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A retrospective study was done in the in-patient department of paediatrics, BIRDEM from January 2002 to November 2006 to determine the clinico-laboratory features, precipitating factors and outcome of diabetic ketoacidosis. Over the five year period, 344 diabetic patients were hospitalized. Among them, 54 (15.6%) had diabetic ketoacidosis (DKA). Among those, 50 were Type I, one was Fibrocalculous Pancreatic Diabetes (FCPD) and 3 were of other specific types. More than half (51.9%) of the patients were newly diagnosed. Amongst the precipitating factors, 28% had missed insulin and 48% had overt infection. Infections, particularly those of the respiratory tract, were the main precipitating cause for the DKA. There was h/o both infection and missed insulin injections in 11.5% patients. The mean age of patients with DKA was 11.2 ± 4.4 years. Those in the age range 10-14 yrs suffered most frequently (p

Introduction: There are various surgical options for treating fracture of femoral shaft in children. Here we compare the results of close with limited open method of Ender’s nails fixation of femoral shaft fractures in children. Methods: We studied 60 children with femoral shaft fractures in age group 5-15 years. Ender’s nail fixation was done by close technique in 40 cases and in 20 cases by limited open technique. Results: The mean operative time was significantly high in limited open group being 64 minutes in comparison to 50 minutes in close group. There was no significant difference between close and limited open groups with respect to time for partial weight bearing and time for full weight bearing. Fracture united sooner in close group as compared to open group. Union was achieved in all patients within a mean of 11 weeks in close group in comparison to 12.4 weeks in open group. According to the Flynn criteria in close group 34 patients had excellent results, 6 had satisfactory and none poor. In limited open group outcome was excellent in 14 patients, satisfactory in 4 patients and 2 had poor result. There was no significant difference in outcome based on Flynn criteria between two groups. Conclusions: Though operative time is more and healing is delayed in Ender’s nail fixation by limited open technique, there is no statistical difference in final outcome as per Flynn criteria between close and limited open technique of Ender’s nail fixation of femoral shaft fractures in children. Keywords: children; close technique; ender’s nail; fracture shaft of femur; flynn criteria.

Studies focused on the receptor's perspective have contributed to the understanding of the relationship between children and television. It has been verified that the association between entertainment and education is the key component for the success of educative television programs for young audiences. The main goal of this study was to understand how children are responding to television programs that teach while entertaining, particularly those related to environmental education. "Flora Encantada", a segment of the program "Angel Mix" from Rede Globo, during the period of October 1999 to March 2000, was employed in this study. Assessment of this children's program, aimed at integrating aspects of environmental education with television, enabled us to better understand its receptiveness among children ., O surgimento de estudos a partir da perspectiva dos receptores tem contribuído para uma melhor compreensão da relação criança e televisão. Constatou-se que a aliança entre o lúdico da televisão e o educativo é chave do sucesso para a educação via televisão junto ao público infanto-juvenil. O presente estudo tern por objetivo compreender como as crianças estão recebendo esse tipo de programa, que ensina divertindo, mais especificamente em relação ã educação ambiental. Para melhor delimitar o trabalho, foi escolhida a novela infantil Flora Encantada, exibida no programa Angel Mix, da Rede Globo, de outubro de 1999 a março de 2060, que buscava uma integração entre educação ambiental e televisão. Será examinada a recepção da novela, visando compreender as leituras que as crianças fazem, para, enfim, mapear essa recepção infantil.

Background: A study was conducted in Zanzibar using ProPAN software to assess nutrient adequacy of foods given to infants and children aged 6-23 months old in Zanzibar.Methodology: The 24-hr dietary recall method embedded in ProPAN software was used to determine the adequacy of energy, protein, iron, calcium, zinc and vitamin A in foods consumed by children. Sample of 200 mothers/caretakers with children aged 6-23 months were interviewed.Results: Most frequent foods given to infants and children were tea, bread, white rice and fish. Key nutrients such as iron, zinc and vitamin A were below the recommended levels except for vitamin C from the diets consumed by children aged 11-23 months. Energy and protein were considered to be adequate as more than 90% of the children received enough of these nutrients. Mean age of introduction of complementary foods was four months.Conclusion: Children diets were limited in fruits and vegetables that caused micronutrients of nutritional importance such as iron, zinc and vitamin A to be supplied below recommended level. Equally, fat intake was below recommended level. Nutrition education on appropriate complementary foods should be given to caregivers. Promotion of consumption of diversified diets and locally available nutrient dense foods should be emphasized so as to achieve adequate intake of nutrients to infants and young children. Keywords: ProPAN, children, nutrient adequacy, Zanzibar.

Objective: To investigate the clinical efficacy of tiotropium in children with asthma. Methods: Eighty children with newly diagnosed moderate persistent asthma were enrolled into this study. The children were randomly assigned to the fluticasone propionate aerosol group or the fluticasone propionate aerosol plus tiotropium group for 12 weeks. Results: Lung function was significantly improved in both groups at 4, 8, and 12 weeks compared with baseline (P < 0.01). Moreover, lung function was significantly improved in the tiotropium group compared with the control group (P < 0.05). However, there was no significant difference in the incidence of severe asthma between the two groups (36.3% and 26.8%, respectively; P > 0.05). Compared with the control group, the number of days and frequency of short-acting beta2-adrenoceptor agonist use was significantly reduced in the tiotropium group (P < 0.05). Awakenings during the night were also significantly decreased (P < 0.00). There were no severe adverse reactions in either of the study groups. Conclusion: Tiotropium could significantly improve lung function, reduce the use of short-acting beta2-adrenoceptor agonists, and improve sleep in children with asthma. Furthermore, few adverse reactions were reported.

UNLABELLED Back ground and Objective: Mechanical Ventilation (MV) is frequently used as one of the most frequent life-supportive technology in Pediatric Intensive Care Units (PICUs). Very little data is available from Asian countries like Pakistan regarding use of MV in PICUs. Our objective was to assess the frequency, indications and immediate-outcomes in mechanically ventilated pediatric patients in tertiary-care center of developing country. METHODS Retrospective cohort study of critically ill pediatric patients admitted in PICU of Aga Khan University Hospital, who required MV for more than 24-hour over two-year period. RESULTS A total of 605 patients were admitted to PICU, 307 (50.7%) patients required MV support for >24hr. The median age was 3 years (IQR 6 month to 6 yr 2 months), and male was 59.6% (183/307). Common indications for MV was neurological illness 35.8%, followed by respiratory diseases in 20.8% patients and cardiac diseases in 13%; and 30.3 % patients were ventilated for other reasons. The median length of MV was 2.1 days. 9.4% developed complications and atelectasis (4.6%) was the most common. The mortality rate of children mechanically ventilated was 30.3% as compared to the overall mortality rate of in PICU was 16.3%. The long duration (> 10 days) and cardiogenic shock were identified as independent risk factor associated with increased mortality. CONCLUSION About half of PICU admission required mechanical ventilation for more than 24 hours. The neurological illness was the most common reason for ventilation. The low incidence of complication rate and relatively high mortality in cardiac cases and long duration of mechanical ventilation were noted in our cohort.

Objectives: This study aims to assess the effects of zinc supplementation on improving the appetite and its subscales in children. Methods: This study was conducted in 2013 in Isfahan, Iran. It had two phases. At the first step, after validation of the Child Eating Behaviour Questionaire (CEBQ), it was completed for 300 preschool children, who were randomly selected. The second phase was conducted as a randomized controlled trial. Eighty of these children were randomly selected, and were randomly assigned to two groups of equal number receiving zinc (10 mg/day) or placebo for 12 weeks. Results: Overall 77 children completed the trial (39 in the case and 3 in the control group).The results showed that zinc supplement can improve calorie intake in children by affecting some CEBQ subscales like Emotional over Eating and Food Responsible. Conclusion: Zinc supplementation had positive impact in promoting the calorie intake and some subscales of anorexia.

Objectives: The objectives of this study were to determine the anthropometric variables of children with sickle cell anaemia and comparing it with those with normal haemoglobin genotype. Methods: A cross sectional study of anthropometric measurements was conducted over a period of six months. Children with sickle cell anaemia in steady state aged between 6-20 years were recruited. Nutritional assessment was done using anthropometrical variables. Data were analyzed using the Statistical Package for Social Sciences program (SPSS), version 20. Results: The sickle cell patients comprised of 20 males and 20 females. There were an equal number of controls with an equal male to female ratio of 1:1. Forty eight percent (19) of the children with sickle cell anemia were underweight (< 5th %ile) and this is statistically significant. χ2=18.02 and p=0.000. When compared with subjects with normal haemoglobin genotype only five of them (13%) were underweight. χ2=10.286 and p=0.001. The controls weighed significantly more than the HbSS patients and also had significantly larger body surface compared to the HbSS population (P

An orientation of modern child care viewed in the light of the trend in Scandinavia and the Netherlands places the following concepts before us. Now that infant mortality has reached a level of twenty per thousand births, we have arrived at an important point in the development of child care. This fact forces us not only to form an impression of the past and present, but likewise to look to the near future. A relatively drastic reduction of child mortality is still possible, although it is less spectacular than in the past. The rates in the near future can be predicted. Now that serious illness and death in children have become a secondary problem– except for perinatal mortality, some acute diseases, some chronic illnesses and the problem of accidents–the essential task of child health care has become the active promotion of the health of the child in order to achieve an optimal development. The doctor, if he wishes to acquit himself properly of this task, should have some idea of socio‐biology and vital statistics, a knowledge of child development and experience in public health, of which maternal and child health is a part that is closely connected to other branches. More and more maternal and child health is integrated into public health. Continuity and coordination in maternal and child health should be assured from conception up to and including adolescence. The observation of growth and development of the individual child in its longitudinal trend from birth until adulthood is the ABC of modern child health. The new child health strives towards an optimal development of the child and thereby towards optimal conditions in family, school and society. The term “maternal and child health” expresses more clearly than “child hygiene” what social obstetrics and pediatrics attempt to achieve. The continuity which characterises the development of the child should be the basis for the organization of maternal and child health. The new orientation of child health adapts itself to modern conditions in a civilisation entering the atomic age. In their interdependence and their interrelationship research, evaluation of methods and organisation deserve to be adjusted towards this modern constellation which they have not yet sufficiently attained.

O presente artigo apresenta o embasamento teórico, metodológico e os resultados obtidos no desenvolvimento do projeto de um artefato de auxílio ao transporte de crianças em diferentes meios. A pesquisa envolve a apresentação da metodologia, definição do público alvo, assim como a coleta de dados sobre as necessidades dos usuários e seu desdobramento até os requisitos de projeto. Por fim, é apresentado o desenvolvimento do projeto, os estágios de geração de alternativas, validações volumétricas e descrição das funcionalidades do produto. This article presents the theoretical, methodological and results in the development of a project of a device to aid the transportation of children in different modes of transport. The research involves the presentation of the methodology, defining the target, as well as collect data about users' needs and extended to to the project requirements. Finally, we present the development of the project, the stages of generating alternatives, validations and volumetric description of product features.