determine frequency of etiological factors in short statured patients presenting at an endocrine clinic of a tertiary care hospital

To determine the frequency of etiological factors in short statured patients presenting at endocrine clinic of National Institute of Child Health, Karachi. This descriptive cross sectional study was conducted at Endocrine clinic of National Institute of Child Health, Karachi. One hundred children [48 boys and 52 girls] aged 3-15 years [mean 9.9 +/- 3.4] with short stature from January 2007 to July 2007 were evaluated during that period. Constitutional growth delay [CGD] and familial short stature [FSS] were identified as the most common, 55% of all short stature cases. Non-endocrinal causes as a single entity was detected in 17 children. Most common etiological factors in order of frequency were normal variant of growth [CGD, FSS], Hypothyroidism, Growth Hormone deficiency [GHD], and Celiac disease. GHD was found in 13% of total cases and it comprises 44% among endocrinal causes. Boys outnumbered girls with ratio of 2.7:1 [p < 0.05]. Most common cause of short stature was normal variants of growth as a group. Children with height falling below 0.4th percentile are more likely to have pathological cause

Assessment of infant feeding practices at a tertiary care hospital

To assess the practice and knowledge of mothers regarding breast feeding, complimentary feeding, and to find out socio-economic correlates of feeding practices. A cross sectional survey conducted at paediatric department of Liaquat University Hospital [LUH] from Jan-Dec 2008. During that period 500 mothers with children less than 24 months were included. Infant feeding patterns were assessed in relation to recommendations and household socio-economic factors by an Interview Technique. Out of 500 mothers, 8.4% started exclusive breast feeding [EBF] while Pre-lacteal use was seen in 31.6%. Regarding the duration 52.2% mothers continued breast feeding for 2 years. Median duration of EBF was 3.5 months. It was seen that 60% of the 0-5 month-old infants breastfed 8 or more times per day. However, exclusiveness of breast feeding decreased from 60% at [0-2 months] to 40% [3-5 months]. Majority 64.2% were poor and 61.5% had no education. There is a statistically significant difference in feeding practices of educated and uneducated [P < 0.0001] and also in poor and middle class mothers [P <0.0003]. Regarding, age of their last born babies, 180 babies were under 6 months, and 320 were 6 to 23 months of age. The knowledge about complimentary feeding [CF] was inadequate. Around 21% of 2-3 months old babies received complementary food and 19% of 6-8 month-olds were only breastfed. In 78% mothers CF was advised by family members while in 23% mothers by doctors. Exclusive breastfeeding was not maintained upto recommended age of 6 months. Knowledge about CF was lacking in the mothers. Regarding, mothers' education and socioeconomic conditions, a positive correlation was noted with feeding practices

Clinical spectrum and outcome of accidental poisoning in children

Childhood poisoning is an important health problem which is usually accidental and is responsible for serious morbidity with mortality all over the world. Accidental poisoning is the second most common cause of death in Iran. This descriptive study is designed to assess the clinical spectrum and outcome of poisoning among children. This study was conducted in Liaquat University Hospital Hyderabad over a period of one year from 1[st] January 2007 to 31[st] December 2007. A total of 62 children up to 12 years of age admitted for acute poisoning to children ward were included. The cases were studied to see the clinical spectrum, complication and outcome of the poisoning. In one year period a total of 62 children including 35 [56.45%] boys' and 27 [43.54%] girls presented with acute poisoning. Maximum number of cases with poisoning was seen in the age group 1-5 year. Kerosene oil was the commonest form of ingredient used followed by drugs. The most common systems involved were cultural nervous system [CNS], respiratory and GIT. Over the period 2 [3.22%] children died, one of them was poisoned by lice killer liquid and other by insecticide. Most of the cases of poisoning are due to common household products and drugs. It is therefore necessary to educate the population on preventive measure

Dengue virus outbreak in the year 2006 at a tertiary care centre in Sindh

Objective: To investigate the outcome of 116 patients with suspected / confirmed diagnosis of Dengue fever at our tertiary care setup. Design: A descriptive study Setting: Liaquat University Hospital Hyderabad / Jamshoro. Study was carried out between October and December 2006

Methods: This study was conducted on 116 patients who were admitted in Liaquat University Hospital. Case definition was high grade fever with leucopenia and thrombocytopenia

Results: Only 52 out of 116 patients were confirmed as having Dengue IgM antibodies. The highest sufferers of Dengue fever were young adults. Almost all cases developed mild to moderate thrombocytopenia and leucopenia. Most patients recovered spontaneously in less than 10 days. Only 3 patients expired

Conclusion: Dengue fever is endemic in sub-Saharan region and in South Asia including Pakistan. Out-breaks occur from time to time. The current outbreak being the 3[rd] episode in the last 13 years points towards the importance of comprehensive research for the prevention and control of the disease. Although case fatality rates are low however it must be considered as public health problem and serious efforts shall be undertaken for public awareness and vector control

Clinical presentation of late haemorrhagic disease of newborn

To observe the clinical presentation of late haemorrhagic disease of the newborn [LHDNB], and clinical improvement after the administration of vitamin K1. This is a prospective descriptive study. All the children older than seven days who presented with bleeding were admitted in pediatrics ward of Isra University Hyderabad from April 2006 to April 2007 were included. Data collection was done by means of detailed proforma. Analysis was done on SPSS version 11. Thirty five cases were included. Commonest site of bleeding was subcutaneous followed by oral and injection site. Mean age of late haemorrhagic disease of newborn was 109 days and minimum age of presentation was 28 days. Common clinical presentations were irritability, convulsions, poor reflexes and poor feeding. Mostly recovery was within 24 hours after vit K. Late HDN results in severe hemorrhage especially hemorrhage in the central nervous system. Administration of Vitamin K [1mg, IM] at birth can present these severe complications

Risk factors of birth asphyxia

Birth asphyxia is a serious clinical problem worldwide. There are many reasons a baby may not be able to take in enough oxygen before, during, or just after birth. Damage to brain tissues is a serious complication of low oxygen that can cause seizures and other neurological problems. This study was designed to asses the risk factors of birth asphyxia in neonates. This descriptive, prospective study was conducted in the Department of Paediatrics, from April 2005 to April 2006. 125 newborn [75 males and 50 females] admitted to the neonatal care unit, who were delivered with delayed cry or low apgar score [<7] were included. Detailed maternal history was taken, regarding their age, gestational age, and complications, if any. Out of 125 neonatal encephalopathy cases, 28% were diagnosed as suffering with moderate or severe encephalopathy, whereas 36% had mild encephalopathy. Risk of neonatal encephalopathy increased with increasing or decreasing maternal age. Antepartum risk factors included non-attendance for antenatal care [64%]. Multiple births increased risk in 4.8%. Intrapartum risk factors included non-cephalic presentation [20%], prolonged rupture of membranes [24%] and various other complications. Particulate meconium was associated with encephalopathy in 9.6%. 60% mothers were anemic. Vaginal bleeding was strongly associated with birth asphyxia in 34.44% of neonates. 56% of mothers delivered at home, while 28% delivered at a private hospital or maternity home. Only 12% delivered at a tertiary care hospital. Lack of antenatal care, poor nutritional status, antepartum hemorrhage and maternal toxaemia were associated with higher incidence of asphyxia. Improvements in the public health of women with associated gains in female growth and nutrition must remain a longer-term goal. Early identification of high-risk cases with improved antenatal and perinatal care can decrease such high mortality. Safe motherhood policy is recommended

Serum electrolytes changes in malnourished children with diarrhea

To determine the frequency of electrolyte disturbances in malnourished children with and without diarrhea and whether these findings have therapeutic value or not. It is a descriptive study conducted at pediatric Unit-II LUH Hyderabad, from1st August to 31st September 2004. One hundred children of protein-calorie-malnutrition between 6 months to 5 year of age of either sex who were admitted due to diarrhoea, failure to thrive, acute respiratory infection, malaria, anemia, cardiac failure and feeding problems were included in the study. On the basis of history, physical examination and anthropometrics measurement they were divided into Group A patients [n=64] who were malnourished but had diarrhoea and Group B patients [n=36] who were also malnourished and had no diarrhoea. Serum electrolytes were done in patients of both groups and the results were analyzed statistically. Analysis of serum electrolyte in both groups revealed that hypokalemia, hyponatremia and low serum bicarbonate were seen more frequently in patients of group A as compared to group B. In group A hypokalemia was seen in 40 patients[62.5%] while it was observed in 8 patients[22.22%] in group B [p<0.001], hyponatremia was seen in 17 patients [26.56%] in group A and in 5 patients [13.88%] in group B [p<0.001]. In group A 41 patients [64%] had low serum bicarbonate while in group B only 15 patients [41.66%] had low serum bicarbonate value [p<0.001] Electrolyte changes were commonly seen in grade II and III malnourished patients particularly who presented with diarrhoeal episode of variable duration. If these changes are diagnosed in time and treated appropriately the morbidity and mortality could be decreased

Pattern of congenital heart disease at Liaquat university hospital Hyderabad

Objective: to find out the frequency of various congenital heart disease among affected children from birth to 12 years of age at Liaquat University Hospital Hyderabad

Setting: Study was conducted in pediatric Department of Liaquat University Hospital Hyderabad

Study design: This descriptive study was conducted over a period of one year from April 2006 to March 2007

Patients and Method: eighty Children up to 12 year of age with clinical suspicion of congenital heart disease were evaluated for type of lesion, gender and age at presentation. They were subjected to chest X-ray, ECG and detailed echocardiography which confirmed the final diagnosis .The results was analyzed on SPSS window version 10

Results: out of eighty cases fifty were male [62.5%] and thirty were female [37.5%].Fifty eight [72.5%] children were having cyanotic heart disease. Among A cyanotic lesion VSD was present in 42 patients [52.5%], ASD were 7 [8.75%] 6 have secondo types. PDA was present in 6 [7.50%] patients. A total of 7 [8.75%] patients had the TOF and 3 [3.75%] had TGA in association with VSD in one and ASD in 2 patients .Severe pulmonary stenosis was seen in 3 [3.75%] patients 2 were in association with ASD. Single ventricle and dextrocardia were seen in 3 [3.75%] patients each. Complex cardiac lesion was seen in 2 [2.5%] patients

Conclusion: majority of Congenital heart disease in children at Tertiary care Hospital are acidotic, VSD is the commonest acidotic lesion while TOF is the commonest cyanotic lesion. Early detection of this defect is important for proper management

Intranasal encephalocele as a cause of reccurent meningitis

Herniation of brain matter through a basal skull defect is a rare occurrence. Both congenital and environmental factors have been implicated. This case report describes a 7 year old boy with nasal discharge since birth and recurrent meningitis. The etiology for these problems was discovered as intra nasal encephalocele

Feeding beliefs and practices of mothers/ caregivers for their infants

To evaluate the nutritional practices and beliefs for infants by mothers/care giversin our set up.A descriptive study.Liaquat University Hospital, Hyderabad - Sindh, from 7[th] November to 16th December,2001.One hundred infants admitted in paediatrics ward were selected for the study. Studywas based on a questionnaire, developed to collect information by interviewing mothers to ascertaintheir infant feeding practices and various beliefs/taboos affecting these practices.One hundred mothers belonging to urban and rural areas were interviewed. At birth,71% of mothers discarded colostrum. The frequency of breast-feeding was high initially but dueto variety of socio-cultural reasons, it declined rapidly with early supplementation of bottlefeeding.Pre-lacteal feeding was a major reason for breast feeding delay. Exclusive breastfeedingwas of short duration. Inadequate weaning in terms of quality and quantity was observedcommon. Cultural beliefs and taboos were affecting the weaning in majority of the cases.Lack of maternal education about feeding the infant is significant in our set up.There is, therefore, a need to educate the mothers about correct feeding practices so thathealthy growth of the infants can be maintained

Maternal risk factors affecting birth weight of newborn

To determine the association of maternal biosocial, medical and obstetric risk factors with low birth weight [LBW]. A case control study. Department of neonatology and paediatrics, Liaquat University Hospital, Hyderabad - Sindh from 1[st] September to 31[st] December 2001. One hundred live born LBW babies were selected against 65 normal birth weight babies as control for this study. Information regarding maternal biosocial, medical and obstetric problems during pregnancy was recorded on a specified proforma and data analysis was done through SPSS 10.0 version and results were interpreted in terms of P-values. The mean birth weight of LBW babies was 1.96 kg as compared to 3.2 kg in control group. Sixty-nine percent of cases were preterm with male predominance. Main factors identified were poverty, maternal malnutrition, short birth interval, teenage mother, lack of antenatal care, anemia, toxemia, antepartum hemorrhage, renal disease and malaria. Maternal biosocial, medical and obstetric factors have strong association with LBW. To overcome this problem, health education of mothers and strengthening of the health care facilities for mother and children in the community are required

Etiology of congestive cardiac failure in children from birth to 15 years

Objective: - To study the various causes of congestive cardiac failure in children. Study Design: - Prospective descriptive study. Period of Study: - 1[st] November 2004 to 31[st] March 2005. Setting: - Pediatric and cardiology Dept of LUH Hyderabad

Patient and Method: - During study period of 5 months all children between the age of 0-15 year presenting with symptom and sign suggestive of congestive cardiac failure were evaluated with relevant investigation for the underlying etiology. Those patients who expired during study before diagnosis was established were excluded

Results: - Out of total 55 patients 30 [54.54%] were male and 25 [45.45%] female and the commonest etiology of CCF was congenital heart disease. Seventeen patients [30.9%] were below one year of age and the commonest etiology was congenital heart disease of which eleven patients [64%] had VSD, seven [63%] of them had lower Respiratory tract infection. Other etiologies included myocarditis with pericardial effusion and gross Anemia. Eleven patients [64%] were between 1-5 years and the commonest cause of congestive heart failure was acute myocarditis other causes were congenital heart disease and Gross Anemia. Twenty seven [49%] patients were between 5-15 years and the commonest cause was Rheumatic carditis found in 12 patients [44%] other causes included congenital heart disease, myocarditis, dilated cardiomyopathy and Anemia, valvular vegetations was seen on preexisting Rheumatic value disease in 2 patients. Ten patients had noncardiac causes of congestive cardiac failure commonest one was Anemia seen in 8 patients

Conclusion: - The cardiac failure could occur at any age and the predominant etiology during infancy was VSD while myocarditis is common in age group 1-5year. Rheumatic carditis was the commonest cause of congestive heart failure beyond 5 yr. Among non-cardiac cause Anemia is on the top