Measles: demographic profile and associated morbidities of measles cases admitted in a teaching hospital

Objective: To determine the different demographic parameters, associated morbidity and mortality of measles cases admitted in a paediatric unit of a teaching hospital

Study Design: Descriptive cross sectional study

Place and Duration of Study: Pediatrics department Combined Military Hospital Kharian from October 2012- September 2013

Material and Methods: All patients admitted with diagnosis of measles according to World Health Organization [WHO] definition of clinical measles up to 12 years of age were included. Detailed history and clinical examination was done. Required information regarding study parameter was collected on a pre designed proforma. Different complications in relation to age, vaccination and nutritional status were assessed. Statistical data was analyzed by SPSS version 17

Results: Among total 68 patients, 48[70.58%] were male and 20 [29.41%] female. Mean age was 21.26 [ +/- 26.95] months. Thirty four [50%] patients were between 6-8 [completed] months of age, 3 [4.41%] less than 6 months whilst 5[7.35%] were aged between 5-12 years. Partially and unvaccinated patients were 19.11% and 88.88% respectively. Thirty [44.11%] cases were well nourished and 38 [55.88%] malnourished. Pneumonia [41.66%] was the commonest complication followed by diarrhea [37.5%], oral lesions [29.16%], otitis media [10.41%], eye changes, encephalitis, myocarditis and hepatitis [each 4.16%]. Mortality was 1.47%. Complications were more common in malnourished than well nourished patients [p-value <0.05] and in unvaccinated than vaccinated children [p-value <0.05]

Conclusion: Majority of patients was less than 9 months age. Pneumonia was the commonest complication and only cause of death. Complications were more common among unvaccinated and malnourished children

Neonatal idiopathic primary hypoparathyroidism: a rare cause of neonatal seizures

Etiology of neonatal seizures [NNS] is diverse and hypocalcemia is one of the treatable causes. Neonatal hypocalcemia [NHC] due to congenital hypoparathyroidism, either permanent or transient, is extremely rare. Its biochemical abnormalities include hypocalcemia, hyperphosphatemia and low levels of intact parathyroid hormone [PTH]. Isolated congenital hypoparathyroidism in which deficiency of PTH has no association with maternal, syndromic or endocrine defects is a very rare entity. We are reporting a case of a newborn who presented with seizures on the 5th day of life and later on investigations revealed hypocalcaemia due to isolated congenital hypoparathyroidism

Comparison of efficacy of oral and intramuscular iron supplementation for treatment of iron deficiency anemia in children

To compare the efficacy of oral iron preparation with intramuscular iron sorbitol in treatment of iron deficiency anemia in children. Randomized controlled trial. Paediatric department of Combined Military Hospital Kharian, Pakistan, from October 2011 to March 2013. In total 200 anemic chldren from 6 months to 5 years of age were included. Cut off value for Hb was < 8 gm/dl. Patients were divided into two groups, each of 100, randomly. Group A received oral sodium feredetate [iron edetate] and group B received intramuscular iron sorbitol. Rise in Hb > 10 gm/dl was kept as the desired value. Maximum duration of treatment planned was 12 weeks for group A and 2 weeks for group B. Laboratory parameters such as Hb%, mean corpuscular volume [MCV], retic count and serum ferritin level were used to detect the responses in both groups at one week, two weeks, four weeks and twelve weeks of treatment. Among 200 patients, male and female distribution was 45% and 55% respectively. Desired rise in Hb in group B was achieved much earlier i.e. at two weeks as compared to group A. Progressive rise in laboratory parameters was observed but this rise was more evident in group B as compared to group A. After one week treatment in group A, rise in retic count, Hb, ferritin and MCV was 0.759 +/- 0.318, 0.814 +/- 0.387, 0.47 +/- 0.154 and 4.28 +/- 2.468 respectively. But rise in these values in group B was 2.235 +/- 0.632, 2.335 +/- 0.135, 6.31 +/- 1.123 and 12.11 +/- 0.414 respectively. Same persistent different trend was observed at 2 and 4 weeks. After 12 weeks treatment in group A, rise in retic count, Hb, ferritin and MCV was 1.044 +/- 0.222, 5.204 +/- 0.134, 17.39 +/- 2.551 and 16.61 +/- 1.214 respectively but rise in these laboratory indices in group B was 0.551 +/- 0.261, 6.097 +/- 0.21, 42.49 +/- 2.768 and 20.68 +/- 2.233 respectively. The comparison of hematological indices after 12 weeks in A and B groups show sigruficant differences. All these parameters improved in both groups but improvement in group B was drastically more prominent when compared with group A [p-value < 0.05]. Intramuscular iron sorbitol therapy is an alternative and comparatively better treatment option as compared to oral iron therapy, sodium feredetate, in regards of treatment duration and earlier rise in the laboratory indices

Degree of thrombocytopeniaand malaria parasite species

Background: Malaria is a common health issue of our country and has shown variable prevalence in different regions of the world. It has a vast array of clinical presentation including, high grade fever with rigors and chills, headache, dizziness, acute renal failure, hepatopathy, joint pains and congenital malaria. It has various abnormalities on laboratory indices like thrombocytopenia, anemia, and leucopenia

Objective: This study was conducted to find out the degree of thrombocytopenia and types of the parasites among malaria patients from upper Punjab

Patients and Methods: This descriptive case series was conducted in CMH, Kharian, from 1[st] September, 2011 to 30[th] September, 2012. All the suspected malaria patients were included on the basis of history, physical examination and diagnosed on laboratory parameters [thick and thin films]

The data was entered and analyzed in SPSS version 16

Results: Out of the 273 enrolled cases in our study, 190 [69.6%] had malaria. 145 [76.3%] were infected by Plasmodium vivax and 45 [23.7%] had falciparum malaria. Out of these 190 patients 151 [79.5%] had thrombocytopenia, and among these patients having thrombocytopenia, 118 [78.1%] were infected by vivax species and 33 [21.8%] were infected by Falciparum species

Conclusion: It is concluded from our study that majority of the patients in this region of country, are suffering from Vivax and Falciparum malaria and present with varying degree of thrombocytopenia

Needle stick injuries in nurses at a tertiary health care facility

This study was aimed to assess the frequency and factors associated with Needle Stick Injuries[NSI] in nurses of a tertiary health care facility. This cross-sectional descriptive study was conducted in Combined Military Hospital Lahore in June-July 2012. Responses were obtained via a self-administered questionnaire with close-ended questions about the knowledge of the nurses regarding hazards of NSI, their frequency, and methods they practice to prevent them. The data was analyzed using SPSS-16. Chi-square test was applied and p-value was fixed at 0.05 to be statistically significant. Out of 118 nurses who participated, all were aware of the occupational hazards of their profession when they joined nursing. Sixty Five [55%] got NSI and 38[58%] of those were injured at the time of recapping the syringe. Sixty Nine [58.5%] did not use gloves while administering injections. After getting stuck by a contaminated needle, 100% squeezed out the blood from the area and 45[69%] out of 65 nurses cleaned the wound with a spirit swab. Only 13[20%] out of 65 consulted a physician regarding safety measures after NSI and 35[53%] had screening for Hepatitis-B Virus [HBV]. Seventy Eight [66%] of the total 118 nurses were immunized against HBV. Needle-stick injuries are highly prevalent among nurses, and prevention is the most effective way to protect nurses from infectious diseases which these injuries can transmit. Mandatory reporting to the concerned authorities, proper follow up, screening of nurses after NSI and promotion of safety measures against it should be greatly encouraged