Pattern and outcome of admissions to neonatal unit of tertiary care hospital Nawabshah

To determine the number, disease pattern and outcome of admitted patients in neonatal unit of tertiary care hospital Nawabshah. Retrospective, descriptive study. This study was conducted at NICU pediatrics ward People's Medical College Hospital, People's University of Medical and Health Sciences for women, Nawabshah, Sindh from 1[st] January 2010 to 31[st] December 2010. Data was retrieved from file record regarding sex, gestational age [term and preterm], reason for admission and outcome [discharge, expired]. 2584 neonates were admitted during study period, among them 1776 [68.73%] were males and 808 [31.27%] were females, majority of patient 1657 [64.12%] were admitted during first 24 hours with the clinical diagnosis of birth asphyxia, 489 [15.85%] having neonatal sepsis, 312 [10.67%] because of prematurity, 117 [8.63%] admissions were due to neonatal jaundice and 19 [0.73%] having various conditions like hydrocephalus associated with meningomyelocele, prune belly syndrome, down syndrome, Icthyosis, HDN and TORCH infection. Birth asphysia, Pre-maturity, neonatal infection, neonatal jaundice were the main causes of neonatal admissions. Regular antenatal visits and timely referral to tertiary care hospitals will hopefully result in better outcome

Frequency of seropositivity of Hepatits C in Thalasemia major patients

Thalassemia is inherited as an autosomal recessive disorder. Children suffering from beta thalassemia major, due to various genetic defects, have deficient synthesis of beta globin chain of Hemoglobin. They need frequent blood transfusions, so they are at increased risk of transfusion transmitted infections especially HCV. To evaluate frequency of hepatitis C in thalassemia major patients. Prospective descriptive study. This study was conducted at the Thalassemia care Center Nawabshah, Sindh from 1[st] January 2011 to 31[st] December 2011. Children ages from 3 months to 14 years with Beta thalassemia major were included. Patients were scrutinized for anti HCV antibodies by third generation ELISA technique. Total of 126 patients of thalassemia major studied in this series, 59 [46.82%] were males and 67 [53.17%] females. Out of these 18 [14.26%] were hepatitis C positive. HCV infection is an important cause of viral infection among thalassemic children with a prevalence of 14.26% in our study population

Lactoferrin levels in mother's milk

This study was aimed to see the significance of Lactoferrin in human breast milk among lactating mothers of healthy and sick babies. This study was conducted at pathology and paediatrics departments of Peoples University of Medical and Health Sciences Nawabshan, Shaheed Benazirabad between Jan 2011 to Dec 2011. Cross sectional study. Lactoferin levels in breast milk of 356 mothers of healthy babies were estimated and similarly lactoferrin levels in breast milk of 318 lactating mothers of sick babies were estimated and these results were analyzed. The mean lectoferrin level in breast milk of 356 lactating mothers of healthy babies was 9.37 mg/ml and the mean lactoferrin level in breast milk of 318 mothers nursing sick babies was 3.73 mg/ml. There is decrease in lactoferrin levels of lactating mothers of sick babies in their mature milk, which could account for the susceptibility of their babies to infection

Frequency of low birth weight in primigravida reported PUMHS hospital Nawabshah

To determine the frequency of low birth weight in primigravida reported at PMC Hospital Nawabshah. Descriptive case series study. Departments of Gynaecology and Obstetrics and paeds medicine, at Peoples University of Medical and Health Sciences Nawabshah, from Jan 2011 to the Dec 2011. this study consisted of 319 pregnant women at 16 weeks of gestational age with singleton pregnancy reporting to the Antenatal Clinic, Obstetrics and Gynaecology Department were selected. Weight was measured by using weight machine throughout antenatal checkups. Weight and height was measured by same person rechecked. Their pregnancies were followed to assess the low birth weight. The neonatologist evaluated the babies. All primigravida women in the reproductive age group between >18 to <35 years with singleton pregnancy, normal fetal lie, and Height 5 feet or more were included. Exclusion criteria were patients associated with uterine anomalies [like uterine polyp, uterine septae, submucosal fibroid], smoking, short stature, other medical disorder like diabetes, hypertension, thyroid disorders, epilepsy and asthma. Results were prepared with help of tables and graphs. Data was analyzed through SPSS software. 319 patients included in this study. There was a wide variation in age was noted. The youngest patient was 18 years old and the oldest patient was 35 years old. The mean age was 21.21 + 4.22 years and peak age group for presentation of primigravida in our study is 26 to 30 years. clinical asses the fetal weight and observed 42 [13.16%] cases were <3.5kg weight while remaining 277[86.83%] cases were 2.5 to 4 kg weight. In conclusion, we observed in our study that low body weight of primigravida mother is associated with low birth weight babies

Evaluation of the efficacy of Saccharomyces boulardii in children with acute diarrhea

To evaluate the efficacy of the yeast Saccharomyces boulardii [SB] as an antidiarrheal agent in 100 children with acute diarhoreal illness. Analytical observational study. Study was conducted From 1st April 2008 31st August 2008, 200 children 6 months to 12 years of age with acute watery diarrhea with duration of less than 07 days without history of fever or blood in stool or severe malnutrition admitted in Paediatric department PMCH were included in the study group. Evaluation of the results showed reduction in the number of stools and an improvement in their consistency in Saccharomyces boulardii group. After 48h and 96h children treated with Saccharomyces boulardii scored better than controls. It is concluded that in Saccharomyces boulardii group significantly more children recovered and normalized stools than controls without adverse reactions. It is concluded from our study that in infant and small children with acute diarrhea treatment with SB achieves significant reduction in the duration of diarrhea and number of stool even in the early period of SB preparation use. This yeast [SB] can be used as an adjunct to oral rehydration in treating acute diarrhea in children

Mortality among neonates having birth asphyxia at neonatal intensive care unit P.M.C.H.

To see the outcome of birth asphyxia in tertiary care hospital Nawabshah. Retrospective descriptive study. The study was conducted at neonatal intensive care unit [N.I.C.U] Paediatric ward of People's medical college and hospital Nawabshah from 1[st] January 2010 to 31[st] December 2010. Record of patients who were admitted in N.IC.U was used for data collection. Data regarding sex, gestational age [term and preterm], and outcome [discharge, expired] was collected. During study period 1657 neonates were admitted, of these 1371. Were term infants 286 were preterm infants, there were 1144 males, and 513 Females. Out of 1657, 466 [22%] patients expired, out of these 466 expired patients, 391 [83.9%] were term babies and 75 [16.09%] were preterm. All the patients admitted in our NICU, birth asphyxia was the leading cause of Neonatal admission and mortality. And birth asphyxia stage 3 HIE had the highest mortality

Determnation of total globulin in serum by direct method in patients with hepatitis-B and C

To establish a convenient and practicable direct method for estimation of globulin in the serum. The study was carried out in the Department of Biochemistry. Basic Medical Sciences Institute, Jinnah Postgraduate Medical Center Karachi. This was a prospective study performed during the period of January 2008 to June 2008. A single, convenient and stable method has been developed for the direct spectrophotometric analysis of globulin in the serum, which has good conformance to Beer's law and is also reproducible. The analysis is based on Hopkins-Cole reaction, which is a direct method for the estimation of total globulin in the serum. The method is based on the estimation of serum tryptophan levels. There is a direct correlation between total serum globulin and total serum tryptophan levels. Globulin differs markedly from albumin in the proportion of their tryptophan content. The glyoxylic acid condenses with tryptophan residues present in globulin and produces purple colour in the presence of copper in an acidic medium. The intensity of colour produced is directly proportional to the concentration of globulin present. The method has no statistical difference with indirect method, both in normal and diseased subjects. In patients when only globulin estimation is required, it can be done by direct method, which is convenient, fast, simple and is not laborious and saves time by avoiding double test performance

Outcome of acute bronchiolitis in hospitalized children at NMC hospital Nawabshah

To estimate the outcome of acute bronchiolitis in children admitted to hospital with respiratory distress. This Prospective study was conducted in the Pediatric department, Peoples Medical College Hospital Nawabshah from October 2008 to March 2009. All the children below two years admitted in hospital with bronchiolitis were included in the study. Presenting signs and symptoms were followed up thrice daily to determine the progress of disease. Ninety cases of bronchiolitis were admitted during the study period. Majority, 70 [78%] of them were below six months. The disease was frequently associated with similar problem in other siblings 42 [47%], noncompliance to exclusive breast feeding 50 [55%] and family history of asthma 37 [41%]. Patchy opacities were found in chest x-ray in 9 [10%] cases. On the other hand, signs such as chest indrawing and hepatomegaly were improved quicker in patients that were given parenteral antibiotic. 5 [5.5%] of the study cases died. Overall outcome of bronchiolitis is good. General supportive therapy is highly effective in bronchiolitis

Maternal risk factors affecting birth weight of babies at PMC hospital Nawabshah

To determine the maternal risk factors responsible for Low Birth Weight babies. This Prospective, descriptive study was carried out in the Pediatric Department, Peoples Medical College Hospital Nawabshah from January 2008 to December 2008. For the assessment of maternal risk factors leading to delivery of low birth weight babies, data from 300 women were assessed at the time of admission of their babies in pediatric department. Maternal age, height, problems during pregnancy like anemia, antepartum haemmorhge, hypertension during pregnancy and urinary tract infection were obtained from self-report at interviewed. Average of the birth weight was 2.80 +/- 0.65 kg. 50% newborns were weight less than 2.5 kg. Maternal factors mostly affect the birth weight were poor antenatal visits, deliveries in young age [<20 years], problems during pregnancy specially anemia, hypertension and urinary tract infection and decreased birth interval between two pregnancies. In order to reduce the low birth weight burden perinatal care should be improved like proper antenatal visits, good nutrition of mother during pregnancy, increase the birth space and early recognition of problems during pregnancy and their proper management

Antibiotic pattern in enteric fever, in children

To determine the treatment response with first line and second line antibiotics in blood culture positive children of enteric fever, in our setup. This prospective cross-sectional, observational study was carried out from January 2007 to December 2007 in the Departments of Paediatrics and Pathology, Peoples Medical College Nawabshah. A total of 65 blood culture positive patients for salmonella typhi having ages ranged between 2-12 years including 40 [61.5%] male and 25 [38.5%] female patients. Five treatment regithens were designed as first and second line antibiotics, and patients were started on any one of first line regimen haphazardly. Response to treatment was observed by improvement in symptoms and settling of fever, if temperature did not settle in 6 days of commencing treatment, the antibiotic was changed. Patient who responded to initial treatment were treated with the same drug for 14 days. Fever with abdominal pain was the commonest clinical presentation. Typhidot was positive in 60 [92.3%] patients and widal test in 49 [75.4%] patients. 48 [73.8%] patients improved with the first line treatment and 17 [26.2%] patients who were not responding to first line treatment were switched to other treatment. The present study highlights the importance of second line antibiotics in treating enteric fever, as there is increasing resistance to first line antibiotics in children so it is better to start with second line antibiotics as culture positive in enteric fever is not more than 50%