Etiology of lower gastrointestinal bleeding in paediatric patients, a colonoscopic surgery

To determine the frequency of various etiologies of painless lower gastrointestinal bleeding [LGIB] in pediatric patients using colonoscopy. Cross sectional descriptive study. This study was carried out at the department of Pediatrics, Military Hospital, Rawalpindi, from June 2010 to February 2012. A total of 80 patients [2-18 years of age] presenting with painless lower gastrointestinal bleeding were subjected to fiber-optic colonoscopy and findings were recorded. Data was analyzed with the help of SPSS version 10. Descriptive statistics were used to determine the mean +/- SD of numerical data, e.g., for age. Categorical data like gender and colonoscopic findings were analyzed by their frequencies and percentages. The study included 80 children out of which 53 were boys and 27 girls [male: female ratio was 1.96: 1]. The majority of children, n=54 [67.5%] were between two and six years of age. The most common colonoscopic findings were polyps. In 47 [58.75%] patients, polyps were found in the colon and were resected. In 9 [11.25%] patients, gross appearance of colon was normal. Evidence of colitis was found in 17 [21.25%] patients. Patients with hemangiomas were 2 [2.5%]. A total of 5 [6.25%] patients had non specific ulcerative lesions. Polyps of the colorectal area are the most common cause of rectal bleeding in children in our set up. Thorough physical examination which includes a digital rectal examination and colonoscopy leads to rapid and accurate diagnosis and appropriate therapeutic measures

Needle stick injuries in nurses at a tertiary health care facility

This study was aimed to assess the frequency and factors associated with Needle Stick Injuries[NSI] in nurses of a tertiary health care facility. This cross-sectional descriptive study was conducted in Combined Military Hospital Lahore in June-July 2012. Responses were obtained via a self-administered questionnaire with close-ended questions about the knowledge of the nurses regarding hazards of NSI, their frequency, and methods they practice to prevent them. The data was analyzed using SPSS-16. Chi-square test was applied and p-value was fixed at 0.05 to be statistically significant. Out of 118 nurses who participated, all were aware of the occupational hazards of their profession when they joined nursing. Sixty Five [55%] got NSI and 38[58%] of those were injured at the time of recapping the syringe. Sixty Nine [58.5%] did not use gloves while administering injections. After getting stuck by a contaminated needle, 100% squeezed out the blood from the area and 45[69%] out of 65 nurses cleaned the wound with a spirit swab. Only 13[20%] out of 65 consulted a physician regarding safety measures after NSI and 35[53%] had screening for Hepatitis-B Virus [HBV]. Seventy Eight [66%] of the total 118 nurses were immunized against HBV. Needle-stick injuries are highly prevalent among nurses, and prevention is the most effective way to protect nurses from infectious diseases which these injuries can transmit. Mandatory reporting to the concerned authorities, proper follow up, screening of nurses after NSI and promotion of safety measures against it should be greatly encouraged

Jervell and Lange-Nielsen Syndrome in deaf school children population

To identify the patients of Jervell and Lange-Nielsen syndrome [JLNS] amongst congenitally deaf children. This was a cross-sectional study, conducted at Hamza Foundation Academy for the Deaf, and Combined Military Hospital Lahore over a period of 4 months from February to May 2012. A total of 379 children with congenital sensorineural hearing loss were included in this study. Echocardiographs of all children [ages 4-18 years] were obtained. The corrected QT [QTc] intervals of all 379 ECGs were calculated using the Bazett's formula. Using the Schwartz's criteria, patients with long QTc intervals were further evaluated for Jervell and Lange-Nielsen Syndrome. Out of 379 children, 84 [22.1%] were found to have QTc intervals equal to or longer than 0.44 seconds. As per Schwartz's criteria, 31 [36.9%] out of 84 children with Long QTc [8.17% in sample population], scored high points [4.0 to 6.0], proving presence of JLNS. A sizable proportion of congenitally deaf children had Jervell and Lange-Nielsen Syndrome in our study

Congenital malformations

To determine frequency, pattern of distribution of congenital malformations in newborn. Cross-sectional observational study. Study was carried out in the Department of neonatology, Military Hospital Rawalpindi during the period of January 2008 to Dec 2008. All the newborns were examined and mothers were interviewed. Baby's antenatal record was also noted and recorded in a Performa. Antenatal ultrasonography record was also recorded. Any internal malformation was also noted. Babies who were found to have any malformations were screened for the congenital malformations. Screening was done with latest laboratory tests, radiological evidences and chromosomal studies for suspected trisomies. Congenital anomalies were noted in a Performa. Neural tube defect [NTD] was found to be the commonest type of anomaly. Among the most frequent NTD were hydrocephalus and menigomyelocele. Following that were the cardiac anomalies and genitourinary tract anomalies. Trisomy 21 was detected in two of the babies while one newborn had trisomy 13. NTD were the most prevalent anomaly detected and early prenatal diagnosis is helpful in decreasing the indirect prevalence of perinatal mortality by offering early termination. Folic acid supplementation should be advocated before conception