Case fatality rate and etiological factors of malnutrition in children less than 5 years of age

To calculate the case fatality rate and etiological factors of malnutrition in children less than 05 years of age presenting to a tertiary care hospital. A descriptive cross sectional study was conducted in the admitted patients in the Department of Pediatrics and Neonatology, Lady Reading Hospital, Peshawar, during one and an half year period from January 2009 to June 2010. A total of 976 patients [aged from 0 day to 60 months, both male and female] with various diseases were recorded as samples. The frequency of different types and grades of malnutrition and important etiological factors for malnutrition in these children were scrutinized. Case fatality was also calculated among the malnourished children. Out of 976, 294 [30.12%] were malnourished. Among these, majority [n= 195, 66.3%] were in the age range of 13-60 months, with mean age of 36.20 + 3.82 months. Many [n=157, 53.4%] were male children with male to female ratio of 1.14:1. majority 139 [44.28%] had grade I malnutrition. The commonest medical etiological factors was chronic or recurrent diarrhea n=205, 69.72%], anemia [n=139, 47.27%], respiratory tract infections [n=115, 39.11%]; and inadequate feeding history [n=111, 37.75%]. Most prominent social etiological factors were poverty [n=236, 80.27%], uneducated mothers [n=223, 75.85%], more than 2 children under 5 years in family [n=136, 46.25%] cases. Case fatality [mortality] rate was 40 [13.6%]. Majority of malnourished children are males between the age of 13 to 60 months. Mass media campaign should be started for the eradication of malnutrition in children

Risk factors for preterm births in lady reading hospital, Peshawar

To determine the various maternal and neonatal risk factors of preterm birth. A descriptive case series was conducted from 1st January 2010 to 3Jxt December 2010. In this study all cases, a live Pre term birth [PTB] [29 - <37 weeks] by vaginal delivery or caesarean section and their mothers were included. A total of 205 [04.04%] neonates were identified as premature neonates. Majority [29.3%] were in the age range of 2 days with mean age of 1.5073 +/- 1.2627 days. Out of 205, 51.7% were male and 48.3% were female. Maternal age of 21-35 years was recorded in majority 79.51% with mean age of 28.10 +/- 5.8982 years. Majority of mothers [96.1%] were illiterate, 76.6% belonged to rural areas, 76.1% belonged to poor class, 35.1% were multiparas. A history of Premature rupture of membrane [PROM] was found in 61% cases, history of burning micturition 4.9%, physical injuries 0.5%, polyhydramnios 14.14%, previous low birth weight baby 41.5%, threaten abortion 27.8%, antepartum hemorrhage 36.1%, previous perinatal loss 31.2%, previous premature birth 30.2%, maternal pyrexia 14.1%, previous twins 6.3% and placenta previa 4.4%. Frequency of prematurity was 04.04%. Among the various risk factors maternal age, illiteracy, rural residence, poverty, joint family setup, history of PROM, previous low birth weight babies, history of antepartum hemorrhage, multiparity, previous perinatal loss, previous premature babies, threaten abortion, were the prominent risk factors found in majority of cases

Frequency of various neonatal complications in infants born to diabetic mothers - a hospital base study

To determine the frequency of various complications occurring in infants of diabetic mothers. This descriptive study was conducted in the neonatal unit and obstetric units of Lady Reading Hospital, Peshawar from January to July 2010. Forty two consecutive cases of infants of diabetic mothers were enrolled in the study. Maternal history especially obstetric history and history regarding diabetes mellitus was obtained and complete neonatal examination was performed. The physical findings and anthropometric measurements were recorded into a printed Proforma. Serum glucose, serum calcium, hematocrit and echocardiography was performed in all enrolled babies. Out of 42 diabetic mothers, gestation diabetes was seen in 71.4% while pre-conceptional diabetes was seen in 28.5%. The male Infants of Diabetic Mothers in this study were 69%. Infant of Diabetic Mothers delivered by C-section were 45%. Macrosomia 40.4% [n=42] was found to be the most common complication followed by hypoglycaemia 23.8%. The mortality rate in our study was 4.7% [n=2]. This study confirms the high occurrence of complications in newborns, born to diabetic mothers. Large for gestational age and hypoglycemia were the commonest complications

Prevalence of rhesus type and abo incompatibility in jaundiced neonates

To determine the prevalence of Rh and ABO incompatibility in jaundiced neonates. This hospital based descriptive study was conducted in Pediatrics Unit, Lady Reading Hospital Peshawar. A total of 200 neonates with clinically diagnosed jaundice were included in the study. Out of 200 neonates 70% were male and 30%female. Majority of neonates 99.5% age was ranged from 0-10 days while only 0.5% neonate was 13 days. Out of 200 neonates, the frequency of ABO-incompatibility and Rh-incompatibility in jaundiced neonates in this study was 22.5% and 12.5% respectively. Out of the remaining 65.5% cases physiological jaundice was diagnosed in 40.5% neonates, prematurity in 15% neonates and G6PD in 9.5% neonates. Among 22.5% cases of ABO incompatibility there were 16.5% males and 6% females. Majority 15% presented on 1[st] day of life, followed by 3% on 2[nd] and 3[rd] day of life respectively, 1% on 4[th] day, 0.5% on 5[th] day of life. Out of 200 neonates presented with jaundice, prevalence of ABO-incompatibility was found to be 22.5% followed by Rh-incompatibility 12.5%

comparative study of measles complications in vaccinated versus non-vaccinated children

To find out and compare the frequency of measles complications among vaccinated and nonvaccinated children. This hospital based cross-sectional comparative study was conducted in Pediatrics Unit, PGMI/LRH, Peshawar All the patients were divided into two groups. In group 1, 100 vaccinated and in group 2, 100 non-vaccinated children were included. Both groups were compared for complications of measles. In group 1, majority [51%] cases were in age range of 1-3 years and in group 2, majority [59%] cases were also in age range of 1-3 years. In group 1, male were 55 [55%] and 45 [45%] were female. In group 2, male were 53 [53%] and 47 [47%] female. In group 1, complications include bronchopneumonia in 49 [49%], upper respiratory tract infection in 39 [39%], diarrhea in 32 [32%], oral ulcer in 31 [31%], dehydration in 15 [15%], otitis media in 10 [10%], malnutrition in 2 [2%], encephalitis in only 1 [1%] case. In group 2, bronchopneumonia in 51 [51%], diarrhea in 50 [50%], upper respiratory tract infection in 24 [24%], oral ulcer in 22 [22%], dehydration in 20 [20%], otitis media in 17 [17%], malnutrition in 12 [12%], and encephalitis in 11 [11%] patients. Nearly 50% of children in both groups were less than 5 years of age. This indicates that many children of this age group are still unprotected. Overall difference in vaccinated and unvaccinated groups was statistically significant [P value = 0.001]

Glucose-6-phosphate dehydrogenase deficiency in jaundiced neonates

To detect the frequency of G-6-PD deficiency in 200 consecutive neonates admitted with jaundice to the neonatal unit, LRH, Peshawar. This descriptive study was conducted in the Neonatal Unit of Lady Reading Hospital, Peshawar from March 2009 to August 2009. Two hundred consecutive cases of neonatal jaundice of both sexes, admitted to the Neonatal Unit, Lady Reading Hospital, Peshawar were enrolled in the study. Detailed history and clinical examination was recorded. All the neonates were subjected to be estimation of Serum Bilirubin levels [Total, Direct and Indirect], G-6-PD detection via Hemolysate Decolorization time test and blood groups of both the mother and the baby besides looking at the peripheral smears and other relevant investigations. Out of the 200 icteric neonates, 145 [72.5%] were males while 55 [27.5%] were females. Thirty two [16%] babies were found to be G-6-PD deficient. No specific precipitating factor for haemolysis was found. Majority of the patients 188 [94%] presented with neonatal jaundice in the first week of life, while the age of presentation amongst the G-6-PD deficient neonates was between 2nd to 4th day of life. An Indirect serum bilirubin level of 9 to 40mg% was found in these G-6-PD deficient neonates. G-6-PD deficiency is a common cause of neonatal jaundice and has more preponderance for male sex. Babies suffering from G-6-PD deficiency present with jaundice relatively earlier than the other causes of neonatal jaundice like ABO/Rh incompatibility and idiopathic causes

Eperisone compared to Physiotherapy on muscular tone of stroke patiehts: a prospective randomized open study

To compare the effects of Eperisone, a muscle relaxant and physiotherapy on the muscular tone after stroke. Twenty six [26] patients were included from age 15 to 75 years in an open prospective randomized study of threeweeks duration and were treated with either Eperisone [n=13] or were advised to undergo formal physiotherapy [n=13] at the department of physiotherapy PIMS. The end point was observed in the form of change in the grade of tone. Safety and tolerability was assessed on the basis of adverse events. Eperisone was found to be comparable to physiotherapy in reducing the spasticity in patients after stroke and improved the grade of tone from 3-2 [n=2], 4-3 [n=2], 2-1[n=2]. The safety analysis showed persistent vomiting [n=1], fatigue [n=1], headache and dry mouth [n=2], epigastric pain [n=1] and slight changes in blood pressure under Eperisone which was generally well tolerated by the patients. Eperisone was found to be comparable to physiotherapy in its effects to improve spasticity in patients after stroke [p>0.05] [JPMA 55:202;2005]

Management of oesophageal foreign bodies

To evaluate management of oesophageal foreign bodies. Cross sectional analytic study. Department of otorhinolaryngology and head and neck surgery Bahawal Victoria Hospital Bahawalpur, from May 2003 to December 2004. A total of 186 patients with history of foreign body ingestion were admitted and included in the study. A structured questionnaire was designed to record the informations. X-ray neck and rigid oesophagoscopy was carried out to diagnose and remove foreign bodies. Out of 186 patients, 155[83.33%] were from paediatric age group and 31[16.66%] above 12 years of age. Coin was the commonest foreign body [77.41%]. Dysphagia was the commonest symptom [96.77%]. X-rays were conclusive in 181[97.3%] patients. Rigid oesophagoscopy was carried out in all cases and removal of foreign body was successful in 95.69% cases, and complication rate was very low