Objective: To assess the immunization coverage of children less than 2 years of age in rural and nomadic population of Balochistan. To assess the knowledge of parents about EPI immunization and find reasons of poor vaccination.
Material and methods:The cross-sectional survey was conducted in rural population and nomadic tribes located in suburbs of district Zhob, Balochistan. One hundred families of rural areas and 100 families of nomadic tribes were interviewed. Information regarding the vaccination status of children, parents' knowledge of EPI vaccinationand reasons of not vaccinating children or skipping vaccines were asked and noted. Education status of parents and socioeconomic status was also noted. Results: There were 295 children under 2 year age in the study population with 146 (49.5%) males and 149 (50.5%) females. Among rural population, 25 (16.4%) children were completely vaccinated, 106 (69.7%) children were partially vaccinated and 21 (13.8%) children never received any vaccination. In nomadic population, 10 (7%) children were completely vaccinated, 88 (61.5%) were partially vaccinated and 45 (31.5%) were unvaccinated. There was significant difference between vaccination status of families belonging to rural population versus those of nomadic population (P=0.002). Most common reason of skipping one or more vaccines was lack of knowledge and awareness in 28.8% cases. There was significant association between education status of fathers and mothers with vaccination status of families. Conclusion: Routine immunization of children in rural and nomadic population of Balochistan is dismal. Main culprits are lack of knowledge and awareness, compounded by illiteracy and poor education status of parents.
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).
Liddle syndrome is a cause of hypertension among children due to mutation in the epithelial sodium channels (ENaC) located in the kidneys. It typically presents with hypertension, hypokalemia, metabolic alkalosis with low renin and aldosterone levels. Although, most cases are children, but adults also present with this disorder owing to late diagnosis. Amiloride and triamterene efficiently improve the condition. Here we present the case of a 6-year-old girl admitted with history of hypertension, diarrhea, vomiting, weakness and palpitations on and off for the last four years. Laboratory investigations revealed metabolic alkalosis, decreased renin and aldosterone levels, hypokalemia and an inverted T wave, U wave and prolonged QT interval on ECG. Any pediatric case presenting with hypertension and electrolyte imbalance should promptly raise suspicion of Liddle syndrome. Timely diagnosis and management play a key role in reducing morbidity and mortality.
Kala Pathar(PPD) is a lethal substance when ingested. PPD poisoning is not limited to adults; many cases of pediatric poisoning are also being reported in Southern Punjab. Mortality due to Kala Patharis high. Tracheostomy should be done immediately in all such cases; and high intensive multidisciplinary approach is required.
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