Maternal factors associated with intrauterine growth restriction

Intrauterine growth restriction is a major neonatal health issue. Maternal factors have been found to have greater impact on IUGR. Studying these factors can help in reducing the mortality and morbidity associated with IUGR. This Case-control study was conducted at the department of Paediatrics Post-graduate medical institute Lady Reading Hospital Peshawar from March 2008-April 2009. Small-for-gestational age [SGA, i.e., IUGR cases and n=200] live born babies were compared with appropriate-for-gestational age [AGA, i.e., controls and n=200] babies. Information regarding socio-demographics of mothers, gestational age and birth weight of baby, maternal clinical characteristics, and medical and obstetric complications during pregnancy was recorded on a predesigned proforma. Data analysis was done through SPSS-16. To find the maternal factors associated with the intrauterine growth restriction, multivariable logistic regression was used. We also did two different sets of logistic regression analysis for Symmetric and Asymmetric SGA babies as Cases. After adjusting for other variables in the multivariable model we found that the mothers of IUGR babies were of younger age [OR=0.8, CI=0.7-0.9], were poor [OR=2.5, CI=1.4-4.4] and underweight [OR=3.5, CI=1.1-5.7] and had anaemia [OR=2.7, CI=1.3-5.4] in the index pregnancy, and had history of Previous IUGR birth [OR=9.7, CI=3.3-18.3] and placenta previa [OR=3.2, CI=1.1-6.6]. There was an interaction between pregnancy induced hypertension and parity of mother with a primary-para mother with pregnancy induced hypertension [PIH] having an increased risk for IUGR babies [OR=10.1, CI=1.0-23.2]. The studied factors need special attention in hospital based settings in order to improve the perinatal outcome in IUGR babies

New approach to the management of scorpion bite

Scorpion's are venomous arthropod of class Arachnida and are considered relatives of Spiders, mites, ticks and harvestmen. There are approximately 1300 species of scorpions worldwide, characterized by an elongated body and a segmented tail that is tipped with a venomous stinger In Pakistan study on scorpion almost nil, even we don't know which species is found in N.W.F.P. As south Asian it is taken for granted that we will be having similar species as in India. Previously we use to lose all patients who developed autonomies storms. So we conducted a study from August 2004-August2005.over period of one year we received total 24 cases. All 24 Pts were saved with 1st or 2nd dose of tablet prozcin[30 micro-gram/ kg/dose] No sustained released tablet should he used Prozocin is magic drug in scorpion bite, provided given in 1-2hrs after start of Autonomic Storms

Bacterial meningitis in children

To study the demographic features, yield of gram staining, cerebrospinal fluid culture and etiological pattern of bacterial meningitis in children of 2 months to 12 years. Material and A hospital based prospective and descriptive study was carried out at the Department of Pediatrics, Postgraduate Medical Institute, Lady Reading Hospital, Peshawar. All those children in the age group between 2 months to 12 years having clinical suspicion of meningitis and cerebrospinal findings suggestive of meningitis i.e. >10'106 WBC/L and/or CSF sugar <40mg% or [<50% of the circulating blood sugar] and/or CSF protein >80mg% were included in the study. Children having history of intake of antibiotic in the last 5 days which can cross the blood brain barrier and children with tuberculous meningitis were excluded. A total of 120 patients [1.7% of the total admissions] were included in the study. Male patients were 69 [57.5%] and female were 51 [42.5%]. Out of 120, 47[39.2%] were in the age group of 2 months- 1 year, 39 [32.5%] were in the age group of >1-5 years and 34 [26.3%] were in the age group of >5-12 years. Majority of our children were below 5years i.e. 71.7%. Gram staining was positive in 68[56.7%] cases and negative in 52[43.3%]. The CSF cultures were positive in 59[49.2%] cases and negative in 61[50.8%]. The three most common pathogens isolated were Streptococcus Pneumoniae 27[22.5%] cases, Neisseriae Meningitides 20[16.7%] cases and Hemophilus influenzae B 11[9.2%] cases. Bacterial meningitis is the major cause of morbidity in children below the age of 5 years. The yield of gram staining and culture though comparable with the national studies but lower than reported internationally. S Pneumoniae, N Meningitides and H Influenzae are the three most common causes of Bacterial Meningitis in our children as reported nationally and internationally