Objective: To determine different causes of portal hypertension in children. Study Design: Cross Sectional study. Setting: Department of Pediatric Medicine, Department of Pediatric Gastroenterology and Department of Medical Emergency, The Children’s Hospital and Institute of Child Health, Multan. Period: 3rd April 2019 to 2nd October 2019. Material & Methods: A total of 71 children presenting with portal hypertension aged 1 month to 15 years of either gender were included. Newborns or children with congenital heart diseases were excluded. Patient samples were collected for complete blood counts and liver function tests, Ultrasound Abdomen and color Doppler ultrasonography were done for portal vein pressure to determine various causes of portal hypertension. Results: Overall, mean age was 9.00 ± 3.64 years. Out of the 71 patients, 51 (71.83%) were male and 20 (28.17%) were females. Different causes of portal hypertension were portal vein thrombosis in 48 (67.61%), liver cirrhosis in 14 (19.72%) and biliary atresia in 9 (12.68%) children. Conclusion: Among children having portal hypertension, portal vein thrombosis was noted to be the commonest cause followed by liver cirrhosis and biliary atresia.
Objective: To evaluate the frequency, common presentation, anti-snake venom (ASV) related management and outcome of snake bite cases in admitted children at a tertiary care hospital. Study Design: Case-series study. Setting: Department of Pediatric, Dera Ghazi Khan Medical College (DGKMC) & Hospital. Period: 1st March 2021 to 31st August 2021. Material & Methods: During the study period, all children presenting with snake bite were included. All cases were observed for their presentation, classified according to signs and symptoms, and managed through ASV as needed. Results: During the study period, a total of 52 patients of snake bite admitted in paediatric medical ward of DGKMC & Hospital. There were 37 (71.2%) male and 15 (28.8%) female. Overall, mean age of the children was 6.1±3.1 years. Maximum number of snake bite cases were reported during May, June and July as 15 (28.8%), 13 (25.0%) and 8 (15.4%) respectively. In the presentation, 29 (55.8%) patients presented with local symptoms only while remaining 23 (44.2%) presented with local as well as systemic symptoms. In the management, 3 (5.8%) cases did not require any ASV vial, 35 (67.3%) needed initial doses only. Fourteen (26.9%) cases required initial as well as maintenance doses. In terms of outcome, 49 (94.2%) children were discharged successfully, 1 (1.9%) expired and 2 (3.8%) got left against medical advice (LAMA). Conclusion: Snake bite was a common pediatric medical emergency at our institute. Most children presented with hemotoxic symptoms and needed ASV for resolution of symptoms. Prognosis is good with timely and judicious management of snake bite.
Kohat city is severely experiencing the problem of solid waste management (SWM). Open dumps in residential areas are creating day by day excessive number of environmental and social problems. This study concentrates on level of awareness and responsibility factors towards solid waste management (SWM) among inhabitants of Ashiq Colony, Kohat. There were 220 households and the sample size was 67 selected through analogy of Uma S, Sekaran. It is found by the study that male members of the community were aware about bad situation of solid waste management but female members were unaware about that. On the other hand both the sex were didn't understand their responsibility towards solid waste management and blame government and municipalities for the situation. Findings of the study suggest that there is need of environmental discourse to show community members that how much these environmental problems cause incredible fiascos. There must be awareness programs on SWM for promotion of clean environment through solid waste management. It is necessary for every individual of community to understand his/her responsibility towards solid waste management and to understand that it is not just the duty of municipality because environment is shared by all.
Objectives: Nephrotic syndrome (NS) is described as the existence of nephrotic-range proteinuria along with edema, hyperlipidemia and hypoalbuminemia. NS is estimated to be 15 time more frequent in children as compared to adults. Relapse is a major problem while managing nephrotic children. This study was aimed to find out the frequency of relapse in children with first episode of steroid sensitive nephrotic syndrome (SSNS) during the first 12 months, after completion of 6 months steroid therapy. Study Design: Descriptive case series study. Setting: Department of Paediatric Nephrology, The Children’s Hospital & the Institute of Child Health, Multan. Period: From February 27, 2018 to February 27, 2019. Material and Methods: A total of 55 children, aged 1 to 10 years, diagnosed with SSNS, 1st presentation of NS (based on history) and who successfully completed 6 months steroid therapy, were enrolled. They were taught to check proteinuria at home by dipstick method and enter daily results on the follow up card provided from the Nephrology department of the hospital. The outcome variable, that is relapse, was noted on the Proforma. Results: Amongst 55 children, gender distribution showed 38 (69.1%) male and 17 (30.9%) females. Children with body weight <20 kg were 33 (60%) and those having ≥20kg were 22 (40%). Patients with age <6 years were 54.5% and patients with age ≥6 years were 45.5%. Mean age was 5.93± 3.36 years. Frequency of relapse was noted to be 78.2% and patients who did not relapse within 1 year of completion of treatment were 21.8%. Conclusion: Nephrotic syndrome is a common presentation of childhood renal problems and is major cause of morbidity in our set up. Relapses are frequently associated with SSNS and most of the patients relapse within 1 year of completion of treatment. Relapses are more common in male children as compared to female children.
Objective: To find out the frequency of necrotizing enterocolitis (NEC) in preterm infants and to compare the frequency of NEC in preterm infants with formula feed versus breast feed. Study Design: Cross-sectional study. Setting: Department of Pediatric Medicine, Ghazi Khan Medical College, Dera Ghazi Khan, Pakistan. Period: January 2022 to June 2022. Material & Methods: A total of 174 preterm infants were enrolled. The NEC was diagnosed as abdominal distention or intolerance to nasogastric feed with pneumatosis intestinalis / portal venous gas or free intraperitoneal air which was confirmed by abdomen X-ray. At the time of enrollment, gestational age and weight were recorded. All preterm neonates were called for follow up every week for 4 weeks to diagnose NEC. Results: Of these 174 study cases, 101 (58.0 %) were male patients while 73 (42.0 %) were female patients. Mean gestational age of our study cases was 30.48 ± 3.24 weeks. Of these 174 study cases, 102 (58.6%) mothers were illiterate. Breastfeeding was noted in 74 (42.5%) infants while formula feeding was recorded among 100 (57.5%) infants. The NEC was reported among 61 (35.1%) cases whereas NEC in breastfeeding cases was found in 14 (18.9%) and 47 (47.0%) infants with formula feeding. Conclusion: High frequency of NEC was observed among preterm infants given formula feeding in comparison to breastfed preterm infants. Significant linkage of NEC was noted with gender, maternal literacy, birth weight and pattern of feeding.
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