Efficacy of lactobacillus acidophilus dds-1, lactobacillus bulgaricus, bifidobacterium infantis in the prevention of necrotizing enterocolitis in preterm neonates

Objectives: To compare the efficacy of combination of lactobacillus acidophilus DDS-1, lactobacillus bulgaricus, bifidobacterium infantis in the prevention of necrotizing enterocolitis in preterm neonates with placebo. Study Design: Randomized controlled trial. Duration of Study: May 2012 to October 2012. Setting: Department of Pediatric Medicine, Allied Hospital, Faisalabad

Methodology: Over 6 months, 220 preterm neonates meeting the inclusion criteria were selected and were assigned randomly to two groups after parental informed consent was obtained. The neonates in study group received probiotic with breast milk or preterm formula milk and neonates in control group received breast milk or preterm formula milk. Both groups were observed for the development of clinical evidence of NEC. The Data was statistically analyzed; Chi square test and Fischer's exact test was applied to compare both groups for presence of NEC

Results: The number of days required to reach full enteral feeding [study group 8.73 +/- 3.87 days vs control group 10.72 +/- 5.43 days; p-value 0.002] and duration of hospital stay was [study group 11.35 +/- 6.74 vs control group 15.35 +/- 10.29; p-value 0.001] significantly low in the probiotic-exposed group compared with the control. The incidence of NEC [study group 10.0% vs control group 22.72%; p-value 0.011] was significantly low in the probiotic-exposed group when compared with non-exposed group

Conclusion: Alteration of microbial florae following oral supplementation of probiotics along with human milk have beneficial effects in reducing the incidence of NEC especially in pre-term neonates

Recurrent meningitis - a case report

Recurrent meningitis is an uncommon but serious condition. A 13 year old girl presented with recurrent meningitis, was admitted and investigated for the cause of meningitis. She had frontal bone fracture due to trauma 5 years back. We present a pediatric patient with recurrent meningitis without CSF rhinorrea or otorrhea

Poland syndrome: a case report

Poland Syndrome is a rare birth anomaly commonly found in males characterized by partial or complete absence of pectoralis major muscle on one side of the body [mostly right side], along with some other associated anomalies like asymmetry of upper limb, hypo-plastic nipple and syndactyly of the effected side. A 4-month old male baby presented with complaint of fever and respiratory distress, was admitted and treated as case of bronchopneumonia. The patient was ultimately diagnosed as a case of Poland syndrome

Bilateral developmental dysplasia of hip joints [DDH]

This case report describes a two year old child with bilateral developmental dysplasia [DDH] of the hip joint, presented with waddling gate and lordotic posture. Treatment with open reduction led to recovery from symptoms

Comparison of serum zinc levels between healthy and malnourished children

To compare serum zinc levels of healthy and malnourished children. Prospective study. Department of Pediatrics and Dermatology Allied/DHQ Hospital Punjab Medical College Faisalabad between July 2006 to September 2006. Serum zinc levels of 150 children between the ages of 2 months to 14 years of either sex were studied, out of which 75 hospitalized children were suffering from malnutrition while 75 healthy children were taken as control from the outdoor. Both groups were further divided into three age groups 2 months to 4 years, 5-10 years and 11-14 years. Verbal consent was taken from all the parents. All the details of children were enrolled on a specific proforma designed for the study. No ethical issue was involved. Malnourished children were classified and sub-grouped according to modified Gomez classification. Serum zinc levels were measured at HiTech Laboratory, Agriculture University, Faisalabad by Atomic Absorption Spectrophotometry, the most widely used and reliable method. The mean serum zinc level of 75 healthy children was found to be 99.97 micro g/dl [Standard Error +/- 10.2] while mean serum zinc level of 75 malnourished children was 51.2 micro g/dl [ +/- 1.14]. The children suffering from 1st, 2nd and 3rd degree malnutrition were 22, 27 and 26 in number with a mean level of 56.36 micro g/dl [ +/- 2.26], 51.56 micro g/dl [ +/- 1.89] and 46.46 micro g/dl [ +/- 1.36] respectively. Statistical analysis of data was done by calculating P-value with analysis of variance of serum zinc level for degree of malnutrition, age and sex. It showed that serum zinc level of malnourished children is significantly low [P-value = 0.001]. There is a significant difference of serum zinc levels between healthy and malnourished children especially in children with diarrhea and respiratory tract infection. This signifies a proper replacement of zinc as part of management of malnutrition and also during disease process

Cutaneous vascular anomalies pattern in neonates and infants

To analyze the patterns of cutaneous vascular anomalies in neonates and infants. To identify the complications arising in various vascular lesions. A descriptive hospital based observational study. Dermatology and pediatric department of DHQ and Allied Hospital PMC, Faisalabad From 1 Feb 2005 to 31 January 2006. 72 consecutive newborns and infants of either sex having any vascular anomaly on cutaneous areas were included in the study. The information regarding size, site, type of lesions, sex of patients, with family history and any complication were recorded on a proforma prepared for this study. Out of 72 infants 25 were male [35%] and 47[65%] were females. Family history was present in 12 cases [17%]. The commonly involved sites were head and neck 45 [62.5%], trunk 18[25%] and upper limb 9[12.5%]. In 59 children [82%] it was single and in 13[18%] the lesions were multiple. The complications observed were ulceration in 13[18%], infection in 8[11%], haemorrhage in 3[4%] and visual impairment in 4[5%], while 56[78%] had no complications

Frequently associated problems of cerebral palsy

To identify the frequently associated problems of cerebral palsy in our setup. Descriptive case series. Department of Pediatrics, Allied Hospital Faisalabad during the period of 2005-2006, Two hundred children from 1 to 12 years of age of either sex who were diagnosed as cerebral palsy on the basis of history and clinical examination were included and associated problems were identified. Out of 200 cases of CP, the most commonly identified problem was nutritional disorder and growth failure followed by mental retardation, constipation, seizures, contractures, aspiration pneumonia, urinary tract infection, oromotor dysfunctions, visual abnormalities, dental anomalies, hearing abnormalities, scoliosis and behaviour disturbances in that order

Clinical presentations of coeliac disease: a prospective study

A prospective study was conducted on 41 children between 2-16 years of age suffering from coeliac disease who attended the department of paediatrics Allied Hospital. Faisalabad. The major presenting symptoms were chronic diarrhoea, abdominal distention, short stature and failure to thrive. The ESPGAN criteria was followed and the diagnosis was clinched on the histological findings of the biopsy taken from proximal jejunum. 81 percent of the patients presented between 2-10 years of age [mean age of diagnosis 7.26 years]. Consanguinity was present in 18 patients [43.9 percent] but the family history was present only in 3 [7.3 percent]. All the children under study had severe malnutrition. 70 percent had chronic diarrhoea, distended abdomen and failure to thrive. Some patients had anorexia, irritability, foul smelling greasy stools and short stature. Abdominal pain and vomiting was reported in few cases. Majority of the children presented with anaemia. Oedema and clubbing of fingers and delayed bone age was a feature in some children. Few patients had signs of vitamin deficiencies. All the children suffering from coeliac disease were advised gluten free diet

Children affected with diphtheria; a retrospective study

To review the clinical features, complications and mode of death in children suffering from diphtheria in an outbreak. DESIGN: Retrospective study. SETTING: A small area of Faisalabad, [Allied Hospital Faisalabad]. PERIOD: 7 months, [April to October 1997]. 21 cases of Diphtheria between the age of 8 months to 10 years [13 male and 8 female] Out of these, 18 were unvaccinated and 3 were partially vaccinated. Antitoxin was given to 15 of them. No one died of those who were partially vaccinated. The complications involved cardiovascular system which manifested in the form of tachycardia. CCF and arrhythmias. Neurological complications included paralysis or paresis of palatopharyngeal muscles, diaphragm, squint, quadriplegia and autonomic disturbances. The respiratory complications included croup with hoarseness, neck swelling, white greyish membrane over pharyngeal and tonsillar regions. Tracheostomy was done in 15 patients. One patient had oliguria/ anuria. CONCLUSIONS: [1] Reinforcement in immunization programme. [2] Updating the knowledge of general and family practitioners through seminars and lectures. [3] Motivation of general public through media. [4] Adequate provision of antitoxin at economical rates in the Local market are recommended