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Objective: To determine the x-ray chest findings in children aged 02 months to 59 months classified as pneumonia according to IMNCI guidelines. Study Design: Descriptive case series. Place and Duration of Study: This descriptive case series study of six months was carried out in the Department of Pediatric Medicine, Liaquat University Hospital Hyderabad
Material and Methods: The study was conducted on the children who met the inclusion as well as exclusion criteria of the study. All the patients presented with history of cough and/or difficult breathing, on physical examination having [i] fast breathing [respiratory rate >50/min if age 2-11 months, rate >40/min if age 12-59 months] or [ii] lower chest wall in-drawing was admitted in the ward and further evaluate for x-ray chest findings specific for pneumonia by advising chest radiograph
Results: The mean age of the patients was 11.2 +/- 5.6 months with age range of 02-59 months. There were 92 [55.8%] male and 73 [44.2%] female patients. There were 64 [38.8%] patients who had consolidation and 66 [40%] patients had reticular shadowing on chest x-ray
Conclusion: It is concluded from this study that considering/ evaluating x-ray chest findings in children according to IMNCI guidelines was a better approach for diagnosing pneumonia. This would certainly contribute towards evidence based clinical assessment of suspected cases of pneumonia
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Acute diarrhea is the fourth-ranking cause of death in children under the age of 5 years. after neonatal causes, malaria, and acute respiratory infections. Objectives: To determine the role of Saccharomyces boulardii in the treatment of acute diarrhea. Design: Comparative study. Period: Six months, Mar to Aug 2013. Setting: Pediatric Unit II- Liaquat University Hospital Jamshoro/ Hyderabad. Patients and methods: It consisted of 100 patients, of acute diarrhea with age between 3 months to 5 years reported to pediatric unit and fulfilled the inclusion criteria. Cases were given low osmolar ORS, Zinc and Saccharomyces boulardii 250mg twice daily for three days and controls were given low osmolar ORS and Zinc. P-value =0.05 was considered as significant. Results: The results showed that 51 patients were male and 49 patients were female. 27 male patients were in control and 24 were in case group. 23 female patients were in control and 26 were in case group. The overall mean age of study subjects was 26.73+/-12.65 months. Among reported patients most of the patients 84% were reported on 1st day. All reported patients had a complaint of loose motion with 73% also had vomiting. All patients had watery loose motion. The mean duration was 4.20+/-1.70 days with the mean frequency of 9.82+/-6.16 times. Among the patients 96 patients were hospitalized and 97 patients were given I/V fluid. Among reported patients 10 were without dehyderation, 8 had some dehyderation, and 82 had severe dehyderation. 52 had acceptability of probiotics. The results were evaluated according to 1st, 2nd, and 3rd day post intervention. Among 50 patients of case group, 18 patients were compliance. 49 patients had decrease in duration. The same results were observed in the decrease in frequency. Consistency was improved in 39 patients. The duration of hospitalization was reduced in 36 patients. It was observed that improvement in the duration, frequency, and consistency was mostly observed on 2nd day of post intervention. Conclusions: The role of S. boulardii as a good biotherapeutic agent allowing to prevent and /or treat several grastrointestinal diseases. In comparison to probiotic bacteria, the use of probiotic yeast is beneficial when the treatment is combined to antibiotherapy
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To determine the frequency of low mid upper arm circumference [MUAC] of children with acute malnutrition. This study was conducted in the department of paediatrics at Liaquat University Hospital Hyderabad from 01-06-2012 to 30-11-2012. All the children with features of malnutrition, of either gender were recruited and evaluated for their mid upper arm circumference which was measured through plastic measuring tape. During six month study period, total 135 children with acute malnutrition were studied for their mid upper arm circumference [MUAC], of which 95[70%] were males and 40[30%] were females. The mean age +/- SD of overall population was 30.24 +/- 10.57 month while the mean age of male children was 32.88 +/- 11.76 and the female child was 31.62 +/- 10.97 months. Regarding the MUAC, was low in 93[68.9%] children with acute malnutrition. The mean age +/- SD of child with low MUAC was 28.99 +/- 12.52 while the mean +/- age of male and female child with low MUAC was 27.63 +/- 10.73 and 29.85 +/- 11.64 respectively. The mean MUAC in children of acute malnutrition with low MUAC was 8.85 +/- 3.93 while it was 8.66 +/- 3.96 and 8.93 +/- 3.31 in male and female child with low MUAC respectively. The present study suggested that MUAC is appropriate and good tool for identifying severe malnutrition in children
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To evaluate effectiveness of treating previously untreated patients with celiac disease with both a gluten free diet and bisphosphonate in order to significantly increase their BMD's to a greater extent than a gluten free diet alone. The study was conducted in National Institute of Child Health [NICH] Karachi to evaluate the effectiveness of treating previously untreated patients with celiac disease with a gluten free diet and bisphosphonate in terms of increase in bone mineral density in comparison to a gluten free diet alone over a period of three months [January 2013 - March 2013]. The study includes 30 children patients below fifteen years of age either sex. All study subjects were untreated celiac patients diagnosed by clinical presentation, small bowel histology and serologic testing. On day dexa scan was done. Fifteen patients kept on Gluten Free Diet [GFD] and remaining 15 patients kept GFD plus tablet of bisphosphonate. After three months dexa scan was repeated. The patients with other disease of bone or mineral metabolism, as well as subjects taking systemic glucocorticoids or high doses of thyroid hormones, were excluded. A total of 30 patients with celiac disease were included in this study. Out of 30 patients 18 [60%] were female and 12 [40%] male [M: F = 1:1.5]. Thirty patients were divided in two equal groups [15 patients in each group]. In group-I we gave gluten free diet and in group-II we gave gluten free diet and one tablet of bisphosphonate. Mean +/- SD of Bone Mineral Density [BMD] in group-I was 0.402 +/- 0.081 gm/cm2 [range=0.234 - 0.503 gm/cm2], and in group-II was 0.543 +/- 0.098 gm/cm2 [range= 0.402 - 0.743 gm/cm2], mean difference of bone mineral density was significant between two groups [P-value=0.0002]. At three months DEXA scan showed a significant rise in BMD in group-II as compared to group-I
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To determine the rate of sero-conversion after first dose of measles immunization in children less than one year of age and to find out association between seroconversion with nutritional status, URTI, fever and diarrhea. Descriptive cross sectional study of 6 month duration conducted at outpatient department, EPI center LUH Hyderabad. Total 240 children between 9 to 12 months, who came for measles immunization were enrolled. Pre-vaccination blood samples were obtained along with assessment of nutritional status, and current associated illness like pneumonia, diarrhea and fever of each child. The post vaccination samples were taken after 3 months. Measles antibodies were estimated by using ELISA technique and titers were compared with controls supplied by manufacturers. The effectiveness of measles immunization was 87.5%. Statistical analysis proved that association sero-negativity with clinical condition was insignificant [Chi square test, P value > 0.05]. Regarding the pre-vaccinated status 222 [92.5%] were found negative for anti-measles antibodies and 18 [7.5%] were found to be with persistent maternal anti-measles antibodies. Measles immunization produces adequate immunological responses even among malnourished children however a second dose is necessary to increase the efficacy more than 95%