HBsAg positive were enrolled in a six month period. Out of 50 patients, 21 [42%] were of hepatic encephalopathy, 14 [28%] were with acute hepatitis, 12 [24%] were cirrhosis, 2 [4%] were asymptomatic carrier and 1 [2%] was presented with chronic hepatitis B. There were 40 [80%] males and 10 [20%] females. The overall male to female ratio was 4:1. Most common presentation was hepatic encephalopathy which has a very bad prognosis, next comes the acute hepatitis and then cirrhosis. There is another inference that males are more and severely affected by hepatitis-B virus infection
Subject(s)
Humans , Male , Female , Hepatitis B, Chronic/complications , Communicable Diseases , Child , Liver Diseases , Hepatitis B virus/pathogenicityABSTRACT
To compare the duration of hospitalization and clinical outcome in children infected with methicilline-sensitive staphylococcus aureus and methicillin-resistant Staphylococcus aureus. [MRSA and MSSA] comparative cross sectional This Study was carried out at the Paediatrics Department, Nishtar hospital Multan from 14.01.2012 to 13.07.2012 Children meeting the inclusion criteria were selected. Clinical samples were collected before starting antibiotics and sent to microbiology lab for culture. Colony morphology, gram straining and production of catalase and coagulase. confirmed growth of S. aureus. Methicillin resistance was determined by disk diffusion method according to CLSI guidelines. S.aureus with inhibition zone more than 18 mm were taken as methicillin-sensitive and those inhibition zone of less than 18 mm were taken as methicillin-resistant. Adequate information regarding identification of patient, clinical diagnosis, duration of hospital stay and clinical outcome were entered. Aftertaking consent from parents. Lab results were entered in the proforma. Children of all age groups up to 12 years of age and both sexes were included to avoid any bias. All patients clinically diagnosed to be suffering from staphylococcal infection [septicemia, pneumonia, skeletal infection, skin and soft tissue infection, meningitis] who were admitted in pediatric ward were included. Sixty patients with S. aureus infection were included in the study. Thirty patients were of MRSA and 30 were of MSSA. In MRSA group 12 [40%] patients remained in the hospital for less than a week and 18 [60%] patients stayed for more than a week but less than 3 weeks. In MSSA group 23[76.6%] patients were hospitalized for less than one week duration and 7[23.4%] patients were admitted for more than 1 week but less than 3 weeks duration. In MRSA group, 15[50%] patients recovered, 4[13.4%] patients improved, 2[6.6%] patients didn't improved and 9[30%] patients expired. In MSSA group, 22[73.4%] patients recovered completely, 4[13.4%] patients improved, 2[6.6%] patients didn't improved and 2[6.6%] patients expired. Children suffering from MRSA infection have more severe illness as compared to those suffering from MSSA infection. Duration of hospitalization of children suffering from MRSA infection is prolonged as compared to MSSA infection while clinical outcome is better in children suffering from MSSA infection as compared to MRSA infection
ABSTRACT
To compare the immunological response of tuberculin test and diagnostic BCG test inoculation given simultaneously to children suffering from tuberculosis. Comparative - Cross sectional. This study was carried out at the Department of Paediatric Medicine, Nishtar Hospital Multan from 6 April 2011 to 5 Oct 2011. Fifty patients with tuberculosis were selected. Relevant data of cases including personal data, presenting complaints, physical examination finding and results of all the relevant investigations were collected. We injected 0.1 ml tuberculin intradermally on ulnar surface of right forearm and 0.1 ml BCG vaccine intradermally on deltoid muscle of left side. Both the BCG and tuberculin tests were performed at the same time by the same doctor. All information was recorded in a specifically designed proforma. 26 patients were male and 24 female. Out of 50 patients; BCG test was positive 36 patients and was negative in 14 patients. Mantoux test was positive in 26 patients and was negative in 24 patients. Both BCG and mantoux tests were positive in 26 patients. Ten patients had a positive BCG test where Mantoux test showed negative results. Both tests were negative in 14 patients. BCG skin test is more superior to Mantoux test as a diagnostic tool in paediatric age group patients suffering from various types of tuberculosis