ABSTRACT
Objective: To determine the outcome of combination of low dose oral Prednisolone with oral propranolol for the treatment of infantile hemangioma
Methods: The patients fulfilling the inclusion criteria were registered through outpatient department. Diagnosis was confirmed clinically and on Color Doppler ultrasonography [CD]. All the patients were given oral prednisolone in a dose of 1mg/kg/day and propranolol in a dose of 0.5mg/kg/day twice a day and increased up to 1.5mg/kg/day BID within three days with close monitoring of heart rate, blood pressure and blood glucose as inpatient. Treatment was given for three months then titered down for two weeks before cessation of treatment. The follow-up of patients were performed at 7[th] day, at 1[st] month and finally at 3[rd] month. Treatment compliance was checked during each visit along with outcome parameters i.e. response which was excellent, good, moderate slight improvement and no effect. All the information's were collected. Data was analyzed by using SPSS version 10
Results: Out of total 73 patients, 36.99% [n=27] were one year of age, 32.88% [n=24] were two years of age and 30.13% [n=22] were three years of age, mean +/- SD: 1.96 +/- 0.54 years, 53.42% [n=39] were male and 46.58% [n=34] were females, frequency of response of the treatment was recorded as 56.16% [n=41] had excellent, 23.29% [n=17] had good, 15.07% [n=11] had moderate response, 4.11% [n=3] had slight improvement and 1.37% [n=1] had no effect while frequency of acceptable outcome revealed as acceptable in 79.45% [n=58] while 20.55% [n=15] had not acceptable outcome
Conclusion: The frequency of acceptable outcome of combination of low dose oral Prednisolone with oral propranolol for the treatment of infantile hemangioma is higher
ABSTRACT
The Bacille-Calmette-Guerin [BCG], a living attenuated vaccine with characteristic residual virulence, has been used to prevent tuberculosis since 1921. The world health organization [WHO] has recommended BCG Vaccination as a part of the global expanded program for immunization [EPI] in developing countries. Lymphadenitis with or without suppuration is the most common complication of this vaccination. Retrospective Study. This study was conducted in Nishtar Hospital, Multan Pakistan and King Faisal Hospital Taif, KSA between May 2009 to June 2012. All patients referred to pediatric surgical service in a period of three years were retrospectively studied for optimum management. Our all 28 patients underwent surgical management and were advised antituberculous treatment but only 6 [21.4%] were compliant with medical treatment. All patients recovered after surgery with or without antituberculous treatment. Optimum treatment for post BCG lymphadenitis who are unresponsive to medical treatment is surgery. Post operative antituberculous treatment seems to be unnecessary
ABSTRACT
To document the causes, mode of presentation and establish the morbidity and mortality of tetanus in childhood age group. Descriptive study. Department of Paediatric Surgery, Nishtar Medical College and Hospital, Multan. It was carried out for three years from January 2002 to December 2004. All paediatric patients presenting with tetanus during these three years were inducted in the study. However neonatal cases were excluded from study. All but two cases were admitted through emergency. The remaining two arise in the ward, one being treated for burns and other for long bone fracture in orthopaedic ward. Complete history and clinical findings were noted in a predesigned proforma and a treatment protocol was started. There is four bedded tetanus bay with basic treatment facilities in our ward. However our tetanus bay lacks ventilators and cardiopulmonary monitors. Complications arising 4 during the treatment were noted. A total of 96 patients were included in the study. There were 66 male and 30 female children. The youngest child was of 15 months of age and elder one of 12 years of age. Almost 2/3[rd] [65.62%] of 5 patients belonged to rural background. Wounds supposedly responsible for tetanus were present in 60 patients. Chronic SOM in 10 patients and idiopathic in 26 patients. Abdominal rigidity was present in 90.62% and lock jaw in 85% cases. Lock fit time was <2 days in 25[26.4%] cases. Seven patients required tarcheostomy. Respiratory and anemic complications were amongst the common. Overall mortality was 21.95%. Children make almost1/3[rd] of the total cases of tetanus. The disease pattern remains the same. However survival is better than adults and neonatal tetanus