Clinical spectrum of dengue fever in pediatric age at a tertiary care hospital in Lahore

Objective: to assess frequency of various clinical presentations of dengue fever in pediatric age group at a tertiary care hospital in Lahore

Methods: a cross sectional survey was conducted from Dec 2012 to Sep 2013 in pediatrics department of Jinnah hospital Lahore. 150 patients were enrolled as per inclusion criteria. Clinical features were abstracted on a standardized Performa and investigations were done, including complete blood count, hematocrit, anti-dengue lgM [If fever more than 5 days], NS1 antigen [If fever less than 5 days] by Elisa and ultrasound scan of abdomen to document free fluid in abdominal or thoracic cavity. Data was analyzed using SPSS Version 17

Results: one hundred and fifty patients with mean age of 8.4 years [SD of+/- 2.8 years] were enrolled. 86 patients [57.3%] were males with male to female ratio of 1.3: 1. High grade fever was present in all the 150 patients [100%] and Diarrhea in 21[14 %] patients. Other clinical features included: petechial in 25 [16.3%], epistaxis in 20 [13.3%], hematemesis in 8 [5.3%], hepatomegaly in 33[22%] and splenomegaly in 15 [10%] subjects. The evidence of dengue hemorrhagic fever was seen in 23 patients [15 %], while there was no case of Dengue Shock Syndrome

Conclusion: most of dengue fever cases were from 5 to 10 years of age group. High grade fever was the most common clinical manifestation of dengue fever, followed by hepatomegaly, petechial, diarrhea, epistaxis, splenomegaly and hematemesis. Dengue fever was more common in males as compared to females, and about one in six cases had dengue hemorrhagic fever

Pediatric myelodysplastic syndrome [MDS] - case series at the childrens hospital and the institute of child health, Lahore

A study was planned to determine the pattren of FAB type distribution of myelodysplastric syndrome in childhood haematological malignancies. It was a cross sectional study carried over a twenty-month period in Haematology and Transfusion Medicine Department of Children Hospital and Institute of Child Health. All patients of age suspected of haematological malignancy were included in the study. All patients underwent a complete blood count, reticulocyte count, peripheral blood film from neonate 15 years examination, bone marrow aspiration and trephine biopsy. During a period of 20 months [from Sep 2000 to May 2002] 195 cases of haematological malignancies were diagnosed. Out of these 9 [4.6%] patients were diagnosed as cases of Paediatric MDS. There were 110 cases of acute lymphoplastic leukemia [ALL], 63 cases of acute myeloid leukemia [AML] and 13 cases of chronic myeloid leukemia [CML]. Out of the 9 MDS cases five were of MDS Type III - Refractory Anemia with Excess of Blasts-[RAEB] and four were of MDS Type I Refractory Anemia [RA]. It can be conducted that paediatric MDS represents 4.6% of all childhood haematological malignancies with nearly equal distribution of REAB and RA