Clinical presentation of typhoid fever

Enteric fever represents a spectrum of acute systemic febrile illness with a myriad of presentations and complications. This study was carried out to evaluate the demographic data such as age, sex, clinical features and outcome of enteric fever patients presenting in District headquarter hospital Muzuffar Garh. Over a period of one year all children presenting with clinical and/or laboratory diagnosis of Typhoid fever, who were admitted to the Social Security Hospital M. Garh, were evaluated. The diagnosis of enteric fever was based on a positive Salmonella typhi or paratyphi blood/stool culture and/or a Widal serodiagnosis > or = 1/160 for O agglutinin, in the presence of evocative symptoms. There were 28 [66.66%] male and 14 [33.33%] female patients, ranging from 1 to 12 years, with a mean age of 6 years. Predominant symptoms were fever, prostration and apathy; anorexia and abdominal pain while the predominant signs were fever, coated tongue, toxic look, hepatosplenomegaly and abdominal tenderness. Hepatomegaly was observed almost as frequently as splenomegaly. Common clinical signs of typhoid fever in adults such as relative bradycardia and rose spots were seldom documented. All patients survived from their severe illness completely. Although there is considerable diversity in the clinical spectrum of typhoid fever, yet a presumptive clinical diagnosis of typhoid fever may be made with a combination of clinical features so that appropriate therapy may be started at the earliest possible time to avoid the increasing drug resistance, morbidity and mortality with typhoid fever

Feeding practices among the infants presenting with acute diarrhoea

To study various feeding practices in children who present with acute watery diarrhea. The objective of the study was not only to study the feeding patterns but also draw an association between different feeding patterns and acute diarrheal episodes Outdoor and indoor unit of Department of Paediatrics Jinnah Hospital affiliated with Allama lqbal Medical College Lahore. Two hundred and fifty patients with acute watery diarrhea of less then 14 days between the ages of I month to I year were included in the study. It was a case control cross sectional study. The data related to 250 patients was collected. The required information was obtained from inother/ attendant of the infant in the questionnaire. All the questionnaire were filled by the doctors. The majority of the infants with acute diarrhea were between 4 months to 1 year 195 [78%]. Forty two [17%] were exclusively breastfed while 78 [310/,] exclusively bottle-fed. Fifty five [22%] had both breast feeding as well as bottle feeding. A large number of mothers 112 [44.8%] gave the teason of insufficient milk for the baby. Majority of the infants with acute diarrhea episodes was between and 12 months when either breast milk is being replaced by bottle milk or improper weaning practices are being used. A large number of infants with acute diarrhea were either mixed fed or bottle fed. Because of increased mixed and bottle feeding there is high incidence of diarrhea in our community

Feeding practices among the infants presenting with acute diarrhoea

To study various feeding practices in children who present with acute watery diarrhea. The objective of the study was not only to study the feeding patterns but also draw an association between different feeding patterns and acute diarrheal episodes. Outdoor and indoor unit of Department of Paediatrics Jinnah Hospital affiliated with Allama Iqbal Medical College Lahore. Two hundred and fifty patients with acute watery diarrhea of less then 14 days between the ages of 1 month to 1 year were included in the study. It was a case control cross sectional study. The data related to 250 patients was collected. The required information was obtained from mother/ attendant of the infant in the questionnaire. All the questionnaire were filled by the doctors. The majority of the infants with acute diarrhea were between 4 months to 1 year 195 [78%]. Forty two [17%] were exclusively breastfed while 78 [31%] exclusively bottle-fed. Fifty five [22%] had both breast feeding as well as bottle feeding. A large number of mothers 112 [44.8%] gave the reason of insufficient milk for the baby. Majority of the infants with acute diarrhea episodes were between 8 and 12 months when either breast milk is being replaced by bottle milk or improper weaning practices are being used. A large number of infants with acute diarrhea were either mixed fed or bottle fed. Because of increased mixed and bottle feeding there is high incidence of diarrhea in our community

Neonatal mortality in a district hospital setup

To evaluate the causes and risk factors of neonatal mortality, in a non-tertiary district hospital nursery. Descriptive study. This study was carried out in the Neonatal Unit of Social Security Hospital Muzuffar Garh, Pakistan from 1st May 2004 to 30th April 2005. All newborns admitted in the nursery during study period were counted and the expired ones were evaluated in detail for the cause of death. A total of 410 neonates were admitted during study period, 53.65% were male and 46.35 females. 47.22% were admitted within 1st 24 hours of their life, and 61.66% within 72 hours of birth. 56.66% of the expired neonates were low birth weight. Neonatal sepsis being the commonest cause of death [44%], 35% being of EOS and 65% cases of LOS. 2"d commonest cause of neonatal death was birth asphyxia [22%] and the third commonest cause was prematurity [19%] with its complications. Other causes of neonatal mortality were neonatal jau ndice [2.77%], meconium aspiration syndrome [1.66%], hyaline membrane disease [6.66%], neural tube defects [1.11%] and congenital heart disease [1.66%]. Many babies had more than one of the above said causes. Neonatal sepsis, birth asphyxia and prematurity are the major killers in nurseries