Clinical audit of treatment of acute watery diarrhoea in paediatrics unit, Hayatabad medical complex, Peshawar

To look into the treatment given to children with acute watery diarrhea by Trainee Medical Officers at the time of admission and to compare it with the standard treatment protocol as recommended by World Health Organization for the treatment of acute watery diarrhoea. This was a retrospective study conducted in Department of Pediatric Postgraduate Medical Institute, Hayatabad Medical Complex, Peshawar from June 15 to August 15, 2008. Treatment charts of children admitted with acute watery diarrhoea were studied for demographical findings, degree of dehydration and other clinical findings and treatment given at the time of admission. The data was statistically analyzed by SPSS version 10. Eighty children were included in the study. The age range was from one month to five years with mean age of 25.5 months. The majority were in the range of 1 to 3 years with male to female ratio of 1.4:1. Majority [68.75%] had bowel movements more than 6 times/24 hours. Blood in the stool was present in only five cases [6.25%]. Thirty-five [44%] and 12 [28%] were presented with some and severe dehydration respectively at the time of admission. Analysis of drug treatment [antibiotics, anti-protozoal, anti-emetics, stool hardeners, probiotics] showed that 65 [81.25%] children received appropriate treatment as per recommendations of World Health Organization. All children were discharged uneventfully. Continuous training and supervision of the Trainee Medical Officers is required to implement standard treatment of acute watery diarrhoea according to laid down World Health Organization guidelines. Such activities will help to reduce inappropriate use of drugs and wrong treatment for diarrhea

Iron deficiency anemia as a cause of breath holding spells

To assess the efficiency of iron therapy in reducing the frequency of breath holding spells. Material and This was a prospective, interventional study conducted in the department of Pediatrics, Hayatabad Medical Complex, Peshawar. A total of 50 patients between the ages of 6 months and 5 years with breath holding spells and mild to moderate iron deficiency anemia were studied. After giving them iron therapy for 8 weeks, they were assessed for the improvement in their anemia and its impact on the frequency of breath holding spells. Fifty children with iron deficiency anemia and breath holding spells were studied prospectively. Thirty-one [62%] cases were males and 19 [38%] females. The mean age was 27 months [SD '12.6]. The mean baseline hemoglobin was 9.79gm/dl. After 4 weeks of iron therapy it was 10.54gm/dl and after 8 weeks it was 11.23gm/dl. There was a statistically significant rise in the hemoglobin level with 8 weeks of iron therapy [p<0.001]. This rise in the hemoglobin level was associated with a statistically significant fall in the frequency of breath holding spells with 8 weeks of iron therapy [p<0.001]. It appears that treating iron deficiency anemia is effective in reducing the frequency of breath holding spells

Frequency of nephrotic syndrome in children

To find out the frequency of childhood nephrotic syndrome and its relation to different solar months. Material and This study was conducted in paediatrics department of Postgraduate Medical Institute, Lady Reading Hospital, Peshawar from 1st August 1995 to 31st July 1996. All children with proteinuria and oedema were studied. All children were thoroughly examined and investigated. Total number of admissions due to various diseases were 3441. Out of these 61 [1.8%] children fulfilled the criterion of childhood nephrotic syndrome. Number of admissions varied in different solar months. 3 [4.9%] cases were admitted in August, 6 [9.9%] in September, 4 [6.5%] in October, 3 [4.9%] in November and December each, 10 [16.4%] in January, 6 [9.9%] in February and March each, 7 [11.5%] in April, 5 [8.2%] in May, 7 [11.5%] in June and 1 [1.6%] in July. Five [8.2%] children were in age range of 1-2 years, 27 [44%] were in age range 2-6 years, 17 [27%] in age range of 6-8 years and 12 [19.2%] above 8 years of age. Nephrotic syndrome is fairly common in children with male preponderance. Most admission due to nephrotic syndrome were in the month of January

Erythrocyte glucose-6- phosphate dehydrogenase deficiency: a cause of neonatal jaundice

Objective: to determine the frequency of glucose-6-phosphate dehydrogenase deficiency in the etiology of neonatal jaundice

Material and Methods: this descriptive study was conducted at the Paediatrics Department, Hayatabad Medical Complex, Peshawar from March 2001 to December 2001. All full term newborns with significant jaundice were included, Serum bilirubin level, mother and baby blood group, coomb's test and G6PD enzyme estimation using sigma diagnostic G6Pd reagent were done in all babies

Results: out of 150 icteric newborns, 14% were deficient in G6PD. 90.5% were male and rest were female. No specific precipitating factor for hemolysis was found. The most common age of appearance of jaundice was within the first 48 hours of life. Serum indirect bilirubin level ranged from 9.4 to 40mg%. All G6PD deficient babies receive phototherapy while in 11 babies, exchange transfusion was performed

Conclusion: G6PD deficiency is one of the common causes of neonatal jaundice. Hence, all jaundiced neonates should be screened for G6PD deficiency

Nosocomial infections as a major cause of sepsis in admitted neonates

To determine the causes of nosocomial infection in admitted neonates having clinical or bacteriological proven sepsis.A retrospective analysis of 100 neonates admitted to neonatology unit of a teaching hospital, having clinical or bacteriological evidence of sepsis. History and laboratory data was scrutinized to collect relevant information. Out of 100 neonates, 58 were females and 42 were males. 63 patients were preterm and 37 were term infants. 68 patients were delivered at home and 32 were delivered in hospital. In 15 patients, mother had some perinatal infections and in 28 cases mothers had prolonged rupture of membranes. In 57 cases, no maternal or neonatal cause of infection was found and these babies acquired nosocomial or hospital acquired infection. Nosocomial infections are very common in our setup. Stringent methods are recommended to improve the basic hygiene of our neonatal units