Factors involved in failure of exclusive breast feeding practices among mothers

Background: Exclusive breast feeding is essential for baby's health

Objective: To determine the factors associated with failure of exclusive breast feeding

Methodology: Study design: Cross - sectional study. Place and duration of study: The study was carried out in Pediatric department of Sheikh Zayed Hospital, Rahim Yar Khan, from 1 July 2015 to 30 June 2016. This study was conducted on five hundred women having infants up to 6 month of age and not on exclusive breastfeeding. A questionnaire was designed and data was collected through interviewing infant's mothers about various risk factors including maternal education, socioeconomic status, maternal employment status, family type, maternal separation, social myths, number of children, mode and place of delivery, maternal systemic illness, maternal breast condition, birth spacing, and counseling for breast feeding. The data was entered and analyzed by SPSS version 16

Results: Our study showed that among mothers having lack of exclusive breast feeding practice, following factors were found including lower socioeconomic status in 51.2%, joint family system 75.8%, male sex of infant in 62.8%, use of water up to 4 months is good in 64%, mother thinking that milk is not good in 29.2% and to familiarize baby to top feeding in 78.4%. Study showed that place of delivery was private clinics in 55.4%, caesarean section in 37.6% of and 73.4% of caesarean sections as mode of delivery took place at private clinics. Pathological maternal breast conditions [engorgement, sore or cracked nipples, abscess] were found in 36.6% and maternal systemic illness in 19.2%. It was found that proper counseling of mothers for exclusive breast feeding was done among 20.8%, at antenatal visits and 37.2% after delivery

Conclusion: Our study showed that among mothers not practicing exclusive breast feeding, most of these belonged to lower socioeconomic status, not employed, living in joint family system, and having social myths like use of water up to 4 months and to familiarize baby to bottle feeding. It was also found that pathological maternal breast conditions and lack of counseling, antenatally and postnatally were also important risk factors

Frequency of congenital heart diseases in neonatal nursery of tertiary care hospital

Background: Congenital heart disease [CHD] are one of condition with significant morbidity and mortality among neonates

Objective: To determine the frequency of congenital heart diseases in neonatal nursery of tertiary care hospital, Rahim Yar Khan

Methodology: Study design: Cross sectional study. Place and duration of study: Neonatal unit, department of Paediatrics, Sheikh Zayed Medical College/Hospital, Rahim Yar Khan from 1[st] January 2015 to 31[st] December 2016. In this study all the neonates admitted in neonatal unit and have some suspicion of cardiac defect [cyanosis, murmur etc] were investigated [CXR, ECG, Echocardiography]. The frequency of CHD was measured and presented as percentage

Results: We found that 0.44 % of congenital heart disease including both cyanotic and acyanotic were admitted in neonatal unit

Frequency of impaired glucose tolerance test in children with celiac disease

Background: oral Glucose Tolerance test among children with celiac disease may help in management

Objective: to determine the frequency of impaired Oral Glucose Tolerance test in the children with celiac disease

Methodology: Study design: Cross - Sectional study. Place and duration of study: Department of Paediatric including Sheikh Zayed Medical College / Hospital, Rahim Yar Khan from 22[nd] April 2014 to 18[th]June 2015. In this study 77 patients of celiac disease were included. Oral glucose tolerance test was performed and noted. The Performa was filled and record was maintained. The data was entered and analyzed for frequency of impaired OGTT by using SPSS version 16

Results: in our study, we found that out of 77 patients of celiac disease, 9 [11.7%] patients were having impaired OGTT

Conclusion: impaired OGTT is frequent in children suffering from celiac disease. It can be used as monitoring tool for glycemic abnormalities in these patients. It will help in earlier detection and initiation of prompt management accordingly

Frequency of bacterial meningitis in children presenting with seizure and fever diagnosed on Lahore puncture

Objective: to determine the frequency of bacterial meningitis in children presenting with seizure and fever diagnosed on lumbar puncture

Material and Methods: this descriptive study was conducted in the department of Paediatrics, Services Hospital, Lahore. The duration of study was 6 months from June 2012 to December 2012. One hundred and fifty cases with fever and seizures were included in this study. Their demographic information was recorded; lumbar puncture was performed and sent for cerebrospinal fluid analysis in the laboratory. All this information was recorded on a pre-designed proforma

Results: majority of the patients were between 1-2 years of age i.e. 50.6% [n=76], 21.3 %[ n=32] between 3-4 years, 19.3% between 5-6 years and only 8.6% [n=13] were of 7 years of age. Mean +/-. Standard deviations were 3.67+/-2.54 years. Males were 58 %[ n=87] and 42% were females. Frequency of acute bacterial meningitis in children with fever and fits, which were diagnosed on lumbar puncture, reveals 6% [n=9], while 94% [n=141] had no finding on CSF examination

Conclusion: the frequency of bacterial meningitis in children with fever and seizure is considerable but not significantly high

Knowledge of triage among nurses in emergency units

The emergency department is one of the key and essential departments in a hospital. It is the preliminary point of contact with the hospital for any kind of patient who has a need for immediate interventions. The assurance of the best possible care in emergency situations depends on the implementation of a swift triage system and strapping knowledge of triage among nurses. A structured triage system in emergency units could have a radical impact to improve the quality care of patients in hospitals. A simple descriptive survey design was used to conduct this study. A sample of 100 nurses was selected from the emergency units of three local teaching hospitals by using the method of non-probability purposive sampling. Data was collected by a self administered questionnaire. The data was analyzed by SPSS version IBM - 20 and was represented in the form of figures, tables and percentages. It was sum that a large number of participants [69%] were having poor knowledge as they corrected less than 50% of the questions in the self administered questionnaires. The overall correct responses of the participants were 43.22%. The current study findings of low level of triage knowledge among nurses reflect that there is a lack of proper training and edifying programs in Pakistan. Nursing curriculum for different nursing programs has not sufficient content of triage to prepare nurses for triage system in emergency units

Appendicular mass, early exploration vs conservative management

Appendicular mass is a common complication of acute appendicitis. The traditional treatment of this is conservative followed by delayed appendectomy. But now with advancement in all the fields of medicine early surgical exploration of the appendicular mass can be done with satisfactory results. A comparison of conservative treatment versus early surgical exploration of appendicular mass. Experimental study. Two years study from December 2003 to November 2005 at district headquarters hospital Khanewal. Total 60 patients, both males and females between 12 to 65 years of age with symptoms and signs consistent with appendicular mass were included. They were randomly divided into group I [Early exploration] and group II [Conservative treatment] each containing 30 patients. A comparison of outcome between two groups was done statistically by applying student Chi-square test. There was a peak incidence of acute appendicitis in Second and third decades of life. Male to female ratio was 2:1. More than 90% of patients had history of shifting of abdominal pain. 100% of the patients had inflamed appendix to variable extent on exploration. The complications in the form of adhesive intestinal obstruction; failure of treatment; lost follow up; misdiagnosis and re admission were less in group I. There was a significant less duration of hospital stay in group I as compared to Group II. The observations and outcome in this study are almost comparable and correspond with other studies done in this regard. Early surgical exploration of appendicular mass is safe and cost effective

Fragility hip fractures

Fragility fractures, the major clinical problem have increased in recent decade due to any increase in expected age. There is a tremendous economic burden to manage this problem, the disability increased from 20% before hip fracture to 50% after this even if managed properly. Fragility hip fracture is associated with a 20% reduction in expected survival in best hands. To study the incidence; types of fractures; treatment options and their outcome. A retrospective study. Armed Forces Hospital Southern Region Khamis Mushayt, Kingdom of Saudi Arabia. From April 1996 to April 2006. 300 patients were included in the study, both males and females above the age of sixty years presented in Emergency Room with hip fractures due to minor or trivial trauma. Diagnosis was based on clinical and radiological grounds. Additional investigations were made when and where indicated to confirm diagnosis and to assess the patient form anesthesia and surgical point of view. Internal fixation was the main treatment to see the ultimate outcome. The incidence of fragility hip fractures increased with age. Sixty percent of the victims were females. The incidence increased with every passing year being 15% in the last year of study. 93% of the fractures were of intertrochanteric type and fixed with engineered metallic device [DHS]. Prevention or delay osteoporosis should be the main objective. Once there is fragility hip fracture internal fixation is the appropriate treatment

Urological injuries

To find out the mechanism of injury and urological organ involved. Prospective study. two years [from 1996 to 1998] West Surgical Ward Mayo Hospital Lahore. A total numbers of 30 patients were included in the study. All the patients above the age of 12 years having injury to kidney, ureters, bladder, and combination were included. Penetrating injuries due to firearms were the dominant cause i.e. in kidneys and ureters [100%] and in urinary bladder [50%]. Kidney was the most common urological organ injured [56.66%] followed by the ureters [20%] and Urinary bladder [13.33%]. Urological injuries account for 10% of abdomen injuries. The vast majority are penetrating injuries due to firearms. The injuries may better be prevented than treated by strict maintenance of law and order

Study of primary open angle glaucoma in Nishtar hospital Multan

This study reviews the cases of open angle glaucoma admitted in Eye Ward of Nishtar Hospital, Multan, over a period of three years, during which there were 8670 admissions with 1366 cases of different types of glaucoma. Out of these 1366 cases, 265 patients [19.39%] presen ted with typical signs of open angle glaucoma. Eighty patients were dropped from the sutdy due to non-cooperation and poor follow up. This series, therefore, deals with 185 patients. Majority of the patients [37.83%] were between 40-50 years. Sixty percent of cases in our study were males and 40% were females. Family history of glaucoma was present in 10% of the cases. Most of patients presented with advanced cupping of the disc and visual field defects; in some patients one eye was already lost. Because of, improved methods of early detection, advances made in medical and surgical treatment and public awareness about the seriousness of this dease, it is possible to prevent blindness due to a glaucoma