Background: Paraphenylene diamine (commonly known as Kala Pathar in Pakistan) poisoning is a common presentation in adults as well as pediatric patients in Southern Punjab. The study was carried out to assess paraphenylene diamine poisoning in pediatric cases. Patients and methods: The cross-sectional study was carried out at Bahawal Victoria Hospital Bahawalpur. All the pediatric cases (<15 years age) of paraphenylene diamine poisoning reported during April 2021 to April 2022. Data was entered and analyzed in SPSS. Results: Total 84 children presented at pediatric department of the hospital. Out of these, 43 (51.2%) were males and 41 (48.8%) were females. Age range was between 02 months and 15 years, mean age being 9.4 + 4.49 years. Majority of cases (46.6%) ingested paraphenylene diamine accidentally, followed by suicidal intention (29.8%), homicidal intent (21.4%) and unknown motive in 2.4% cases. Of all, 49 (58.3%) died of poisoning and 35 (41.7%) survived. Of all the cases, 44 (52.4%) underwent emergency tracheostomy. Conclusions: Paraphenylene diamine poisoning in children is an alarming trend. Although majority of the cases ingested it accidently but intake due to suicidal or homicidal reason were also high. Positive outcome was associated with higher age, carrying out early tracheostomy and mode of poisoning (homicidal cases had poorest outcome whereas accidental and suicidal pediatric cases had more chances of survival).
Objective: To determine the association of iron deficiency anemia (IDA) with febrile seizures (FS). Study Design: Case Control study. Setting: Department of Pediatric Medicine, Bahawal Victoria Hospital, Bahawalpur. Period: January 2022 to July 2022. Material & Methods: A total of 30 children of both genders of age 1 to 5 years with febrile seizure and 30 children in control group (febrile without seizures) were included. Three ml blood sample of each patient was taken as sent to the institutional laboratory for assessment of iron deficiency anemia (hemoglobin < 11.5 g/dl). Association of IDA with FS was calculated. Results: Out of 60 patients, 28 (46.7%) were boys and 32 (53.3%) girls with boy to girl ratio of 1:1.1. The mean age in case group was 2.93 ± 1.23 years and in control group was 3.0 ± 1.31 years. Majority of the patients 39 (65.0%) were between 1 to 3 years of age. Frequency of IDA in case group (febrile seizure group) was found in 11 (36.7%) while in control group (febrile disease without seizures) it was found in 4 (13.3%) children (p=0.037, odds ratio=3.76).
Objective: To determine the frequency of rickets among children ≤ 5 years of age presenting with poor growth visiting a tertiary care facility. Study Design: Cross-sectional study. Setting: Pediatric Unit-2, Bahawal Victoria Hospital, Bahawalpur. Period: July 2021 to January 2022. Material & Methods: A total of 261 patients with poor growth and ≤5 years of either gender were included. A written consent was taken from the parents/guardian of all study participants after explaining them the nature of this study. All demographic data along with outcome variable (frequency of rickets) was noted on a predesigned proforma. Results: Mean age was 3.34 ± 1.41 years. Majority of the patients 136 (52.11%) were between 4 to 5 years of age. Out of the 261 patients, 153 (58.62%) were male and 108 (41.38%) were females with male to female ratio of 1.4:1. Mean sunlight exposure time was 25.67 ± 11.72 minutes/day. Mean age of start of weaning was 8.13 ± 4.33 months. Frequency of rickets among children ≤ 5 years of age presenting with poor growth was found in 18 (6.9%) patients. Conclusion: The frequency of rickets among children ≤ 5 years of age presenting with poor growth was high (6.9%).
Objective: To know the status of hepatitis C virus (HCV) infection in children admitted in Pediatric ward of Bahawal Victoria Hospital Bahawalpur. Study design: Cross-sectional descriptive study. Place and duration of study: Pediatric unit-1 Bahawal Victoria Hospital Bahawalpur over a period of 2 months and 15 days. Material and methods: This study was conducted over 500 children admitted in children ward-1 of Bahawal Victoria Hospital Bahawalpur. Children of 1-15 years of age were included in the study. The blood samples of these children were taken at the time of admission and serum was tested for HCV with ICT method and later on confirmed by ELISA. Children having HCV infection were tested for SGPT level. Different risk factors for transmission of HCV infection were also studied. Results: Out of 500 children 43 were HCV positive by ICT method. Out of these 43 ICT positive children 38 were confirmed by ELISA. In this way 7.6% children were found positive for HCV. In 23 cases (60.5%) SGPT was raised (>40). Statistically significant risk factors for transmission of HCV infection found in this study were past history of blood transfusion and history of injections in past. Conclusions: HCV infection is quite common in children. Safe blood transfusions and use of disposable and sterilized syringes is important for prevention of this infection.
Background: Nephrotic syndrome is a medical problem clinically characterized by proteinuria, generalized body edema and hypercholesterolemia. We did this study to compare the effectiveness of single dose versus split dose prednisolone in achieving remission in patients with nephrotic syndrome in children.Patients and methods: This open-ended randomized control trial was done in pediatric unit of tertiary care hospital from January to December 2019.We included one hundred Patients of nephrotic syndrome in the study who met the inclusion criteria. We divided total Patients into 2 groups (group A & B) 50 patients in each group. Group A was given single dose prednisolone, while group B was given split dose prednisolone therapy. Both groups were compared with respect of achievement of remission.Results: Out of 50 patients of group A who were given single dose prednisolone 37 (74%) were male, while in group B who were given split dose prednisolone 22 (44%) were male (p-value=0.137). Mean age of patients of study group A and B was 4.5 ±1.67 years and 4.9 ±1.49 years respectively (p-value=0.1876). Mean serum creatinine level in study group A and B was 0.744±0.189 and 0.736±0.167 (p-value=0.823). Similarly mean serum albumin level in study group A and B was 2.34±0.358 and 2.39±0.33 (p-value=0.473). When both groups were compared with regard to response to treatment, in group A mean remission duration was 16.48 ±3.69. In group B mean remission duration was 19.42 ±3.11 days (p-value<0.05).Conclusion: From our study we concluded that single dose prednisolone is more effective in achieving remission in steroid sensitive nephrotic syndrome as compared to split dose prednisolone.
Objective: Tetanus remains a major public health problem in the developing countries despite the availability of active immunization and passive immunization since long. Non-sterile ear piercing and instrumentation pose a constant threat of developing tetanus associated with morbidity and mortality. Study Design: Retrospective Cross-sectional study. Setting: Department of Pediatric, Bahawal Victoria Hospital Bahawalpur. Period: June 2019 to June 2022. Material & Methods: The data of children admitted with tetanus following ear piercing, ear cleaning/instrumentation and chronic ear discharge was collected. The data included their age, gender, history of ear piercing, instrumentation and chronic ear discharge (otorrhea), duration between piercing/instrumentation and development of signs & symptoms of tetanus, history of tetanus vaccination (during routine childhood EPI vaccination), history of tetanus toxoid administration after the causative event, residence, socioeconomic status, education status of parents and outcome of cases. Results: Total 17 cases of otogenic tetanus (tetanus following ear piercing, ear instrumentation and with chronic otorrhea) were admitted in pediatric department of the hospital during study period. Age range was between 03 to 13 years with mean age 7.71+2.80 years. Of these cases, there were 12 females (70.6%) and 5 males (29.4%). Nine cases developed tetanus after ear piercing, five cases developed tetanus following ear instrumentation and three cases had history of chronic ear discharge. Conclusion: Tetanus is an uncommon but dreadful complication of non-sterile ear piercing, ear instrumentation and chronic discharging ears in chronic otitis media, and is still occurring in our country.
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