To determine the frequency of malarial hepatopathy in children that are visiting Lyari General Hospital in Karachi, Pakistan. Study design Cross sectional descriptive study. Material and methods Patients with age between two months and 15 years, who had positive blood film for Plasmodium falciparum or P. vivax, were included in the study. All patients were monitored for malarial hepatopathy. Result A total of 241 cases were included in the study. Mean age at admission was 4.1 ± 1.3 years and male to female ratio was 1.2:1. There were 133 (55.2%) cases of P. vivax, while 108 (44.8%) were of P. falciparum. Malarial hepatopathy was observed in 37 patients (15.4%). Malaria hepatopathy was present in 24.1% and 8.3% children having P. falciparum and P. vivax, respectively. Malaria hepatopathy was present in 24%, 18% and 6% in age groups two months to five years, >5 years to 10 years and >10 years, respectively. Conclusion Malarial hepatopathy was observed in about one-sixth of study population and it was more common between two months and five years age group.
Objective: To determine the frequency of different complications in admitted patients of diabetic ketoacidosis (DKA). Study Design: A cross-sectional study. Place and Duration: Diabetic ward of National Institute of Child Health (NICH), Karachi Pakistan from 1st November 2020 to 31st October 2021. Methodology: A total of 253 children of either gender aged 1 to 15 years admitting with DKA and duration of diabetes mellitus ≥3 years were included. All patients were subjected to detailed history and clinical examination for DKA and its complication like hypoglycaemia, hypokalaemia, hyponatraemia, hypocalemia, hyperkalaemia. Resutls: In a total of 253 children admitted with DKA, 123 (48.6%) were girls and 130 (51.4%) boys. Mean age of patients was 6.11 ± 2.87 years, mean BMI was 20.9± 4.7 kg/m2, while mean duration of diabetes mellitus was 3.5± 1.2 years. Mean plasma glucose was 22.5±6.0 mmol/L (405±108mg/dl), mean HbA1c 10.2±2.1% while mean pH was 6.9±0.4. In a total of 253 patients with DKA, hypoglycemia was noted in 47(18.6%), hypokalemia 17 (6.7%), hyponatremia 22 (8.7%), hypocalcaemia 11 (4.35%) while hyperkalaemia was observed in 9 (3.56%) patients. Conclusion: Most of the patients admitted with DKA were aged <10 years who developed complications. Hypoglycemia was the most common complication of DKA while hyponatremia the 2nd most frequent complication observed in DKA patients. Electrolytes should be investigated and managed timely to avoid unwanted outcomes among patients admitted with DKA. Keywords: Complications, diabetic ketoacidosis, diabetes mellitus, children.
Bukhari et al. This is an open access article distributed under the terms of the Creative Commons Attribution License CC-BY 4.0., which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Objective: to evaluate safety and efficacy of ultrasound guided cvc insertion in picu of resource-limited, public-sector children hospital. Study Design: Prospective Observational study. Setting: National Institute of Child Health. Period: March 2020 to September 2020. Material & Methods: We prospectively conducted this study after the IRB approval. Parental consent was obtained. All procedures were done under aseptic precautions with central line insertion checklist according to guidelines of ultrasound guided CVC insertion. We use 8hz linear probe of ultrasound to localize internal jugular vein or femoral veins and needle insertion done under real-time us. The data was collected on structured proforma, including age, gender, weight, admitting diagnosis, size of CVC, success rate. Results: Out of 360,72 (20.20%) required CVC placement during study period of 06 months. The mean age was 7.0±3.53 years with range of (1-15 years). We categorized the patients into three groups 0.1-3 (infant & toddler group) 3-10 (school aged group) 10-15 (adolescent group%). Out of 72 cannulations, 68 (94.4%) were successful in 1st prick, while other 04 (5.6%) were in 2nd prick. Conclusion: Ultrasound guided CVC insertion is easy to perform, safe and highly effective in critically ill children.
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