Iron deficiency Anemia: a risk factor for Febrile seizures in children

Objective: To find out the association between iron deficiency anemia and febrile seizures in children

Study Design: Analytical: case-control study

Place and Duration of Study: The study was conducted at Paediatrics department, Pak Emirates Military Hospital Rawalpindi, from May 2013 till Oct 2013

Material and Methods: Two Hundred patients were selected through non probability consecutive sampling, one hundred in each group i.e. patients with febrile seizures and patients without febrile seizures. The blood sample of cases and controls were taken at the time of admission and was sent for assessment of hemoglobin [Hb], serum ferritin level, mean corpuscular hemoglobin concentration [MCHC] and mean corpuscular volume [MCV]. The samples were analyzed for iron deficiency anemia and compared in both groups [patients with febrile seizures and those without febrile seizures]

Results: In the febrile seizures group 58 [58 percent] were anemic with a hemoglobin level less than 10gm/dL and 59 [59 percent] had a low plasma ferritin of less than 10ng/dL. In the control group 39 [39 percent] were anemic with a hemoglobin level less than 10gm/dL and 26 [26 percent] had a plasma ferritin of less than 10ng/dL. The frequency of anemia with low MCV, MCHC and serum ferritin was more in the febrile seizure group 38 percent as compared to 20 percent in controls [p-value = 0.002]

Conclusion: The children with febrile seizures have lower hemoglobin, MCV, MCHC and serum ferritin level as compared to the control groups suggesting that iron deficiency anemia has a positive role in the pathogenesis of febrile seizures

Serum triglycerides and cholesterol status in patients with and without gestational diabetes mellitus

Objective: To measure the differences of lipids including total cholesterol and triglycerides among subjects with or without GDM

Study Design: Cross sectional comparative study

Place and duration of study: This study was carried out between Dec 2010 to Jun 2012 at the department of gynecology and obstetrics Pakistan Naval Ship [PNS] Shifa and department of pathology, PNS Rahat

Material and Methods: Pregnant women who presented in outpatient department of gynaecology between 24-34 weeks of gestation were randomly selected, and were requested to undergo 100 Gm oral glucose tolerance test for diagnosis of gestational diabetes mellitus [GDM]. A total of 93 pregnant women were included in the study

Afterwards they were divided in 2 groups on basis of presence and absence of GDM. Later all the patients were analyzed for total cholesterol and triglycerides. Results of triglycerides and total cholesterol were compared among subjects with or without GDM

Results: The differences for serum triglycerides and total cholesterol were not found to be significant among subject with or without gestational diabetes mellitus, where 0.05 was considered significant

Conclusion: There was no difference between serum triglyceride and total cholesterol levels among subjects with or without gestational diabetes mellitus

Croup not always a benign condition

A 16 month old male baby was brought to emergency department with stridor and low grade fever. He was diagnosed with croup. Tracheostomy was done in emergency due to his worsening condition. Tracheostomy ended up with multiple complications. These were addressed promptly and the patient recovered quickly

Diagnosis and outcome of birth asphyxia in resource constrained health care set up

Objective: To determine morbidity and mortality of neonates with low APGAR score in a resource constrained health care set up

Study Design: Prospective descriptive study

Place and Duration of Study: The study was carried out in combined military hospital Attock, from Jan 2013 to Jan 2015

Material and Methods: All term neonates with 37 completed weeks of gestation and APGAR score less than 7 were included in the study. APGAR score was calculated by an attending pediatrician, gynecologist or trained female nurse at 0 and 5 minutes. In Neonatal Intensive Care Unit [NICU] the babies were daily examined by pediatrician. Outcome was documented in term of morbidity i.e. fits and mortality i.e. death of babies

Results: Total number of neonates included in the study were 85 of which 55 [65%] were males and 30 [35%] were females. Of the total neonates 65 [76%] were discharged in satisfactory conditions and 20 [24%] expired during stay in the hospital. The mean APGAR score of newborns was 4.98 +/- 0.98 at 5 minutes. During stay in hospital 46 [54%] were diagnosed to have hypoxic ischemic encephalopathy 2 [HIE2], those diagnosed with HIE3 were 5 [6%] and the rest 14 [16%] with HIE1

Conclusion: Low APGAR score is an important cause of admission to NICU. Low APGAR score was found associated with increased risk of fits in neonates and one of the most important cause of mortality in our set up

Antioxidant, antibacterial and antiproliferative activities of pumpkin (cucurbit) peel and puree extracts - an in vitro study

Natural resources right from the beginning of the human civilization has paved the way to human being to combat different challenges. The big challenge was to safe the human being from diseases and shortage of food. Plants helped the man in both areas very efficiently. No doubt when plants are used as food actually we are also taking lot of compounds of medicinal values in an excellent combination which naturally reduce the risk of diseases. Extraction and purification of several medicinally important compounds also gave the way to develop pharmaceutical industry in addition to its own therapeutic effects against different lethal diseases. Pumpkin is one of the several medicinal important vegetables used in different way on the behalf of its admirable power to combat different diseases. Antioxidant and biological studies showed very important results. A good coherence was found among extraction yield [10.52 to 18.45%], total phenolics [1.13 to 6.78 mg GAE/l00g], total flavonoids [0.23 to 0.72mg CE/l00g] and antioxidant potential [-70%]. Antibacterial assays of peel and puree extracts advocated good potential to stop the growth and division of pathogenic bacteria. Further biological activity study was carried out using MDBK cancer cell line. The growth inhibitory effect on cancer cell line using MTT assay showed methanol extracts of peel and puree both remained efficient to inhibit growth [-35%] and cell division of cancer cells. Our results showed that extracts of pumpkin puree and its waste, peel, may be utilize to prepare functional food against pathogenic born diseases and most active compounds may also be extracted, concentrated and converted into tablets or suspension form for therapeutic purposes

Novel indium-111 labeled gastrin peptide analogues [MG-CL1-4]: synthesis and quality control

Radiolabeled neuropeptides are widely investigated to diagnose and therapy of tumors. These peptides get internalization after binding with particular receptors at the surface of cells and finally move to lysosome. Internalization into tumor cells helps in mapping the infected site. Minigastrin peptide analogues [MG-CL1-4] were synthesised and labeled with 111-In radioisotope under different sets of conditions for imaging CCk-2 receptor bearing tumors. Different parameters such as temperature [80-100[degree]C], pH [4-12], incubation time [5-30 minutes] and dilution effect were investigated to get the maximum labeling yield and stability. The results indicated that MG-CL1-4 is successfully labeled with indium-111 at pH 4.5 with heating at 98[degree]C for 15 minute. At these conditions i.e. heating, pH and incubation minimum oxidized and maximum labeling yield, more than 94 %, was obtained. The labeling stability was studied by incubating the radiolabeled complex for predefined time points in PBSA and blood serum. Results show that more than 90% radiolabeled MG-CL1-4 remained intact

Epidural analgesia in labour; maternal and fetal outcome

To evaluate the effects of epidural analgesia on the pain relief and maternal and fetal outcome. Comparative and analytical study. In Military Hospital Rawalpindi from Oct 1998 to Oct 1999. 100 full term healthy primigravida admitted for induction of labour. Fifty patients were given epidural analgesia and 50 served as control to whom no analgesia was given. Outcome measures observed were duration of labour, mode of delivery; Apgar score of the newborn; untoward reaction and intra-partum complications. The data analysis revealed that epidural analgesia significantly prolonged labour time and was associated with increased instrumental delivery rate. Significant reduction in intra-partum fetal complications was seen, while C-section rate was not effected by epidural analgesia. Apgar scores were higher in analgesia group as compared to control. Although accused of prolonging labour time, it's benefits in terms of great maternal satisfaction and reduced intra-partum complications still makes it an option for labouring patients

Eclampsia

To evaluate incidence, morbidity and mortality associated with eclampsia. A prospective study. The study which was carried out at PAF Hospital Rafiqui, Shorkot spanned over a period of 2% years from Jun 2002-Dec 2004. The study comprises of 55 eclamptic cases diagnosed out of 3391 consecutive deliveries, carried out in our hospital. The incidence of eclampsia, in this study, was found to be 1.62%. Out of 55 cases 38[69.1%] patients were primigravida. Forty three [78.2%] of the patients were between the ages of 21 to 30 years. In 50[90.9%] patients gestational age was less than 35 weeks. Thirty seven [67.3%] cases had antepartum eclampsia. Forty four [80%] patients received diazepam while the remaining 11[20%] received magnesium sulphate [MgSO4] as anticonvulsant. Commonest mode of delivery was spontaneous vaginal delivery [31 cases, 56.4%] followed by lower caesarean section [21 cases, 38.2%]. Fetal loss was seen in 12[20.7%] cases. T wo patients died of eclampsia, maternal mortality rate being 3.6%. Eclampsia is a life threatening complication of pregnancy. However an improvement in antenatal care, upgrading the neonatal facilities and early delivery by cesarean section can improve the perinatal outcome