Auto immune hemolytic anemia in a child precipitated by chicken pox

Auto Immune Hemolytic Anemia [AIHA] is a rare entity in children. We report a case of an adolescent girl with AIHA, which was precipitated by chicken pox. Clinical course over 3 years, till remission is described

Management of Acute Asthma in children using metered dose inhaler and small volume nebulizer

To determine whether the administration of 32 - agonist by Metered Dose inhaler [MDI] with accessory device [AD] is a as effective as the administration of 32 - agonist by small volume nebulizers [SVN] for the treatment of acute asthma. A cross sectional study was conducted at Emergency Room [ER] of National Institute of Child Health [NICH], Karachi, between October 2000 to March 2001. This study included 150 children, 6 months and older with a history of wheeze and presenting with an acute asthma exacerbation. Children were categorized into mild, moderate and severe asthma according to medical scoring system. Children were assigned randomly into group A and B to receive standard dose of 32 - agonist [salbutamol] by MDI/AD [group A] or SVN [group B]. Baseline : characteristics and asthma severity were recorded. All variables [dyspnoea, use of accessory muscles, cyanosis, respiratory rate, heart rate, blood pressure, oxygen saturation, pulsus paradoxus, and wheeze] and Peak Expiratory Flow Rate [PEFR] in children 5 years and older, were determined at pre and post inhalation therapy. Both groups did not differ in demographic characteristics. There were no significant differences in outcome measures. In children treated with MDI/ADs and SVNs. PEFR increased significantly in both the groups after completion of treatment, but PEFR was not statistically significant when compared in between groups. The data suggested that MDI/AD is an effective alternative to nebulizer for the treatment of children with acute asthma exacerbation in the ER

Effect of weaning period on nutritional status of children

To determine the effect of age of introduction and the type of weaning foods used, on the nutritional status of children under three years of age. Cross-sectional, community-based study. The study was conducted in rural areas of District Malir in Karachi, Pakistan, comprising of 900 villages spread over 1200 square kilometer, from November 2000 to April 2001. Patients and Three hundred and fifty-nine children under 3 years were included in the study. Based on the age of commencement of weaning, the children were categorized as children weaned at appropriate and inappropriate age. For the type of weaning foods, the children were grouped into two categories based on the nature of food items. Children for whom weaning was started at the recommended age of 4-6 months were found to be significantly less malnourished on anthropometric measurements as compared to the other set in which weaning was started at an earlier or later age. Significant statistical difference was noted in the children weaned on nutritious home-made items compared to children having commercial foods. Malnutrition is of multi-faceted origin beyond only poverty and food shortage. Inappropriate feeding practices can result in growth faltering as noted in the present study. Programmes should be launched for education of mothers regarding weaning practices