Management of thoracic in juries in children

Objective: the aim of the study was to know the effective way of treatment and to sort out the measures for the prevention of various complications arising from thoracic injuries in children

Material and Methods: this is a prospective study performed on 173 children with thoracic injuries. Birth trauma was not included in this study. All these patients were received in emergency and were admitted to Paediatric surgery unit of Lady Reading Hospital Peshawar during a period of 2 years from January 2000 to December 2001

Results: blunt trauma [121 cases] was the most common cause of chest injuries seen in these children as compared to penetrating injuries [52 cases]. All of them [156 cases] except lung contusion and chest wall injuries were treated with chest tube drainage and under water seal. The clinical condition resulting from these chest injuries confirmed on X-ray chest were haemothorax [99 cases], haemopneumothorax [51 cases] and pneumothorax [6 cases]. Cardiac injuries, great vessel injuries, esophageal injuries, tracheobronchial injuries, stove in and flail chest injuries were not encountered during the course of this study. There is no mortality hm chest intubation in this study. There was no case of emergency thoracotomy however only 2 cases needed elective thoracotomies for complications after treatment with chest intubation

Conclusion: emergency thoracotomy is a lifesaving procedure in all the clinical conditions resulting from thoracic trauma. Isolated chest injuries can be treated effectively by tube drainage of the chest on the affected side, which is safe, less traumatic and associated with least morbidity and no mortality

Study of rickets in admitted patients at lady reading hospital, Peshawar

Objective: a survey of rickets in Postgraduate Medical Institute, Lady Reading Hospital Peshawar and to pinpoint the cause

Material and Methods: this study was carried out in children A unit, Postgraduate Medical Institute Lady Reading Hospital, Peshawar from September 1998 to August 2001. During the three years period 300 cases were included in the study. Total number of admitted patients during three years period were 10161

Results: frequency of Rickets was found to be 2.25%. 198 [66%] patients were less than one year of age, 72 [24%] were of 1-2 years age, 18 [6%] were of 2-3 years old and 12 [4%] patients were above 3 years age. Rickets was predominant in less than one-year age group. 192 [64%] patients were male and 108[36%] were female patients. Male to female ratio was 1.77: 1. Rickets was predominant in male children. 228 [76%] patients were of low socioeconomic group, 54 [18%] were of middle and 18 [6%] patients were of high socioeconomic group. Rickets was predominant in low socio- economic group. 162 [54%] patients belonged to urban areas and 138 [46%] patients were of rural areas of different districts of NWFP. 144 [48%] patients were malnourished, and 120 [40%] patients were associated with acute respiratory infections[AR1]. 78 [26%] were associated with gastroenteritis, 30[10%] were associated with hypocalcemic fits, 24 [8%] had with meningitis, 21 [7%] were associated with various other diseases. Rickets was commonly found in malnourished children. 273 [91%] patients had nutritional rickets and 27 [9%] had of non-nutritional rickets in our study. In these 300 children of rickets, 273 [91%] patients responded to treatment with vit.D3 and 27 [9%] patients were resistant to treatment with vit. D3

Conclusion: it is clear that in our province [NWFP] most cases of rickets are nutritional and responsive to vit. D3 treatment

Erythrocyte glucose-6- phosphate dehydrogenase deficiency: a cause of neonatal jaundice

Objective: to determine the frequency of glucose-6-phosphate dehydrogenase deficiency in the etiology of neonatal jaundice

Material and Methods: this descriptive study was conducted at the Paediatrics Department, Hayatabad Medical Complex, Peshawar from March 2001 to December 2001. All full term newborns with significant jaundice were included, Serum bilirubin level, mother and baby blood group, coomb's test and G6PD enzyme estimation using sigma diagnostic G6Pd reagent were done in all babies

Results: out of 150 icteric newborns, 14% were deficient in G6PD. 90.5% were male and rest were female. No specific precipitating factor for hemolysis was found. The most common age of appearance of jaundice was within the first 48 hours of life. Serum indirect bilirubin level ranged from 9.4 to 40mg%. All G6PD deficient babies receive phototherapy while in 11 babies, exchange transfusion was performed

Conclusion: G6PD deficiency is one of the common causes of neonatal jaundice. Hence, all jaundiced neonates should be screened for G6PD deficiency

Prevalence of urinary tract infections in school children in Islamabad

A total of 400 school children were studied for Bacteriuria and Pyuria. The children with significant bacteriuria [105 or > 105 organisms/ml of urine] were considered positive for Urinary tract infection. Six children [1.5%] urinary infection. The organisms isolated were E. coli, Klebsiella and Enterobacter. All of these organisms were sensitive to most of the antibiotics used for inviter sensitivity test

Detection and enumeration of fecal coliforms and other microorganisms in drinking water: a comparative of two techniques

Comparative efficacy of two water analysing techniques, based on bacterial analysis has been investigated. Method of Rand et al with some alterations has proved to be ideal as it provides information on presumptive coliform, feacal coliforms, standard plate counts and confirms the identity of the isolates. Moreover, the improvised method is less time consuming and is comparatively inexpensive