Abstract Objective: To identify the vaccination status and risk factors for mortality in children admitted with complications of measles. Methods: The retrospective study was conducted at Children Hospital, Pakistan Institute of Medical Sciences, Islamabad, Pakistan, and comprised data of children admitted with complications of measles between 2013 and 2017. Information on vaccination history, complications of measles, anthropometry, hospital stay and outcome within 15 days of admission was retrieved from hospital records. Data was analysed using Stata 14. Results: Of the 307 children admitted, 79(26%) were aged <9 months and were excluded. Of the remaining 228 subjects, 109(47.8) were unvaccinated. Risk factors significantly associated with mortality were an unvaccinated state of measles vaccine, being stunted, and encephalitis in comparison with pneumonia (p<0.05). A total of 39(17%) children died within 15 days of admission. Conclusion: Encephalitis, non-vaccination and under-nutrition were significantly associated with mortality in children with complications of measles. Key Words: Child, Measles, Risk factors, Mortality, Vaccination. Continuous...

Introduction The prevalence of deafness is high in Pakistan. Knowledge regarding the clinical features of patients with profound hearing loss will not only help identify the cause but will also help in the strategic planning for public health interventions. Objective The present study was conducted to cover in detail the clinical aspects of children with hearing loss, that is, age at presentation, associated deficits and disorders, possible cause of the disease, associated family history, and role of consanguineous marriage. Methods The present study was performed from November 2016 to September 2018. All of the patients under 6 years of age with profound bilateral hearing loss who would benefit from cochlear implantation were included in the study. Detailed history was taken. The developmental skills were assessed for all areas, and the patients were scored regarding their motor, manipulative, visual, language, social and self-care skills according to the Schedule of Growing Skills II. Detailed family history was taken from the parents of the affected children. The Statistical Package for the Social Sciences (SPSS) software, version 20.0, was used for the statistical analysis. Results The mean age of the children to be treated was 3.2 ±  1.25 years. Most patients (51.5%) had a positive family history of disease. Consanguineous marriage was common; the parents of 76.9% of the patients were first-degree relatives. Most patients (90.8%) had associated language impediments. In total, four (Ł3.07%) patients had global developmental delay. Conclusion Consanguineous marriage pattern plays an important role in diseases running in families. Development in these children is strongly linked to their age at the consultation.

Background: In children, clinical profile of malaria may vary from nearly asymptomatic disease to febrile illness leading to life threatening complications. The mortality among children is largely due to complications like cerebral malaria, severe anemia and pulmonary complications. The current study was conducted to study the clinical profile of malaria, its complications and factor associated with its complications. Methodology: This observational study was conducted at Children Hospital, PIMS from March 2018 to March 2021. All patients with positive immunochromatographic test and needing hospitalization due to unsettled fever or other troublesome symptom were included. Total 53 patients were included in the study.  All patients underwent routine investigations which included ICTMP, complete blood picture, ultrasound abdomen, chest x rays, and routine urinary analysis. Severe malaria was characterized upon WHO guidelines.   Patients were treated with chloroquine while those resistant to chloroquine were given artemisinin-based therapy. Data was analyzed by applying appropriate statistical tests via SPSS v 20. Results: Mean age of the patients was 5.80±3.5 years with male predominance (n=32, 60.4%). Majority of the patients had P.vivax (n=45, 84.9%) infection followed by P.falciparum (n=5, 9.4%), while 3 patients (5.7%) had positive immunochromatographic test for both P.vivax and P.falciparum. Severe malaria developed in 17 (32.1%) of the patients. Most common complication was severe anemia (n=10, 18.8%) followed by black water fever, ADEM disease, pneumonia and convulsions  Patients  with P.falciparum infection had higher risk (OR=8.00, P-value=0.07) of developing complication compared to P.vivax one. Conclusion: Rate of severe malaria was found to be 32.1% in children of current study which is quite high. Therefore, every child with malaria should be properly investigated for complications and treated accordingly.

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Background: To evaluate the efficacy and safety of sofosbuvir (SOF) plus ribavirin (RIB) in naive patients with chronic HCV genotype 3. The study design was open label, quasi experimental study. The study was conducted at Medical Outpatient Department of Medical Unit-1, Bahawal Victoria Hospital, affiliated with Quaid e Azam Medical College (QAMC), Bahawalpur, from April 2016 to June 2019.Methods: A total of 627 treatment-naive patients, aged above 18 years, with chronic Hepatitis C virus (HCV) genotype 3 infection were enrolled. SOF as 400 mg once a day plus weight-based RIB (1000 mg/day <75 kg and 1200 mg/day >75 kg) was given to all the study participants for 24 weeks. Qualitative polymerase chain reaction (PCR) for HCV ribonucleic acid (RNA) were done at 4 weeks to note the rapid virological response (RVR) whereas end of treatment response (ETR) was recorded at 24 weeks and sustained virological response (SVR) was noted 3 months after completion of treatment.Results: By 4th week, PCR of 524 (83.6%) patients was available, out of which, 492 (93.9%) had undetectable HCV RNA. By the end of treatment (24 weeks), PCR of 401 (64.0%) patients was available, out of which, 393 (98.0%) had undetectable HCV RNA. Data of 291 (46.4%) patients was available for SVR, 274 (94.1%) had undetectable HCV RNA. Weakness and fatigue turned out to be the commonest side effects, observed in 236 (37.6%) patients.Conclusions: Sofosbuvir was found to have good efficacy and safety in the local population of South Punjab having treatment-naïve chronic HCV genotype 3 infection.