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Objective: To compare the effectiveness and complications of bolus versus continuous tube feeding in pre-term newborns <1500 grams. Study Design: Quasi-experimental study Place and Duration of Study: Neonatology Department of Pakistan Institute of Medical Sciences Islamabad, from Nov 2014 to Mar 2016. Methodology: A total of 60 pre-terms; <34 weeks meeting the inclusion criteria, were included in the study and grouped according to birth weight; group A between 1000 to 1250 grams, and group B between 1250 to 1500 grams. Newborns from each group were randomly selected for bolus feeds given intermittently after every 2 hours, and continuous feed given with infusion pump. All infants were maintained in closed incubators until they weighed approximately 1800 g and the neonatal staff followed standard nursery protocols other than for feeding. Results: There were 10 patients (9 in the bolus group and 1 in the continuous group) who did not reach the end point of 150 mL/Kg/day. One was transferred to another hospital before completing the protocol; 2 were diagnosed with congenital syphilis and Rubella syndrome; 1 switched to breast feeding due to parental concerns; 1 required the surgery for intestinal malrotation, and 5 died. The number of days to achieve full feeding calculated from the initiation of feeding was not significantly different between the groups. The main daily gastric residual volumes were significantly lower in the continuous group than in the bolus group, as was the total number of patients with feeding interruptions. Conclusion: Birth weight was inversely related to days to achieve full enteral feeding. The method of feeding was not associated with differences in outcome when similar energy intakes were provided and when guidelines for discontinuation of feedings are followed. [ABSTRACT FROM AUTHOR]

Objective: To measure the frequency of ophthalmia neonatorum among all babies born in MCH Center, PIMS (Pakistan Institute of Medical Sciences), Islamabad, in one month's time and to determine their causative organisms., Study Design: An observational study., Place and Duration of Study: The MCH Center, PIMS, during the month of November 2008., Methodology: All babies born from 1st to 30th November, 2008 in the MCH Center, PIMS, Islamabad, Pakistan were included in the study. All babies were examined for signs of conjunctivitis on days 1, 3, 7, 14, 21 and 28 of life. Conjunctival swabs were taken for gram staining and culture from those with clinical diagnosis of conjunctivitis. Frequency of known maternal and neonatal risk factors for the disease were assessed. Proportions were compared using chi-square test with significance at p < 0.05., Results: Seventeen percent of the 1010 babies developed conjunctivitis. Staphylococcus aureus (65% of all positive cultures) was the most common causative organism. No case of gonococcus was isolated. Meconium stain liquor (p=0.004) and caesarain section (p < 0.001) were found to be the most frequent associated conditions in conjunctivitis., Conclusion: There was a high frequency of neonatal conjunctivitis, with Staphylococcus aureus as the most common causative agent. Poor hygienic conditions and practices could be an important risk factor in Pakistan.

Objective: To describe the presentations, complications and to look at the subtypes of children with osteopetrosis., Design: A case series., Place and Duration of Study: This study was conducted at the National Institute of Child Health (NICH) from July 2002 to December 2003., Subjects and Methods: All children presenting as outpatients or inpatients with anemia, thrombocytopenia, and hepatosplenomegaly were evaluated. Those suspected of the disorder (n=126) were screened by X-rays of long bones., Results: Eighteen children including 10 girls and 8 boys in 16 families were diagnosed as having osteopetrosis over a period of 18 months. Fifteen had isolated autosomal recessive osteopetrosis. The mean age at diagnosis was 33 months. Parental consanguinity was high (83.3%). Anemia, hepatosplenomegaly, failure to thrive, recurrent infections and neurological manifestations were common. A high mortality (33.3%) owing to infection was noted., Conclusion: Osteopetrosis should be considered in children presenting with unexplained anemia and hepatosplenomegaly. Once diagnosed, these children should then be monitored for the complications that occur with high frequency in the disorder. Early diagnosis and treatment of the disorder improves the outcome.