Clinical features and outcome in paediatric newly diagnosed immune thrombocytopenic purpura in a tertiary care centre

Objective: The study aimed to demonstrate the pattern of clinical presentations and outcome of acute Immune Thrombocytopenia [ITP] in our Centre

Methods: A descriptive, observational study was conducted by collecting and analysing the data of 103 patients of acute ITP, ageing between 1-14 years, at The Children's Hospital, Lahore from January 2016 to December 2016. We collected the data regarding age, sex, clinical presentations, history of preceding viral infections, vaccination history, laboratory values, different treatment options used, and response to the treatment concerning complete response, partial response and poor responders. Statistical analysis performed by using IBM SPSS statistics version 20

Results: We retrospectively, reviewed total 103 patients cases. The median age, at the time of presentation, was 5 +/- 3.4 years while mean age was 4.5 +/- 2.9 years. The male to female ratio was 1.28:1. Mean platelet count on presentation was 7 x 109/L [range: 0-24]. Twenty three [22.3 percent], patients had the history of preceding illness. Bruises, petechiae, epistaxis and hematemesis remained the common presentations. Six [5.8 percent] patients showed spontaneous recovery while 97 [94 percent] patients received treatment for ITP. Overall, 71 [68.9 percent] showed a response after treatment. Sixty-two patients [59.22 percent] showed loss of response and received treatment again. Among these patients, thirty-four patients [33 percent] developed chronic disease

Conclusion: Majority of patients presenting to our tertiary care centre had severe acute ITP on presentation. After management and follow-up, almost 1/3 of the patients develop chronic disease hence the incidence of developing chronic disease remained high as compared to the other centers

Developmental concerns in adolescents: behavior autonomy and psychological stress

The current study was undertaken to empirically examine the impact of behavior autonomy on psychological stress in adolescents. Based on the existing evidences it was hypothesized that behavior autonomy would predict psychological stress in adolescents. The sample of the study comprised of 600 adolescents recruited from different schools and colleges of Rawalpindi and Islamabad, Pakistan through convenient sampling technique. The participants ranged in age between 12 to 18 years with mean age of 15.14 [ +/- SD1.98]. The Urdu translated versions of Behavior Autonomy Scale [Peterson, 1986] and Stress Scale [a subscale of Depression, Anxiety, Stress Scale by Lovibond and Lovibond, 1995] were used In addition, a short demographic sheet that comprised of participants' personal information regarding their institutional affiliation and age was also used The Linear Regression analysis was employed for statistical analysis of data. The results revealed behavior autonomy a significant predictor of psychological stress in adolescents. Implications of the findings and avenues for future studies are suggested