IntroductionRetinopathy of prematurity (ROP) is a treatable cause of blindness in neonates. In Pakistan, ROP is often not recognized early because screening and treatment programs are not yet in place in most neonatal units, even in tertiary care hospitals. It is hoped that this report will help inform medical professionals of the magnitude of the problem and help to design appropriate management strategies.ObjectivesThe aim was to determine the frequency of ROP in premature and very low birth weight (BW) neonates (BW<1500 g and gestational age (GA) <32 weeks).Study DesignCross-sectional study.Study SettingNeonatal intensive care unit (NICU) of a tertiary care hospital in Karachi, Pakistan.Study DurationFrom June 2009 to May 2010.Subjects and MethodsNeonates with a Birth weight (BW) <1500 g and Gestational Age (GA) <32 weeks who were admitted to the NICU and received an eye examination, or were referred for a ROP eye examination as an outpatient, were included in the study. GA was estimated from intrauterine ultrasound findings. Neonates with major congenital malformations, syndromes or congenital cataracts or tumors of the eyes, and those that died before the eye examination or did not attend the out patients department for an eye examination, were excluded. The neonatal eye examination was performed by a trained ophthalmologist at 4 or 6 weeks of age.ResultsOut of 86 neonates, ROP was identified in nine neonates (10.5%) at the first eye examination. ROP was significantly associated with BW (P = 0.037), GA (P = 0.033), and chronological age (P<0.001).Conclusionswe identified ROP in 10.5% of neonates at first eye examination. Significant associations between ROP and a GA<32 weeks and a BW<1500 g were also observed.we also stress that serial follow-up of neonates at risk for ROP is important when making a final diagnosis.

Background: Almost two-thirds of parents report one or more problems with their children’s eating. Although knowledge of the health-related outcomes of picky eating is limited due to a lack of longitudinal studies, research suggests that picky eating is associated with nutrient deficiency, underweight, behavioral problems and symptoms of anxiety and depression. Aim of present study was to assess the Parental perception and maternal strategies in solving feeding difficulties in relation with parenting style.Methods: The present cross sectional study conducted on 1652 parents of preschool children of 1-6 yrs age group. A structured parental questionnaire was administered to parents by Pediatricians based on Stanford feeding Questionnaire on Child- parent feeding.Results: About 58.9% of the children were found to be picky eaters. The prevalence is increasing with age and higher at 6 years age. The mean height and weight are seen affected significantly in picky eaters. Infantile Anorexia is the commonest type of Feeding difficulties, followed by Highly selective intake category. Commonest Parenting style is Authoritarian type, followed by Permissive parenting.Conclusions: As the prevalence of picky eating behaviour is increasing with age, causing parental anxiety and conflict in the family, disrupting parent child bonding, Paediatricians should be thoroughly equipped with knowledge of different Feeding difficulties and their specific management and help parents in doing their best by correcting their parenting style.

Background. The success of orthotopic liver transplantation as a life-saving treatment has led to new indications and a greater competition for organ grafts. Pediatric patients with acute liver-related crises can benefit from orthotopic liver transplantation, but organ availability in the limited time can be a major obstacle. Crossing ABO blood group barriers could increase the organs available to such patients Methods. From November 2010 to June 2015, 176 children aged 0.2−to18 y were transplanted in the King Faisal Specialist Hospital and Research Center. Out of those, 19 children were transplanted across blood group barriers (ABO incompatible). The underlying diseases were biliary atresia (n = 6); progressive familial intrahepatic cholestasis type 2 (n = 4); Crigler-Najjar syndrome (n = 3); hepatoblastoma (n = 2); and urea cycle disorder, Caroli disease, cryptogenic cirrhosis, and neonatal sclerosing cholangitis (n = 1 each). Immunosuppression consisted of basiliximab, mycophenolate, tacrolimus, and steroids. Pretransplant prophylactic plasmapheresis, high-dose immunoglobulins, and rituximab were not administered. Results. The grafts were from living donors (n = 17) and deceased donors (n = 2). Living donor morbidity was nil. The recipient median age was 21 mo (5−70 mo). After a median follow-up of 44 mo, 2 recipients (10%) died because of sepsis, 1 because of uncontrolled acute myeloid leukemia. The overall rejection rate was 7%, and no grafts were lost because of antibody-mediated rejection (AMR). HLA matching was 3.8 of 6 (A, B, DR), and there were 2 patients presented with acute cellular rejection, 1 patient with AMR, and 1 patient with biliary strictures. Conclusions. ABO incompatible liver transplantation is a feasible and life-saving option even with antibody and B-cell depletion-free protocol without increasing the risks for AMR. We speculate that this excellent result is most likely because of presence of relatively low titer ABO isoagglutinins and the high HLA match compatibility caused by habit of longstanding interfamilial marriages as typical of Saudi Arabia.

Introduction: Preterm birth is the leading cause of death in children younger than 5 yearsworldwide. Although preterm survival rates have increased in high-income countries, pretermnewborns still die because of a lack of adequate newborn care in many low-income and middle-income countries. This study was aimed to find out the effectiveness of anthropometricmeasurement, a simple and inexpensive method, for identifying premature babies at birth. Method:We conducted a cross-sectional study in a tertiary care hospital with 350 consecutively live-bornnewborns. Their birth weight, mid-arm circumference, length and head circumference weremeasured and compared with gestational age assessed by New Ballard score. We summarized thevariables using descriptive statistics, and the strength of association was determined throughcorrelation analysis. The correlation was strong for head circumference. Linear regression analysiswas done to develop predictive equations. Result: Amongst 350 newborns, 76% were term and24% were preterm. Pearson's correlation coefficient between gestational age as assessed by NewBallard score and head circumference, birth weight, mid-arm circumference and length all showed asignificant positive correlation in the decreasing order [maximum with head circumference (r =0.566)]. Linear regression analysis was done to develop predictive equations. Conclusion: Headcircumference measurement can be a surrogate marker to predict prematurity as a significantcorrelation is seen between it and gestational age assessed by the New Ballard score. Furtherstudies are needed to cross-validate our result.

Background: A Systematic review & meta-analysis revealed that there is 'Strong evidence for tracking of Blood pressure from childhood to adulthood i.e., the Children in the upper percentile of Blood Pressure levels are more likely to become hypertensive in adulthood. Objective: To study the prevalence of Pre-hypertension & Hypertension and the relationship of Blood Pressure with variables like age, sex, weight, height, body Mass Index (BMI), Socioeconomic status and Family history in Urban school children. Materials & Methods: The present Cross-sectional study conducted in urban school children, Hyderabad. Total 2500 children of 5-14 years age group were involved in the study group; children were selected in random sampling method. Results: The Prevalence of Hypertension among children between 5-14 yrs was 7.2% (6.6% in Boys & 7.9% in girls). Pre-hypertension prevalence was found higher in boys (6.2%) compared to girls (3%). Multiple Regression Analysis showed Positive and significant correlation of age, weight, height with each systemic blood pressure and diastolic blood pressure (P value <0.001). Conclusion: Regular Blood pressure measurement of children is mandatory for early detection of Pre-hypertension & hypertension.