Frequency of infantile pyloric stenosis and ocular abnormalities in Turner's syndrome in Bahawalpur city

Turner's syndrome is one of the most common of all chromosomal abnormalities. Pyloric stenosis is the most common pediatric surgical disorder of infancy that requires surgery for associated emesis.4 Ocular abnormalities are common in Turner's syndrome, but are under estimated and often neglected. The study that was hospital - based observational, was conducted from September 1[st], 2005 to August 31, 2011 in the Al-Noor Hospital Yazman [Bahawalpur] in collaboration with ophthalmology department, Bahawal Victoria Hospital Bahawalpur. Laboratory investigations including electrolytes, blood gas analysis, and osmolality were done in pathology department, Quaid-e-Azam Medical College Bahawalpur. Frequency of pyloric stenosis in infants from 0 - 6 months 64.95% and infants 6 - 12 months is 35.09%, the ocular abnormalities amblyopia 19%, strabismus 23%, phoria only 43.5%, epicanthus 10%, hypertelorism 3%, ptosis 1%, nystagmus 0.5%. There is a high frequency of ocular abnormalities and pyloric stenosis in infants with karyotype XO. Timely diagnosis may save from devastating effects of ocular complications leading to blindness and life threatening alkalosis due to pyloric stenosis in infants below one year of age

Knowledge, attitude and practice - regarding EPI among parents attending paediatric outdoor, Nishtar hospital Multan

To assess the Knowledge, Attitude and Practice regarding Expanded Programme of Immunization [EPI] among parents attending Paediatric Department, Nishtar Hospital, Multan. Cross sectional descriptive study. This study was carried out among the parents attending Paediatric medicine and Paediatric Surgery out patients Departments, Nishtar Hospital, Multan for the treatment of their children during the month of September 2011. Two hundred and sixty parents were selected by convenient sampling and surveyed with a self reported questionnaire comprising of questions regarding knowledge attitude and practice about EPI. Data gathered was analyzed and results were obtained to make table. Among 260 parents interviewed, 40 [15.4%] were male and 220 [84.6%] were female. 258 [99.2%] had knowledge about EPI and only 2 [0.8%] had not. According to 242 [93.1%] EPI was beneficial, while 18 [6.9%] thought it to be non beneficial. Children of 197 [75%] parents were fully immunized. 40 [15.38%] were partially immunized and 25 [9.62%] were not immunized at all. 158 [60.8%] parents were educated and 102 [39.2%] were illiterate. Out of 260 parents 214 [82.3%] reported fever/ rash/ itching as a result of vaccination, while 46 [17.7%] were not. Majority of the parents belong to middle class i.e. 137 [52.7%] while 46 [17.7%] rich class and 77 [29.6%] of the lower class. We conclude that there is a significant difference in the knowledge of the parents. Majority of the parents had awareness about EPI. Middle class has greater attitude to get immunized their children as compared to poor and rich class. Our study demonstrates the importance of education in the practice of vaccination of the children

Etiology and outcome of thrombocytopenia in sick neonates

Enlist risk factors of thrombocytopenia in sick neonates and determine the outcome in sick neonates with thrombocytopenia in relation to risks factors. This descriptive case series study was conducted for a period of 6 months from 2007 to August 2007 in Pediatric Unit-TI, Nishtar Hospital, Multan. A total of 100 sick neonates with thrombocytopenia were included in the study. Neonates with different risks factors were evaluated which were of neonatal infection, birth asphyxia, prematurity, RDS, NEC and others [jaundice, infant of diabetic mother]. Among 100 cases with thrombocytopenia [platelets count< 150,000/ul] were included in this study, Out of 100 cases 35 [35%] were found to have early onset thrombocytopenia and 65cases [65%] were found to have late onset thrombocytopenia. Out of 100 cases, 43 cases were neonatal infection with thrombocytopenia, 23 [67.4%] were with early onset sepsis and 20 cases [46.5%] were late onset sepsis. Out of 100 cases, 17 [17%] cases were of birth asphyxia,11 cases were prematurity with birth weight <2.5 kg and gestational age <37 weeks, 6 cases of prematurity [54.5%] were with hemorrhage skin manifestation and remaining were occult mild thrombocytopenia, 20 cases of RDS with thrombocytopenia, 5 cases with NEC with thrombocytopenia and 4 cases with mild thrombocytopenia. The common manifestations in thrombocytopenic cases were petechiae and bruises followed by gastrointestinal hemorrhages. The leading causes of thrombocytopenia in sick neonates are infections, asphyxia, prematurity, RDS, NEC. Apart from the platelets counts the bleeding manifestations also depend upon underlying ailments

Comparison of retrobulbar anesthesia and intracameral anesthesia using preservative free bupivacine hydrochloride 0.5 % in phacoemulsification with posterior chamber intraocular lens implantation

To compare the retrobulbar anesthesia and intracameral anesthesia using preservative-free bupivacaine hydrochloride 0.5% in terms of effectiveness, complications and comfort to the patient during phacoemulsification with posterior chamber intraocular lens implantation. This was a hospital based comparative study of two methods of anesthesia, conducted at LRBT Free Eye and Cancer Hospital, Lahore from January to July 2000. Study included 200 patients with uncomplicated age-related cataract, equally divided in two groups on simple random basis. Group A [100 patients] received the retrobulbar anesthesia and Group B [100 patients] received the intracameral anesthesia with bupivacaine hydrochloride 0.5% for phacoemulsification with posterior chamber intraocular lens implantation. Outcome measures like pain, visual acuity, intraocular pressure and anterior chamber reaction were compared. On day 1, 79% of the patients in group A and 82% patients in group B had unaided visual acuity ranging between 6/6-6/18. On day 7, this was 88% in group A and 89% group B. On day 1, 99% in group A and 98% in group B had <1+ cells in the anterior chamber while on day 7 this increased up to 100%. On day 1, 97% in group A and 98% group B had intraocular pressure less than 20 mmHg. On day 7, it increased up to 100% in both groups. 97% patients in group A and 96% patients in group B had painless surgery. Results were analysed using computer software SPSS version 10.0. Results showed no significant statistical difference between two groups in terms of pain, visual acuity, intraocular pressure, anterior chamber reaction and patient comfort. In the hands of expert surgeons and in selected patients, intracameral anesthesia with preservative-free bupivacaine hydrochloride 0.5% is a safe and effective technique of ocular anesthesia for phacoemulsification with posterior chamber intraocular lens implantation