Prevention of diarrhea; the role of health education

To identify the role of health education in reducing diarrheal diseases in children by improving awareness among mothers regarding, washing hands with soap and water, safe feeding practices i.e. avoiding feeding left over food, use of boiled water and keeping surrounding clean. It is a quasi experimental study. Children Hospital Complex [CDDU-CHC] From March to August 2005 A total of [n= 400] mothers were randomly selected and health education was imparted during their stay in ward, Oral Rehydration Therapy [ORT] corner and Out Patient Department [OFD] visits through lectures, posters, charts, practical demonstrations and individual counseling. After this intervention, the mothers who had completed at least four follow up visits at 6 months, were studied again as at the base line on various aspects and data was analyzed in terms of percentages and frequencies. At 6 months the environmental sanitation and personal hygiene of the mothers were improved. There was marked improvement in hand washing practices, avoidance of feeding leftovers and use of boiled water. There was overall reduction in the incidence of diarrhea. Heath education is an effective tool in bringing about a positive behavior modification in mothers and thus reducing incidence of diarrhea

Awareness of malnutrition and diarrheal diseases among mothers in multan region

To assess the knowledge, attitude and practices of mothers about malnutrition and diarrheal diseases; perceptions about signs and symptoms of dehydration; preparation and use of ORS; breast feeding and weaning practices. A cross -sectional descriptive study. The study was carried out in [CDDU-CHC] Control of Diarrheal Disease Unit, Children Hospital Complex, Multan, over a period of six months [March-Aug 2005]. A total of 400 mothers, with children of age group 2 months-5 years, were randomly selected and knowledge, attitude, behavior and practices regarding malnutrition and diarrheal diseases were determined on a pre-coded questionnaire. The data was analysed using SPSS-10 software. The baseline knowledge of the mothers about malnutrition, diarrheal diseases, breast feeding, weaning practices and hand washing was not adequate, probably because of low literacy rate. Considering high prevalence of malnutrition and diarrheal diseases and the relative lack of knowledge, it is imperative that a public health intervention program be initiated in the communities. This must include the education of caretakers as well as health workers

Management practices of childhood diarrhea

To elicit management practices of childhood diarrhea in this region. A cross-sectional survey. This study was carried out in CDDU-CHC [Control of Diarrheal Disease Unit Children Hospital Complex] Multan, over a period of nine months [March-Nov 2005]. Five hundred and twenty patients [age group 2 months-5 years] presenting with diarrhea and dehydration at CDDU-CHC Multan, were randomly selected. Management practices; use of medicines and intravenous fluids, preparation and use of ORS and other home made rehydration solutions, feeding practices during diarrheal attack were determined. Interviewing each mother, a pre-designed questionnaire was filled. Most of the families belonged to a poor socio-economic class; only 18.3% mothers could read and write. Mean duration of diarrheal attack was 4.1 days. Most of the mothers [95%] used allopathic medicine but only 49% from qualified doctors. Mothers [78%] knew about ORT [Oral Rehydration Therapy], but preparation and use of ORS and home available solutions was not appropriate in most of the cases. A large number of mothers withheld semisolid foods during diarrheal attack. ORT and adequate feeding during and after diarrhea are keys to the successful management of diarrhea. With regard to the management practices, there is a great need to improve awareness among mothers and caretakers about continuation of breast-feeding and/or semisolids during diarrheal attack, hand washing practices, preparation and use of ORS and avoiding antidiarrheal drugs

Various presentations of typhoid fever in children

To study various presentations of typhoid fever in children. As certain laboratory investigations are required to make the definite diagnosis of typhoid fever, it is very important to see the clinical spectrum of the disease, so to start appropriate treatment while waiting for laboratory investigations. Descriptive study of inpatients involving 60 subjects suffering from typhoid fever. The study was conducted over 18 month's period [September 2002 to February 2004] at Children's Hospital Complex Multan. A total of 60 admitted patients [Age group 6 months-14 years] with biologically and/or serologically diagnosed typhoid fever cases were included in the study. There were 42 [70%] male and 18 [30%] female patients. Out of 60 patients 4 [6.7%] were below 2 years of age and 5 [8.3%] above 10 years. In addition to the typical manifestations like fever [100%], headache [55%], anorexia [70%], diarrhea [30%], constipation [5%], vomiting [35%], abdominal pain [15%], abdominal distension [10%], bleeding per rectum [5%], bronchitis [10%], lobar pneumonia [3.3%], jaundice [5%], epistaxis [5%], meningeal irritation [15%], fits [5%], encephalopathy [6.7%], cerebellar ataxia [1.7%] and choriform symptomatology, so a presumptive clinical diagnosis may be made to start early treatment

Protein-energy malnutrition: a descriptive study to evaluate risk factors in children under five years of age

To see the risk factors responsible for malnutrition in children less than five years of age in the region of Multan. A descriptive observational study. This study was conducted in the department of paediatrics, Children Hospital Complex Multan from November 2002 to October 2003. A total of 80 malnourished patients [34 males and 46 female], with 3[rd] degree malnutrition according to modified Gomez classification were included in the study. Welcome's classification was also used to assess the type of malnutrition. The age of the patients ranged from 1 month to 5 years with mean age of 21.7 months. A questionnaire comprising 25 different aspects of malnutrition was designed. Data was collected and analyzed. Out of these 80 patients, marasmus was the most frequent type of malnutrition found, followed by marasmic kwashiorkor and then kwashiorkor. Malnutrition was more frequent during first 2 years of life and number of malnourished patients decreased as the age increased. The significant risk factors predisoposing to malnutrition were illiteracy, lack of breast feeding, poverty, inadequate weaning, use of diluted milk, bottle feeding practices, vaccination failure, large family size, recurrent infections history of measles and tuberculosis. Though poverty and household income play a direct role in the development of malnutrition but illiteracy and lack of knowledge about breast feeding and weaning practices, poor awareness about immunization and family planning are the also the main contributory factors