Psittacosis: rare respiratory problem in children

Psittacosis is a rare disease particularly in children with usual presentation of respiratory and constitutional symptoms. The cases may remain undiagnosed or diagnosis may be delayed because of lack of awareness among the paediatricians and physicians. Early diagnosis is very important as this is potentially curable and preventable disease. An interesting case of psittacosis is being reported here, which has been treated successfully with azithromycin

Vitamin D levels in children with growing pains

To estimate the serum levels of vitamin D in children with growing pains and determine the relationship between serum vitamin D levels, parathormone and routine biochemical markers. Cross-sectional study. Department of Paediatrics, Liaquat National Hospital, Karachi, from October 2008 to September 2009. Hundred children, aged 5-12 years presenting in Paediatric Outpatient Department of Liaquat National Hospital, Karachi, with limb pains, fulfilling the diagnostic criteria of growing pains, were included. Children with any systemic illness, organic cause of pain, rheumatologic disorders and signs of rickets were excluded from the study. Children were investigated for serum total calcium, inorganic phosphorus, alkaline phosphatase, vitamine D3 [25-hydroxecholecalciferol] and parathromone levels. On the basis of serum vitamin D3 level, patients were divided into 3 groups; group 1 with normal level of vitamin D3 [> 75 nmol/L], group 2 with vitamin D insufficiency [level between 50-75 nmol/L], and group 3 with vitamin D deficiency [level <50 nmol/L]. Significance of group proportions was determined using chi-square test with significance at p< 0.05. The mean age of the participants was 8.05 years with the majority [59%] being females. Only 6% had normal vitamin D levels. Over 95% of the children with vitamin D insufficiency had normal alkaline phosphatase and parathormone levels. Hypovitaminosis D may have a role in pathogenesis of growing pains. All children with unexplained limb pains without identifiable organic pathology should be tested for vitamin D status, and treated, if necessary. Routine biochemical markers alone are not sufficient to detect all cases of hypovitaminosis D

childhood asthma being treated appropriately

It was a descriptive study done in the department of Pediatrics, Jinnah Medical College hospital Karachi from October 2005 to September 2006. All children between 1 to12 years, diagnosed as asthma [on clinical grounds] were enrolled. Information regarding asthma severity and use of regular drugs in past 6 months was recorded in a pre-de-signed Proforma. Disease severity was classified according to GINA guidelines as intermittent and persistent. Persistent group was further subdivided into mild, moderate and severe categories. Treatment in accordance to GINA guidelines was considered as a standard therapy. A total of 150 patients were enrolled, out of which only 4.7% were of intermittent category while 95.3% were of persistent type [39.3% mild persistent, 44% moderate persistent and 12% severe persistent]. Patient in intermittent group were not on any regular long term medication. Seventy six percent of the patients with persistent asthma were on quick relief drugs, while controller drugs were being used in19.3% cases only. Limited use of inhalers with or with out spacer device and nebulizers was observed [14% cases]. Inappropriate drugs according to GINA guidelines, e.g.: antihistamines, cough and cold preparations, mast cell stabilizers and drugs from hakims and homeopaths, were not included in the study results. Majority of the patients was not found to be treated according to GINA guidelines. Controller medications were being under prescribed while in its place reliever medication was being inappropriately advised on regular basis