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Aim: To determine the frequency of common congenital anomalies among neonates in tertiary care hospital Study Design: A cross-sectional study. Place and Duration: Children Hospital Larkana Pakistan from April to October 2018. Methodology: One hundred twenty-four newborns with congenital anomalies were included in this study after taking parental consent. All the newborns were assessed by prenatal, natal, and postnatal history, general physical examination, and relevant investigations like ultrasound abdomen, echocardiography, and CT Scan Brain were done; Questionnaire was filled out immediately within 24 hours after hospital admission. Results: The mean maternal age of the patients was 24.16±4.13 years. Central nervous system (CNS) anomalies were observed in 21% of cases. Neural tube defects like hydrocephalus 6.5%sacrococcygeal teratoma 2.4%, meningomyelocele 11.3%, and encephalocele 0.8%. Cardiovascular system (CVS) anomalies were found in 11.3% cases in which cyanotic 2.4%, (2 were Tetralogy of Fallot and 1 was Transposition of great arteries) Acyanotic 8.9% (10 Ventricular septal defects and 1 atrial septal defect). Gastrointestinal tract (GIT) Anomalies (39.5%) like, duodenal atresia (0.8%), anorectal malformations (25%), Pyloric Stenosis (0.8%), exomphalocele (5.6%), diaphragmatic hernia (2.4%), Hirschsprung disease (4.8%). Genitourinary system abnormalities (16.9%) like Hypospadias (14.5%), undescended testes (0.8%), cloacal exstrophy (0.8%) and hydrometrocolpos (0.8%). Musculoskeletal abnormalities (11.3%) like clubfoot (0.8%), developmental dysplasia of Hip (0.8%), polydactyly (1.6%) and cleft lip & palate (8.1%) of cases. Conclusion: Congenital abnormalities are prevalent in our setup, and the CNS is the most commonly involved system, followed by the gastrointestinal system, genitourinary system, cardiovascular system, and musculoskeletal system. The prevalence and pattern of congenital defects must be known in order for healthcare providers to create preventive interventions at various levels.

Aim: The purpose of this study was to determine the knowledge of parents regarding polio vaccination in unvaccinated children less than 5 years of age. Study Design: Cross-sectional study. Place and Duration: Department of Pediatrics, Shaheed Mohtarma Benazir Bhutto Medical University, Larkana Pakistan from February 2018 till August 2018 Methodology: All parents of unvaccinated children of either gender with ages from 2 months to less than 5 years of age visiting the hospital outpatient department for any reason were included in the study. Information about the OPV immunization status, demographics, education of the family earner, occupation and income, accessibility of vaccination center in terms of distance, the behavior of immunization staff, parents' views regarding vaccines were recorded. Questions were asked about the vaccination schedule. Results: Mean age of the child and respondent’s age was 2.96 ±0.89 years and 31.40 ±3.96 years respectively. Male preponderance was found to be higher 146 (63.50%). Adequate knowledge about polio was found in 58 (25.20%) parents. Conclusion: The Knowledge of parents regarding polio vaccination was found unsatisfactory in unvaccinated children less than 5 years of age.

Objective: To determine the neonatal mortality and ascertain the disease patterns at neonatal ward in a tertiary care hospital Material and Methods: Design: Hospital based cross sectional study. Participants: Two thousand, two hundred and seventy five neonates were registered using retrospective data from 1st January 2020 to 31st Dec 2020. We recorded gender, birth weight, cause of admission, and admission outcome. Data was analyzed using Microsoft excel data spread sheet. Results: There were 2275 patients registered from CPDR (complete patient data record register) from 1st January 2020 to 31st Dec 2020. The mean birth weight was 2.35 kg, with lowest birth weight of 0.9kg and highest birth weight of 4.8kg (SD 0.8 and SE 0.01, CI 0.025). Out of 2175 admitted neonates 506 (23.2%) died, 1250 (57.4%) were discharged after desired improvement, most common presenting complaint and cause of admission was HIE grade 1 , followed by Sepsis, 418 (18.5%), 380(16.9%), respectively. Conclusions: Hypoxic Ischemic Encephalopathy grade I is the most common morbidity pattern in our study, the mortality rate was observed very high, indicators of birth weight were also poor. There is a great need for improvement of antenatal care for mothers to enhance different measures of newborn welfare and wellbeing.

Adolescence, the time between childhood and adulthood, is typically accompanied by significant and frequently challenging changes in a young person's life. An adolescent's personal growth and sense of self-worth are influenced by biological, cognitive, social, and environmental factors. The reason for this research was to find out the Self-esteem among Higher Secondary School Students (VIII, IX, X). The objective of this study was to obtained having 100 items questionnaire for Higher Secondary School Students. The result demonstrated that there was no significant difference in the level of Self-esteem among Higher Secondary School Students based on gender. So the aim of the present study was to examine the level of Self-esteem among Higher Secondary School Students.

Learning outcomes The learning outcomes of this paper is as follows: understand the impact of macroeconomic challenges on startups; gain insights into the effects of self-management attribute over entrepreneurial effectiveness and performance; create a conceptual framework for customer satisfaction; analyze the internal and external factors affecting the entrepreneurial journey of new startups. Case overview/synopsis This case revolves around the entrepreneurial journey of Mr Khursheed Chohan who belonged to Sukkur (Pakistan). He started his journey as a daily wage worker in the year 2002 at the age of 17 years. After one year he acquired a rickshaw on rent and would drive the same as a taxi. In the year 2006, he started the job as a private driver. For achieving his dreams, he moved to Karachi (the land of opportunities) at the age of 27 years. During his stay in Karachi, he learned about insights into the wedding decoration industry. Keeping in view the market requirements, he also took some training courses on learning computers. By the age of 34, he returned to his hometown with the will to start his business venture of wedding decoration services. It had been around one year, he was successfully running his business. However, the emergence of Coronavirus (COVID-19) and the imposition of lockdown over businesses were his most recent challenges. While Chohan had pre-booked several orders and secured advance money, shall he be able to survive the COVID-19 effects? Shall he be able to continue his entrepreneurial journey? Complexity academic level Undergraduate. Supplementary materials Teaching Notes are available for educators only. Subject code CSS 3: Entrepreneurship.

Objective: To determine the status of thyroid function among β-thalassemia major patients dependent on transfusion. Material And Methods: This descriptive, cross sectional analysis was conducted at Dept. of Pathology (Hematology) - Liaquat University of Medical and Health Sciences, Jamshoro and Thalassemia Centre Hyderabad upon a sample of 114 pre-diagnosed patients of either gender aged 5 and above and suffering from Beta Thalassemia with history of recurrent blood transfusions (more than 20 transfusions or a transfusion history of more than 2 years), chosen via non-probability - consecutive sampling. The laboratory results were recorded onto a pre-structured questionnaire after taking written informed consent. Data obtained was analyzed using SPSS v. 16. 0 and MS. Excel 360. Results: Among the total 114 patients studied, a majority comprised of females. The mean age, TSH level and FT4 of the sample stood at 12.38 (+5.71 SD) years, 3.53 (+3.67 SD) and 1.34 (+1.16 SD) respectively. An interesting association between serum ferritin level and history of extensive blood transfusions, especially when the transfusions roughly exceeded 300 (P = 0.003). Conclusion: After careful consideration, it can be concluded that Hypothyroidism is common among transfusion dependent β-thalassemia major patients. Key Words: β Thalassemia Major, Blood Transfusion, Endocrinopathy, Hypothyroidism and Serum Ferritin.