Factors associated with cessation of breast feeding

To determine factors associated with cessation of breast feeding in children. This was a cross sectional study carried out at Lyari general hospital from 1[st] January to 30[th] June 2009. Children up to two years of age were included. Information entered in a pre-designed proforma. Total of 543 children included. Maternal factors were insufficient milk secretion 57% and insufficient rest during first six weeks of post partum 43%. Among factors in children, formula feeding 41% and disruption during feeding 36% were common. No enough milk during first few days after birth 64% and baby remains hungry after breast feeding for enough time 62% were common myths. The major maternal and child factors and myths responsible for termination of breast feeding were insufficient milk secretion, breast problems, maternal stress, bottle feeding and initial breast milk is harmful to the babies. These misconception must be addressed during antenatal visit

Juvenile myelomonocytic leukaemia

Juvenile Myelomonocytic Leukemia [JMML] is a rare hematopoietic malignancy of early childhood. Infection remains the principal cause of death in patients with myelodysplastic syndrome [MDS]. Sixty percent of patients are anemic and 26 percent have petechiae and/or purpura [thrombocytopenia]. Bone Marrow Transplant [BMT] is the best available treatment option. We describe the management of an eight months old male child who presented with complaints of fever, cough and pallor since six months. Despite medication his fever did not subside. He developed meningitis and intracranial bleed and expired on 11th day of hospitalization

Chediak-higashi syndrome

Chediak Higashi Syndrome is a rare inherited autosomal recessive disorder of immune system. Susceptibility to infection due to phagocyte dysfunction ranges from recurrent skin infection to over whelming fatal systemic infection. A five years old male child was admitted on 31st March 2006 with the complaints of pallor, fever and ear discharge for 6 month. He was treated by several medications but had temporary relief. The ear discharge was bilateral, foul smelling and of yellowish color. Past history was significant with episodes of abscess involving the different parts of body. Myeloid precursors shows giant, purple stained granules mainly in metamyelocytes, band cells and mature neutrophils

Acquired aplastic anemia: treatment in a developing country

The aim of this study was to evaluate the clinical presentation of aplastic anemia as well as to assess the efficacy of Cyclosporin-A in patients with aplastic anemia. This is a hospital based interventional study. During the three year study period, 44 children were enrolled. Mean age was 9.3 years and there was a male predominance. Most common clinical presentation was anemia and bleeding. Four children died before therapy was started. Cyclosporin-A was started in 40 patients. Eleven patients died before completion of therapy and three patients were lost to follow-up. Out of 26 patients who completed therapy, 11 were cured and 9 were responders while 6 were non responders according to the selected criteria. In developing third world countries like Pakistan majority of the patients with aplastic anemia cannot afford BMT. Alternative modalities of treatment must therefore be looked into. Cyclosporin-A seems to be a reasonable therapeutic option in such cases