Search

A 7 years old girl diagnosed as case of juvenile idiopathic arthritis since the age of 1.5 years, generalized onset with systemic presentation is complicated by secondary nephrotic syndrome. Renal biopsy showing amyloidosis. Patient has severe disease course being complicated by sever flare ups of disease symptoms and body swelling. Since onset of disease patient got NSAIDs, methotrexate, steroids, anti TNF inhibitors with no or partial response. After diagnosis with secondary nephrotic syndrome due to secondary amyloidosis patient is started on intravenous tocilizumab. There is improvement of patient symptoms.

Introduction: The relationship between physicians and pharma industry is an old and significant one. This study was conducted to evaluate the relationship between doctors and sales representatives of different pharmaceutical companies. Moreover, it evaluates the conflict of interest arising from some unethical practices. Material & Methods: The study was conducted in the outpatient department of Ayub Teaching Hospital Abbottabad for a period of three months. The representatives of different pharmaceutical companies visiting the department of paediatrics were included in the study after informed consent. The data were recorded using a proforma having set of questions and then analysed using SSPS 24 software. Results: A total of 92 pharmaceutical company representatives were included in the study. Out of 92 representatives, 93.5% were given proper training. About 12% responded they openly gave incentives to doctors for boosting their company sales and 34.8% responded that doctors demanded personal gains from them. There is significant relationship between open incentive given to doctors and open demand by doctors (p = 0.005). Conclusion: Interaction of doctors with the pharmaceutical companies is complex and conflict of interest is there. On one hand pharmaceutical companies are not following code of conduct in promotion/sales of their products and on other hand a reasonable number of doctors are not following the ethical guidelines and are involved in malpractice.

OBJECTIVES Accidental poisoning in children is a serious public health problem in developing countries, especially where chemicals used in agriculture are ingested. Paraquat is a herbicide which is still used in Pakistan. We report a case of fatal unintentional paraquat ingestion by 3 years old child who could not survive. Lack of care in the storage of paraquat lead to the poisoning but initial inappropriate management was also one factor in the fatal outcome. Detailed history and provision of poison containers are important in the proper management of patients with poisoning.

In developing countries, accidental poisoning is a serious public health problem in children. But unintentional poisoning by parents in the form of medication is very rare. Ivermectin belongs to the group of Avermectins and is used in veterinary medicine and in use for human parasitic diseases. We report the case of 10 years old girl given ivermectin by her mother for an unspecified amount. The patient presented to the hospital with seizures and remained in a coma for five days. The patient was managed symptomatically and discharged home in stable condition with parents' counselling regarding child safety.

OBJECTIVE: To assess for the neurological complications and Bacille Calmette-Guerin (BCG) vaccination status of children with tuberculosis meningitis (TBM). METHODS: This retrospective study was conducted in Ayub Teaching Hospital, Abbottabad, Pakistan. Data of diagnosed case of TBM who received anti-tuberculous therapy from 2017 to 2020 was retrieved from records. Records of children, aged 6 months to 10 years of either gender were included and vaccination status was documented along with CT scan findings. Neurological complications in hospital and outcome were recorded as discharge, expiry and transfer to other hospital. RESULTS: Out of 40 patients, 17 (42.5%) were males and 23 (57.5%) females. Age ranged from 6 months to 8 years with mean age of 2.81±2.29 years. Weight ranged from 5 to 24 kg and mean weight was 10.36±4.96 kg. About 72.5% patients were

OBJECTIVES: The objective of the study was to evaluate factors associated with vaccine hesitancy and refusal at District Swabi, Khyber Pakhtunkhwa. METHODOLOGY: This cross-sectional study was conducted at a teaching hospital of Khyber Pakhtunkhwa District Swabi over a period of four months. Children between the ages of 9 months to 10 years from the local population admitted to the children ward/daycare centre were included in the study. Parents were inquired about vaccination status and in case of no vaccination or partial vaccination; then the reason was inquired after proper informed consent. Data were collected by using a structured proforma and analyzed using SPSS-24. RESULTS: A total of 828 children were included in this study. Out of these 492 (59.4%) were male and 336 (40.6%) were females. Of the total 828 children, 753 (90.9%) were vaccinated up to date, 48 (5.8%) were not vaccinated and 27 (3.3%) were partially vaccinated. Under vaccinated were 75 patients, 52% were left out due to misconception/beliefs, 6% patients were having issues due to living far away, 2.7% patients could not be vaccinated due to presence of other diseases and 37.3% due to lack of knowledge regarding vaccination. A significant correlation was found between the vaccination status of children and aforementioned reasons (p-value ≤0.001). CONCLUSION: The most common cause of not vaccinating children with polio vaccines was misconceptions/beliefs and lack of knowledge of the parents.

Malrotation of the gut can present at any age but the majority of patients present in neonatal period or early infancy. Most children present with a history of recurrent colicky abdominal pain, vomiting which can be bilious and failure to thrive. Delay in diagnosis leads to increase in mortality and morbidity. Here we present a series of three patients, one girl aged 6 years, one 10 months old boy and one 10 years old boy, who got admitted at our Pediatric Department in a one month period. Patients had a history of recurrent abdominal pain and occasional vomiting, seen and managed by multiple paediatricians and GP doctors with extensive diagnostic workup but never the accurate diagnosis was made. Thorough history was taken and examination done, planned work up done for diagnosis. High index of suspicion is needed in children presenting with recurrent pain in the abdomen. Targeted work-up should be done and patients be kept on follow-up for diagnosis of late presentation of congenital malrotation of the gut.

The right of women’s inheritance is quite debatable in the revealed religions. But in Islam there is crystal clear criteria and guidelines for all the heirs including women. Even in the old and new testament are silent regarding this important issue and Jews and Christians adopted the law of women inheritance from Roman law. In this paper we will discusses various cases in brief from history and will present a comparative analysis of the three religions in detail. Specifically the share of women as Mother, Sister, Daughter and Wife of deceased.