Medicine and Health Sciences Commons^™

A Comparison Of Treatments Offered To Patients With Nonalcoholic Steatohepatitis, Saleem Perwaiz Iqbal, Sadia Mahmud, Saeed Hamid, Omrana Pasha, Khabir Ahmad

Department of Paediatrics and Child Health

OBJECTIVE: To compare various treatment options provided to patients with Nonalcoholic Steatohepatitis (NASH) and assess improvement in liver status via reduction in serum Alanine Aminotransferase (ALT) levels.

STUDY DESIGN: Retrospective cohort study.

PLACE AND DURATION OF STUDY: The Aga Khan University Hospital, Karachi, from April 2000 to April 2007.

METHODOLOGY: All available records of patients aged between 20-70 years, fatty liver on ultrasound, elevated serum ALT and having at least one follow-up, after a baseline visit were included. The patients had variable number of follow-ups and a maximum of 3 follow-ups were considered. Information was collected on demographic and clinical …

Fluoroquinolones For Treating Typhoid And Paratyphoid Fever (Enteric Fever), Durrane Thaver, Anita K. M. Zaidi, Julia A. Critchley, Asma Azmatullah, Syed Ali Madni, Zulfiqar Ahmed Bhutta

Department of Paediatrics and Child Health

Background: Fluoroquinolones are recommended as first-line therapy for typhoid and paratyphoid fever (enteric fever), but how they compare with other antibiotics and different fluoroquinolones is unclear.
Objectives: To evaluate fluoroquinolone antibiotics for treating enteric fever in children and adults compared with other antibiotics, different fluoroquinolones, and different durations of fluoroquinolone treatment.
Search strategy: In November 2007, we searched the Cochrane Infectious Diseases Group Specialized Register, CENTRAL (The Cochrane Library 2007, Issue 4), MEDLINE, EMBASE, LILACS, mRCT, conference proceedings, and reference lists.
Selection criteria: Randomized controlled trials of fluoroquinolones in people with blood or bone marrow culture-confirmed enteric fever.
Data collection …

Seroprevalence Of Varicella Zoster Antibodies Among Children With Malnutrition, Malignancies And Hiv Infection, Bashir Admani, William Macharia, F. Were

Paediatrics and Child Health, East Africa

Objective: To determine the seroprevalence of varicella zoster in paediatric patients at a high risk of developing complications.

Design: A cross-sectional study.

Setting: Paediatric general wards at Kenyatta National Hospital.

Subjects: Children with malignancies, severe malnutrition and were HIV positive.

Interventions: The sample size was calculated at 147 subjects. Venous samples were tested for varicella zoster virus (VZV) antibodies using enzyme immunosorbent assay (ELISA) technique at Kenya Medical Research Institute (KEMRI) laboratories, The data were anaIysed using the SPSS software and presented in form of tables and graphs. The prevalence of VZV antibodies was determined and 95% confidence interval computed. …

Familial Chylomicronemia In A Nine Months Old Infant, Saira Waqar Lone, Aamer Imdad, Abdul Gaffar Billoo

Department of Paediatrics and Child Health

Familial chylomicronemia syndrome is a rare disorder of lipoprotein metabolism due to familial lipoprotein lipase or apolipoprotein C-II deficiency or the presence of inhibitors to lipoprotein lipase. It manifests as eruptive xanthomas, acute pancreatitis, and lipaemic plasma due to marked elevation of triglyceride and chylomicrons levels. We report a rare case of familial chylomicronemia in a 9-month-old infant, who was diagnosed after his plasma was incidentally found to be milky. Lipid profile showed familial chylomicronemia (Type 1 Hyperlipidemia). The infant was started on a low fat diet and advised a regular follow-up.

Alma-Ata: Rebirth And Revision 8 - Primary Health Care: Making Alma-Ata A Reality, John Walley, Joy E. Lawn, Anne Tinker, Andres De Francisco, Mickey Chopra, Igor Rudan, Zulfiqar Ahmed Bhutta, Robert E. Black

Department of Paediatrics and Child Health

The principles agreed at Alma-Ata 30 years ago apply just as much now as they did then. "Health for all" by the year 2000 was not achieved, and the Millennium Development Goals (MDGs) for 2015 will not be met in most low-income countries without substantial acceleration of primary health care. Factors have included insufficient political prioritisation of health, structural adjustment policies, poor governance, population growth, inadequate health systems, and scarce research and assessment on primary health care. We propose the following priorities for revitalising primary health care. Health-service infrastructure, including human resources and essential drugs, needs strengthening, and user fees …

Factor Xiii Deficiency In Children--Clinical Presentation And Outcome, Zehra Fadoo, Ali Faisal Saleem

Department of Paediatrics and Child Health

OBJECTIVE: To determine the demographic features and clinical outcome of children with Factor XIII deficiency.

STUDY DESIGN: Observational case series.

PLACE AND DURATION OF STUDY: The Aga Khan University Hospital, Karachi, from January 1996 to December 2006.

METHODOLOGY: Records of all hospitalized pediatric patients with discharge diagnosis of FXIII D, on the basis of factor XIII assay 5 mol/L urea test were retrospectively reviewed and abstracted on a pre-specified proforma. Demographic features, coagulation profile, family history and outcomes were noted.

RESULTS: A total of 10 charts were reviewed. There were 5 boys and 5 girls. Almost all the children (9/10) …

Perinatal Arterial Ischaemic Stroke: An Update With Literature Review, S. H. Ibrahim, Zafar Abdul Mueed

Department of Paediatrics and Child Health

Perinatal arterial ischaemic strokes are a major cause of morbidity in the neonatal period and leads to significant neurological morbidity. It is however under recognized as an entity and usually missed till the baby is 3-4 months of age when they first present with hemiplegia. Perinatal arterial ischaemic strokes are not reported from our country and this may be due to the fact that neurodiagnostic modalities were not available until the last few years. Even now this is not available in the smaller cities of our country. In this review we will discuss the common issues related to etiology and …

Clinical Profile And Outcome Of Cyanotic Congenital Heart Disease In Neonates, Khadija N Humayun, Mehnaz Atiq

Department of Paediatrics and Child Health

OBJECTIVE: To determine the clinical profile and assess the outcome of all neonates diagnosed with cyanotic congenital heart disease.

STUDY DESIGN: A case series.

PLACE AND DURATION OF STUDY: The Aga Khan University Hospital from January 1998 to December 2000.

PATIENTS AND METHODS: Neonates admitted with diagnosis of cyanotic congenital heart disease were evaluated for clinical diagnosis, survival and mortality.

RESULTS: Forty four neonates met the inclusion criteria. Eleven babies (25%) had Tetralogy of Fallot or its variants. Other malformations were d-transposition of great arteries, tricuspid valve anomalies (tricuspid atresia and Ebstein's anomaly), hypoplastic left heart syndrome, truncus arteriosus, total …

A Family With Acute Intermittent Porphyria, Abdul Gaffar Billoo, Saira Waqar Lone

Department of Paediatrics and Child Health

Porphyrias are inherited defects in heme metabolism that result in excessive secretion of porphyrins and porphyrin precursors. Porphyrias can be classified into acute, (neuropsychiatric), cutaneous and mixed forms. There are seven main types of porphyrias; acute intermittent porphyria and plumboporphyria are predominantly neuropsychiatric; congenital erythropoietic porphyria, porphyria cutanea tarda and erythropoietic protoporphyria have predominantly cutaneous manifestations and hereditary coproporphyria and variegate porphyria are classified as mixed as they both have neuropsychiatric and cutaneous features. They cause life-threatening attacks of neurovisceral symptoms that mimic many other acute medical and psychiatric conditions. Lack of clinical recognition often delays effective treatment, and inappropriate …

Making A Difference - Drug Resistant Infections In Poor Countries - A Major Burden On Children, Zulfiqar Ahmed Bhutta

Department of Paediatrics and Child Health

No abstract provided.

Drug Resistant Infections In Poor Countries: A Major Burden On Children, Zulfiqar A. Bhutta

Department of Paediatrics and Child Health

No abstract provided.

Short-Course Versus Long-Course Antibiotic Therapy For Non-Severe Community-Acquired Pneumonia In Children Aged 2 Months To 59 Months, Batool A. Haider, Muhammad Ammad Saeed, Zulfiqar Ahmed Bhutta

Department of Paediatrics and Child Health

Background: Pneumonia is the leading cause of mortality in children under five years of age. Treatment of pneumonia requires an effective antibiotic used in adequate doses for an appropriate duration. Recommended duration of treatment ranges between 7 and 14 days, but this is not based on any empirical evidence. Shorter duration of therapy, if found to be effective, could be particularly important in resource-poor settings where there is a high risk of death, poor access to medicines and health care, and limited budgets for medicines.
Objectives: To evaluate the efficacy of short- course versus long-course therapy with the same antibiotic …

Chediak-Higashi Syndrome, Emaduddin Siddiqui, Shaheena Hanif

Department of Emergency Medicine

Chediak Higashi Syndrome is a rare inherited autosomal recessive disorder of immune system. Susceptibility to infection due to phagocyte dysfunction ranges from recurrent skin infection to over whelming fatal systemic infection. A five years old male child was admitted on 31st March 2006 with the complaints of pallor, fever & ear discharge for 6 month. He was treated by several medications but had temporary relief. The ear discharge was bilateral, foul smelling and of yellowish color. Past history was significant with episodes of abscess involving the different parts of body. Myeloid precursors shows giant, purple stained granules mainly in metamyelocytes, …

The Need For Formal Paediatric Resuscitation Training In Pakistan., Adina R., Sheikh Sajjad, Junaid Razzak

Department of Emergency Medicine

No abstract provided.

Managing Severe Pneumonia In Children In Developing Countries - Increasing Resistance To First Line Antibiotics Means Recommendations Need Changing, Zulfiqar Ahmed Bhutta

Department of Paediatrics and Child Health

No abstract provided.

Pediatric Emergency Medicine--An Evolving Sub-Speciality In Pakistan, Emaduddin Siddiqui, Junaid Razzak

Department of Emergency Medicine

No abstract provided.

Focus On The Profession: Academic And Clinical Departments, Robert Armstrong

Paediatrics and Child Health, East Africa

The departments within the Faculty of Medicine at UBC play a central role in achieving the goals of the expanded medical school, and the goals of the broader health care system. Four strategies are needed for success: make professionalism the tie that binds the Faculty of Medicine and the health authorities; engage clinical and academic de­partments as key drivers of professionalism; ensure knowledge development and continuous learning are recognized as central to professionalism; challenge government to focus on supporting professionalism.

Waiting For Child Developmental And Rehabilitation Services: An Overview Of Issues And Needs, Anton R. Miller, Robert Armstrong, Louise C. Mâsse, Anne F. Klassen, Jane Shen, Maureen E. O’Donnell

Paediatrics and Child Health, East Africa

Concern about the length of time that children, young people, and families may have to wait to access assessment, diagnostic, interventional, therapeutic, and supportive child developmental and rehabilitation (CDR) services is widespread, but adequate data collection and research on this issue remain limited. We review key concepts and issues relevant to waiting for CDR services from the published literature, a national workshop devoted to this topic, and international experience. We conclude that gaps in data, evidence, and consensus challenge our ability to address the issue of waiting for CDR services in a systematic way. A program of research coupled with …