Seroprevalence of measles antibodies in school going children in Pakistan

To determine the Seroprevalence of measles IgG antibodies in school going children [age 4 to7.5 years] and assess the need for second dose of vaccination. Study type, settings and duration: National study in randomly selected primary school children for a duration of 12 months. Subjects and Methods: A national representative sample of 6000 school going children between 5-7 years of age was taken out. As 500 children were already studied an year before in Islamabad, therefore, 2500 children from Punjab, 2000 from Sindh and 500 each from Khyber Pakhtonkhaw and Balochistan making a total of 6000 children. These children were selected from major cities of Pakistan that included Peshawar, Lahore, Multan, Faisalabad, Karachi, Hyderabad, and Quetta. Consent was taken from the parents and principals of the schools for collection of blood samples. About 5 ml of whole blood was taken from which serum was separated and stored for testing. Measles antibody titres [serum IgG antibodies] were measured by enzyme-linked Immunosorbant assay [ELISA]. Antibodies concentration<200 m IU was considered negative [non-protective]; those having levels between 200-300 m IU were labeled as border line and>300 m IU as positive [protective]. For the purpose of analysis, ages of the children were divided into three groups

Frequency of osteoporosis in patients with cirrhosis due to hepatitis B and hepatitis C: a study of 100 cases

Osteoporosis is the disease of bone that affected King David of Israel 3000 years ago. This condition is no long considered to be due to aging alone and is increasingly recognized as a major health concern and accounts for about 1.5 million fractures annually in United States. Objective of this study was to see the frequency of osteoporosis in patients with cirrhosis due to Hepatitis B and C, and any correlation between the Bone Mineral Density [BMD] and duration and stage of the liver disease. The study was conducted in the Department of Gastroenterology, Postgraduate Medical Institute, Hayatabad Medical Complex, Peshawar, from January 2008 to December 2008. All patients from the OPD or Ward fulfilling the criteria and consenting were included. Physical examination, with special emphasis on any signs of chronic liver disease was performed. Full blood count, platelet count, prothrombin time and INR, liver function tests including serum albumin, and renal function tests were done on all patients. Viral serology was checked for those patients who were either newly diagnosed as cirrhotic or were cirrhotic but not screened for viral markers. Abdominal sonogram was recorded on all patients. The child's score was calculated for each patient using the clinical and lab parameters. The BMD was calculated for all patients using computer based ultrasound probe. Calcaneum was used for evaluation of BMD. The information collected was entered on structured data collection sheets and was analysed using SPSS version 11. Osteoporosis was found in 26% of subject and osteopenia in 42%, while 32% had BMD in the normal range. The mean T score was -1.483 [ +/- 1.29]. The mean duration of liver disease was 3.77 [ +/- 1.56] year. Majority of the patients [81%] were in Child's Class C, followed by Class B and A [16% and 3% respectively]. Fifty-nine percent of the patients were males with a mean age of 37.65 years, while 41% were females with mean age of 37.76 years. Osteoporosis is a common finding in patients with cirrhosis due to Hepatitis B and C. Osteoporosis is more frequent in patients with long duration of liver disease but there is no significant correlation between the aetiology or severity of liver disease and osteoporosis

Osteomyelitis and pyogenic arthritis in patients with sicke cell disease: the Bahrain experience

Identify the most common aetiologic agent of osteomyelitis and pyogenic arthritis in children with a sickle cell haemoglobinopathy. Setting: Paediatrics Department, Salmaniya Medical Centre, State of Bahrain. Subject and Design: Chart review of all patients under the age of 14 years discharged with a diagnosis of sickle cell disorder and osteomyelitis or pyogenic arthritis between January 1988 through December 1993. Method: Diagnosis was based on a positive culture of blood, pus or tissue / joint aspirate in the presence of clinical, radiological and or operative findings suggestive of osteomyelitis or pyogenic arthritis. Seven children with a sickle cell disorder and eight episodes of osteomyelitis and or pyogenic arthritis were identified in a review of 6 years experience. Salmonella species was isolated from the blood, pus or tissue / joint fluid aspirate culture on 7 of the 8 episodes. Salmonella species is the most common cause of osteomyelitis and pyogenic arthritis in children with sickle cell haemoglobinopathy in Bahrain

Relapsing pancreatitis in association with familial hyperlipidemia and hyperparathyroidism

Relapsing pancreatitis associated with familial hyperlipidaemia or primary hyperthyroidism is very rarely seen in children. Ocurrence of these disorders together, in a child with relapsing pancreatitis has not been reported before. We describe a ten year-old boy who presented with two attacks of pancreatitis. Metabolic studies and family screening revealed familial hyperlipidaemia and primary hyperthyroidism. The possibility of these disorders as the underlying predisposing factors should be borne in mind when a child presents with relapsing pancreatitis

Acute pyogenic meningitis in childhood: a 17-year experience in Bahrain

The aetiologic, epidemiologic and clinical aspects of 452 cases of acute pyogenic meningitis in children treated over a 17-year period, from January 1970 through December 1986, were reviewed. An aetiologic agent was identified in 237 cases [52.4%]. H influenzae b was the commonest organism isolated in the culture-positive cases. Ninety per cent [90%] of influenzal, 66% of pneumococcal and 42% of meningococcal meningitis cases were under 2 years of age. About 60% of influenzal and pneumococcal meningitis cases occurred during October through February. A male: female ratio of 2:1 in pneumococcal meningitis was consistently seen throughout the entire period of study. Gross neurological handicaps in 15% of H influenzae b and 14% pneumococcal meningitis were noted. Thirty per cent [30%] of the culture-proven and 59% of the culture-negative cases had received prior antibiotic treatment. Twenty-eight per cent [28%] of the cases presented with seizures and 85% of these were aged 1 year or less. Overall mortality was 9% with a marked reduction in mortality in culture-proven meningitis during the last 7 years of the study. Ampicillin-resistant H influenzae b was isolated from 3 cases, 2 of whom died

G Syndrome: a case report

A case is reported who had many features of G syndrome plus some additional findings, high arched palate, partial rotation of the gut and localised eventration of the diaphragm, none of which have been reported so far in this syndrome

Mucoviscidosis [cystic fibrosis of the pancreas] in Bahrain, Arabian Gulf

We report on 8 proved and 2 probable cases of mucoviscidosis diagnosed in Salmaniya Medical Centre over a period of 62 months. Six of the ten cases were anaemic, 4 were hypoproteinaemic and 2 had anasarca. In all instances there was history of siblings dying in early infancy from pulmonary and gastrointestinal problems. The two probable cases, on whom sweat chloride tests could not be carried out because of non-availability of the test kit at the time, were siblings of our proved cases