Appraisal of knowledge, attitude and practices of trained doctors regarding IMNCI

Background: It is estimated that more than 6 million children die in the developing world at the hands of preventable conditions; primarily pneumonia and diarrhea. WHO in 1992 initiated the Integrated Management of Childhood Illness [IMCI] program as a strategy to provide an integrated approach for the management of major causes of childhood morbidity and mortality

Objective: To assess if IMNCI workshops that are held in hospitals that have post graduate training program in field of pediatrics are effective in enhancing knowledge; hence skills for improving health care delivery in limited resources

Methods: A KAP survey was conducted in 2013 among IMNCI trained doctors working in 5 tertiary care hospitals of Karachi. N=57 doctors were identified and administered a structured questionnaire based on recall questions and scenarios. Questionnaire was developed from a similar study conducted elsewhere. Data entry and analysis was done on SPSS version 20

Results: A total of n=57 doctors were included in the study, out of them resident medical officers [RMO] were n=10, postgraduate trainees [PG] n=38 and Medical Officers [MO] were n=9. Mean score of correct answers was 14 [3]. No significant difference was observed when mean scores of PGs was compared with RMO and MO combined through application of Independent sample t test

Conclusion: The study revealed gaps in knowledge and practices of trained doctors regarding management according to IMNCI guidelines

Frequency of and factors leading to obesity and overweight in school children

Obesity is considered as a global epidemic. Obesity in childhood and adolescent is an issue of concern because it is an important predictor of adult obesity. Identifying individuals who are physically inactive, overweight or obese in school going age is very important. The objective of this study was to determine the frequency and factors leading to obesity in school children. A cross-sectional survey was conducted on children aged 13-16 years. It was a questionnaire based survey with measurement of height and weight. Total 431 children were included in the study. Three hundred and nine [71.7%] of the students were in the normal category, i.e., less than 85[th] centile while 122 [28.3%] had weight greater than 85[th] centile and were overweight and obese. Positive association was found between eating out and weight categories, eating breakfast, intake of fresh fruits and vegetables and soft drinks, low physical activity, and increased screen time. Frequency of overweight and obese children was high in children from higher socioeconomic status. There is strong association between strong determinants of obesity and overweight. Health education of students for known risk factors should be integrated with curriculum of science from elementary classes.

Haemophilia B: clinical manifestations and complications

Haemophilia B is X-linked recessive inherited disorder of factor IX deficiency. It is classified as severe, moderate and mild depending upon plasma levels of factor IX. The development of inhibitors is seen during treatment of haemophilia B against F-IX. This study was aimed to determine the frequency of different complications in haemophilia B patients. Total 45 patients of Haemophilia B already enrolled in the Haemophilia society of Pakistan Lahore chapter were included in this study. Clinical history and physical examinations were recorded on a pre designed proforma. Laboratory testing for establishment of diagnosis of haemophilia B and inhibitors of FIX was done. Out of 45 patients, 10 [22.2%] had severe disease while 28 [62.2%] had moderate and 07 [15.6%] had mild disease. Twenty nine [64.4%] of patients with severe and moderate disease were diagnosed below 5 years of age while none with mild disease was diagnosed under 5 years of age. Arthropathy was the most frequently developing complication in patients 10 [100%] of severe Hemophilia B. Post circumcision bleeding was found to be the most common first episode of bleeding in patients of haemophilia B 29 [64.4%]. Inhibitor against F-IX developed in only one patient of severe disease 1 [10%]. Arthropathy is the commonest complication and circumcision is the first bleeding site in most of the haemophiliacs