Intrathecal anti-tetanus human immunoglobulin in the treatment of neonatal tetanus

To determine the outcome of tetanus in neonates treated with intrathecal tetanus immunoglobulin in terms of mortality and hospital stay. Experimental study. Paediatric Unit I, Bahawal Victoria Hospital, Bahawalpur, from April 2004 to December 2007. Seventy neonates with diagnosis of neonatal tetanus were included in the study. The neonates with fits due to causes other than tetanus were excluded. Thirty five patients received intrathecal immunoglobulin in addition to standard treatment [group A] while, the other 35 patients received only standard treatment [group B]. The mortality and duration of hospital stay in 2 groups were recorded. In group A, mean duration of hospital stay was 10 days while, in group B it was 13 days [p<0.001]. One patient from group A and 8 patients from group B expired [p=0.026]. The occurrence of refractory fits, repeated apnoeic episodes and high grade fever did not show any statistically significant difference in the 2 groups. Intrathecal anti-tetanus immunoglobulin in addition to the standard improved the outcome of neonatal tetanus in terms of mortality and hospital stay

Farber disease: a rare neurodegenerative disorder

This is the case report of a two-and-a-half-year old male infant with Farber disease, which is a rare neurodegenerative mucolipidosis. The child presented with regression of milestones, laryngeal involvement and painful joints with swellings around the joints. Neuroimaging findings and the biopsy of the soft tissue swellings helped to reach the diagnosis

Assessment of nutritional status of children under 48 months of age

To assess the frequency and severity of malnutrition, and its association with mothers education, breast feeding duration, weaning age, family income and family size, in children under 48 months of age. Case- Control study. The study was conducted at E.P.I. Centre, Paediatrics out patient department B.V. Hospital, Bahawalpur, from March 1999 to September 2000. The weight for age, a direct anthropometric measurement, was used for assessment of malnutrition. Inclusion criteria were the children under 48 months of age attending E.P.I. Center B.V.H., Bahawalpur. Children loosing weight due to acute diarrhoea were excluded from the study. The results indicate that 587 [58.7%] children were normal and 413 [41.3%] were suffering from malnutrition. Among malnourished children, 208 [20.8%] had first degree, 110 [11%] had second degree and 95 [9.5%] had third degree malnutrition at 95% confidence intervals [+ - 2SD]. In the mother education group, the 462 illiterate mothers having 220 [47.6%] normal and 242 [52.4%] malnourished while 161 higher educated were having 123 [76.4%] normal and 38 [23.6%] malnourished children only. Odd Ratio is 3.56, showing that those children who were exposed to mother illiteracy were having 3.56 time more malnutrition as compared to educated mothers group. The 192 non breast feeding mothers had 100 [52%] normal and 92 [48%] malnourished children as compared to 409 mothers breast feeding their children for one year and above having 249 [61%] normal and 160 [39%] malnourished children. The Odd ratio is 1.43 showing that children exposed to non breast feeding factor are 1.43 times more malnourished as compared to breast fed children. Among the weaning variable, it has been found that 270 mothers, giving early weaning from 4[th] month, had 184 [68.2%] normal and 86 [31.8%] malnourished children. The 315 mothers beginning weaning after one year and above had 144 [45.7%] normal 171 [54.3%] malnourished among them. The Odd ratio is 2.54 showing that children exposed to late weaning after one year are having malnutrition 2.54 times more as compared to other children who received weaning earlier than 4[th] month. Similarly, the family size had shown that 235 mothers having only one child had 165 [70.2%] children normal and 70 [29.8%] malnourished but 255 mothers, having 4 or more children, had 120 [47.1%] normal and 135 [52.9%] malnourished children. The Odd ratio is 2.65 showing that the children exposed to large family size of 4 or more than 4 children suffer from malnutrition 2.65 times more as compared to those who belong to a small family size. The family monthly income shows that 508 mothers from a low income group have 253 [49.8%] normal and 255 [50.2%] malnourished children but 207 mothers from families with a higher income, had 156 [75.3%] normal and 51 [24.7%] children malnourished. The Odd ratio is 3.08 showing that children exposed to poor socio-economic status are having 3.08 times more malnutrition among them as compared to children belonging to rich families. Malnutrition is more prevalent in illiterate sectors of the community where breast feeding is not practiced. The delayed weaning as well as large family size with poor socio-economic status is also associated with malnutrition. By removing these factors, we can reduce the malnutrition load among children

Rotavirus enteritis in hospitalized infants and young children

The relative importance of rotaviral diarrhoea was assessed by etiological evaluation of 264 patients suffering from acute diarrhoea admitted in Diarrhoeal Diseases Control Centre, Nishtar Hospital, Multan. Rotavirus was found to be the second most common enteropathogen [28.4%], the first most common being E. coli, although neonates and older children were found to be affected less frequently [12%]. Mixed rotaviral and bacterial infection was found in 6.4% of patients. Collectively rotavirus was isolated from 34.8% of patients. There was no change in the relative frequency of rotaviral diarrhoea with the change of season. Breast fed babies had a slightly lower incidence of rotaviral diarrhoea. Roughly 75% of patients had isonatremic dehydration, but the incidence of hyponatremia was more [16.8%] in rotaviral group while hypernatremic dehydration was more frequently seen [15.8%] in non-viral group. Episodes of rotaviral diarrhoea more often resulted in severe symptoms and slightly higher mortality