study of clinico-epidemiological profile and outcome of poisonous snake bites in children

Objective: To study the poisonous snake bite cases with particular attention to demography, epidemiology, clinical profile and outcome in children

Study Design: Observational / Descriptive / cross sectional study

Place and Duration of Study: This study was carried out at the Pediatric Unit I, Bahawal Victoria Hospital Bahawalpur from 1 st January 2012 to 31 st December 2013

Methods and Materials: The record of 41 cases of poisonous snake bite admitting in Bahawal Victoria Hospital Bahawalpur was reviewed. Detailed information was collected

Results: Among 41 cases studied 85.37% were males. The majority of the cases [68.29%] were in the age group of 10-15 years. The majority of the cases [97.56%] were from rural area. The site of bite was on lower extremity in 82.93% cases. The timing of snake bite was evening or night in 87.8% cases

The 68.29% snake bites were in the months of monsoon season. The main type of envenomation encountered in this study was vasculotoxic

The common symptoms include local edema in 82.92%, pain in 75.61%, cellulitis in 63.41%, bleeding from bite site in 43.9% cases

The mean [ +/- SD] antisnake venom vials used was 9.39 [ +/- 4.77]

Abnormal bleeding profile was noted in 58.54% cases. The mean [+/-SD] hospital stay was 6.27 [ +/- 1.75] days. The case fatality rate was 4.88%

Conclusion: Anti snake venom should be a part of primary health care in areas where snake bites are common thereby referral to higher centers can be minimized and timely treatment can be given

Frequency and outcome of diabetic ketoacidosis in newly diagnosed type-1 diabetic children

Objective: To determine the frequency and outcome [mortality] of DKA in newly diagnosed cases of T1DM of one to 15 years of age

Study Design: Cross sectional study

Place and Duration of Study: This study was carried out at the Pediatrics Unit-I, Bahawal Victoria hospital Bahawalpur from 1 st January 2011 to 30th March 2014

Materials and Methods: The study was conducted on newly diagnosed cases of T1DM with or without DKA in children of one to 15 years of age admitting in pediatrics unit-I. The children with DKA were managed in the Pediatric Intensive Care Unit according to the standard DKA protocol of International Society of Pediatric and Adolescent Diabetes. Patients were examined at 96 hours after admission to see the outcome in term of death and survival. The data about the age, sex, severity of the disease and outcome was collected

Results: There were 65 cases of T1DM in the study; 60% were males. Out of 65 cases of T1DM 56 were cases of DKA; 59% were male. The frequency of DKA was 86.15%. The frequency of DKA among males and females was 84.61% and 88.46% respectively but the difference was statistically insignificant. Out of 56 cases of DKA, 25% were mild in severity, 32.14% moderate and 42.86% severe

The case fatality in DKA was 5.36%. The mortality was only among severe form of DKA

Conclusion: DKA is common among TIDM with mortality among severe cases of DKA

Knowledge, practice and attitude of mothers regarding oral rehydration salt

Objective: To assess awareness about the knowledge; attitude and behaviour of mothers about use of ORS

Study Design: Cross-sectional study

Place and Duration of Study: This study was conducted at the Pediatric Outpatient Department, Civil Hospital Bahawalpur from May 10, 2015 to July 25, 2015

Methods and Materials: This study was conducted on mothers who attended Pediatric Outpatient Department, Civil Hospital Bahawalpur with 2 months to 5 years old child having history of diarrhea at the time of visit of the hospital or within the last two weeks. The mothers were interviewed by the one of the researchers using a structured questionnaire about ORS including the demographic data

Results: There were 200 mothers included in this study. Their mean age +/- SD was 27.78 +/- 7.637 years. Among the studied mothers 18.5% were having at least secondary school certificate and 90% mothers were house wives. 4.5% mothers did not hear about ORS, 50.5% heard it from medical practitioners, 33.5% from some family member/ neighbours while 16.5% from media. ORS use within the last two weeks was in 44.5% cases of diarrhea. 49% mother gave opinion that it 'stops diarrhea', 29.5% 'does not know' while 21.5% gave opinion that it 'stops dehydration.' 38% mothers knew the correct technique for making ORS solution. 35% mother were in the opinion of giving ORS to the child by 'cup and spoon' in 70 [35%], 34% by cup and 31% by feeding bottles. There were only 34% mothers could prepare ORS correctly. 33% mothers described the correct amount of ORS solution to be given to the child while 41.5% mothers replied to continue giving ORS even if child developed vomiting

Conclusion: The awareness of mothers about the use of ORS is moderate. Further community based research is needed in this respect

attitude and knowledge of mothers regarding use of colostrum in newborn feeding

Objective: To assess awareness about the knowledge, attitude and behaviour of mothers about the use of colostrum for the newborn feeding

Study Design: Observational / descriptive /cross-sectional study

Place and Duration of Study: This study was conducted at Pediatric Outpatient Department, Civil Hospital Bahawalpur from July 10, 2015 to August 8, 2015

Materials and Methods: This study was conducted on mothers who attended Pediatric Outpatient Department, Civil Hospital Bahawalpur for the medical checkup of their children less than one year of age. The mothers were interviewed by the one of the researchers using a structured questionnaire about colostrum including the demographic data

Results: There were 100 mothers included in this study. There were 4% mothers younger than 20 years, 63% in the age group 21-30 years, 20% age group 31-40 years while 3% were older than 40 years. 17% mothers were having at least matriculation, 59% were having education less than that while 34% were uneducated. 94% mothers were house wives. There were 79% mothers who had heard about colostrum; among which 51% heard from either family members or from friends, 21% from medical personnels, 7% from media while 21% never heard of it. There were only 25% mothers who believed that colostrum was the best first feed of newborn, while 61% mothers believed it is GHUTTI that was best. There were 22% mothers who believed that it was beneficial for the health, 13% were in the opinion that it is injurious for the health while 65% replied 'do not know'. There were 41% mothers who told colostrum as yellow and thick, 11% replied it was milk like. There were 32% mothers who believed that colostrum is sufficient for initial newborn feeding, 25% believed it is insufficient. There were only 19% mothers who believed that baby must be put on breast for feeding within half an hour

Conclusion: The awareness of mothers about the use colostrum is poor to moderate

Tuberculosis; the spectrum in admitted children at Bahawal Victoria hospital

The purpose of study is to know the admission rate and spectrum of the tuberculosis in children admitted in the pediatric unit of a high endemic country. This retrospective study was conducted at the Pediatric unit-I, Bahawal Victoria Hospital Bahawalpur. The records of children older than one month but below 15 years of age diagnosed as tuberculosis [TB] during the years 2007-2011 were reviewed and were included for the study. The data [age, sex, history of contact, BCG vaccination, tuberculin test, diagnosis] were entered on a proforma. Data were entered into SPPS version 13 [Statistical Package for Social Sciences] package were presented as rates and proportions. There were 72765 children [excluding children below the age of one month] admitted during the period of five years [2007-2011], out of which 847[1.16%] were diagnosed as tuberculosis. There was no consistent fall in admission rate over the years due to TB cases. There were 61% male cases. The maximum cases were reported under the age of 4 years [46%]. Out of total 847 TB cases BCG scar was present in only 410 [48.4%] cases. The history of contact with adult TB case was found in 243 [28.7%]. Tuberculin skin test was positive [>/= 10mm] in 309 [36.5%] cases. The most common forms of TB were tuberculous meningitis and pulmonary tuberculosis each accounting for 37.5% cases. Other forms of tuberculosis included TB pleural effusion 12.5%, TB abdomen 7.1%, miliary TB 3.1% and TB arthritis 2.2%. The most common form of TB is meningitis and pulmonary each accounting for 37.5% cases and the maximum cases were reported under the age of 4 years