Risk factors for febrile seizure in children in hawler governorate

Febrile seizure is the most common convulsive disorder in childhood. Intense parental anxiety and fear from recurrence is observed. The aim is to determine the risk factors for febrile seizure in children. this observational study undertaken from 1st February to the end of June 2008. One hundred ten children between 6months-6years of age admitted with attack of febrile seizure were recruited. Demographic data including age, sex, type and duration of febrile seizure, family history of febrile seizure and epilepsy, interval between fever onset and occurrence of seizure were recorded. Out of 110 patients 54 cases were male [49.1%] and 56 were female [50.9%], male to female ratio among those with recurrent febrile seizures was 1, 4:1.The peak age group for febrile seizure was 13-24 months [49, 1%] and the mean age was 22.1 months. Complex febrile seizure was observed in 40patients [38.2%]. Positive family history of febrile seizure was noted in 48 patients [43.6%] and family history of epilepsy in 10 patients [9.1%] was positive. It was found that 52.7% of cases were having respiratory tract infection, 39.1% having gastroenteritis and in 2% no focus of infection were found. It can be concluded from the present study that first attack of febrile seizure in younger age [<12months], complex febrile seizure and Positive family history of febrile seizure in children <12months were risk factors for recurrent febrile seizures

How frequent are consanguineous marriages?

To determine the frequency of consanguineous marriages in parents and grand parents of all admitted children in a pediatric unit. An observational study. All patients admitted over one year period from January to December 2001 in Unit I of Pediatric Department were included. Information was obtained regarding consanguinity of parents and grandparents of the children Clinically evident inherited disorders were also noted. Consanguinity was found in 72.7% of marriages. First cousin marriages were seen in 87% while second cousin marriages were seen in 12%. Consanguinity was also seen in the grandparents. It was found in 64.15% of maternal and 60.3% of paternal grandparents. Cousin-marriages are a norm in the population studied. Its effect on inherited disorders deserves further studies

experience with vascular trauma

This prospective study was conducted at Jinnah Hospital, Lahore over a period of sixty months. Patients between the ages 18-32 years presenting with Vascular Trauma in A/E department were included in the study. Gender distribution was 36 males and 8 females. The vascular trauma was as follows: 5 radial arteries, 5 posterior tibial arteries, 14 femoral arteries, 7 popliteal arteries, 1 popliteal vein, 3 axillary artery, 5 brachial, 1 external iliac artery, 2 IVC and 1 Infrarenal aorta. All of these patients were managed surgically. The end results for all were patent vessels except 2 [1 popliteal vein and 1 external iliac artery ligated] with functional limbs averting deaths and preventing life long disabilities thereby improving the quality of life and productivity as a human being

Dengue fever

Pakistan has reported sporadic cases of Dengue fever [DF] and Dengue Haemorrhagic fever. The first recognized epidemic of DHF was recorded from Civil Hospital, Karachi and Aga Khan University Hospital, Karachi in 1994-1995, published in 1997- 98. Majority of affected individuals are children. Although most children suffer non-specific symptoms, the mortality due to Dengue shock syndrome and Dengue haemorrhagic disease is much higher in children than in adults. Symptoms and signs include respiratory symptoms, as well as anaemia, hepatomegaly. A few studies have recorded patients with encephalopathy as well. Although the burden of disease due to dengue fever has not been determined in Pakistan, there is evidence that the menace of DF is increasing. Data from India, Bangladesh strongly suggest increasing incidence, with all 4 serotypes. This may be due to rapid urbanization with increase in breeding grounds for Aedes aegypti the vector which carries dengue virus. It is imperative for Pakistan to document the extent of the problem not only in Karachi but all over Pakistan. This is especially important considering the likely availability of various dengue vaccines in the near future. Surveillance studies should be under taken to document incidence of DF and DHF especially in children. This would help in considering Pakistan's policy regarding appropriate management and prevention to ensure universal morbidity and mortality secondary to DHF

Febrile seizures: Factors affecting risk of recurrence in Pakistani children presenting the Aga Khan University Hospital

To [a] describe the effect of temperature rise on seizure recurrence in the ER [b] investigate the effect of age, gender, family and developmental history, type, duration and multiple seizures, past history and number of seizures and treatment given [either late or early] on seizure recurrence in the ER and [c] explore prognostic indicators for seizure recurrence. Data from 352 children [ages 3 - 84 months; 220 males [62.5%] 132 females [37.5%]] was taken using chart reviews for the years January 1998 - August 2000 inclusive, from the Pediatric department of the Aga Khan University Hospital. Descriptive statistics, Chi-square, and Discriminant Analysis were used. Of the 52 [16%] cases that had seizure recurrence in the ER, majority [36.5%] occurred in >38.5o < 39.5oC temperature range. The percentage declined to 15% at higher temperatures. Bivariate tests showed that age, family and developmental history, type of seizure and treatment given did not affect seizure recurrence in the ER. Past history number of seizures [p =.006], duration of seizure [p <0.001], past history of seizures [p=0.004] and multiple seizure [p=0.024] were factors significantly associated with seizure recurrence in the ER at the bivariate level of analysis. Duration of seizure was the most important prognostic indicator for FS recurrence in the ER at the multivariate level with b =0.79. Duration of seizure [>5 minutes] was the most important prognostic factor for FS recurrence. Early treatment did not affect recurrence,suggesting timely anti-pyretic vs. anti-leptic medication use

Drug resistant malaria

Malaria is a major killer. The problem is heightened by reports of resistance to chloroquine. Rational use of antimalanal is necessary A patient who presented with drug resistance is reported here

To study the risk factors for hepatitis C in cirrhotic patients

The purpose of the study was to evaluate predisposing risk factors for the development of Hepatitis C in cirrhotic patients who tested positive for Hepatitis C. Twenty three cirrhotic patients who tested positive for hepatitis C were included in the study. All were questions about possible risk factors resulting in infection with Hepatitis C. 4 patients [17.3%] gave a history of previous blood transfusion, 5 [20.8%] had a previous history of jaundice, 5 [20.8%] had a history of needle stick injury in the past. No patient gave a history of surgery and no history of contact with a jaundiced patient was available. 1 patients [4.35%] who also gave history previous blood transfusion, gave a history of contact with multiple partners. In 9 cases [39.1%] no cause could be established. This shows that in a significant number of cases the mode of transmission of Hepatitis C still remains a grey area

Effect of intervention on promotion of exclusive breast feeding

community-based intervention study was conducted in a Katchi Abadi [slum area] of Karachi with the objective of improving optimal breast feeding practices, including promotion of exclusive breast feeding and giving of colostrum to newborns. Sixty-seven mothers were registered in the intervention group and 53 in the control group. Health education to promote exclusive breast feeding was provided in the form of flip-charts, videos and photographs. Sixty-six% mothers in the control group gave prelacteals as compared to 31% in the intervention group [P <.0001]. Colostrum was given by 97% mothers in the intervention group and 3% in the control group. Majority [94%] of intervention group mothers continued exclusive breast feeding till four months of age against 7% in the control group. It was concluded that health education programmes in the antenatal period as well as after birth can promote exclusive breast feeding practices

prevalence of antibodies to hepatitis A, B, and C viruses in children of Karachi

A prevalence survey of antibodies to hepatitis A, B, C, in children of Karachi is reported. The study was carried out in children from Civil Hospital, Karachi between September 1990 to October 1991. The prevalence of IgG antibodies to hepatitis-A was very high; with 5 year old children showing 94% positivity of exposure to Hepatitis A virus Antibody to Hepatitis B surface antigen [anti-HBS] was found in nearly 2% of children upto 14 years of age. The prevalence of Hepatitis C [anti-HCV] was negligable being 0.43% upto 14 years of age

Study of pneumonia in hospital practice

A total of 56 patients admitted in acute general medical ward at Sir Ganga Ram Hospital, Lahore with the clinical diagnosis of pneumonia are analysed. Their ages ranged from 30-70 years. Thirty six [64.3%] were male and 20 [35.7%] were females. Seventy five% of the males were smokers as compared to 10% of the females. Streptococcus pneumonia was isolated in 19 [33.9%] cases and staphylococci in two [3.6%]. Treatment with amoxycillin and cloxacillin yielded clinical improvement in all except fifteen cases. Six patients failed to survive despite the change of antibiotics. In nine cases of unresolved pneumonias, bronchoscopic biopsy showed bronchogenic carcinoma in two and fungal infection in one case. Bronchoscopy did not reveal any abnormality in the remaining six patients who improved later with ciprofloxin

Neonatal sepsis: etiological study

The microbiological pattern of proven early neonatal sepsis is reported between the period of 1st January, 1984 to 31st December, 1985. Of 198 blood cultures, 30[43.5%] and 53 [41.0%] were positive in 1984 and 1985, respectively. There was considerable variability in the spectrum of organisms in these two years. The type of organisms found and their sensitivity to antibiotics was marked different from that reported in Western literature. Most organisms were found to be resistant to commonly used antibiotics. Cefotaxime and Tobramycin were most effective, while Fosfomycin was found to be effective against enterococci

Nutritional risk factors in a well baby clinic

Cross sectional data from a "Well Baby" [immunisation] clinic over a period of 1 year and certain associated environmental factors were studied to establish if any of these "risk factors" were significant in causing malnutrition. Thus the concept of "at risk" child has been highlighted for the under priviledged paediatric population

Prevalence of malnutrition in a well baby clinic

A retrospective study was done in children between 0-5 years of age attending the well baby clinic in the Civil Hospital Karachi outpatient department. The period of study was between 1979-1981 [3 years] and was done to determine the average weight for age of these children. The average weights of children between 0-3 months and 4-9 months fell above the 80[th] percentile [Harvard standard]. Between 10-24 months it was above 50[th] percentile ad between 2-5 years it was between 80-90[th] percentile. Next an attempt was made to ascertain the percentage of malnutrition found in these children according to Gomez's criteria. The overall percentage was 29.7% 31.2% and 16.7% of grade I, II AND III PEM respectively with only 22.2% children having a normal weight for age. The breakdown of cases in different age group revealed a similar distribution. This study highlights the presence of malnutrition [according to weight] seen in well babies in sick children this problem is more pronounced it reinforces our concern finding children at risk in such follow up clinics and preventing PEM from becoming severe