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Articles 571 - 600 of 1099
Full-Text Articles in Pediatrics
Multicentre Pilot Study Evaluation Of Lung Ultrasound For The Management Of Paediatric Pneumonia In Low-Resource Settings: A Study Protocol, Jennifer L. Lenahan, Giovanni Volpicelli, Alessandro Lamorte, Fyezah Jehan, Quique Bassat, Amy Sarah Ginsburg
Multicentre Pilot Study Evaluation Of Lung Ultrasound For The Management Of Paediatric Pneumonia In Low-Resource Settings: A Study Protocol, Jennifer L. Lenahan, Giovanni Volpicelli, Alessandro Lamorte, Fyezah Jehan, Quique Bassat, Amy Sarah Ginsburg
Department of Paediatrics and Child Health
Introduction:
Pneumonia is the leading infectious cause of death among children under 5 years of age worldwide. However, pneumonia is challenging to diagnose. Lung ultrasound (LUS) is a promising diagnostic technology. Further evidence is needed to better understand the role of LUS as a tool for the diagnosis of childhood pneumonia in low-resource settings.
Methods and analysis:
This study aims to pilot LUS in Mozambique and Pakistan and to generate evidence regarding the use of LUS as a diagnostic tool for childhood pneumonia. Children with cough <14 days with chest indrawing (n=230) and without chest indrawing (n=40) are enrolled. World Health Organization Integrated Management of Childhood Illness assessment is performed at enrolment, along with a chest radiograph and LUS examination. Respiratory and blood specimens are collected for viral and bacterial testing and biomarker assessment. Enrolled children are followed for 14 days (in person) and 30 days (phone call) post-enrolment with LUS examinations performed on Days 2, 6 and 14. Qualitative and quantitative data are also collected to assess feasibility, usability and acceptability of LUS among healthcare providers and caregivers. The primary outcome is LUS findings at enrolment with secondary outcomes including patient outcomes, repeat LUS findings, viral and bacterial test results, and patient status after 14 and 30 days of follow-up.
Ethics and dissemination:
This trial was approved by the Western Institutional Review Board as …
Impact Of Maternally Derived Pertussis Antibody Titers On Infant Whole-Cell Pertussis Vaccine Response In A Low Income Setting, Romesa Ibrahim, Syed Asad Ali, Abdul Momin Kazi, Arjumand Rizvi, L. Beryl Guterman, Robert A. Bednarczyk, Ellie Kim, Sohee Park, Simon Paulos, Amilia Jeyachandran
Impact Of Maternally Derived Pertussis Antibody Titers On Infant Whole-Cell Pertussis Vaccine Response In A Low Income Setting, Romesa Ibrahim, Syed Asad Ali, Abdul Momin Kazi, Arjumand Rizvi, L. Beryl Guterman, Robert A. Bednarczyk, Ellie Kim, Sohee Park, Simon Paulos, Amilia Jeyachandran
Department of Paediatrics and Child Health
Background: Maternal vaccines against pertussis are not yet recommended in the developing world. Besides unclear burden estimates, another concern is that transplacental transfer of maternal pertussis antibodies could result in attenuation of the immune response to whole cell pertussis (DTwP) primary vaccination series in infants. This study was taken up to determine whether higher levels of maternal pertussis antibodies attenuate immune response of infants to DTwP vaccination series given at 6-10-14 weeks of age.
Methodology: A total of 261 pregnant women and their infants from four low-income settlements in Karachi, Pakistan were enrolled in this study. The study endpoints were …
Phase I Of The Surveillance For Enteric Fever In Asia Project (Seap): An Overview And Lessons Learned, Caitlin Barkume, Kashmira Date, Samir K. Saha, Farah Qamar, Dipika Sur, Jason R. Andrews, Stephen P. Luby, M Imran Khan, Alex Freeman, Mohammad Tahir Yousafzai, Denise Garret
Phase I Of The Surveillance For Enteric Fever In Asia Project (Seap): An Overview And Lessons Learned, Caitlin Barkume, Kashmira Date, Samir K. Saha, Farah Qamar, Dipika Sur, Jason R. Andrews, Stephen P. Luby, M Imran Khan, Alex Freeman, Mohammad Tahir Yousafzai, Denise Garret
Department of Paediatrics and Child Health
Objective: The objective of Phase I of the Surveillance for Enteric Fever in Asia Project (SEAP), a multiphase surveillance study characterizing the burden of disease in South Asia, was to inform data collection for prospective surveillance and to capture clinical aspects of disease.
Methods: Through a retrospective record review conducted at hospitals in Bangladesh, India, Nepal, and Pakistan, we examined laboratory and clinical records to assess the culture positivity rate for Salmonella Typhi and Salmonella Paratyphi, age and sex distribution, and antimicrobial susceptability in each country.
Results: Of all blood cultures performed in Bangladesh, India, Nepal, and Pakistan, 1.5%, 0.43%, …
A Retrospective Study Of Laboratory-Based Enteric Fever Surveillance, Pakistan, 2012-2014, Farah Naz Qamar, Mohammad Tahir Yousafzai, Shazia Sultana, Attaullah Baig, Sadia Shakoor, Farzeen Hirani, Abdul Wassay, Sehrish Khushboo, Junaid Mehmood, Alexander Freeman
A Retrospective Study Of Laboratory-Based Enteric Fever Surveillance, Pakistan, 2012-2014, Farah Naz Qamar, Mohammad Tahir Yousafzai, Shazia Sultana, Attaullah Baig, Sadia Shakoor, Farzeen Hirani, Abdul Wassay, Sehrish Khushboo, Junaid Mehmood, Alexander Freeman
Department of Paediatrics and Child Health
Introduction: The Surveillance for Enteric Fever in Asia Project (SEAP) is a multisite surveillance study designed to capture morbidity and mortality burden of enteric fever (typhoid and paratyphoid) in Bangladesh, Nepal, and Pakistan. We aim to describe enteric fever disease burden, severity of illness, and antimicrobial resistance trends in Pakistan.
Methods: In this retrospective, cross-sectional study, laboratory records of hospitalized patients who received a blood culture in any of 3 Aga Khan University hospitals in Karachi and Hyderabad, Pakistan, from 2012 to 2014 were reviewed. A case was defined as having a positive blood culture for Salmonella Typhi (S. Typhi) …
Integrating Facility-Based Surveillance With Healthcare Utilization Surveys To Estimate Enteric Fever Incidence: Methods And Challenges, Jason R. Andrews, Caitlin Barkume, Alexander T. Yu, Samir K. Saha, Farah Qamar, Denise Garrett, Stephen P. Luby
Integrating Facility-Based Surveillance With Healthcare Utilization Surveys To Estimate Enteric Fever Incidence: Methods And Challenges, Jason R. Andrews, Caitlin Barkume, Alexander T. Yu, Samir K. Saha, Farah Qamar, Denise Garrett, Stephen P. Luby
Department of Paediatrics and Child Health
Cohort studies and facility-based sentinel surveillance are common approaches to characterizing infectious disease burden, but present trade-offs; cohort studies are resource-intensive and may alter disease natural history, while sentinel surveillance underestimates incidence in the population. Hybrid surveillance, whereby facility-based surveillance is paired with a community-based healthcare utilization assessment, represents an alternative approach to generating population-based disease incidence estimates with moderate resource investments. Here, we discuss this method in the context of the Surveillance for Enteric Fever in Asia Project (SEAP) study. We describe how data are collected and utilized to adjust enteric fever incidence for blood culture sensitivity, facility-based enrollment, …
Oral Ondansetron Administration To Nondehydrated Children With Diarrhea And Associated Vomiting In Emergency Departments In Pakistan: A Randomized Controlled Trial, Stephen B. Freedman, Sajid Bashir Soofi, Andrew R. Willan, Sarah Williamson Urquhart, Noshad Ali, Jianling Xie, Fady Dawoud, Zulfiqar Ahmed Bhutta
Oral Ondansetron Administration To Nondehydrated Children With Diarrhea And Associated Vomiting In Emergency Departments In Pakistan: A Randomized Controlled Trial, Stephen B. Freedman, Sajid Bashir Soofi, Andrew R. Willan, Sarah Williamson Urquhart, Noshad Ali, Jianling Xie, Fady Dawoud, Zulfiqar Ahmed Bhutta
Department of Paediatrics and Child Health
Study objective: We determine whether single-dose oral ondansetron administration to children with vomiting as a result of acute gastroenteritis without dehydration reduces administration of intravenous fluid rehydration.
Methods: In this 2-hospital, double-blind, placebo-controlled, emergency department–based, randomized trial conducted in Karachi Pakistan, we recruited children aged 0.5 to 5.0 years, without dehydration, who had diarrhea and greater than or equal to 1 episode of vomiting within 4 hours of arrival. Patients were randomly assigned (1:1), through an Internet-based randomization service using a stratified variable-block randomization scheme, to single-dose oral ondansetron or placebo. The primary endpoint was intravenous rehydration (administration of 20 …
Novel Public-Private Partnerships To Address The Double Burden Of Malnutrition, Adam Drewnowski, Benjamin Caballero, Jai K. Das, Jeff French, Andrew M. Prentice, Lisa R. Fries, Tessa M Van Koperen, Petra Klassen-Wigger, Barbara J. Rolls
Novel Public-Private Partnerships To Address The Double Burden Of Malnutrition, Adam Drewnowski, Benjamin Caballero, Jai K. Das, Jeff French, Andrew M. Prentice, Lisa R. Fries, Tessa M Van Koperen, Petra Klassen-Wigger, Barbara J. Rolls
Department of Paediatrics and Child Health
Public–private partnerships are an effective way to address the global double burden of malnutrition. While public–private partnerships operate in multiple forms, their leadership usually falls to governments, public health agencies, or nongovernmental organizations, with the private sector taking a subordinate role. The rapid ascent of social media and mass communications worldwide has provided a disruptive technology for new nutrition intervention programs. A new model, provisionally called private–public engagement, takes advantage of social media, mass media, and integrated social marketing to reach parents, families, and communities directly. These new private–public engagement initiatives need to be managed in ways suggested for public–private …
Spectrum, Management And Outcomes Of Structural And Functional Uropathies In Children Attending A Tertiary Care Center In Karachi; Pakistan, Arshalooz Rahman, Saima Hanif, Noor Ul-Ain Baloch, Abdul Rehman, Tauqeer Sheikh, Mohammad Irfan Ladhani
Spectrum, Management And Outcomes Of Structural And Functional Uropathies In Children Attending A Tertiary Care Center In Karachi; Pakistan, Arshalooz Rahman, Saima Hanif, Noor Ul-Ain Baloch, Abdul Rehman, Tauqeer Sheikh, Mohammad Irfan Ladhani
Department of Paediatrics and Child Health
Causes and outcomes of children diagnosed with hydronephrosis in resource-limited countries with a low utilization of antenatal ultrasonography remain unexplored. We performed a retrospective, crosssectional study of all paediatric patients diagnosed with hydronephrosis and managed at a tertiary care center in Karachi, Pakistan between 2005 and 2010. Data relating to demographics, clinical features, etiologies and treatment modalities were systematically collected. Of a total of 234 cases (74.4% male), 83 (35.5%) and 42 (17.9%) were neonates and infants respectively. Congenital urinary tract pathologies were noted in 192(72.2%) patients, of which only 96(50%) had undergone foetal ultrasonography and 77(40.1%) first presented after …
Development And Internal Validation Of The Multivariable Cipher (Collaborative Integrated Pregnancy High-Dependency Estimate Of Risk) Clinical Risk Prediction Model, Beth A. Payne, Helen Ryan, Jeffrey Bone, Laura A. Magee, Alice B. Aarvold, J. Mark Ansermino, Zulfiqar Ahmed Bhutta, Mary Bowen, J. Guilherme Cecatti, Cynthia Chazotte
Development And Internal Validation Of The Multivariable Cipher (Collaborative Integrated Pregnancy High-Dependency Estimate Of Risk) Clinical Risk Prediction Model, Beth A. Payne, Helen Ryan, Jeffrey Bone, Laura A. Magee, Alice B. Aarvold, J. Mark Ansermino, Zulfiqar Ahmed Bhutta, Mary Bowen, J. Guilherme Cecatti, Cynthia Chazotte
Department of Paediatrics and Child Health
Background: Intensive care unit (ICU) outcome prediction models, such as Acute Physiology And Chronic Health Evaluation (APACHE), were designed in general critical care populations and their use in obstetric populations is contentious. The aim of the CIPHER (Collaborative Integrated Pregnancy High-dependency Estimate of Risk) study was to develop and internally validate a multivariable prognostic model calibrated specifically for pregnant or recently delivered women admitted for critical care.
Methods: A retrospective observational cohort was created for this study from 13 tertiary facilities across five high-income and six low- or middle-income countries. Women admitted to an ICU for more than 24 h …
Rubber Tourniquet Technique: A Simple, Safe, And Cost-Effective Methodof Hepatic Resection In Neonates And Infants, Zafar Nazir
Rubber Tourniquet Technique: A Simple, Safe, And Cost-Effective Methodof Hepatic Resection In Neonates And Infants, Zafar Nazir
Section of Paediatric Surgery
Background: Despite the improvements in patient care, understanding of surgical anatomy of liver and surgical techniques, liver resection is a high-risk procedure specifically in infants and neonates; whose blood volume is limited (80 ml/kg). This report shares the experience of hepatic resection with “Rubber tourniquet technique” in patients less than 6-months of age.
Methods: Hepatic resection in a 4-month-old pair of Conjoined twins with shared liver and a 3-day old baby with large Congenital Hepatoblastoma was performed using Penrose rubber drain as a tourniquet around the liver parenchyma to reduce blood loss.
Results: Blood loss was minimal (< 20CC) and all the three babies survived the procedure without complications.
Conclusion: Rubber …
Kawasaki Disease: Two Case Reports From The Aga Khan Hospital, Dar Es Salaam-Tanzania, Mariam Noorani, Nuruddin Lakhani
Kawasaki Disease: Two Case Reports From The Aga Khan Hospital, Dar Es Salaam-Tanzania, Mariam Noorani, Nuruddin Lakhani
Paediatrics and Child Health, East Africa
Background: Kawasaki disease is a common childhood vasculitis which may result in cardiovascular morbidity if not adequately treated. Its epidemiology in the African region is not well described. Its features may mimic other childhood infections and hemoglobinopathies and it is rarely diagnosed in the East African region. These are the first reports of this disease from Tanzania. Case presentation We present two cases of complete Kawasaki disease seen over a 2 year period and diagnosed as per the criteria defined by the American Heart Association. One child was and infant and the other a 3 year old. Both of them …
Alma Ata And Primary Healthcare: Back To The Future, Zulfiqar Ahmed Bhutta, Rifat Atun, Navjoyt Ladher, Kamran Abbasi
Alma Ata And Primary Healthcare: Back To The Future, Zulfiqar Ahmed Bhutta, Rifat Atun, Navjoyt Ladher, Kamran Abbasi
Department of Paediatrics and Child Health
No abstract provided.
Factors Associated With Substance Use Among Adolescents Living With Hiv In Kenya, Wambui Kagucia
Factors Associated With Substance Use Among Adolescents Living With Hiv In Kenya, Wambui Kagucia
Master of Medicine in Paediatrics and Child Health
Background: Substance use is rife in our society and adolescents (10-19 years) do face this problem during this vulnerable period of growth and development. Use of substances is known to be associated with poor health choices and risky sexual behaviour. Since the advent of antiretroviral therapy (ART), significant progress has been made with reduced rates of mother to child transmission (MTCT) and a general downward global trend in acquired immunodeficiency disease (AIDS) related mortalities. However, human immunodeficiency virus (HIV)/AIDS is still a leading cause of mortality in adolescents living in Sub Saharan Africa, with an upward trend in new HIV …
Reducing Micronutrient Deficiencies In Pakistani Children: Are Subsidies On Fortified Complementary Foods Cost-Effective?, Simon Wieser, Beatrice Brunner, Christina Tzogiou, Rafael Plessow, Michael B. Zimmermann, Jessica Farebrother, Sajid Bashir Soofi, Zaid Ahmad Bhatti, Imran Ahmed, Zulfiqar Ahmed Bhutta
Reducing Micronutrient Deficiencies In Pakistani Children: Are Subsidies On Fortified Complementary Foods Cost-Effective?, Simon Wieser, Beatrice Brunner, Christina Tzogiou, Rafael Plessow, Michael B. Zimmermann, Jessica Farebrother, Sajid Bashir Soofi, Zaid Ahmad Bhatti, Imran Ahmed, Zulfiqar Ahmed Bhutta
Department of Paediatrics and Child Health
Objective: To estimate the cost-effectiveness of price subsidies on fortified packaged complementary foods (FPCF) in reducing iodine deficiency, iron-deficiency anaemia and vitamin A deficiency in Pakistani children.
Design: The study proceeded in three steps: (i) we determined the current lifetime costs of the three micronutrient deficiencies with a health economic model; (ii) we assessed the price sensitivity of demand for FPCF with a market survey in two Pakistani districts; (iii) we combined the findings of the first two steps with the results of a systematic review on the effectiveness of FPCF in reducing micronutrient deficiencies. The cost-effectiveness was estimated by …
Accuracy Of Echocardiography In Diagnosing Total Anomalous Pulmonary Venous Return, Fatima Ali, Sonia Qureshi, Muneer Amanullah, Mehnaz Atiq
Accuracy Of Echocardiography In Diagnosing Total Anomalous Pulmonary Venous Return, Fatima Ali, Sonia Qureshi, Muneer Amanullah, Mehnaz Atiq
Department of Paediatrics and Child Health
Objective: Total anomalous pulmonary venous return is an uncommon cyanotic congenital heart defect. Echocardiography is the initial diagnostic tool. Complimentary non-invasive modalities like cardiac computerized tomographic angiography and cardiac magnetic resonance imaging have replaced the need for cardiac catheterization in difficult cases. This study aimed to determine the accuracy of echocardiography in diagnosing total anomalous pulmonary venous return, and to determine the factors that may decrease its sensitivity.
Methods: This was a cross-sectional study conducted at the Aga Khan University Hospital Karachi, Pakistan from January 2010 to August 2016. All patients who were diagnosed with Total anomalous pulmonary venous return …
Use Of Quantitative Molecular Diagnostic Methods To Assess The Aetiology, Burden, And Clinical Characteristics Of Diarrhoea In Children In Low-Resource Settings: A Reanalysis Of The Mal-Ed Cohort Study, James A. Platts-Mills Md, Jie Liu, Elizabeth T. Rogawski, Furqan Kabir, Paphavee Lertsethtakarn, Adil Kalam, Fatima Aziz, Shahida Qureshi, Najeeha Talat Iqbal, Zulfiqar Ahmed Bhutta
Use Of Quantitative Molecular Diagnostic Methods To Assess The Aetiology, Burden, And Clinical Characteristics Of Diarrhoea In Children In Low-Resource Settings: A Reanalysis Of The Mal-Ed Cohort Study, James A. Platts-Mills Md, Jie Liu, Elizabeth T. Rogawski, Furqan Kabir, Paphavee Lertsethtakarn, Adil Kalam, Fatima Aziz, Shahida Qureshi, Najeeha Talat Iqbal, Zulfiqar Ahmed Bhutta
Department of Paediatrics and Child Health
Background: Optimum management of childhood diarrhoea in low-resource settings has been hampered by insufficient data on aetiology, burden, and associated clinical characteristics. We used quantitative diagnostic methods to reassess and refine estimates of diarrhoea aetiology from the Etiology, Risk Factors, and Interactions of Enteric Infections and Malnutrition and the Consequences for Child Health and Development (MAL-ED) cohort study.
Methods: We re-analysed stool specimens from the multisite MAL-ED cohort study of children aged 0–2 years done at eight locations (Dhaka, Bangladesh; Vellore, India; Bhaktapur, Nepal; Naushero Feroze, Pakistan; Venda, South Africa; Haydom, Tanzania; Fortaleza, Brazil; and Loreto, Peru), which included active …
Use Of Quantitative Molecular Diagnostic Methods To Investigate The Effect Of Enteropathogen Infections On Linear Growth In Children In Low-Resource Settings: Longitudinal Analysis Of Results From The Mal-Ed Cohort Study, Elizabeth T. Rogawsk, Jie Liu, James A. Platts-Mill, Furqan Kabir, Paphavee Lertsethtakarn, Adil Kalam, Fatima Aziz, Shahida Qureshi, Najeeha Talat Iqbal, Zulfiqar Ahmed Bhutta
Use Of Quantitative Molecular Diagnostic Methods To Investigate The Effect Of Enteropathogen Infections On Linear Growth In Children In Low-Resource Settings: Longitudinal Analysis Of Results From The Mal-Ed Cohort Study, Elizabeth T. Rogawsk, Jie Liu, James A. Platts-Mill, Furqan Kabir, Paphavee Lertsethtakarn, Adil Kalam, Fatima Aziz, Shahida Qureshi, Najeeha Talat Iqbal, Zulfiqar Ahmed Bhutta
Department of Paediatrics and Child Health
Background: Enteropathogen infections in early childhood not only cause diarrhoea but contribute to poor growth. We used molecular diagnostics to assess whether particular enteropathogens were associated with linear growth across seven low-resource settings.
Methods: We used quantitative PCR to detect 29 enteropathogens in diarrhoeal and non-diarrhoeal stools collected from children in the first 2 years of life obtained during the Etiology, Risk Factors, and Interactions of Enteric Infections and Malnutrition and the Consequences for Child Health and Development (MAL-ED) multisite cohort study. Length was measured monthly. We estimated associations between aetiology-specific diarrhoea and subclinical enteropathogen infection and quantity and attained …
Compound Heterozygosity For A Whole Gene Deletion And P.R124c Mutation In Cyp21a2 Causing Nonclassic Congenital Adrenal Hyperplasia, Hamza Nasir, Syed Ibaad Ali, N Haque, Stefan K. Grebe, Salman Kirmani
Compound Heterozygosity For A Whole Gene Deletion And P.R124c Mutation In Cyp21a2 Causing Nonclassic Congenital Adrenal Hyperplasia, Hamza Nasir, Syed Ibaad Ali, N Haque, Stefan K. Grebe, Salman Kirmani
Section of Diabetes, Endocrinology and Metabolism
We present a family with 2 members who received long-term steroid treatment for presumed classic congenital adrenal hyperplasia (CAH) due to 21-hydroxylase deficiency, until molecular testing revealed nonclassic CAH, not necessarily requiring treatment. A 17-year-old male presented to our clinic on glucocorticoid and mineralocorticoid treatment for classic CAH. He was diagnosed at 4 years of age based on mild-moderate elevations of 17-hydroxyprogesterone (17-OHP) and adrenocorticotropic hormone (ACTH), but without evidence of precocious adrenarche/puberty. Due to his diagnosis, his clinically asymptomatic 3-year-old sister was tested and also found to have elevated ACTH and 17-OHP levels and was started on glucocorticoids for …
Reducing Typhoid Burden Within A Generation, Zulfiqar Ahmed Bhutta, Anita K. M. Zaidi, Tikki Pangestu
Reducing Typhoid Burden Within A Generation, Zulfiqar Ahmed Bhutta, Anita K. M. Zaidi, Tikki Pangestu
Department of Paediatrics and Child Health
No abstract provided.
Needs Assessment For Curricular Reform Of A Post Graduate Paediatric Training Programme At A Private University Hospital In Karachi, Pakistan, Sana Saeed, Khadija N. Humayun, Farah Qamar, Arshalooz Rahman, Kashif Karim
Needs Assessment For Curricular Reform Of A Post Graduate Paediatric Training Programme At A Private University Hospital In Karachi, Pakistan, Sana Saeed, Khadija N. Humayun, Farah Qamar, Arshalooz Rahman, Kashif Karim
Department of Paediatrics and Child Health
In order to make and sustain changes in the curriculum, needs assessment is the key. We conducted a need assessment survey using a questionnaire based on a 7 point Likert Scale by residents and alumni. Over all response rate in the study was 77.5%. Fifty eight percent participants were females. Highest level of agreement (mean score 5.7) was found between the alumni and residents regarding the need to revise the content, teaching and assessment strategies in the programme. Twenty seven alumni (n= 38, 71%) had cleared their FCPS exams. The alumni thought that the existing teaching and assessment strategies do …
Maternal Predictors Of Intrauterine Growth Retardation, Nadia Mohammad, Arjumand Sohaila, Unaib Rabbani, Sufian Ahmed, Shakeel Ahmed, Syed Rehan Ali
Maternal Predictors Of Intrauterine Growth Retardation, Nadia Mohammad, Arjumand Sohaila, Unaib Rabbani, Sufian Ahmed, Shakeel Ahmed, Syed Rehan Ali
Department of Paediatrics and Child Health
Objective: To identify maternal factors associated with intrauterine growth restriction (IUGR).
Study Design: A case-control study.
Place and Duration of Study: Neonatal Unit of The Aga Khan Hospital for Women (AKHW), Karimabad, from January 2014 to December 2015.
Methodology: Cases were IUGR live born babies (n=90), while control were appropriate-for-gestational age (AGA) babies (n=180). Information recorded in pre-designed proforma included gestational age and birth weight of baby, demographics of mothers, pregnancy related medical and obstetric complications. Data were analysed through SPSS-19. Multivariable logistic regression was used to determine the maternal factors associated with the intrauterine growth restriction.
Results: Maternal factors …
Fungal Osteomyelitis In A Patient With Chronic Granulomatous Disease: Case Report And Review Of The Literature, Muhammad Khalid, Syed Asad Ali
Fungal Osteomyelitis In A Patient With Chronic Granulomatous Disease: Case Report And Review Of The Literature, Muhammad Khalid, Syed Asad Ali
Department of Paediatrics and Child Health
Chronic granulomatous disease (CGD) is the most common of the primary immunodeficiency in children. It is caused by single gene defect resulting in dysfunctional nicotinamide adenine dineucleotide phosphate (NADPH) oxidase complex causing recurrent bacterial and fungal infections. Here we present the case of a 9 year old boy who was a known case of CGD since three years of age. He presented with recent history of fever, left sided pain in the scapular region and difficulty in breathing. Chest imaging revealed developing left upper lobe consolidation and erosion of the 3rd posterior rib. The child underwent video assisted thoracoscopic surgery …
Pathophysiology Of Environmental Enteric Dysfunction And Its Impact On Oral Vaccine Efficacy, Chelsea Marie, Syed Asad Ali, Kanta Chandwe, William Petri Jr A, Paul Kelly
Pathophysiology Of Environmental Enteric Dysfunction And Its Impact On Oral Vaccine Efficacy, Chelsea Marie, Syed Asad Ali, Kanta Chandwe, William Petri Jr A, Paul Kelly
Department of Paediatrics and Child Health
Environmental enteric dysfunction (EED) refers to a subclinical disorder of intestinal function common in tropical countries and in settings of poverty and economic disadvantage. The enteropathy that underlies this syndrome is characterized by mucosal inflammation and villus blunting mediated by T cell activation. Epithelial cell disruption and microbial translocation drive systemic inflammation. EED in young children is associated geographically with growth failure, malnutrition, and greatly impaired responses to oral vaccines, notably rotavirus and poliovirus vaccines. In this review, we describe the pathophysiology of EED and examine the evidence linking EED and oral vaccine failure. This evidence is far from conclusive. …
Invasive Community Acquired Methicillin-Resistant Staphylococcal Aureus (Ca-Mrsa) Infections In Children, Muhammad Khalid, Samina Junejo, Fatima Mir
Invasive Community Acquired Methicillin-Resistant Staphylococcal Aureus (Ca-Mrsa) Infections In Children, Muhammad Khalid, Samina Junejo, Fatima Mir
Department of Paediatrics and Child Health
Staphylococci are gram-positive bacteria divided into coagulase positive and coagulase negative classes, Staphylococcus aureus is the most important bacterium of this class. Epidemiology of methicillin-resistant Staphylococcus aureus (MRSA) has changed a lot. It is no more the problem of only hospitalised patients. Children coming from community has also been increasingly affected by MRSA-called community acquired methicillin-resistant (CA-MRSA) infection. The higher severity of CA-MRSA is due to its ability to produce the toxin Panton-Valentine Leukocidin (PVL) associated with staphylococcal cassette chromosome mec (SCCmec) type IV gene. Here, we are presenting five cases of CA-MRSA infection in children having age range 0.5 …
“You Travel Faster Alone, But Further Together”: Learning From A Cross Country Research Collaboration From A British Council Newton Fund Grant, Priscilla Reddy, Rachana Desai, Sibusiso Sifunda, Kalipso Chalkidou, Charles Hongoro, William Macharia, Helen Roberts
“You Travel Faster Alone, But Further Together”: Learning From A Cross Country Research Collaboration From A British Council Newton Fund Grant, Priscilla Reddy, Rachana Desai, Sibusiso Sifunda, Kalipso Chalkidou, Charles Hongoro, William Macharia, Helen Roberts
Faculty of Health Sciences, East Africa
Abstract: Providing universal health coverage (UHC) through better maternal, neonatal, child and adolescent health (MNCAH) can benefit both parties through North–South research collaborations. This paper describes lessons learned from bringing together early career researchers, tutors, consultants and mentors from the United Kingdom, Kenya, and South Africa to work in multi-disciplinary teams in a capacity-building workshop in Johannesburg, co-ordinated by senior researchers from the three partner countries. We recruited early career researchers and research users from a range of sectors and institutions in the participating countries and offered networking sessions, plenary lectures, group activities and discussions. To encourage bonding and accommodate …
Epidemiology Of Patients Presenting To A Pediatric Emergency Department In Karachi, Pakistan, Nadir Ijaz, Matthew Strehlow, N. Ewen Wang, Elizabeth Pirrotta, Areeba Tariq, Naseeruddin Mahmood, Swaminatha Mahadevan
Epidemiology Of Patients Presenting To A Pediatric Emergency Department In Karachi, Pakistan, Nadir Ijaz, Matthew Strehlow, N. Ewen Wang, Elizabeth Pirrotta, Areeba Tariq, Naseeruddin Mahmood, Swaminatha Mahadevan
Department of Paediatrics and Child Health
Background: There is little data describing pediatric emergencies in resource-poor countries, such as Pakistan. We studied the demographics, management, and outcomes of patients presenting to the highest-volume, public, pediatric emergency department (ED) in Karachi, Pakistan.
Methods: In this prospective, observational study, we approached all patients presenting to the 50-bed ED during 28 12-h study periods over four consecutive weeks (July 2013). Participants’ chief complaints and medical care were documented. Patients were followed-up at 48-h and 14-days via telephone. Results: Of 3115 participants, 1846 were triaged to the outpatient department and 1269 to the ED. Patients triaged to the ED had …
Comparison Of Neonatal Outcomes Between Category-1 And Non-Category-1 Primary Emergency Cesarean Section: A Retrospective Record Review In A Tertiary Care Hospital, Dureshahwar Kanwar, Iffat Ahmed, Azra Amerjee, Zahra Hoodbhoy
Comparison Of Neonatal Outcomes Between Category-1 And Non-Category-1 Primary Emergency Cesarean Section: A Retrospective Record Review In A Tertiary Care Hospital, Dureshahwar Kanwar, Iffat Ahmed, Azra Amerjee, Zahra Hoodbhoy
Department of Obstetrics & Gynaecology
Objective: To compare neonatal outcomes between Category-1 and Non-Category-1 Primary Emergency Cesarean Section.
Methods: This was a retrospective analysis, conducted at Aga Khan University Hospital Karachi from January 1st 2016 till December 31st 2016. Non-probability purposive sampling technique was used. A sample size of 375 patients who had primary Emergency Caesarean Section (Em-CS) was identified by keeping CS rate of 41.5% and 5% bond on error. Data was collected from labor ward, operating theatre and neonatal ward records by using structured questionnaire.
Results: In the current study, out of 375 participants who underwent primary Em-CS; majority (89.3%) were booked cases. …
Global Trends In Typhoidal Salmonellosis: A Systematic Review, Daina Als, Amruta Radhakrishnan, Paul Arora, Michelle F. Gaffey, Susan Campisi, Russanthy Velummailum, Farhana Zareef, Zulfiqar Ahmed Bhutta
Global Trends In Typhoidal Salmonellosis: A Systematic Review, Daina Als, Amruta Radhakrishnan, Paul Arora, Michelle F. Gaffey, Susan Campisi, Russanthy Velummailum, Farhana Zareef, Zulfiqar Ahmed Bhutta
Department of Paediatrics and Child Health
Typhoid and paratyphoid fever continue to significantly contribute to global morbidity and mortality. Disease burden is higher in low-and middle-income settings where surveillance programs are rare and little systematic information exists at population level. This review evaluates national, regional, and global trends in the incidence of typhoid fever and of related morbidity and mortality. A literature search in Medline, Embase, and Web of Science was conducted in June 2016, followed by screening and data extraction in duplicate. Studies reporting blood culture estimates of typhoid or paratyphoid morbidity and mortality were included in the analysis. Five thousand five hundred sixty-three unique …
Causes And Incidence Of Community-Acquired Serious Infections Among Young Children In South Asia (Anisa): An Observational Cohort Study., Samir K. Saha, Stephanie J. Schrag, Anita K. M. Zaidi, Zulfiqar Ahmed Bhutta, Sajid Bashir Soofi, Muhammad Imran Nisar, Benazir Baloch, Furqan Kabir, Sheraz Ahmed, Imran Ahmed
Causes And Incidence Of Community-Acquired Serious Infections Among Young Children In South Asia (Anisa): An Observational Cohort Study., Samir K. Saha, Stephanie J. Schrag, Anita K. M. Zaidi, Zulfiqar Ahmed Bhutta, Sajid Bashir Soofi, Muhammad Imran Nisar, Benazir Baloch, Furqan Kabir, Sheraz Ahmed, Imran Ahmed
Department of Paediatrics and Child Health
Background: More than 500 000 neonatal deaths per year result from possible serious bacterial infections (pSBIs), but the causes are largely unknown. We investigated the incidence of community-acquired infections caused by specific organisms among neonates in south Asia.
Methods: From 2011 to 2014, we identified babies through population-based pregnancy surveillance at five sites in Bangladesh, India, and Pakistan. Babies were visited at home by community health workers up to ten times from age 0 to 59 days. Illness meeting the WHO definition of pSBI and randomly selected healthy babies were referred to study physicians. The primary objective was to estimate …
Sinus Of Valsalva Aneurysm Rupturing Into Main Pulmonary Artery: A Rare Paediatric Cardiac Emergency, Faiz Rasool, Muhammad Asim Khan, Muneer Amanullah
Sinus Of Valsalva Aneurysm Rupturing Into Main Pulmonary Artery: A Rare Paediatric Cardiac Emergency, Faiz Rasool, Muhammad Asim Khan, Muneer Amanullah
Section of Paediatric Surgery
Congenital Sinus of Valsalva aneurysm is a rare congenital cardiac disease. Most common site of origin is the right sinus. It ruptures into right ventricle or right atrium most of the times. Only in less than 2% of the cases it ruptures into the pulmonary artery. We report a rare case of right sinus of valsalva aneurysm rupturing into pulmonary artery.