Search

Objective: To determine the diagnostic accuracy of modified computed tomography severity index (CTSI) and Bedside index for severity in acute pancreatitis (BISAP) scoring system in predicting severity in acute pancreatitis, keeping the Revised Atlanta Classification (RAC) as the gold standard. Study Design: Prospective longitudinal study. Place and Duration of Study: Department of Gastroenterology, Pak Emirates Military Hospital, Rawalpindi Pakistan, Pakistan from Jan to Jul 2022. Methodology: This study was conducted on 100 patients with acute pancreatitis, both genders and ages. Patients with chronic pancreatitis, pancreatic calcifications, dilated pancreatic duct, areas of atrophy and pseudocysts were excluded. Detailed history and physical examination, and laboratory investigations were performed. Modified CTSI, BISAP and RAC were calculated. RAC was used as the gold standard. Sensitivity, specificity and other diagnostic parameters were calculated using R programme. Results: The mean age was 42.42±18.07 years. The males were 53%, and the females were 47%. CTSI was sensitive at 100%, specific at 58.43%, and overall diagnostic accuracy at 63%. BISAP was sensitive at 100%, specific at 68.54%, and overall diagnostic accuracy at 72%. Conclusion: BISAP and modified CTSI can assess severe acute pancreatitis (SAP) at primary and secondary care levels, enabling early triage and referral to higher centers.

In Pakistan, child abuse has risen alarmingly, i.e., 30% of cases from 2020-2021 statistics.1 WHO comprehensively drafts the definition as, "Child abuse or maltreatment constitutes all forms of physical and or emotional ill-treatment, sexual abuse, neglect or negligent treatment, or commercial or other exploitation, resulting in actual or potential harm to the child’s health, survival, development or dignity in the context of a relationship or responsibilities, trust or power." There is an urgent need to address these issues in the prevention, psychotherapeutic treatment and rehabilitation of such victims and suffering. On the contrary, there will be a scary consequence. According to WHO, about 1 billion old children (2-17 years) across the globe are subjected to physical, sexual, or emotional harm by their caregivers or strangers Violence or abuse does not have boundaries of country, religion, class, or gender.2 At the same time, the related stigma keeps it underreported. Every year, around 500 million children suffer from abuse. In the USA, more than 3 million cases are reported, causing 2000 deaths and 18000 permanent disabilities, the victim results every year. The count for sexually molested girls is 1 in 4, and for boys, it is 1 in 7.3 In New Delhi, Child abuse is 8 in 10 kids, whereas boys (7 in 10 kids) are more vulnerable than girls (6.5 in 10 kids).4 The percentage of sexual abuse in India is 52% only admitted patients annually, whereas statistics for unreported and other molestation are unknown.5 In Sri Lanka, more than 40000 children were involved in prostitution, where children are used by paedophile sex tourists.6 In an unofficial report, every year, somewhat 15-20% of children are sexually abused in Pakistan. According to an NGO, there is a rise of 2 to 10 reported cases of Child Sexual Abuse (CSA) per day in the upcoming year, whereas the actual numbers would be much higher because CSA is culturally veiled. They documented that both genders were equally victimized, although 0-5 years of CSA victims were mostly boys. The perpetrators included close family ties and acquaintances, marking an increase in per year cases reported. Out of a total 3852 number of CSA cases, 2211 (51%) were from Punjab. A total number of 92 cases were reported murder after the assault.7 According to the latest study, the amygdala in the brain shrinks with repeated trauma, resulting in delayed learning abilities and deficient memory.8 Depression, isolation, and delinquency are a few more to enumerate. There are physical, behavioural and emotional indicators of abuse that a physician must be able to identify, address and refer to a psychologist for professional treatment. The prevention measures of awareness, training for parenting, character building of parents and psychological treatment can prevent and decrease a victim’s suffering. The only way to prevent CSA is to educate and spread awareness against this act on two levels. One is educating parents and teachers, and the other is making the child aware of the good and bad touch. In this regard, the PAAC group has worked. They have prepared useful brochures to protect the child from encountering the issue. The whole structure of society needs renovation, and the best renovation is building attributes based on the psychological training present in the seerah of the Prophet (SAW) and his companions.

OBJECTIVES: To determine the frequency of lumber puncture-proven acute bacterial meningitis among children with fever and seizures of first onset. METHODOLOGY From March 2020 to March 2021, a hospital-based descriptive cross-sectional study was conducted at the paediatrics department of Hayatabad Medical Complex Peshawar. The sample size for a total of 342 people was estimated using WHO software. The study included all children who had first-onset febrile seizures through OPD and the emergency department. All children underwent lumber punctures using a stringent aseptic procedure, and the hospital laboratory received the samples to look for bacterial meningitis. On a pre-made Proforma, details including name, age, and gender were entered. The gathered data were input into the computer for additional SPSS analysis (version 23). RESULTS Most individuals were male and were lies in the 21-40 months of age group. Mean weight and length/height were evaluated, respectively. The majority had a history of 6-10 days of disease duration. Bacterial meningitis was found significantly (p0.05) associated with the duration of diseases. CONCLUSION All children between the ages of 6 months and 60 months who presented with episodes of fever and seizures were found to have a statistically significant (p

Background: Asymptomatic bacteriuria (ASB) in not an uncommon disease in children. It may lead to symptomatic infection and later on renal damage. The objectives of this study were to determine the prevalence of ASB and its distribution by sex and age groups in children coming for routine immunization in District Peshawar, Pakistan. Material and methods: This cross-sectional study was conducted in Department of Pediatrics, Khyber Girls Medical College, Peshawar, Pakistan form March 2017 to August 2017. 146 children presenting for routine immunization were selected. Sex, age groups, age in years and presence of ASB were variables. Sex, age groups and presence of ASB were analyzed by count and percentage with 80%CL. Age in years was analyzed by mean, SD and range with 95%CI. Results: Out of 146 children, 65 (44.52%) were males and 81 (55.48%) females, and 51 (34.93%) in age group ≤3 years, 52 (35.62%) in 3.0-6.50 years and 43 (29.45%) in 6.51-10 years. Mean age of sample was 4.82±2.81 (09-9.50, range 8.60) (95%CI 4.36-5.28) years. ASB was found in 16 (10.96%) cases. Prevalence of ASB was higher 4.11% in boys than 6.856% girls. It was highest 6.85% in age group 3.0-6.50 years, followed by 2.74% in 6.51-10 years and 1.37% in age group ≤3.0 years. Conclusion: Asymptomatic Bacteriuria is quite common in our children. It is a significant health risk especially among females, and we suggest more studies to find out the underlying factors and follow up studies on its complications.

OBJECTIVES To determine the frequency of hypovitaminosis D in children presenting with Idiopathic musculoskeletal pain IMSP). METHODOLOGY The cross-sectional research was carried out at Peshawar’s Hayatabad Medical Complex’s Department of Pediatrics. The study duration was 6 months. The study comprised 151 patients with non-specific musculoskeletal pain who were tested for vitamin D levels to diagnose hypovitaminosis. RESULTS The age range of the participants was 3 to 15 years with a male predominance of 72.8%. The sample’s average the weight was above the 25 percentile. Hypovitaminosis D was found in 23.2%. Decreased sun exposure was documented in 82.85% of cases with hypovitaminosis. Hypocalcemia, hypophosphatemia and increased alkaline phosphatase were documented in 71.4%, 11.4% and 42.8% participants respectively with hypovitaminosis. CONCLUSION Hypovitaminosis D Is one of the risk factors for non-specific musculoskeletal pain but the current study revealed only 23.2% of participants had hypovitaminosis and inadequate sun exposure was a major risk factor for hypovitaminosis.

Background: Pancytopenia is a common problem in clinical and haematological practice in pediatrics. A vast majority of diseases may present with pancytopenia. The clinical manifestations are usually attributable to anemia, leucopenia or thrombocytopenia, which may manifest clinically as pallor, infections or bleeding problems respectively. It is very important to know the common causes of pancytopenia in children, as some of them are completely curable while others can be treated to reduce morbidity and to prolong survival. Material & Methods: This was discripative cross-sectional study, conducted in Department of Pediatric, Hayatabad Medical Complex, Peshawar. A total of 168 patients presented with new onset pancytopenia on peripheral blood smear were included in the study. Results: There were 102(60.71%) males and 66(39.29%) females. Male to female ratio was 1.60:1. Average age of the patients was 7.46 years ±3.8SD with range 2 months - 15 years. The aplastic anemia was found in 57(33.93%) patients. Conclusion: Pancytopenia is more common in males than females. Aplastic anemia is a common finding of pancytopenia in this part of world in the specific age group.

Background: Hemorrhagic disease of the newborn is a coagulation disturbance in newborns due to vitamin K deficiency. In our region most babies are delivered at home or in private clinics where vitamin K is not given in routine, leading to hemorrhagic disease of the newborn. The current study was conducted to determine the clinical presentation of hemorrhagic disease of the newborn and to assess the response to injection vitamin K. Material and Methods: This descriptive study was conducted at Neonatal Unit, Department of Child Health, Hayatabad Medical Complex, Peshawar, from January to December 2011. All neonates who presented with bleeding were admitted in the Neonatal Unit of Hayatabad Medical Complex, Peshawar. After sending blood for investigations, 2mg Vitamin K was injected intravenously. In babies with continuous bleeding, fresh frozen plasma was also given. PT and APTT were repeated after 6 to 12 hours and after one week. Results: 42 cases were included in the study. 76.2% were born at home and did not receive vitamin K at birth. 57% were low birth weight. 88% were breastfed. Gastrointestinal tract, skin and nasal mucosa were the common sites of bleeding. PT and APTT were prolonged in all the cases. Their values improved after 6 hours and normalized in one week. Conclusion: Vitamin K deficiency causing hemorrhagic disease of the newborn is a common problem in neonates. It shows a dramatic response to vitamin K injection. It is more common in male, preterm and low birth weight babies.