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Background: Iron deficiency is the most common nutritional deficiency worldwide. Common causes of IDA in children are excessive consumption of cow's milk and prolonged breast feeding with delayed and poor weaning. Oral iron is the first line of treatment in children with IDA but occasionally there is inadequate response due to poor compliance. The objective of this study is to assess the effectiveness and safety of intravenous iron in children with IDA, poorly compliant to oral iron therapy., Methods: This study consisted of 90 children from 12-60 months with IDA who were not responding adequately to oral iron therapy. Total iron requirement was calculated and given intravenously (IV) in two divided doses over two consecutive days. Participants were followed up at 2 and 4 weeks to assess the rise in haemoglobin level. Any adverse event was also noted. SPSS version 25 was used for statistical analysis., Results: Of the 90 enrolled children the mean age was 23.1±10.7 months, 47 (52.2%) were males and 43(47.8%) were females. The mean ferritin level before IV iron therapy was 3.75±2.53 ng/ml and mean haemoglobin was 5.9±1.3 g/dL. After IV iron therapy the haemoglobin level was raised to 8.38±1.09 g/dl and 9.74±0.88 g/dl at 2 and 4 weeks respectively which was statistically significant (p<0.05). The adverse events were fever in 3 (3.3%) and urticaria in 2 (2.2%) patients., Conclusions: Intravenous iron therapy is effective and safe to raise the haemoglobin levels in children with IDA who are poorly compliant to oral iron therapy.

Competing Interests: Competing interests: None declared.

Objective: To determine decrease in respiratory distress and hospital stay in bronchiolitis patients with and without family history of atopy when treated with prednisolone., Methods: The multi-centre quasi-experimental study was conducted in three hospitals of Sialkot, Pakistan, from October 2017 to March 2018, and comprised patients of bronchiolitis who were divided into 2 groups on the basis of presence or absence of family history of atopy. Half of the patients in each group received oral prednisolone 2mg/kg/day for three consecutive days along with supportive care, and the remaining half received only supportive care. Patients were monitored at 12 and 24 hours for clinical response using Modified Respiratory distress Assessment Instrument score. Length of hospital stay was monitored upto 72 hours. SPSS 20 was used for data analysis., Results: Of the 212 patients, 72(34%) were in the atopic group and 140(66%) in the non-atopic group. In atopic group, there was a significant respiratory distress difference observed between steroid and non-steroid subgroups at 24 hours (p=0.001) and all (100%) patients in the steroid subgroup got discharged at 24 hours, while only 8(22%) were discharged in the non-steroid subgroup. In non-atopic group, no significant improvement in corresponding terms was observed (p>0.05)., Conclusions: Oral prednisolone in bronchiolitis was found to be only effective in patients with family history of atopy.

Background: Nasal continuous positive pressure has been used for management of respiratory distress in neonates in various conditions as a primary modality. Objective of the study is to evaluate the frequency of improved outcome and complications of use of nasal CPAP through infant flow drivers in neonates with respiratory distress. The study was conducted from 2nd April 2017 to 2nd October 2017 in neonatal intensive care unit of Allama Iqbal Memorial Teaching Hospital Sialkot., Methods: All neonates with respiratory distress fulfilling the clinical criteria (Neonates with gestational age 28 weeks to 40 weeks having clinical signs of respiratory distress classified according to down score (tachypnea, grunting, decreased air entry, cyanosis, recessions), neonates having pc02 <60 mmhg, neonates having x-ray findings consistent with respiratory distress syndrome (RDS), Transient tachypnea of newborn (TTN) and pneumonia) were included in the study. Nasal CPAP was used at variable settings. Outcome, complications, indications, associated diseases and hospital stay along with other baseline characteristics were assessed. Success was defined as improvement of the respiratory distress as assessed by down score, maintenance of SPO2 above 90% in room air after weaning from CPAP for about consecutive 4 hours and normalization of blood gases while the failure as need for mechanical ventilation., Results: Total 60 neonates were included in the study. Mean weight was 2113.3±580.32 g while mean gestational age was 33.35±2.59 weeks. Total 52 (86.7%) babies were successfully weaned off from nCPAP while only 8 (13.3%) neonates required mechanical ventilation. Main indication of use of CPAP was RDS (65%). No complications were observed in 73.3% babies while 26.7% had complications of which nasal deformities accounted for 20% and abdominal distension for 6.37%., Conclusions: Nasal CPAP can be safely and easily used as primary support for neonates with respiratory distress even in resource limited developing countries. It reduces the need for mechanical ventilation and thus hospital stay.