Serum zinc level in children presenting with febrile seizures

To determine the frequency of low serum zinc level in children presenting with febrile seizures at The Children's Hospital and the Institute of Child Health [CH/ICH] Multan. This is an observational cross sectional study conducted at the Department of Pediatric Medicine, The Children's Hospital and the Institute of Child Health, Multan from September 2010 to March 2011. Children [6 months to 6 years of age] presenting with febrile seizures who satisfied inclusion and exclusion criteria were enrolled for the study. Cause of fever was determined after detailed history, physical examination and relevant investigations. Four milliliters centrifuged blood sample was preserved in acid washed test tube. Separated serum was used to measure serum zinc level by employing Randox kit on auto-analyzer in all cases. The outcome variable [serum zinc level] was recorded on a predesigned proforma. Out of 100 enrolled children, there were 66 [66%] male with male to female ratio of 1:0.52. Mean age of the children was 23.97 +/- 14.45 months. Upper respiratory tract infection was the most frequent cause of fever apparent in 24 children [24%] followed by tonsillitis 17 [17%], pneumonia 16 [16%], urinary tract infection 16 [16%], otitis media 15 [15%], and bronchiolitis 12 [12%]. Frequency of low serum zinc level was 26% in children with febrile seizures. Zinc deficiency could be a potential risk factor for febrile seizure in children

Significance of bone marrow biopsy in diagnosis of pediatric diseases; one year experience at a single pediatric hematology/oncology center

Despite the recent advances in the field of hematology in the form of molecular studies and immunophenotyphing, morphological study of bone marrow remains a corner stone in the diagnosis of pediatric hematological diseases. It is also helpful in the diagnosis of many non-hematological diseases. This study is unique in a sense that bone marrow biopsy procedure and morphology reporting were done by a pediatrician trained in clinical hematology. To describe the indications of bone marrow biopsy and frequency of pediatric hematological and non-hematological diseases on morphological basis. This study was conducted at the Pediatric Hematology/Oncology Department, The Children Hospital and the Institute of Child Health Multan from January 2010 to December 2010. This study was conducted on children whether admitted in hematology / oncology ward or referred from various departments of this hospital. A Performa was filled for each patient including detailed history, clinical examination, base line investigation reports and provisional diagnosis. All bone marrow biopsies were performed from posterior iliac spines according to standard protocol for this procedure. Biopsy samples were stained with Leishman stain for morphological study. Bone marrow biopsy report was issued with detailed morphology, morphological diagnosis and suggestion for further investigations e.g. immunophenotyping. Patients age range was 3 months to 13 years with Male: Female = 1:1. Out of 100 bone marrow biopsy reports, disease distribution was acute lymphoblast leukemia [ALL] 30%, acute myeloid leukemia [AML] 7%, lymphoma infiltration 3%, aplastic anemia 18%, idiopathic thrombocytopenic purpra [ITP] 7%, storage disorders 11%, hemolytic anemia 5%, congenital dyserythropoitic anemia [CDA] 2%, red cell aplasia [RCA] 2%, refractory anemia with excessive blasts [RAEB] 2%, nutritional anemia 3%, malaria 3%, reactive changes 5% and normal morphology 2%.In children, acute leukemia is a leading hematological disease on bone marrow morphology followed by aplastic anemia and various non-hematological diseases. Despite availability of advanced diagnostic facilities, bone marrow biopsy is still a useful diagnostic test in many childhood diseases

Incidence of "stress syndrome" or type A personality in medical students

1. To assess the frequency of type A personality in medical students. 2. To compare different personality types of medical students from 1st to final year. A cross sectional study. This study was conducted at the Department of Community Medicine, SMC, DUHS, Karachi from 15th, May to 25th, November 2010. A sample size of 140 students was drawn by using systemic random sampling; every 22nd student from each year was selected according to the roll numbers from first year to final year in Sindh, Dow Medical College and Karachi. Data was collected through a structured questionnaire. Three personalities [Type A, Type AB, Type B] Personality Types: Type B Scores 0-35 Personality Types: Type AB Scores 36-45 Personality Types: Type A Scores 46-80. Out of 140 students, 42 were males, 69 were females. The results showed Type A personality was 82.9%, Type AB 16.4%, TYPE B was 0.7%. Students having type A personality in first year were 92.85%, in second year 100%, in third year 46.4%, in fourth year 85.7%, in final 89.2%. Type A personality in males were found to be 92.30% as compared to females 83.67%. Students who took their tasks very seriously 45%, easily got Irritated 51.4%, Restless during studies 32.1%, dissatisfied with task performed 49.3%, Work conscious 43.6%. On the basis of these results majority of the medical students fall in the category of type A personality, surprisingly 100% students of 2nd year fall in type A category. The study proved major population of medical students had Type A personality which showed they were tensed, impatience, aggressiveness, time conscious, concerned about their studies, highly competitive, ambitious, vulnerable to stress related diseases

Health problems in children of imprisoned mothers

To describe the health problems faced by children who accompanied their mothers in the prison. An observational cross-sectional study. 30 children who accompanied their mothers in women jail Multan were examined from 1 October 2009 to 30 December 2009. The department of preventive and social pediatrics visited the woman jail Multan fortnightly for regular medical checkup and support to the children who were residing with their mothers in the jail. All the information regarding their ailments was recorded on a pre-designed questioner. 17 children were male and 13 were female. Mostly children were between 1 to 5 years. Anemia and malnutrition was common. Other illnesses like ARI, scabies Diarrhea and asthma were also noted in these children. One child was suffering from Epilepsy. 26 children were fully vaccinated and 4 were partially vaccinated .childrens environmental condition was inadequate. The children who accompany their mothers in the prison have to face multiple medical and social problems like anemia, malnutrition, infections, asthma and Immunization. These disorders can be prevented by providing adequate living conditions, avoiding overcrowding, providing sufficient and balanced diet, sterilized water, proper Immunization and proper hand washing

Bottle feeding in children under two years of age in Multan; a hospital based study

To explore the factors responsible for bottle-feeding practice among mothers of children less than two years of age in Multan region. An observational cross-sectional study. The patients who were admitted in Pediatric ward and/or attending OPD at Children Hospital and The Institute of Child Health Multan from 1 January 2010 to 26 June, 2010. 450 mothers, feeding their children with bottle, were interviewed about their infant feeding practices. A predesigned questioner was used to get detailed information. Bottle feeding was more prevalent in illiterate 98 [48%] and poor education class mothers, lower social class women 109 [45%], Multigravida 159 [54%] and in the mothers between 26 to 30year of age 78 [61%]. More common causes of bottle feeding were complaint of insufficient milk by mothers 89 [41%] and early baby illnesses 42 [39.2%]. In my study major determinants of bottle feeding are related to poverty and lack of education about breast feeding and proper weaning practices

Diagnostic usefulness of anti-tissue transglutaminase in celiac disease: correlation with intestinal mucosal biopsy

To describe the clinical value of Anti-tTG [IgA, IgG] in the diagnostic work-up of celiac disease patients. Children with clinical suspicion of celiac disease, presenting in Gastroenterology and Hepatology out patient department, Children's Hospital and The Institute of Child Health, Multan were recruited. It was a descriptive case series, study was conducted from Jan 2007 to Jan 2009, blood samples for Anti-tTGs [IgG, IgA] and duodenal biopsies for histological analysis were taken. Data was analyzed for descriptive analysis. Sixty patients with symptoms suggestive of celiac disease were submitted for Anti-tTGs [IgG, IgA] and duodenal biopsy, 46 patients had histological changes according to the Marsh criteria and 49 had raised Anti-tTGs. A total of 54 patients who had one or both the tests positive, were considered for final analysis. 41 patients showed histological changes of celiac disease on duodenal biopsy and raised Anti-tTGs, 5 patients with histological changes of celiac disease had Anti-tTGs levels within normal limits. Five patients with raised Anti-tTGs levels had nonspecific inflammatory changes [not consistent with celiac disease] and 3 patients with raised Anti-tTGs levels had normal histology of intestinal mucosa. Anti-tTGs [IgA, IgG] is very valuable screening marker in the diagnostic work-up of celiac disease, specially in selecting the patients for duodenal biopsies

Patterns of feeding in children under eighteen month of age in Multan; a hospital based study

To see the patterns of feeding in children under eighteen months of age in Multan region. An observational cross-sectional study. Two hundred mothers were interviewed about their infant feeding practices who were admitted in Pediatric ward and/or attending OPD at Children Hospital Multan from 1 January 2009 to 26 March, 2009.Information was collected on a predesigned questionnaire. Exclusive breast feeding declines with age. [Only 24% between the ages of 7 to 12 month]. Continued breastfeeding was practiced more by educated mothers [intermediate and above] 21 out of 23. Only 86 babies were taking complementary feeds, it was seen more between 13 to 18 months of age. Homemade complementary foods were used more as compared to commercial foods Lack of maternal awareness and education about feeding practices was responsible for rapid decline in breast feeding. Therefore it is the dire need to educate the mothers about correct feeding practices for the healthy growth of children in society