<p><strong>Objective:</strong><strong>  </strong>To determine the effect of phototherapy on platelet count in neonates having unconjugated hyperbilirubinemia.</p><p><strong>Patients and Methods:</strong><strong>  </strong>This cross sectional study was conducted in the Neonatology unit of a Hospital, Faisalabad during a period of nine months i.e., January to September 2015. All the neonates having unconjugated hyperbilirubinemia and requiring phototherapy with normal initial platelet count were included in the study. Platelet count was evaluated before the start of phototherapy and then during phototherapy at 24 hrs, 48 hrs and 72 hrs interval. Platelet counts were compared after 24, 48 and 72 hours of phototherapy. P value < 0.05 was considered significant.</p><p><strong>Results:</strong><strong>  </strong>Total 150 newborns having unconjugated hyperbilirubinemia were included with mean age of 3.95 ± 1.71days. After 24 hours of phototherapy, about 8.1% of the patients were having severe thrombocytopenia (platelet count < 50 ×10<sup>9</sup>/L); this percentage rose to 18.4% after 48 hours and 33.3% after 72 hours of phototherapy. None of the patients developed clinical manifestation of bleeding. The number of patients with normal platelet count (1,50 × 10<sup>9</sup>/L – 400 × 10<sup>9</sup>/L) after 24 hours of continuous phototherapy was 50%, gradually reducing  to 38% after 48 hours and only 33% after 72 hours of completion of phototherapy(p value < 0.05).</p><p><strong>Conclusion:</strong><strong>  </strong>Hyperbilirubinemic neonates undergoing phototherapy had a fall in platelet count without any clinical manifestation of bleeding.</p><p> </p>
Congenital chloride diarrhoea is one of the rare causes of diarrhoea during infancy and it is infrequently reported throughout the world. It is an autosomal recessive condition which is more prevalent in Poland, Finland, Saudi Arabia and Kuwait while rarely reported in Pakistan. Our patient was 7.5-month-old baby boy who presented with diarrhoea since neonatal period. He had consanguineous parents. On examination, baby had distended abdomen, hypotonia and hyporeflexia. Investigations revealed hypochloremic hypokalemic metabolic alkalosis. Urinary electrolytes were normal. Stool electrolytes revealed increased stool chloride excretion that confirmed our diagnosis of congenital chloride diarrhoea. Patient was treated with intravenous fluids and electrolyte replacement, followed by oral potassium and sodium replacement. He was also started on butyrate, cholestyramine and proton-pump inhibitors. He started gaining weight during his hospital admission and is being followed up in clinic.
Objective: To find out the frequency of cardiovascular anomalies in infants born to diabetic mothers (IDMs). Study Design: Case-control study. Setting: Department of Pediatric Medicine and the Department of Obstetrics & Gynecology, Rai Medical College / Teaching Hospital, Sargodha. Period: January 2022 to December 2022. Material & Methods: A total of 50 term IDMs were enrolled in case group while equal number of healthy infants (n=50) were enrolled as controls. All mothers received prenatal care. Standard diagnostic criteria were followed for labeling diabetes and gestational diabetes. All infants underwent detailed physical and clinical examination. Demographic and maternal characteristics along with perinatal and maternal information were noted. All infants underwent echocardiographic evaluation. Results: In a total of 100 infants, 51 (51.0%) were boys and 49 (49.0%) girls. The mean birth weight, Apgar score (at 5-minutes), maternal age and gestational age were 2.84±1.8 kg, 8.8±0.7, 29.5±3.2 and 37.4±1.8 weeks respectively. Maternal hypertension was observed among 12 (12.0%) subjects. Birth weight (p<0.0001), maternal age (p=0.0129) and gestational age (p=0.0110) were significantly higher among cases while Apgar score was significantly lower among cases in comparison to controls (p=0.0028). Cardiovascular anomalies were diagnosed in 10 (20.0%) cases in comparison to 3 (6.0%) controls and the difference was found to be statistically significant. Among IDMs, hypertrophic cardiomyopathy (HCM) was the most frequent cardiovascular anomaly, noted in 4 (8.0%) cases. Conclusion: The frequency of cardiovascular anomalies was significantly high among IDMs in comparison to infants born to non-diabetic mothers. IDMs should undergo cardiac examination to rule out the possibility of existing cardiovascular anomalies.
Objective: To analyze children of congenital heart defect hospitalized with lower respiratory tract infections (LRTIs). Study Design: Cohort study. Setting: Department of Pediatrics, Rai Medical College Teaching Hospital, Sargodha Pakistan. Period: July 2021 to June 2022. Material & Methods: Echocardiography confirmed known CHD cases of both genders aged 1 month to 10 years and hospitalized with LRTI were included. Demographic and clinical data were noted while relevant radiological examination and bacterial culture / respiratory virus panel from nasopharayngeal swabs examined. Types of CHD (acyanotic or cyanotic), types of bacterial causative agents and outcomes in terms of duration of hospitalization (days) and mortality or discharged were noted. Results: In a total of 63 children, 34 (54.0%) were male. The mean age was 1.56±1.42 years while 46 (73.0%) children were aged below 1 year. Assessment of causative agents revealed that 9 (14.3%) had viral involvement, 8 (12.7%) bacterial agents. Majority of the children, 44 (69.8%) had acyanotic CHD while remaining 19 (30.2%) had cyanotic CHD. Need for pediatric intensive care unit (PICU) admission was noted in 22 (34.9%). Although, need for PICU stay was more among children with acyanotic CHD when compared to cyanotic CHD, but the difference did not reach statistical significance (40.9% vs. 21.1%, p=0.1292). Likewise, duration of hospitalization was relatively more among children with acyanotic CHD when compared to children with cyanotic CHD but the difference did not reach statistical significance (17.65±8.21 vs. 14.3±6.84, p=0.1243). Conclusion: Majority of the children with CHD hospitalized with LRTI were below 1 year of age. Acyanotic CHD was the most common CHD type. Mortality was relatively low and most of the children with CHD hospitalized with LRTI were treated and discharged successfully.
Objective: To determine the frequency of thrombocytopenia in neonates undergoing exchange transfusion of blood for severe neonatal jaundice. Methodology: Total 200 neonates fulfilling the selection criteria were included in the study from neonatology unit, The Madinah Teaching Hospital Faisalabad during Nov, 2020 to October 2022. An informed consent was taken from parents. Demographic information (name, age, gender, and contact) was obtained. Then all neonates underwent exchange transfusion under standard procedure. After exchange transfusion 3cc Blood sample was obtained with the help of a staff nurse by using butterfly needle and 5cc BD syringe under aseptic measures. Sample was sent to the laboratory of the hospital for platelet count. If platelet count was found below 100.000/dL, thrombocytopenia was labelled (platelet count in complete blood count is <100,000/dL assessed at the end of exchange transfusion). Results: In our study, the mean age of the patients was calculated as 15.17+4.85 days. Gender distribution reveals that 94(47%) were male and 106(53%) were females. Frequency of thrombocytopenia in neonates undergoing exchange transfusion of blood for severe neonatal jaundice was recorded in 15(7.5%) of the cases, and among them 7(46.7%) were between 1-14 days and 8(53.3%) were between 15-28 days of life, p-value=0.533, regarding gender 5(33.3%) were male and 10(66.7%) were females, p-value=0.203. Conclusion: We found that the rate of thrombocytopenia in neonates having blood exchange transfusion for severe neonatal jaundice was not significantly greater than the rate in other studies. However, our results are from a single site and need to be confirmed by additional multicenter local investigations. Keywords: Severe neonatal jaundice, exchange transfusion of blood, thrombocytopenia
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