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Objectives: We planned this study to find out morbidity patterns as well as outcome of admitted children aged less than 5 years of age with severe acute malnutrition (SAM). Study Design: Cross Sectional study. Setting: Department of Pediatrics Medicine, Ghurki Trust Teaching Hospital, Lahore. Period: From 1st January 2018 to 30th June 2018. Material & Methods: A total of 80 children aged 1 to 59 months, of both genders, having SAM were considered. Physical examination, detailed clinical as well as laboratory findings related to nutritional status and comorbidities were noted. Outcome in terms of recovery/discharge, left against medical advice (LAMA) or death during the stay was noted in all the children. Results: Out of a total of 80 children, 20 (25.0%) were aged 1 to 6 months, 39 (48.8%) from 7 to 24 months and 21 (26.2%) from 25 to 59 months. Most of the patients, 39 (48.8%) were from 7 to 24 months of age, 62 (77.5%) were admitted through emergency, 52 (65.0%) had WHZ score-4SD and 27 (33.8%) using bottle feeding. Severe wasting without having edema was reported in 67 (83.8%) children. Diarrhea was the commonest comorbidity, found in 43 (53.8%) children, followed by sepsis 17 (21.3%) and pneumonia 15 (18.8%). There were 69 (86.3%) children noted having anemia. Hyponatremia was the commonest metabolic abnormality seen in 40 (25.0%) children. In terms of outcome, 71 (88.7%) children recovered well and got discharged while mortality was reported in 5 (6.3%) children. Conclusion: Diarrhea along with sepsis and pneumonia along with metabolic abnormalities were found to be more prevalent amongst children having SAM. Early identification of anemia as well as infections in children with SAM can contribute to better outcome.

Objectives: Childhood and adolescent obesity is increasing especially in developing countries like Pakistan. It seem to affect most socio-economic classes as well as all ethnicities and geographies. We planned this study to analyze the clinical and biochemical profile of obese as well as overweight children at a tertiary care hospital for the existence of metabolic syndrome. Study Design: Cross sectional study. Setting: Department of Pediatrics Medicine, Children Hospital Chandka Medical College / Shaheed Mohtarma Benazir Bhutto Medical University, Larkana. Period: 1st July 2018 to 31st December 2018. Material & Methods: Children, aged 5 to 16 years, both gender, having BMI > 85th percentile regarding age and gender were enrolled. Demographic characteristics along with history, lifestyle parameters and physical examination were noted for all the study participants. Metabolic syndrome (Met S) was evaluated while overall results were presented in terms of proportions, mean and standard deviations. Results: A total of 78 cases were enrolled during the study period. There were 46 (58.9%) male and 32 (41.1%) female, with a male to female ratio of 1.4:1. Mean age amongst study participants was 10.8 years. We had 56 (71.8%) children as overweight whereas 22 (28.2%) obese. Acanthosis nigricans was the most common entity seen in 55 (70.1%) children during clinical examination. Metabolic syndrome was found to be present in 31 (39.7%) participants. Conclusion: Met S is not only limited to obese children as it can also affect children who are overweight.

Objectives: We planned this study to observe the pattern related to bacterial isolates causing neonatal septicemia along with their pattern of antibiotic susceptibility. Study Design: Prospective study. Setting: Department of Neonatology, Sheikh Khalifa Bin Zaid Al Nahyan Teaching Hospital, Rawlakot. Period: From 1st January 2018 to 30th June 2018. Material & Methods: Prior to empiric antibiotic usage, blood was collected from neonates having clinical sepsis and sent for blood culture. A total of 60 neonates with culture proven sepsis were enrolled for this study. Reports of blood culture were evaluated for isolates of bacteria as well as patterns of sensitivity for frequently used antibiotics in the institution. SPSS version 21.0 was used for data entry and analysis. Results: A total of 60 neonates having culture proven sepsis were enrolled in the current study. Amongst these, 39 (65.0) were male and 21 (35.0%) female. Early onset of sepsis was diagnosed in most, 42 (70.0%) neonates. Majority of neonates, 50 (83.3%) were delivered in the same hospital. Gram negative isolates were found in 43 (71.7%) and 15 (25.0%) gram positive while 2 (3.3%) candida spp. In terms of pattern of antibiotic sensitivity, 4 (9.3%) isolates of gram negative were found resistant to every antibiotic routinely used while gram positive isolates showed excellent sensitivity to vancomycin. Conclusion: Gram negative isolates of organisms were found to be the most sensitive to carbepenems (especially meropenem) as well as aminoglycosides while gram positive isolates showed excellent sensitive regarding vancomycin.

Objectives: Relationship amongst celiac disease (CD) and lung diseases has been discussed in the past. Studies have documented that CD is linked with lung diseases. CD has also been described to complement asthma. This study was planned to document the prevalence of asthma as well as allergic rhinitis in confirmed cases of CD and conducted pulmonary function testing in children aged 5 to 16 years while comparing them with controls. Study Design: Cross sectional study. Setting: Department of Pediatrics Medicine, Children Hospital Chandka Medical College / Shaheed Mohtarma Benazir Bhutto Medical University, Larkana. Period: From 1st January 2018 to 30th June 2018. Material & Methods: We enrolled 50 confirmed cases of CD along with 100 controls with non specific abdominal pain. All were aged 6 to 16 years, of both genders. Demographics as well as questions related to asthma and allergic rhinitis were noted. Results: Amongst a total of 150 children, 61 (40.7%) male and 89 (59.3%) female. Overall mean age amongst children was 9.80 years with standard deviation of 2.6 years. A total of 40 (26.7%) children who had weight below the 3rd percentile while 36 (24.0%) had height below the 3rd percentile. Most children, 82 (54.7%) had normal BMI. Weight below the 3rd percentile and height below the 3rd percentile were of statistical significance as children with a weight and height below the 3rd percentile were significantly higher in the CD group (P = 0.026 and P = 0.005, respectively). Asthma and allergic rhinitis characteristics were not much different between the two groups (p > 0.05). The Pulmonary function test (PFT) results showed that 7 (14.0%) cases with CD and 12 (12.0%) controls had obstructive pulmonary changes (p > 0.05). Conclusion: Rates of Asthma and allergic rhinitis in children having CD were not significantly higher in comparison to controls. No linkage between asthma and allergic rhinitis symptoms was seen children having CD.