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Background: acute kidney injury [AKI] is rapid decrease of renal function. AKI has been resulted in significant morbidity and mortality. The term RIFLE consist of risk, injury, failure, loss, and end-stage renal disease. A modified version of this criteria pRIFLE is used in pediatric population with AKI, for the severity assessment and its outcome. Therefore early intervention can be made. This study helps to make recommendations based on pRIFLE criteria for severity and outcome
Objectives: to determine severity and outcome of AKI in pediatric population using pediatric RIFLE criteria
Study design, settings and duration: it was a descriptive case series carried out in departments of Pediatric ICU and pediatric nephrology unit at National Institute of Child Health [NICH], Karachi from August 2010 to March 2011
Patients and Methods: total ninety seven children with acute kidney injury [AKI] were included in this study. Schwartz equation was applied for calculation of estimated glomerular filtration rate [eGFR] and severity of AKI was assessed using pRIFLE criteria at presentation andt then on daily basis till discharge. Outcome was labeled as death or alive. Data entered and analyzed by using SPSS version 19.0
Results: the pediatric RIFLE identified those at risk, injury, and failure in 16 [16.5%], 25 [25.8%], and 56 [57.7%] patients respectively. Outcome in term of mortality was observed in 11.3% cases. There was 6.3% death in those at risk, 17.9% [10/56] in those with failure and no significant in injury
Conclusion: there are significant number of patients in renal failure due to AKI, this implies lack of early detection of AKI and delayed referral to the pediatric tertiary care hospital so "pRIFLE criteria" can be widely used by all pediatricians for early detection of children with AKI in risk category so that early interventions may halt the progression of AKI to failure
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Background: Herbal medicines are being widely used and likely to cause side effects and interactions with allopathic drugs
Objective: To assess knowledge, attitude and use of herbal medicines among patients in the Northern Border Area of Saudi Arabia
Methodology: A cross sectional study was carried out among 445 patients attending outpatient departments of tertiary care health units in Arar city of Saudi Arabia from 1[st] November 2015 to 31[st] March 2016. Besides demographic data, information regarding knowledge, attitude and use of herbal medicines was obtained using predesigned questionnaire. Response to various questions was analyzed with SPSS program version 16. Data was further analyzed by using chi-square test
Results: A significant percentage of patients were familiar with herbal medicine use [93.7 %]. Male patients has more knowledge of herbal medicines than females [P = 0.024]. High proportion of patients were personally using herbs [93.6 %], mostly in relatively lower income families. Almost 90% Physicians don't ask history of herbal medicines consumption. Only 5% of patients were taking herbal medicine prescribed by Hakeem [Authorized Physician]. Persons [parents and grandparents] were prescribing herbal medicines
Conclusion: The residents of Saudi Arabia [Northern Region, Arar] have shown high usage of herbal medicine, additionally its awareness was high
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Introduction: Clove is used as spice commonly and exerts beneficial effects in different human pathologies especially diabetes and infectious diseases discovered in recent times
Objective: Current study was aimed to investigate the effects of clove extract on paracetamol induced liver toxicity
Methodology: This animal study was conducted in Department of pharmacology, Isra University Laboratory Hyderabad and at animal house of veterinary department, Sindh Agriculture University, Tando Jam between September 2013 to October 2013. Through non probability purposive sampling, 30 Rabbits were divided into three groups I, II and III. Acetaminophen 500mg was given to group II and III for 10 days orally, while group I served as control. Group III was co administered 100mg of clove powder for 20 days while group II was started 100mg clove powder on 11[th] day till 20[th] day of experiment. All blood samples were taken from ear lobe Base line blood sample before intervention was taken at day 0, then 2nd and 3rd samples were taken at 10 and 20 days respectively after intervention. Liver enzymes were also measured. Data was analyzed on SPSS version 21 using t-test, keeping P-value < 0.05 significant
Results: No significant rise in liver enzymes noticed in group I and group III while all enzymes were increased in group II in initial 10 days but declined back in next 10 days. P-value calculated was 002, 0.001 and 0.001 for ALT,AST and GGT respectively
Conclusion: Paracetamol induced elevation of hepatic enzymes was reversed by clove
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Background: Neonatal sepsis [NS] is a major cause of neonatal admissions to hospital and mortality. This study was conducted to evaluate different methods for rapid and reliable diagnosis of NS with an aim to rationalize the use of antibiotics and stay in Neonatal Intensive Care Unit
Objectives: To compare the different available methods for rapid and reliable diagnosis of neonatal sepsis. Study design, settings and duration: This comparative study was conducted in Emergency Department of National Institute of Child Health [NICH] Karachi for the period of six months
Subjects and Methods: Neonates who were brought to the emergency department of National Institute of Child Health with suspicion of NS were clinically examined. Those, supposed to be septic were included as study population and informed written consent was taken from their parents. After this, 3 ml blood was drawn for complete blood count [CBC], blood culture, C-reactive protein [CRP], polymerase chain reaction [PCR] and neutrophilic ratio. PCR and CRP results were compared with blood culture for specificity, sensitivity, positive and negative predictive values
Results: Out of 129 neonates, 23 [17.82%] were positive for bacterial DNA by PCR method while 42 [32.55%] were positive for infection when tested for C reactive protein marker of the blood. Whereas, only 15 [11.62%] were positive by blood culture. Sensitivity and specificity of PCR were 60% and 88% while positive and negative predictive values were 39% and 94% respectively. Sensitivity and specificity of C reactive protein were 60% and 71% while positive and negative predictive values were 21% and 93% respectively
Conclusion: Our study revealed high specificity and positive predictive values of PCR suggesting that PCR is more reliable, rapid and specific adjunct of blood culture for diagnosis of NS
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OBJECTIVE: To assess the impact of mass level public awareness campaigns regarding dengue fever among parents visiting tertiary care children hospital Karachi
METHODOLOGY: A descriptive cross sectional survey was conducted among parents visiting medical outpatient department at National Institute of Child Health, Karachi from 1st January to 31[st] December, 2014. Total of 400 respondents were interviewed using simple random sampling technique. Pre coded semi structured proforma consisting of dengue specific symptoms and safety measures were used. After interview, every individual was educated regarding preventive and safety measures against dengue fever
RESULTS: Out of 400 respondent, 68% [n=272] were males and 32% [n=128] females. Almost 98% [n=392] knew that dengue fever is caused by mosquito bite. More than two-third of study participants were not aware about dengue specific symptoms. Awareness regarding retroorbital pain was reported by 1% only. Use of anti mosquito mats, coil and other repellants was reported by 88%. Use of mosquito nets was only 3.5%. Electronic media was the major [89%] source of information regarding preventive measures of dengue in our study population
CONCLUSION: It is concluded that awareness of target population about dengue specific symptoms and effective preventive measures remains very low. It suggests to revisit the existing awareness related interventional strategies at public level with contextual relevance to enhance overall impact from preventive aspect
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Objectives: To determine the etiological agents by Latex Particle Agglutination [LPA] and Polymerase Chain Reaction [PCR] in patients admitted with Cerebrospinal Fluid [CSF] culture negative bacterial meningitis
Methods: This descriptive case series was conducted at National Institute of Child Health, Karachi from January 2010 to December 2012. Patients meeting the WHO case definition of suspected meningitis from one month to 59 months of age were included in the study. CSF examination and culture was carried out on every patient and CSF culture negative patients were enrolled. Demographic data, clinical signs and symptoms and laboratory findings were entered into the proforma. Data was analyzed using statistical package for social sciences [SPSS] version 17. P-value < 0.05 was taken as significant
Results: A total of 166 patients were included. Male were 96 and female were 76 with the male to female ratio of 1.26. The mean age of patient was +/- SD 14.6 +/- 14.5 months. The etiological agents identified by LPA were in 26/166 [15.66%] cases and the organisms were H. influenzae type b 10 cases, streptococcus pneumoniae 15 cases and meningococcus only one case respectively. The organisms identified by PCR were in 65/166 [39.15%] cases and the isolates were H. influenzae type b 16 cases, streptococcus pneumonia 48 cases and meningococcus 01 case respectively
Conclusion: LPA and PCR are superior and useful diagnostic tools in microbiology. They can be used for rapid etiological diagnosis of bacterial meningitis for the early administration of proper antibiotic
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Malnutrition is one of the major causes of morbidity and mortality in children. It is important to realize that normal length and weight being attained at 1 year of age, would predict the nutritional status at 3 years of age. To asses the nutritional status and the associated socio-demographic characteristics in supposedly healthy children of up to 2 years of age and highlight the importance of anthropometric measurements in routine child health care. A cross- sectional study using purposive sampling technique was conducted on children attending well baby clinic of National Institute of Child Health, Karachi during the year 2003-2005. Anthropometric measurements i.e. height and weight, were measured and a standard questionnaire was used to interview the mothers regarding sociodemographic back ground information after a verbal informed consent and ensuring confidentiality. Height for age, weight for age and weight for height of the children were compared with the National Centre of Health Statistics [NCHS] reference population of the United States, and Z-score < -2 SD were considered as stunted, under weight and wasted respectively. Data was analyzed using SPSS software package. We observed stunting in 22%, wasting in 15% and under weight in 31.6% children. Majority of children with low weight were between 19 - 24 months of age. Regarding socio-economic status of the households, 53.8% had family income less than Rs6000 /month and almost 50% had a family size of 6-10 persons. Parents' education to the level of illiteracy [father, 27% and mother, 40%] and incomplete immunization [20%] were other associated factors for stunting, wasting and under weight. About 32% of children up to 2 years of age in the selected population were under weight, followed by stunning [22%]. Anthropometric measurement of children is a useful in routine child care settings as it will facilitate early identification and timely interventions for emerging health problems
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Humans , Male , Female , Infant, Newborn , Infant , Nutritional Status , Anthropometry , Cross-Sectional Studies , Surveys and Questionnaires , Socioeconomic Factors , MalnutritionABSTRACT
Objective: To evaluate the effect of combination therapy of Nigella sativa and Trigonella foenum-graecum seeds on body mass index [BMI] in type 2 diabetic patients.
Setting: This clinical trial was conducted in the diabetic outpatient clinics of Isra University Hyderabad and Liaquat University of Medical and Health Sciences Jamshoro, from March to August 2008
Design:A randomized clinical trial
Subjects and Methods: For this study, Type 2 diabetic patients on glibenclamide, who gave written consent to volunteer in the study, were randomly divided into two groups. Fifty patients in group A [control group] were kept on glibenclamide, while 50 patients in group B [test group] were given capsules containing combined powders of N. sativa and T. foenum-graecum seeds in addition to their routine dose of glibenclamide. Patients in both groups were treated for 3 months. BMI was calculated for every patient at the start and after 3 months of therapy
Results: A favorable impact of combination therapy with N. sativa and T. foenum-graecum seeds in reducing BMI was noted in the test group in comparison to the control group, but overall differences between groups were not statistically significant
Conclusion: This study indicates that combination therapy of N. sativa and T. foenum-graecum has some effectiveness in controlling BMI in type 2 diabetic patients. Further study with an adequate sample size is recommended