Asthmetic childrens; clinical pattern and frequency of asthma triggers

Objective of this study to determine the clinical presentation and frequency of asthma triggers in the children suffering from asthma at Liaquat university of medical and health science. This cross sectional study was carried out at Liaquat University Hospital Hyderabad. All the patients were selected from OPD and pediatric ward of LUMHS. Complete history of allergy was taken from the cases and their parents and all the triggers of asthma were documented on the proforma. Total 100 patients were included in the study. Majority of the cases in the age group of 1- 3years and 2nd most common age group was 4- 7 years with the percentage of 39% and 33% respectively. Majority of the cases 51%, while moderate was present in 35% cases and 14% children were seen with severe asthma condition. Asthma triggers in the children was found as; Smoking, Exercise, Dust, Pets, Ice, Plants, Carpets, Eggs, Corn oil, Allergic rhinitis and Without triggers, with the percentage of 22.%, 55.%, 51.%, 10.%, 34.%, 05.% ,11.%, 12.% , 27.%, 46.% and17.% respectively. In the conclusion of this study we concluded that allergic triggers perform the important role in the severity of asthma disease, these triggers attacks at night and early morning, so to avoid from the smoke, dust, allergens and proper management of asthma with good compliance and regular follow up of the patients

Outcome of early management of club foot by ponseti technique

The Objective of this study is to assess the anatomical correction, cosmetic and functional outcome of the Ponseti method in idiopathic congenital Talipes Equino Varus [CTEV]. Experimental and case series study. The study was carried out in the Department of Orthopaedic Surgery and Traumatology [DOST] Liaquat University of Medical and Health Sciences Jamshoro for a period of two years from 21-01-2009 to 20-01-2011. This study was contains 50 cases of congenital talipes equino varus "CTEV". In this study all the case were selected with age of one year from the birth with congenital "talipes Equino Varus". All the cases with Acquired "Talipes Equino Varus", atypical foot, "talipes Equino Varus' with Arthrogryposis Multiplex Congenital, "talipes Equino Varus previously treated by method other than ponseti technique were excluded from the study. Total 50 cases of congenital Telipase Equine, Varus [CTEV] having 77 feet were analyzed in this study with [male female ratio 1:7]. Out of 50 cases, 27 [54.0%, n = 50] had bilateral [54 feet] deformities and 23 [46.0%, n = 50] cases were unilateral deformities. Severity was assessed according to Pirani Scoring system. 48 [62.0%] had severe foot deformity while 29[37.60%, n = 77] patients had moderate foot deformity. Out of 77 feet, rocker bottom foot deformity developed in 03[18%] feet, increased stiffness of ligaments and joints occurred in 1[1.2%, n 77] foot while vascular complications like skin ulceration and necrosis was observed in 1[1.2%, n =77] feet. At the end of 2 to 3 years follow-up period, in 72 [94.0%, n = 77] patients congenital clubfoot deformities were corrected successfully by using Ponseti method while 05 [6.0%, n = 77] patients were not fully corrected due to other complications. The Ponseti method is a fast, safe and effective treatment for congenital idiopathic clubfoot and radically decreases the need for extensive corrective surgery

Celiac disease; effectiveness of treating previously untreated patients with both a gluten free diet and bisphosphonate, gluten free diet alone

To evaluate effectiveness of treating previously untreated patients with celiac disease with both a gluten free diet and bisphosphonate in order to significantly increase their BMD's to a greater extent than a gluten free diet alone. The study was conducted in National Institute of Child Health [NICH] Karachi to evaluate the effectiveness of treating previously untreated patients with celiac disease with a gluten free diet and bisphosphonate in terms of increase in bone mineral density in comparison to a gluten free diet alone over a period of three months [January 2013 - March 2013]. The study includes 30 children patients below fifteen years of age either sex. All study subjects were untreated celiac patients diagnosed by clinical presentation, small bowel histology and serologic testing. On day dexa scan was done. Fifteen patients kept on Gluten Free Diet [GFD] and remaining 15 patients kept GFD plus tablet of bisphosphonate. After three months dexa scan was repeated. The patients with other disease of bone or mineral metabolism, as well as subjects taking systemic glucocorticoids or high doses of thyroid hormones, were excluded. A total of 30 patients with celiac disease were included in this study. Out of 30 patients 18 [60%] were female and 12 [40%] male [M: F = 1:1.5]. Thirty patients were divided in two equal groups [15 patients in each group]. In group-I we gave gluten free diet and in group-II we gave gluten free diet and one tablet of bisphosphonate. Mean +/- SD of Bone Mineral Density [BMD] in group-I was 0.402 +/- 0.081 gm/cm2 [range=0.234 - 0.503 gm/cm2], and in group-II was 0.543 +/- 0.098 gm/cm2 [range= 0.402 - 0.743 gm/cm2], mean difference of bone mineral density was significant between two groups [P-value=0.0002]. At three months DEXA scan showed a significant rise in BMD in group-II as compared to group-I