Analgesic effect of sucrose observed during heel prick in healthy neonates

To assess pain response during heel prick and compare analgesic effect of oral sucrose with placebo in response to pain associated with this procedure in healthy neonates. Randamoized controlled study Neonatal Unit Combined Military Hospital Multan from December 2006 to June 2007. This study was conducted on 60 healthy full term neonates with postnatal age 1-7 days who were assessed for pain response after heel prick. They were randomized into two groups. Newborns in group A were given 2ml 25% sucrose solution and group B neonates received 2ml sterile water as placebo 2 minutes before heel prick procedure. Pain was assessed by Premature Infant Pain Profile [PIPP] score and total duration of first cry. Increase in heart rate and decrease in oxygen saturation along with behavioral changes were observed in significant number of newborns who received placebo [group B]. While significant reduction in PIPP score and total duration of first cry was noted in neonates who were given oral sucrose [group A.] Perception of pain decreased significantly with oral sucrose. Sucrose can be used as safe and effective analgesic for minor procedure related pain

Etiology of short stature in children

To determine the causes of short stature in children with special emphasis on growth hormone deficiency. Case series. Department of Paediatrics, Military Hospital, Rawalpindi and Combined Military Hospital, Multan from September 2004 to January 2007. Two hundred and fourteen children [140 boys and 74 girls], ranging from 02 to 15 years presenting with short stature were studied. Height and weight were plotted on appropriate growth charts and centiles determined. Relevant hematological and biochemical investigations including thyroid profile were done. Bone age was determined in all cases. Growth hormone axis was investigated after excluding other causes. Karyotyping was done in selected cases. Data was analyzed by SPSS 10.0 by descriptive statistics. Mean values were compared using t-test. In this study, the five most common etiological factors in order of frequency were Constitutional Growth Delay [CGD], Familial Short Stature [FSS], malnutrition, coeliac disease and Growth Hormone Deficiency [GHD]. In 37.4% of patients, the study revealed normal variants of growth - CGD, FSS or combination of both, 46.7% cases had non-endocrinological and 15.9% had endocrinological etiology. CGD [22.1%] in males and FSS [27%] in females were the most common etiology. GHD was found in 6.1% children and it comprised 38.2% of all endocrinological causes. Children with height falling below 0.4[th] centile were more likely to have a pathological short stature [79.2%] compared to 39.3% whose height was below 3rd centile but above 0.4[th] centile [p<0.05]. CGD and FSS are most common causes of short stature in boys and girls respectively, whereas, GHD is a relatively uncommon etiology