Pattern and outcome of neonatal ailments in a tertiary care hospital

The pattern and outcome of neonatal diseases varies not only in different geographical settings and time spans but it also changes within the same unit at different times. Moreover, it can also be used to determine the availability, utilization and effectiveness of mother and child health services in the community. To determine and correlate the pattern and outcome of neonatal ailments in a tertiary care children hospital Karachi. Descriptive observational study carried out at National Institute of Child Health Karachi from 1st February 2011 to 31st January 2012. Subjects and The data regarding the demography, diagnosis and outcome of all admitted neonates was obtained from the patient's files. The data was entered and analyzed on Statistical Package for Social Sciences 17 to find out the frequency and mortality rate of various diseases among the patients. [p value of <0.05 was taken as significant]. A total of 4747 neonates were admitted during the study period. The male to female ratio was 1:0.6. Majority [66.2%] were referred within 72 hours of birth. The major causes of admission were sepsis [29.2%], low birth weight [23.4%], birth asphyxia [11.3%], prematurity [9.8%], meconium aspiration syndrome [8.9%], neonatal jaundice [7.0%] and pneumonia [6.4%]. Almost 55.6% cases were discharged after improvement, 29.9% expired, and 12% left against medical advice [LAMA]. Sepsis and low birth weight showed strong correlation [>/= 57.81] with overall mortality rates. Sepsis and low birth weight were the major causes of death. Public awareness and use of MNCH facilities by the communities need to be further stressed to reduce neonatal mortality and morbidity. Policy message: Monitoring of high risk pregnancies at the antenatal checkups, timely referral and availability of resuscitation facilities at delivery sites must be ensured. Regular awareness workshops for health care providers and community especially mothers could also be helpful

Pattern of diseases, reason of visiting and waiting time at various stages of tertiary hospital

Objectives: To determine the frequency of diseases in children, reasons of visiting out patients department of tertiary care children, hospital and to evaluate the waiting time of patients at different stages of treatment

Study Design: Descriptive observational study

Place And Duration: National Institute of Child Health, Karachi from October 2007 to July 2008

Methodology: Patients up to 13 years of age attending OPD were recruited in to study using simple random sampling procedure. Sample size was 400

Results: Children were selected from three OPDs of NICH, Karachi. Majority of patient were below 5 years of age [69.7% [n=279]]

Mean age was 3.53years + 3.3 with range 155 months [1-156]. The main diseases in medical OPD were respiratory problem 19.43 % [n=34], followed by renal problems 17.7% [n=31], and GIT problem 13.7% [n=24]. In surgical OPD, trauma and fracture 23.2% [n=36], hernia 17.42 % [n=27], and urology 15.5 % [n=24] were important problems in children. Respiratory distress 31.43% [n=22], sepsis 18.61% [n=13], NNJ+ 17.1% [n=12], and constipation 11.43% [n=8], were theicommon disorders in infants attending well baby clinic. Mean number of visits per patient was 2.5 +1.9 [range 1-20]

Conclusion: Most frequent disorders in medical OPD were respiratory problem, trauma and fracture in surgical OPD, and respiratory distress, sepsis and neonatal jaundice at well baby clinic. Availability of free of cost facilities was the main reason for attending the OPD

Knowledge and educational intervention pertaining to viral hepatitis in adolescent male students of urban and rural Sindh, Pakistan

In Pakistan, collective infection rate of hepatitis B surface antigen [HBsAg] and anti-hepatitis C virus [HCV] is 7.6% where as their prevalence are 2.5% and 5% respectively. Most commonly occurring viral hepatitis is hepatitis C, closely followed by hepatitis B and in males both are common, with hepatitis B seen earlier than hepatitis C. A cross sectional study was conducted on 585 adolescent college boys. Respondents were interviewed after informed consent and ensuring confidentiality. An anonymous questionnaire of close ended questions was completed followed by an educational intervention session. Knowledge regarding types of viral hepatitis was known to 11% urban and 22% rural respondents, while 75% from Karachi and 84% from interior Sindh had awareness that hepatitis B and C are infectious diseases. About 58% urban respondents knew that hepatitis B can develop cirrhosis and lead to liver cancer as compared to 73% rural inhabitants. Knowledge regarding spread of hepatitis B and C by transfusing infected blood or blood products or injury by infected sharp or tattooing/ body piercing was known to 43.5% from Karachi and 40% from interior Sindh. About 45% urban and 19% rural respondents were vaccinated for hepatitis B and reasons for not being vaccinated were non awareness and cost of vaccine. Knowledge regarding all aspects of disease was surprisingly better in the rural than urban population. Low vaccination status makes adolescents vulnerable to hepatitis. It is crucial to generate understanding about the disease in general and vaccination for hepatitis B in particular

Frequency of normal appendicectomy in a tertiary care hospital

To determine the frequency of normal appendicectomy in a tertiary care hospital. prospective observational study. This study was carried out in Surgical Unit-I, Liaquat University Hospital Hyderabad, from Oct 2010 to Oct 2011. This study consisted of hundred patients admitted through the outpatient department, as well as from casualty department of Liaquat University Hospital Jamshoro/Hyderabad. Detailed History was taken from all the patients with special reagard to the Pain in RIF, Pain starting around umbilicus, nausea, vomiting, fever and Altered bowel habits. Detailed Clinical examination of the patient was done. Site of right iliac fossa was especially examined for assessment of tenderness and recorded in proforma. Systemic review was also done to see any co-morbidity. All patients underwent base line and specific investigations especially ultrasound of abdomen as diagnostic modality for assessment of acute appendicitis. Inclusion criteria were all these patients who after counseling for this study and gave written consent. Irrespective of their age and sex admitted in Surgical Unit-I through outpatient department/ casualty and diagnosed as case of acute appendicitis. Exclusion criteria included all history of previous operation on lower abdomen. Follow up of all these patients was done. Results were prepared with help of tables and graphs. Data was analyzed through SPSS software. Out of 100 patients included in this study 65 were male [64%] and 36 patients were female [36%]; with male to female ratio of 1.7:1. There was wide variation of age ranging from a minimum of 10 year to 70 year. The mean age was 26.78 year. Symptoms of patients were pain in RIF in 99 [99%], pain starting around umbilicus in 42 examination of patients revealed tenderness at Mc Burney's point in 99 [99%] patients, while guarding was present in 80[80%] patients, rebound tenderness was present in 84[84%] patients and 33 [33%] patients had fever. Ultrasonographic findings revealed Wall thickness of appendix in 58[58%] patients where as normal appendix in 42[42%] patients, Free fluid in the R.I.F and pelvis was found in 36[36%] patients, Thickening of the surround intestinal lobes was seen in 40[40%] patients and Mass ob abscess formation in 8[8%] patients. Operative and histopathological findings were acute appendicitis in 59[59%] patients where as normal appendix in 21[21%] patients, adherent to bower or omentum was found in 7[7%] patients, pus was seen in 5[5%] patients and perforated 3[3%] patients. In conclusion, we found 21% of appendices to be histopathologically normal after emergency appendicectomies performed in this hospital. There was no mortality

Prevalence of nocturnal enuresis in children: a community study

Enuresis is a common distressing problem among children and can lead to important social or psychological disturbances. To determine the prevalence of nocturnal enuresis in a community. The study was carried out in a community of Korangi town, Karachi from 12[th] January-20[th] March, 2009. A total of 300 children aged 4-14 years, suffering from nocturnal enuresis were included in the study. Information was collected on semi-structured proforma, comprising of personal profile, frequency of bedwetting, drinking of water and urinary habit before going to bed, concern shown by parent/care givers and treatment etc. Respondents were interviewed after taking a verbal informed consent and confidentiality was assured. Data was analyzed using SPSS software package. Of 300 children, 183 [61%] were boys and 117[39%] girls. Bedwetting was common in age group to 10 years and 90% of them were primary enuretic. Most of the parents showed concern about this problem but only 23% consulted a doctor/hakim/homeopath and 19% received treatment. Family history of nocturnal enuresis was present in 35% cases. Though parents were apprehensive about enuresis but only few consulted or received treatment from medical professionals while majority sought orthodox management, probably because of ignorance. Health education about nocturnal enuresis is required for its right management