Parent reported wheeze in school children of South Punjab, Pakistan

To find the prevalence of wheeze as reported by the parents in school children of Southern Punjab Pakistan. It was a cross sectional, questionnaire based survey of the children aged 3-18 years, in randomly selected primary and secondary schools, from October 2002 to March 2003. The data was analyzed using Statistical Analysis System. Of 6120 questionnaire sent to the parents/guardians, we received 3180 back [52%]. Of the 3180 respondents, 1767[56%] were for boys and 1413[44%] were for girls. The median age was 8.25 years. Around 71% of children were between 4 to 11 years of age. The parents reported wheeze in 222[7%] of their children with a slight predominance in boys 120[4%] than in girls 102[3%]. The wheeze was not reported in 14-18 years age group. Childhood wheeze was reported in children by 7% parents. Most of the time wheeze is not reported or disclosed rather denied. An extensive educational media campaign is required for creating awareness in masses regarding wheeze

Nocturnal asthma in school children of South Punjab, Pakistan

At the present time, the epidemiology of the childhood asthma is of considerable interest. There is an understandable concern that changes in the geographical area, lifestyle, and environment. This study was conducted to find the prevalence of nocturnal asthma, in school children of south Punjab, Pakistan. It was a cross sectional, questionnaire based, descriptive survey of the children aged 3-18 years, in randomly selected primary and secondary schools, from October 2002 to March 2003. The data was analyzed with Statistical Analysis System [SAS]. Of 6120 questionnaire sent to the parents/guardians, we received 3180 back [52%]. Of the 3180 respondents, 1767 [56%] were for boys and 1413 [44%] were for girls. The median age was 8.25 years. Around 71% of children were between 4 to 11 years of age. The parents reported nocturnal asthma in 177 [6%] of their children with an equal prevalence in boys and girls, i.e., [3% each, rounded off to nearest whole number]. Of these 177 children with nocturnal asthma, 99 [56%] were boys and 78 [44%] were girls. Of the 1767 boys and 1413 girls, the nocturnal asthma reported by parents was 6% each [99 and 78 respectively]. The nocturnal asthma was not reported in 14-18 years age group of females. The asthma is taken as a stigma in our society and as such is not reported or disclosed rather denied. An extensive educational media campaign is required for awareness of the masses

Physician diagnosed asthma as reported by the parents in school children of South Punjab, Pakistan

To find the prevalence of doctor diagnosed asthma, as reported by the parents, in school children of South Punjab, Pakistan. It was a cross sectional, questionnaire based, descriptive survey of the children aged 3-18 years, in randomly selected primary and secondary schools, from October 2002 to March 2003. The data then was analyzed by the coauthor with Statistical Analysis System [SAS]. Of 6120 questionnaire sent to the parents/guardians, we received 3180 back [52%]. Of the 3180 respondents, 1767[56%] were for boys and 1413[44%] were for girls. The median age was 8.25 years. Around 71% of children were between 4 to 11 years of age. The parents reported asthma only in 129 [4%] of their children as was told to them by their doctor with almost equal distribution in boys [60] and girls [69] of 2%, respectively. Of these 129 children with doctor diagnosed asthma, 60 [47%] were boys and 69 [53%] were girls. Of the 1767 boys, the doctor diagnosed asthma as reported by parents was 3% [60]. Of the 1413 girls, the doctor diagnosed asthma as reported by parents was 5% [69]. The asthma was not reported in 14-18 years age. The asthma is taken as a stigma in our society and as such is not reported or disclosed rather denied. An extensive educational media campaign is required for awareness of the masses

Exercise induced asthma in school children of south Punjab, Pakistan

To find the prevalence of exercise induced asthma, in school children of South Punjab, Pakistan. It was a cross sectional, questionnaire based, descriptive survey of the children aged 3-18 years, in randomly selected primary and secondary schools, from October 2002 to March 2003. The data then was analyzed by the statistician with Statistical Analysis System [SAS]. Of 6120 questionnaire sent to the parents/guardians, we received 3180 back [52%]. Of the 3180 respondents, 1767[56%] were for boys and 1413[44%] were for girls. The median age was 8.25 years. Around 71% of children were between 4 to 11 years of age. The parents reported exercise induced asthma in 306[10%] of their children with an equal prevalence in boys and girls i.e. [5% each, when figures were rounded off to the nearest whole number]. Of this 306 children with exercise induced asthma, 159 [51%] were boys and 147[49%] were girls. Of the 1767 boys and 1413 girls, the exercise induced asthma reported by parents was 9% in boys and 10% in girls, [159 and 147 respectively]. The exercise induced asthma was not reported in 14-18 years age group of males. The asthma is taken as a stigma in our society and as such is not reported or disclosed rather denied. An extensive educational media campaign is required for awareness of the masses

Right atrial Myxoma - A rare diagnosis in pediatrics

A three and-a-half years old baby girl was presented with intermittent, high grade fever and generalized dull abdominal pain of two months duration. The respiratory difficulty was progressing since fifteen days. Her growth and development was normal prior to her illness. She had taken multiple antibiotics in high dosages without any sustained improvement. On examination, she was pale and dyspnoeic with nasal flaring, intercostal and subcostal recessions. The respiratory rate was 72/min, pulse 160/min, temperature 101oF and blood pressure 110/70 mm of Hg. The jugular venous pressure was raised. The precordium was hyperdynamic with multiple visible pulsations. The apex beat was in fifth intercostal space without any particular character. The first and second heart sounds were normal. There was a pan-systolic murmur, best audible at the tricuspid area. There was bronchial breathing at the left lower chest and diminished breath sounds in the right lower lung. The liver was tender, pulsatile and 12 cm palpable in the right mid clavicular line. The spleen was 10 cm palpable in it's longest axis and tender. Due to prolonged illness as well as non- specific symptoms and signs a provisional diagnosis of congestive cardiac failure due to congenital heart disease or infective endocarditis was made. The hemoglobin was 5.6g%. The total leukocyte count was 15,200/mm3, with 79% neutrophils and 15% lymphocytes. The serum electrolytes and renal parameters were normal. The slide for malarial parasite was negative. Three samples of blood were taken for culture, from different sites and at different times. These were sent to different laboratories, but none of these showed any growth of microorganisms. The chest x-ray revealed increased vascular markings without cardiomegally. The electro-cardiography showed right axis deviation and right ventricular hypertrophy. The ultra-sonography revealed right pleural effusion, ectopic left kidney and a mass in the right atrium adherent to the tricuspid valve. On echocardiography the diagnosis of right atrial myxoma was confirmed. The child was promptly referred for the surgery but the parents refused to undertake surgery

Poliomyelitis as an etiology of acute flaccid paralysis and its epidemiology

According to confirmed total polio cases in the world the incidence in Pakistan has decreased from 20% in 1997 to 6% in 1998. To find out the relative incidence of the poliomyelitis and to assess its epidemiological variables, a prospective open clinical study of acute flaccid paralysis [AFP] was carried out. A total of 44 patients with AFP were admitted to the Paediatric Medicine-II, Nishtar Hospital, Multan, during April 95 to August 96. Thirty of these patients completed the study and their stool samples were sent for the isolation of polio virus. Only 12 of these were positive for polio virus. It was P-1, wild type virus. The 6 of polio virus excretors were completely vaccinated, 3 partially vaccinated and 3 non-vaccinated. As a whole 25 [83%] were vaccinated [13 complete and 12 partial] and 8 [27%] of these had taken polio drops only on National Immunization Days [NIDs]. The cases mostly occurred during early and late summer. The maximum of cases were under 5 years [93%] and half of the total were less than 1.5 years. The majority belonged to male, lower socioeconomic and urban group

Polioimmunizations status and acute flaccid paralysis at Multan

A prospective, cohort, open clinical study was carried out to assess the immunization/ vaccination status of children presenting with acute flaccid paralysis [AFP]. A total of 44 patients with acute flaccid paralysis were admitted to the Pediatric Medicine-Il, Nishtar Hospital, Multan during April 95 to August 96. Thirty of these patients were labelled as "Probable Poliomyelitis" and their stool samples were sent for isolation of polio virus. Polio virus type-I was isolated in 12 patients. Four [33.33 percent] of these were fully vaccinated while three [25 percent] were partially vaccinated; three cases [25 percent] were nonvaccinated and 2 [16.66 percent] bad taken polio drops on the National Immunization Days [NID] for polio eradication. Necessary measures have been suggested to improve the Immunization situation