Objective: To compare the mean change in respiratory rate with salbutamol nebulization versus placebo for treatment of transient tacyopnea of newborn. Study Design: Randomized Control Trial. Setting: Department of Neonatology, Federal Government Polyclinic (PGMI), Islamabad. Period: 8th August 2017 to 7th February 2018. Material & Methods: 100 neonates fulfilling selection criteria were enrolled in the study. Informed consent was obtained from parents. Demographic information was also noted. All baseline respiratory rate were noted. Neonates were divided into two groups by lottery method. Neonates in Treatment group were nebulized with Salbutamol. Placebo group was nebulized with Normal Saline. Then neonates were followed-up in N.I.C.U after 4 hours of second nebulization. After 4 hours, respiratory rates were assessed and change in respiratory rate was noted. Both groups were compared for mean reduction in respiratory rate by using independent sample t-test. Results: In nebulized salbutamol, group, mean respiratory rate was changed from 79.62±8.18bpm to 52.06±4.96bpm. This was a significant decrease (p<0.05). In placebo group, mean respiratory rate was changed from 81.88±8.86bpm to 62.50±6.75bpm. This was significant decrease (p<0.05). The difference between both groups at baseline was insignificant while after 4 hours was significant. The mean changed in respiratory rate with nebulized salbutamol was 27.56±6.83bpm while with placebo was 19.35±9.83bpm. There was significant difference in mean reduction in respiratory rate (p<0.05). Conclusion: It has been proved that nebulized salbutamol can be helpful in reducing respiratory rate significantly in neonates with TTN as compared to placebo.
Objectives: To determine the mean serum electrolyte level in neonates with perinatal birth asphyxia with moderate hypoxic ischemic encephalopathy. Study Design: Descriptive Cross Sectional study. Setting: Pediatric Ward, Emergency and OPD, Allied Hospital, Faisalabad. Period: December 2017 to May 2018. Material & Methods: In our study, out of 190 cases were included, Results: mean g. age was calculated as 39.44+1.51 weeks, 49.47% (n=94) were male and 50.53% (n=96) were females. Mean APGAR score at 1 minute was calculated as 4.59+0.49 whereas 5.41+0.67 at 5 minutes. Mean weight of the neonates was calculated as 2771.58+256.83 grams. Frequency of delivered through history of fetal distress was recorded in 43.68% (n=83), mean serum electrolytes shows that serum sodium 137.71+1.69 mg/dl, serum potassium 3.92+0.18 mg/dl and serum calcium 8.45+0.51 mg/dl. Conclusion: We concluded that mean serum electrolyte level in neonates with perinatal birth asphyxia with moderate hypoxic ischemic encephalopathy were in normal range, however, in absence of control group and data analysis in qualitative way, we are unable to record the frequency of hypocalcemia, hyponatremia and hyperkalemia, which may be done in coming trials.
Objectives: To compare the outcome of nebulized epinephrine versus salbutamol for the management of children presenting with bronchiolitis. Study Design: Randomized Controlled Trial. Setting: Department of Pediatrics, Federal Government Polyclinic Hospital, Islamabad. Period: 6 month (1st October, 2016 to 1st April, 2017). Material & Methods: Children fulfilled selection criteria were enrolled. Then patients were randomly divided in two groups by using lottery method. In Group A, children received salbutamol. In group B, children received nebulized adrenaline. After 48 hours, children were evaluated for heart rate, respiratory rates, oxygen saturation and Respiratory Distress Assessment Index (RDAI) score. All the information was collected using proforma. Data was analyzed using SPSS version 21. Results: The mean age of children was 10.45±6.70 months in epinephrine group and13.07±6.28 months in salbutamol group. There were 29 (52.7%) males & 26 (47.3%) females in both groups. After 48 hours, mean heart rate was 122.58±4.75bpm with epinephrine while 127.87±4.4.44bpm with salbutamol. Mean respiratory rate was 35.16±3.29bpm with epinephrine while 39.84±3.32bpm with salbutamol. Mean RDAI score was 8.35±1.36 with epinephrine while 10.07±1.37 with salbutamol. Mean oxygen saturation was 85.24±2.74% with epinephrine while 80.38±3.26% with salbutamol. The difference was significant (P<0.05). Conclusion: Thus the nebulized epinephrine was found to be more effective in maintaining heart rate, respiratory rate, oxygen saturation and RDAI score of children as compared to salbutamol.
In underdeveloped nations, TB in children is a major public health issue, with tubercular meningitis being a devastating consequence with high death rate. Tuberculous Meningitis (TBM) is caused by the spread of main or secondary pulmonary illness through the bloodstream. One of the most dangerous clinical symptoms of TB is infection of the central nervous system. The advanced stage of TBM may have a negative impact on the result. Objective: To determine frequency of different spectrum of clinical presentation of tuberculosis meningitis in children at tertiary care hospital Material and Methods: This was a cross sectional study carried out at the Children hospital and Institute of child health from May, 2018 to Nov, 2018. About 364 patients were employed in the research. Patients' or attendants' informed written consent was attained, and their demographic information (including name, age, gender, residence, and duration of pain) was recorded. All newly diagnosed cases were taken in this study for further investigation about their stages of the disease. All stages were labeled as per operational definition. Results: The patients' normal age was 6.56 SD 3.46 years, with the lowest and highest ages being 1 and 12 years, respectively. There were 200 male cases (54.9%) and 164 female cases (45.1%), with a larger male to female ratio. With a minimum and highest GCS score of 5 and 15, the mean GCS is 11.76 2.77. According to the operational definition, 30 patients (8.2%) had stage I TBM, 150 cases (41.2%) had stage II TBM, and 184 instances (50.5%) had stage III TBM. Conclusion: The outcomes of this study revealed that about half of the cases had stage III TBM, implying that patients with TBM should be managed properly if this stage is remembered. With aggressive and selective treatment plan the prognosis can be increased and rate of mortality may be decreased. Keywords: Children, developing country, meningitis, mortality, Tuberculosis
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