Role of intravenous iron hydroxide sucrose in the management of iron deficiency anemia in pregnancy

Objective: To determine the safety and efficacy of iron hydroxide sucrose complex infusion in the correction of iron deficiency anemia in second and third trimester of pregnancy

Study Design: A prospective observational study

Place and duration: One year, from 1[st] April 2013 to 30[th] March 2014 at department of Gynae and Obstetrics, Cantonment General Hospital Rawalpindi Pakistan

Methodology: A total of 122 women were studied. Thirty two [26.2%] women had mild anemia, 74 women [59.0%] had moderate anemia and 16 [13.1%] women had severe anemia .The mean age of women was 26 yrs [range 18-38 years] and the mean gestational age at the of diagnosis was 26.79 +/- 4.2 weeks [range 17-32 week]. Six women went into preterm labor and delivered at 33-34 weeks. Four women didn't receive the required iron dosage schedule because of loss of follow up. Time taken to achieve the required hemoglobin level was 4.5 +/- 1.3 week

Result: Mean hemoglobin was 6-9 gm/dl on which intravenous iron sucrose 600- 1000 mg was given parenterally in patients with pregnancy related anemia and the average hemoglobin rise was 2.2 gm/dl

Conclusion: Iron sucrose complex was effective and safe treatment of pregnancy associated iron deficiency anemia

Frequency of acute bacterial meningitis in children presenting clinically as first simple febrile seizures under 6 years of age

Objective: To determine the frequency of acute bacterial meningitis in children [6 months to 6 years] presenting with first episode of simple febrile seizures

Study Design: A Cross sectional study

Place and Duration: Rawal Institute of Health Sciences Islamabad over a period of one and half year from 1st August 2013 to 31st January 2015

Methodology: One hundred and fifty patients of both genders aged from 6 months to 6 years were included who presented with fever and first episode of seizures but with no definite signs of meningitis. Sample of cerebrospinal fluid was sent to laboratory for cerebrospinal fluid [CSF] routine examination including cell count, protein and glucose content of CSF

Results: There were 103 males and 47 females with mean +/- SD of age 2.31 +/- 1.65 years. The mean +/- SD of protein, glucose and TLC were 53.89 +/- 51. Mg/dl, 69.27 +/- 22.51 mg/dl and 4.91 +/- 4.37/mm3 respectively. Among 150 children, 14 children had an acute bacterial meningitis

Conclusion: Meningitis have been documented in significant number of children with fever and seizures. Children less than six years of age is a major group at risk and Lumbar Puncture [LP] should be performed in every case of febrile seizures in this age group

Age, pattern of presentation and risk factor for enteric fever in 2-15 years old children

Objective: To find out age related common pattern of presentation of enteric fever in children

Study design: A cross sectional study

Place and duration: Pediatric Department Al-Nafees Medical College and Hospital Islamabad over a period of 6 months from 1[st] July 2013- 31[st] Dec 2013

Methodology: Patients irrespective of gender between 2-15 years, with fever of more than 4 days without focus were included in the study. Complete blood count and typhi dot test performed on all patients for diagnosis. Performa containing bio data, symptoms and clinical signs was filled of patients with positive serology

Results: A total of 60 patients studied and among them 92 %[ n= 55] and 90% [n=54] patient presented with poor appetite and fever respectively. Among them 90% [n=54] had white coated tongue and 66% [n=40] had low grade fever [100[degree]F -102[degree]F] while 33% [n=20] were having high grade fever [?102[degree]F]. Hepatomegaly was found in 73% [n=44] patients while Hepatosplenomegaly in 20% [n=12] patients. Leukocytosis was more common in children than leucopenia

Conclusion: Common symptom of enteric fever is poor appetite and low grade fever, and white coated tongue with hepatomegaly is common findings on clinical examination. Thrombocytopenia is consistent laboratory finding

Reasons for failure of exclusive breastfeeding in children less than six months of age

Human milk is the natural food for full term infants and is the most appropriate milk for the human infants. The objective of the study was to determine the frequency of common reasons of failure of exclusive breastfeeding in children less than six months of age. It was a crosssectional study conducted at Rawal institute of health sciences [RIHS] from March to October 2013. Three hundred and ten infant-mother pairs not receiving exclusive breastfeeding were included. The mean infants' age was 99.2 +/- 57.9 days and 185 [59.7%] were male infants. The average number of children in the family was 2.74 +/- 1.86, the mean monthly income was 16542 +/- 12761 rupees; 169 [54.5%] infants belonged to urban areas, 122 [39.3%] babies were low birth weight; 241 [77.7%] infants were born in the hospital; majority, i.e., 135 [43.5%] mothers were illiterate majority, i.e., 282 [91%] mothers were housewives. In only 2 [0.6%] babies the breast feeding was started within <1 hour after birth. Among the study group 246 [79.4%] were partially breastfed and 64 [20.6%] were completely bottle-fed, 90 [29%] were already started on complementary feeding and the mean age of starting complementary feeding was 4.54 +/- 0.783 months. The commonest reason of failure of exclusive breastfeeding was insufficient milk production in 289 [93.2%], working mother in 13 [4.2%] mothers, illness of baby in 2 [0.65%], illness of mother in 6 [1.9%] cases. The commonest reason of failure of exclusive breastfeeding was insufficient milk production in over 90% cases and was followed by working mother, illness of baby and illness of mother in the remaining