Objective: To assess the mean change in bone mineral level in children with treatment of epival for management of epilepsy Study Design: Quasi experimental study Material and Method: The present study was carried out in the Paediatric department, Services hospital Lahore. Duration of study was 6 months from 02-03-2017 to 02-09-2017. 110 children suffering from epilepsy and taking epival were enrolled in the study from OPD of Department of Pediatrics, Services Hospital, Lahore. Informed consent was obtained from parents. Demographic profile (name, age, gender, address and contact) were also noted. Their blood samples were collected for assessing serum ALP and calcium. Reports were assessed and baseline values were noted. Children were followed-up in OPD for 90 days. After 90 days, calcium and ALP were assessed again. All this information will be recorded in pre-designed proforma. Data was analyzed by using SPSS-20 software. Results: The results showed that average age of children was 7.68±4.05years. There were 56(50.91%) males while 54(49.09%) females. The mean BMI of patients was 22.40±2.60kg/m2. The mean calcium level at baseline was 9.34±0.53mg/dl which was decreased to 8.56±0.77mg/dl after 09 days of treatment with epival. The mean change in calcium was 0.78±0.43mg/dl which was significant (P<0.05). The mean ALP level at baseline was 96.20±30.47U/L which was increased to 118.07±38.41U/L after 09 days of treatment with epival. The mean change in ALP level was 21.87±9.38U/L which was significant (P<0.05). Conclusion: There is significant impact of epival on bone mineral density of epileptic children
Introduction: Bleeding issues specific to women and adolescent females are common across the world. These issues can present either due to gynecological causes or obstetric one; however these can result in significant morbidity and work up needs to be done to rule out any underlying bleeding diathesis. Aims & Objectives: To determine frequency of various bleeding disorders among gynecological and obstetric patients presenting with bleeding. Place and duration of study: It is a cross sectional study which was conducted in the Hematology Department, Services Institute of Medical Sciences, Lahore. The duration of study was 6 months i.e from 21st Oct, 2018 to 30th April, 2019. Material & Methods: Females with age range of 15 to 50 years irrespective of pregnancy presenting as menorrhagia, metrorrhagia or obstetrical bleeding were included. Results: In the present study there were total 140 cases with mean age of 30.14±9.59 years. There were 98 (70%) cases that were pregnant. There were 35 (25%) cases presented with PPH (Post Partum Hemorrhage), 42 (30%) with IPH (Intra Partum Hemorrhage), 49 (35%) with menorrhagia and 14 (10%) with metrorrhagia. HELLP (Hemolysis, Elevated Liver enzymes and Low Platelet count) syndrome was seen in 13 (9.29%) cases, DIC (Disseminated Intravascular Coagulation) in 2 (1.43%), gestational thrombocytopenia in 7 (5%), while factor deficiency in 34 (24.29%) cases; and 84 (60%) of cases revealed none of the bleeding disorder. Out of total 34 cases of factor deficiencies, vWD was the most common, seen in 20 (58.82%) cases. There was none of the cases seen having deficiency of factor II, VII, VIII, XI, XII. HELLP syndrome was seen in 11 (84.62%) of the cases with age group 15 to 32 years and similarly both cases of DIC were seen in same age group; but the difference in both the age groups regarding these bleeding disorders was not statistically significant with p= 0.38. There was no significant difference in terms of pregnancy; however, both cases of DIC were seen in pregnancy with insignificant p value of 0.51. HELLP syndrome was more seen in IPH affecting 5 (38.40%), factor deficiency in menorrhagia affecting 13 (38.2%) with p value of 0.61. vWD and factor V Leiden presented in 44.4% cases each with PPH, and vWD affected 87.5% of cases in IPH without any significant difference with p= 0.42. Conclusion: Bleeding disorders are not uncommon in gynecological and obstetric conditions. Factor deficiency were the most common causes and amongst these vWD was the most deficient factor. There was no significant association with any confounding variable; however, DIC was only seen in obstetrical conditions. Key words: Bleeding, menorrhagia, HELLP, DIC, IPH, PPH
Objectives: The purpose of this scrutiny was to note the part played by folic acid and vitamin B 12 inadequacies resulting in macrocytic anemia in pediatric community visiting our institute. Study Design: Retrospective cross sectional study Place and duration: Department of Hematology and Transfusion Medicine, The Children Hospital, University of Child Health Sciences, Lahore from Jan 2021 to Dec 2021. Methodology: Medical data of 294 children demonstrating features of megaloblastic anemia were scrutinized. Records related to complete blood count (CBC) specially hemoglobin level, MCV, MCH, MCHC, peripheral blood findings, serum folic acid and vitamin B 12 amounts were noted from registers along with the other relevant medical presenting, past and family socioeconomic history. Results: Out of total 294 cases with CBC and peripheral blood findings of macrocytic anemia, 160 were males and 134 found to be females. Mean age was 57 months (4.75 years). Vitamin B12 insufficiency alone was noted in 162 (55.1%) cases, folic acid alone appeared to be deficient in only 8 cases where as combined paucity of both was noticed in 30 cases. Conclusion: Vitamin B12 deficiency found to be the predominant cause of macrocytic anemia in children referred to our institution with 65.3 % of total case population. Considering its significance in the regulation of nervous system, awareness programs with proper guidance are essential to deal this manageable issue. Key words: Megaloblastic anemia, macrocytosis, cobalamin, Vitamin B 12 deficiency, Folic acid deficiency, Anemia, Lahore Pakistan
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