audit of morbidity and mortality of hospitalised neonates in neonatal care unit of a tertiary care hospital in abbottabad

Background: Perinatal as well as neonatal mortality record in our country is one of the highest in the world. Home deliveries, lack of adequate facilities, poverty and lack of education are some of the important known causes. The present study was planned to determine neonatal mortality in Hazara. Methods: Hospital records of neonatal admissions at Ayub Teaching Hospital [ATH] Abbottabad from 1 st January 2007–31st December 2007 were analysed retrospectively. Percent neonatal mortality was calculated from the record, along with the causes of neonatal mortality. Results: A total of 1705 neonates were admitted in the study period at the department of neonatology Ayub Teaching Hospital Abbottabad. Out of 1, 705 neonates 947 [56%] were males while 857 [44%] were females with a male to female ratio of 1.24:1. Majority, 1, 411 out of 1, 705 [83%], of the neonates was admitted during the 1st week of their life, mean age 6 days. Asphyxia, sepsis and prematurity were the three most common causes of neonatal admissions contributing 27%, 26% and 24% respectively. Overall mortality was 11%. Conclusion: Neonatal mortality is an important contributing factor to infant mortality in Hazara Division. Majority of patients was admitted in the first week of life which indicates that good antenatal and natal care can reduce the mortality and morbidity of our neonates. Improvement in the prenatal, natal and nursery care as a whole can reduce the neonatal mortality in preterm as well as full term neonates. Keywords: Neonatal Mortality, Morbidity, Asphyxia

Rchildhood strokes: epidemiology, clinical features and risk factors

Background: Stroke constitutes a significant health problem in paediatric population. The impact of childhood stroke can easily be realised in terms of economic, social and psychological burden related to disability of the affected children. The objective of study was to outline the epidemiology and clinical features of stroke in a cohort of Pakistani children and also ascertain the causes and potential risk factors in these patients. Methods: The study was conducted at the Department of Paediatrics, Ayub Teaching Hospital from January 2008 to October 2010. It was a cross sectional study. A total of 46 patients were included in the study who presented with cerebrovascular disease and were assessed clinically using general physical and systemic examination. The salient epidemiological, clinical, neuro-imaging and laboratory data was retrieved in designed protocol. Results: Out of a total of 46 patients, 50% were from either gender. Mean age of presentation was 39 months. Limb weakness was the commonest presenting feature being present in 37 [80.43%] patients. Infectious disorders was the most prevalent risk factor present in 31 [67.39%] patients followed by microcytic hypochromic anaemia in 28 [60.86%] patients. Conclusion: A Childhood stroke is a disorder with long term morbidity. Identification of risk factors is important in preventing the disorder by guiding appropriate interventions.Keywords: Childhood stroke, Infectious disorders, risk factors