Frequency of metabolic syndrome in psychiatric patients, is this the time to develop a standardized protocol to reduce the morbidity from an acute care psychiatry unit

To determine the frequency of Metabolic Syndrome among psychiatric patients and to look for the correlation between the two medical conditions. The cross-sectional study was conducted from February to April 2013 at the acute care psychiatry in-patient unit at Kingston General Hospital, Ontario, Canada, and comprised adult patients of both genders diagnosed under the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. For Metabolic Syndrome, definitions outlined by the International Diabetes Federation were used. The patients were divided into two groups on the basis of presence or absence of the Syndrome and were compared for clinical and demographic characteristics. SPSS 22 was used for statistical analysis. Of the 50 patients in the study, 24[48%] were found to have Metabolic Syndrome. Besides, 40[80%] patients were taking atypical antipsychotics regardless of the diagnosis; 20[83%] among those with the Syndrome, and 20[77%] among those without it. Patients at high risk of developing metabolic syndrome need to be identified early so that an individualised care plan can be formulated. Identifying the variables to make a management plan is vital

Investment in paediatric tuberculosis prevention in Pakistan: loss or gain?

To assess the effectiveness of paediatric tuberculosis prevention, by reevaluation factors in children exposed to tuberculosis from less privileged strata of Pakistan. This cross sectional descriptive study was conducted at National Institute of Child Health, from January 2004 to December 2005. Paediatric patients under 15 years of either gender, diagnosed with active tuberculosis were enrolled. Interviews were conducted with parents regarding common preventive measures and factors advocating tuberculosis spread. Later factors leading to non-compliance to safety recommendations were also evaluated. Fifty five [70%] children younger than 5 years, had index cases in direct contact within their own house. Fifteen [14%] patients contracted the infection from neighbours, with 11 being older than 5 years. There were 82 [51%] cases with Protein Calorie Malnutrition [PCM]. Total of 66 [41%] cases of PCM were <5 years age [p <0.005]. Data showed 123 [77%] children living in a family with 5 or more members. Sixty eight [55%] children of these large families had to live in a single room house. There is a high frequency of direct contact tuberculosis in children belonging to the lower socio-economic class. This is attributed to poor housing condition and over crowding. The current paediatric tuberculosis prevention strategies as adapted from World Health Organizations' Millennium Development Goals are ineffectual to make changes in children exposed to tuberculosis from less privileged strata of Pakistan. Our societal and demographic factors remain static, continually exposing our children to higher risk of tuberculosis exposure

Juvenile myelomonocytic leukaemia

Juvenile Myelomonocytic Leukemia [JMML] is a rare hematopoietic malignancy of early childhood. Infection remains the principal cause of death in patients with myelodysplastic syndrome [MDS]. Sixty percent of patients are anemic and 26 percent have petechiae and/or purpura [thrombocytopenia]. Bone Marrow Transplant [BMT] is the best available treatment option. We describe the management of an eight months old male child who presented with complaints of fever, cough and pallor since six months. Despite medication his fever did not subside. He developed meningitis and intracranial bleed and expired on 11th day of hospitalization

Chediak-higashi syndrome

Chediak Higashi Syndrome is a rare inherited autosomal recessive disorder of immune system. Susceptibility to infection due to phagocyte dysfunction ranges from recurrent skin infection to over whelming fatal systemic infection. A five years old male child was admitted on 31st March 2006 with the complaints of pallor, fever and ear discharge for 6 month. He was treated by several medications but had temporary relief. The ear discharge was bilateral, foul smelling and of yellowish color. Past history was significant with episodes of abscess involving the different parts of body. Myeloid precursors shows giant, purple stained granules mainly in metamyelocytes, band cells and mature neutrophils

Acquired aplastic anemia: treatment in a developing country

The aim of this study was to evaluate the clinical presentation of aplastic anemia as well as to assess the efficacy of Cyclosporin-A in patients with aplastic anemia. This is a hospital based interventional study. During the three year study period, 44 children were enrolled. Mean age was 9.3 years and there was a male predominance. Most common clinical presentation was anemia and bleeding. Four children died before therapy was started. Cyclosporin-A was started in 40 patients. Eleven patients died before completion of therapy and three patients were lost to follow-up. Out of 26 patients who completed therapy, 11 were cured and 9 were responders while 6 were non responders according to the selected criteria. In developing third world countries like Pakistan majority of the patients with aplastic anemia cannot afford BMT. Alternative modalities of treatment must therefore be looked into. Cyclosporin-A seems to be a reasonable therapeutic option in such cases

importance of contact history in childhood tuberculosis

Tuberculosis is an ancient disease that is known to have existed in the prehistoric times, and has been a major health burden, even today 95% of the cases are present in the developing countries. The exact proportion of children with tuberculosis is unknown but it is estimated to be between 3-13% of all cases [Ejaz and Mumtaz, 2002]. The child with TB in a community will represent a failure of TB control in that community. Patients included in the study were children age between 1-15 years of either sex coming to a tertiary hospital with history, clinical and laboratory findings of tuberculosis. Diagnosis of tuberculosis was made on the basis of WHO criteria, with the support of MT, chest X-ray, clinical history and history of contact with patients of pulmonary tuberculosis. There were total 160 patients include in our study, 109 [68.1%] patients had positive history of contact from home, close relatives and from neighbors while in 51[30%] cases there was no history of contact detected