Objective: To assess efficacy of salbutamol delivered through metered dose inhaler (MDI) - spacer in paediatric patients with acute exacerbation of asthma. Study Design: Prospective observational study. Place and Duration of Study: Department of Paediatrics, Pakistan Naval Ship, Shifa Hospital, Karachi-Pakistan, from Jan to Dec 2018. Methodology: Ninety Five patients aged ≥6 to ≤12 years, with acute asthma exacerbation were enrolled. Any patient with fever, clinical asthma score (CAS) >7, on home treatment with drugs delivered through nebulization or on oral steroids was excluded. Clinical asthma score recorded on presentation, followed with salbutamol via Metered Dose Inhaler & spacer at dose of 400 µgm (4 x puffs of 100 µgm). Clinical asthma score rechecked after 20 min. Response to salbutamol was then compared in relation to the presenting Clinical asthma score. Results: Out of 95 children, 45 (47.9%) were male & 50 (52.1%) female with 67.4% having positive family history for asthma. Average premedication clinical asthma score was 2.44. Sixty nine (72.9%) patients had an adequate response as they exhibited clinical asthma score of 0 or fall in score of ≥2. Patients with adequate response had average clinical asthma score of 2.07 on presentation in contrast to 3.42 with inadequate response. Conclusion: Salbutamol delivered via Metered Dose Inhaler & spacer at dose of 400 µgm is an effective medication for quick relief in children with acute exacerbation of asthma. Moreover, its administration at a point where exacerbation is not much severe steers us towards more favourable outcome.
Objective: To study the prevalence and the pattern of distribution of congenital heart disease.Study Design: Descriptive cross-sectional study.Place and Duration of Study: The study was conducted at outpatient department (OPD) of CMH Chhor and DHQ Umerkot, Sindh (Pakistan), from Dec 2019 to Mar 2020.Methodology: All the children (<12 years age) presenting to Paediatric OPD of the two hospitals were enrolled into study. Any patient with either a history or clinical examination pointing towards a suspected congenital heart disease was referred to Paediatric Cardiologist for 2-D echocardiogram. Details of the patient were recorded on designated proforma. Results: A total of 273 patients were diagnosed with congenital heart disease. Out of these, 114 (41.7%) were female and 159 (58.2%) were male (male: female of 1.4:1). The age of the children was ranging from 2 months to 12 years, 153 (56.04%) had simple heart defects, while 120 (43.9%) had complex or multiple congenital heart anomalies. Amongst the 273 patients, 25.3% were cyanotic and 74.7% had acyanotic heart disease. Most common lesion identified was ventricular septal defect (29.6%), followed by Tetralogy of Fallot in 20.8%. Conclusion: Acyanotic heart defects confirms to the major bulk of congenital heart defects with male preponderance.
Objective: To compare the outcome of Salbutamol nebulization with normal saline (placebo) in transient tachypnea of the newborn. Study Design: Comparative prospective study. Place and Duration of Study: Department of Neonatal Medicine, Military Hospital Rawalpindi, from Jan 2017 to Mar 2018. Methodology: Sixty term neonates with respiratory rate >60 breaths/min and transient tachypnea of newborn score of ≥4 were enrolled. They were randomly allocated to two equal groups. Group-1 received Salbutamol nebulization (0.15 mg/kg) while Group-2 received normal Saline (placebo) nebulization. Results: The mean gestational age was 38.31±1.28 weeks, while the average birth weight was 2.97±0.27 kg. The mean change in transient tachypnea of newborn score with Salbutamol nebulization was 5.63±1.22, while 0.63±1.54 with normal Saline nebulization. Likewise, the mean change in respiratory rate with Salbutamol was 9.80±2.05, while -3.73±2.57 with normal saline. Conclusion: This study demonstrated nebulized Salbutamol as an effective tool in reversing transient tachypnea of newborns with decreasing respiratory rate compared to normal saline nebulization (placebo).
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