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Objective: To find out different bacterial isolates of urinary tract infection (UTI) in neonates with late onset sepsis (LOS) at a tertiary care hospital. Study Design: Cross-sectional study. Setting: Department of Pediatrics, Nishtar Hospital Multan. Period: August 2020 to February 2021. Material & Methods: A total of 176 neonates with LOS and culture positive UTI were enrolled. The urine samples were sent to the institutional laboratory for isolation and identification of the causative agents. Baseline information like age, gender, socioeconomic status, family system and maternal literacy were noted. Once registered, the urine samples were sent to the laboratory of the hospital for isolation and identification of the causative agents. Urine samples were collected within 48 hours of admission. Results: Of the 176 neonates, 110 (62.5%) were male while 66 (37.5%) were female. Overall, mean age was 8.64±5.22 days. There were 90 (51.1%) neonates who belonged to rural areas and 86 (48.9%) to urban areas. Poor socioeconomic status was noted in 116 (65.9%) neonates. In terms of maternal literacy, 118 (67.0%) mothers were illiterate. Overall, mean gestational age was 38.59 ± 2.17 weeks. Escherichia coli (E. coli) was the predominant causative organism noted among 146 (83.0%) neonates whereas Klebsiella was seen in 23 (13.1%) while other bacterial isolates were Proteus 2 (1.1%), Pseudomonas aeruginosa 1 (0.6%), Enterobacter aerogenes 1 (0.6%), Enterococcus fecalis 1 (0.6%), Staphylococcus aureus 1 (0.6%) and Group B Streptococcus 1 (0.6%). Conclusion: High frequency of Escherichia coli was observed followed by Klebsiella among neonates having urinary tract infection presenting with late onset of sepsis in our study. [ABSTRACT FROM AUTHOR]

Objectives: Renal failure (RF) is associated with significant mortality and morbidity. its management still remains challenging for treating physicians. Acute peritoneal dialysis (APD) is an option for treatment of renal failure among young children. We aimed to determine the efficacy of peritoneal dialysis (PD) in RF among children admitted. Study Design: Case series study. Setting: Nephrology Department of Children's Hospital and Institute of Child Health, Multan. Period: February 2018 to July 2018. Material & Methods: A total of 74 children with renal failure were included. All the patients were treated with acute peritoneal dialysis. The outcome of interest was clinical and biochemical improvement. Result: Amongst all there were 46 (62.2%) male and 26 (37.8%) female. Mean age of the children was found to be 57.72 months. Mean weight of children was 12.36 kg with a standard deviation of 6.4 kg. Most of the children, 43 (58.1%) had acute renal failure (ARF) whereas 31 (41.9%) had chronic renal failure (CRF). With PD, mortality was reported in 22 (29.7%) children. Conclusion: Acute peritoneal dialysis showed good rates of improvement in renal function, so, it should be recommending among children with acute renal failure. [ABSTRACT FROM AUTHOR]

Objectives: Asthma affects about 15% of children while it is one of the commonest reason for admissions in pediatric emergencies and wards. We aimed this study to determine outcome of Salbutamol alone and salbutamol in combination with Ipratropium Bromide in acute asthma in children. Study Design: Randomized Controlled trial (RCT). Setting: Unit-II Department of Pediatric Medicine, Nishtar Medical College and Hospital, Multan. Period: 20th Nov 2017 to 30th June 2018. Material & Methods: The study consisted of 104 children, with 52 children each in Group ‘A’ and ‘B’ who were subjected to salbutamol alone and salbutamol in combination with Ipratropium bromide respectively. In both groups oxygen was administered via nasal prongs at a flow rate of 3L/minute. These children was monitored at 30 minutes interval for 2 hours (least value out of these 4 values was taken). Both groups were compared for outcome in terms of mean heart rate, respiratory rate, accessory muscle score, peak expiratory flow rate (PERF) percentage and SPO2. Results: Of these 104 study cases, 61 (58.7%) were boys while 43 (41.3%) were girls. Mean age of our study cases was noted to be 9.92 ± 3.01 years. Mild level of asthma severity was noted in 35 (33.7%) and moderate severity in 69 (66.3%). Mean heart rate in group A was noted to be 119.40 ± 12.22 and in group was 119.29 ± 8.51 beats per minute. (p=0.956). Mean respiratory rate in group A was 29.98 ± 4.00 while in group B was 27.88 ± 3.85 (p=0.000). Mean accessory muscle score in group A was 0.537 ± 0.336 while in group B was 0.130 ± 0.030 (p = 0.000). Mean PEFR percentage in group A was 68.69 ± 18.64 while in group B was 87.12 ± 17.10 (p = 0.000). Mean SPO2 in group A was 96.15 ± 1.05 while it was 95.94 ± 1.29 (p = 0.362). Conclusion: Our study results have shown that nebulization of salbutamol in combination with Ipratropium Bromide is more effective in the management of children with acute asthma. It was safe, effective and reliable as there was no adverse side effect noted in our study. We recommend the use of this combination nebulization therapy in children with acute asthma. [ABSTRACT FROM AUTHOR]

Objectives: Acute gastroenteritis is a common illness that leads to significant morbidity and mortality in pediatric population. This study was aimed to determine the frequency of hyponatremia among hospitalized children having acute gastroenteritis. Study Design: Crosssectional Study. Setting: Unit-ll, Department of Pediatric Medicine, Nishtar Medical College and Hospital, Multan. Period: From 1st January 2018 to 30th June 2018. Material & Methods: A total of 232 children aged 1-12 years of either sex, clinically assessed cases of acute gastroenteritis with duration of illness < 7 days, were considered. Mean and standard deviation was calculated for quantitative variables while frequencies and percentage were tabulated for the qualitative variables. Post stratification chi-square test was applied to see effects of studied variables and P value <0.05 was considered as significant. Results: Mean age of our study cases was 2.33 ± 2.11 years. Majority of patients, 135 (58.2%) were boys, 143 (61.6%) from urban areas and 161 (69.4%) were having poor socioeconomic status. History of hypotonic IV fluid therapy was positive in 18 (7.8%) and history of ORS intake was positive in 71 (30.6%). Mean duration of illness was 4.19 ± 1.27 days. Mean serum sodium level 135.37 ± 2.20 mEq/L. Hyponatremia was present in 90 (38.8%). Male gender, poor socioeconomic status, no use of hypotonic IV fluid therapy, no intake of ORS and disease duration of >3 days were significantly associated (P value < 0.05) with hyponatremia. Conclusion: Frequency of hyponatremia was high in children with AGE. Male children, poor socioeconomic status, no use of hypotonic IV fluid therapy, no intake of ORS and prolonged disease duration were significantly associated with hyponatremia. [ABSTRACT FROM AUTHOR]

Objectives: To determine the frequency of risk factors and acute complications for SGA in term new borns during first 24 hours after delivery. Study Design: Descriptive Case Series. Setting: Department of Pediatric Medicine, Nishter Hospital, Multan. Period: 15 Aug 2014 to 30 Apr 2015. Material & Methods: A total of 157 term babies, delivered in labor room in Nishter hospital Multan were evaluated in 24 hours of birth. Mother of each SGA baby was examined regarding history, clinical examination and nutritional status were noted. SGA babies were completely monitored for 24 hours in the department of pediatric medicine for complications. Results: There were 88 (56.1%) male and 69 (43.9%) female. Mean age and weight of the patients at the time of presentation were 12.73 + 6.65 hours and 2.03 + 0.65 Kg respectively. Among mothers, 61.1% were nulliparous, anemia was found in 47.8%, inter pregnancy intervals of less than or equal to one year in 58.6% and hypertension in 61.8%. Among SGA babies, perinatal asphyxia was found to be present in 63.7%, meconium aspiration in 51%, hypothermia in 37.6%, hypoglycemia in 24.2%, hypocalcaemia in 32.5%, polycythemia in 47.1% and thrombocytopenia in 41.4%. Conclusion: Maternal hypertension, nulliparity, short inter pregnancy interval and anemia were frequently encountered risk factors for SGA babies. The most frequently encountered perinatal complications observed were perinatal asphyxia, meconium aspiration, polycythemia, thrombocytopenia, hypothermia, hypocalcaemia and hypoglycemia in decreasing order of frequency. [ABSTRACT FROM AUTHOR]

Objectives: This study was conducted to determine the frequency of hypomagnesaemia among children admitted in pediatric intensive care unit (PICU). Study Design: Cross-sectional study. Setting: Department of Pediatric medicine, Unit-I, Nishtar Hospital, Multan. Periods: From 1st August 2017 to 31st May 2018. Material & Methods: A total of 379 children of age group 1-12 years and either gender were admitted at PICU irrespective of presenting complaint with duration of illness less than 2 weeks were included. Post stratification chi-square test was applied to see the effect of different variables like age of the patients, BMI, duration of illness and serum Magnesium levels, hypomagnesaemia, residential status, socioeconomic status, mother's education and gender, on hypomagnesaemia. P value < 0.05 was considered as significant. Results: Of these 379 study cases, 221(58.3%) were boys while 158 (41.7%) were girls. Mean age of our study cases was 4.81 ± 2.27 years. Mean duration of illness was 5.57 ± 2.34 days. Mean weight of study cases was 17. 30 ± 5.92 kilograms. Mean serum Magnesium level was 1.45 ± 0.67 mg/dl. Hypomagnesemia was found to be present in 190 (50.1%). Male gender, urban residential status, illiteracy, hospitalization before PICU admission, disease duration of 1 to 2 weeks and weight < 20 kg turned out to be significantly associated (p < 0.05) with hypomagnesaemia. Conclusion: High frequency of hypomagnesaemia was noted among children admitted at PICU. Children with hypomagnesaemia had prolonged hospital stay and adverse outcomes. Hypomagnesaemia was significantly associated with male gender, residential status, mother's educational level, hospitalization before PICU admission, disease duration and weight. [ABSTRACT FROM AUTHOR]