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

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

Group B streptococcus neonatal meningitis-less common cause of neonatal meningitis in pakistan and disparity between csf culture and other parameters

Neonatal bacterial meningitis is a devastating illness with significant mortality and morbidity. Incidence and etiology of neonatal bacterial sepsis and meningitis varies among developed and developing countries. We are reporting a case of 6 days old neonate who presented with fever, refusal to take feed and then followed by an episode of seizure activity. Laboratory parameters for complete sepsis screening including cerebrospinal fluid [CSF] and metabolic screening were absolutely normal for his age, but CSF culture revealed growth of group B Streptococcus [Streptococcus agalactiae] Patient was treated successfully without any morbid sequel