Objective: To compare the efficacy of zinc-probiotic combination therapy and probiotic therapy alone in the treatment of acute pediatric watery diarrhea. Study Design: Randomized Clinical Controlled trial. Setting: The study was completed at The Department of Pediatrics, Unit I, Bolan Medical Complex Hospital, Quetta, Pakistan from July 2021 to January 2022. Methodology: A total number of 144 children of either gender aged 3 months to 5 years presented with acute watery diarrhea were included. Patients were randomly allocated into either Group-A (zinc supplementation with probiotics) or Group-B (only probiotics) for the treatment of acute diarrhea. Relief from diarrhea and duration of diarrhea were the main study end-points. Results: In a total of 144 children, the mean age was 27.04+14.43 months while the mean duration of diarrhea was 8.05+5.18 hours. On comparison of recovery from diarrhea, all the 72 children who received combination of probiotics and zinc were recovered from diarrhea, while 4 children (5.6%) children did not recovered from diarrhea within 5 days after starting the treatment in probiotics alone group (p=0.04). Duration of diarrhea was 27.63±14.22 hours in probiotics plus zinc group and 38.86±20.70 hours in probiotics only group (p<0.001). Practical Implications: Combination of probiotics with zinc resulted in early recovery among children with acute diarrhea but further randomized controlled trial enrolling large sample size from local population are necessary to verify the findings of this study. Conclusion: Combination of probiotics and zinc was superior as compared to the probiotics alone in the treatment of acute diarrhea in children. Keywords: Diarrhea, probiotics, recovery, stool, treatment, zinc.
Objective: To determine the frequency of congenital hypothyroidism (CH) in newborn at tertiary care hospital in Quetta, Pakistan. Study design: Cross-sectional study. Place and Duration: The Department of Paediatrics, Unit-II, Bolan Medical College Hospital, Quetta, Pakistan from January 2022 to June 2022. Methodology: Neonates of both genders born with birth weight above 1500 grams having gestational age above 28 weeks, presenting between 3 to 5 days following birth were analyzed. At the time of enrollment, demographic characteristics of the neonates were noted and screening of CH was done. The CH was labeled as serum TSH ≥ 20mU/ml and T4 < 9 pmol/l. Results: During the study period, a total of 383 neonates as per inclusion/exclusion criteria were analyzed. There were 239 (62.4%) boys and 144 (37.6%) girls. The mean age was 3.87+0.843 days. The mean TSH level was 12.807+5.11 mU/ml (ranging 7 to 50 mU/ml). We noted that CH was found in 10 neonates (2.6%). Practical Implications: The reported frequency of CH seems higher as compared to contemporary literature which raises the importance of CH screening programs at national level. Conclusion: The frequency of congenital hypothyroidism was 2.6% among newborns at a tertiary care hospital of Quetta, Pakistan. Keywords: Congenital hypothyroidism, newborn, thyroid-stimulating hormone.
Objective: To determine the frequency of urinary tract infection (UTI) in neonates admitted with indirect hyperbilirubinemia. Study Design: A cross-sectional study. Place and Duration of the Study: Inpatient department of Pediatric Medicine, Bolan Medical College/Hospital Quetta from Jan 2019 to Dec 2020. Methodology: A total of 130 neonates of either gender (delivered at ≥ 32 weeks) admitted with primarily complaints of jaundice (with evidence of indirect hyperbilirubinemia) were included. Sex, age, weight and height of all neonates were noted. Serum bilirubin levels were asses and urine samples were also evaluated for the existence of urinary tract infection (UTI). Results: In a total of 130 neonates, 58 (44.6%) were males and 72 (55.4%) females. The UTI was found to be present in 41 (31.5%) neonates admitted with indirect hyperbilirubinemia. Among these 41 culture proven UTI cases, most common organism was E. coli found in 15 (36.6%) cases while Klebsiella was the 2nd most commonly found microorganism noted in 11 (26.8%) cases. Conclusion: Frequency of UTI was high (31.5%) among asymptomatic jaundiced newborns. Children presenting with jaundice needs to be evaluated for UTI. Keywords: E.Coli, indirect hyperbilirubinemia, Klebsiella , Urinary tract infection (UTI).
Objective: To find out the frequency of acute bacterial meningitis (ABM) in children presented with fever and fits aged 6-59 months old. Methodology: This cross-sectional study was done at The Department of Pediatric Medicine, Bolan Medical College/Hospital Quetta from September 2017 to February 2019. A total of 168 children, of either gender, aged between 6-59 months who presented with 1st episode of febrile seizure, and who arrived at emergency department within 12 hours of episode were included. Samples of cerebrospinal fluid (CSF) were obtained. Later, results were analyzed. Results: Of total 168 patients, 111 (66.1%) were male. The mean age was 27.19±13.80 months while the mean weight and frontooccipital circumference (FOC) was found 12.01 ± 2.05 kg and 48.68 ± 2.77 cm correspondingly. Twenty-four (14.3%) patients were diagnosed with ABM. The most common organism found among 11 positive CSF cultures was Streptococcus pneumonia in 6 (54.6%). Conclusion: Every clinician needs to thoroughly evaluate infants or young children after a simple febrile seizure. Lumber puncture can be done in every child if there is any suspicion of meningitis. Keywords: Acute bacterial meningitis, febrile seizures, fever, fits.
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