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Objective: To compare frequency of short term (first 7 days of life) neonatal morbidities in late preterm vs term infants. Study Design: Prospective cohort study. Place and Duration of Study: Study was carried out over a period of six months from Jan 2016 to Jun 2016. Methodology: A total of 130 patients (65 in each group) were included in this study. All infants enrolled in study were followed till first 7 days of life for any morbidity by clinical evaluation. Infants who were discharged before 7 days were called for mandatory follow up evaluation in the outpatient clinic on 7th day of life. Results: Mean age of the babies was 3.28 ± 1.45 and 1.58 ± 0.65 in group-A and B, respectively. Mean gestational age in group-A was 35.18 ± 0.73 weeks and in group-B was 38.38 ± 11.07 weeks. Mean weight (kg) of neonates was 2.53 ± 0.33 in group-A and 3.24 ± 0.49 in group-B. Morbidities were found as follows: Probable sepsis was seen in 17 cases (26.2%) of group-A and 7 cases (10.8%) of group-B with p-value of 0.024. Respiratory morbidity observed in 15 cases (23%) of group-A and 3 cases (4.6%) of group-B with p-value of 0.002. Hyperbilirubinemia developed in 33 cases (50.8%) of group-A and in 15 cases of group-B with p-value of 0.001. Conclusion: The frequency of sepsis, respiratory morbidity and hyperbilirubinemia was more in late preterm as compared to term infants. [ABSTRACT FROM AUTHOR]

Objective: To explore the impact of corona virus disease-19 pandemic on postgraduate paediatric residents. Study Design: Mixed method study. Place and Duration of Study: Pak Emirates Military Hospital Rawalpindi, from Apr to May 2020. Methodology: Post graduate paediatric residents working in Pak Emirates Military Hospital and Combined Military Hospital Rawalpindi, Pakistan were included by purposive sampling technique. Sample size was predetermined, included all (forty total) residents of two hospitals. Participant‘s written response was obtained on an open ended self administered-questionnaire distributed in person. All enrolled participants responded. Thematic analysis of data was done. Results: The participants were predominantly female (n: 30, 75%) of age range 31-35 (50%) years. The first theme category was ―Impact on personal life‖ The residents reported an unprecedented physical, psychological and social stress. The second category was ―Family life during COVID-19‖ Residents had to share extra family/ financial/health responsibilities of their families. ―Professional duties and training‖ was another theme category. Residents worked in new context of environment, fear of contagion, managing interpersonal / interprofessional relationships, less volume of patients/clinical experience / skills and new e-learning modalities. ―Challenges and suggestions to cope‖ is another category, where residents suggested strategies and sources to improve patient care, their well being and training during pandemic. Conclusion: The residents had experienced intensive physically, emotional and social stress. Most of them behaved with resilience and extreme professional dedication. Different competencies of training are being affected. Concerned authorities must adopt new strategies to support resident‘s training and personal life. [ABSTRACT FROM AUTHOR]

Coronavirus disease 2019 (COVID-19) is a communicable illness which has become a global pandemic involving all the age groups. We report a case of neonatal SARS-CoV-2 infection in NICU of Pak Emirates Military Hospital Rawalpindi in a 26-day-old neonate who presented to us with fever and refusal to feed. Laboratory parameters revealed SARS-CoV-2 and typical CT-chest findings. Considering this scenario, we are of the opinion that the transmission of the virus was horizontal. Under the current circumstances, COVID-19 should be in the differentials while evaluating all the neonates presenting with fever. [ABSTRACT FROM AUTHOR]

Objective: To determine the clinico-endocrinal spectrum of XY Disorders of Sex Development (DSD) according to the new classification in our population. Study Design: Cross sectional study. Place and Duration of Study: Department of Chemical Pathology and Endocrinology Armed Forces Institute of Pathology Rawalpindi, from Jan 2012 to Aug 2015. Material and Methods: A total of 151 patients who reported for work-up of DSD during 2012-2015 and labeled XY on karyotyping were included in the study. Patients without karyotyping results, mixed sex chromosome or XX karyotypes were excluded from the study. Patient's clinical features and results of serum hormones i.e. LH, FSH, Testosterone, 17 hydroxy progesterone, DHEAS and hCG stimulation test were analyzed. Results: Out of 151 patients of XY DSD, 68 (45%) patients were diagnosed as partial androgen insensitivity syndrome (PIAS), 18 (12%) as isolated micropenis, 25 (16.6%) as partial gonadal dysgenesis, 12 (7.9%) as hypogonadotropic hypogonadism, 11 (7.2%) as primary hypogonadism, 13 (8.6%) as complete androgen insensitivity syndrome (CAIS) and 4 (2.6%) as 5a reductase deficiency. There was a wide variation in age of presentation ranging from three months to twenty five years with the median age of 9.5 years. Nineteen (12.6%) were raised as female and 132 (87.4%) were raised as male. The main complaints at presentation were ambiguous genitalia (30.5%), undescended testes (21.2%), delayed puberty (19.2%), micropenis (16.6%), inguinal hernia (8.6%), and primary amenorrhea (3.9%). Conclusion: Androgen insensitivity syndrome (AIS) in its various forms is the commonest of all XY DSD. All DSD including AIS require complete investigations in a tertiary care setup. [ABSTRACT FROM AUTHOR]

ABSTRACT Objective: To look for the associative factors in avoidance of exclusive and nonexclusive breastfeeding among mothers after lower segment Caesarean section. Study Design: Cross-sectional study. Place and Duration of Study: Paediatrics department, Pak Emirates Military Hospital, Rawalpindi Pakistan, from Oct to Mar 2020. Methodology: Mothers bringing their infants for vaccination at six weeks of age with babies born with lower segment caesarean section were included in the study. They were asked simple questions regarding exclusive or nonexclusive breastfeeding. Relevant sociodemographic factors were also recorded and compared among mothers breastfeeding their babies and those avoiding it. Results: A total of 500 mothers were included in the study. The mean age of the study participants was 33.576±9.174 years. 336(67.2%) women were primiparous, while 164(32.8%) were multiparous. 208(41.6%) women were actively breastfeeding their child, while 292(58.4%) avoided breastfeeding their babies. 150(72.1%) women were nonexclusively breastfeeding, while 58(27.9%) showed an exclusive breastfeeding pattern. Pearson chi-square test revealed that low education and working outside the home had a statistically significant association with the avoidance of breastfeeding the babies among our target population (p-value <0.05). Conclusion: Avoidance of breastfeeding was a common finding after six weeks of birth among women who delivered the babies via lower segment caesarean section. Mothers with low education and duties to work outside the home were more at risk of avoiding this highly beneficial practice for the baby. [ABSTRACT FROM AUTHOR]

Rothmund-Thomson syndrome is a rare autosomal recessive poikilodermatous disorder with various inconsistent features. Clinical features of two siblings are described, which raised only just cosmetic concerns for the parents. The parents were counseled and advised regular follow-up for early detection of complications including malignancies and to protect the children from sun exposure by using broad spectrum sun screens and physical barriers.