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Objective: To study the prevalence and frequency of hyperglycemia in critically ill children. To juxtapose mortality rate in critically ill patients with hyperglycemia against those having normal blood glucose levels. Study Design: Descriptive Case Series. Setting: Pediatric Intensive Care Unit (PICU) of HITEC, IMS Taxila, Al-Ihsan Hospital Rawalpindi & Hameed Latif Teaching Hospital, Lahore. Period: March 2023 to October 2023. Methods: One hundred critically ill children admitted to PICU were included. Patients who had blood glucose levels more than 150mg/dl within 48 hours of admission were included in the hyperglycemic group (Group A).Patients with normal blood sugars were included in Group B. The normoglycemic and hyperglycemic groups were followed till 10 days to determine the mortality associated with hyperglycemia. Results: Mean age of the children was 6.7± 6.29 months. There were 72% male children and 28% female children. Mean blood glucose levels at baseline, after 24h hours, after 36 hours and after 48 hours were 194.91± 135.66mg/dl, 156.91±74.89mg/dl, 156.21 ±83.05mg/dl and 150.13±70.68mg/dl. Frequency of hyperglycemia was observed in 55% (n= 55). Mortality rate was 43% (n= 43/100). Furthermore, mortality rate was crucially inflated 63.6% (n= 35) in hyperglycemic victims than normoglycemic patients (p=<0.001). Conclusion: Frequency of high blood sugar along with mortality within 10 days of hospitalization in children with hyperglyceemia was found higher in patients admitted to Pediatric ICU. [ABSTRACT FROM AUTHOR]

Objective: To assess the frequency of major congenital anomalies in newborns delivered in three different hospitals of Pakistan. Study Design: Cross Sectional study. Setting: Department of Pediatrics Hameed Latif Teaching Hospital, Lahore, Ittefaq Hospital Lahore and HITEC-IMS Taxilla. Period: Jan 2023 to November 2023. Methods: 205 neonates who met the inclusion criteria were included in the study from labour room of Hameed Latif Teaching Hospital Lahore, Ittefaq Hospital Lahore and HITEC-IMS Taxilla. Informed consent was obtained from parents. Demographic variables (name of mother, gender, birthweight and gestational age at birth) were recorded. Then neonates were admitted in NICU and evaluated for presence of congenital malformations including cardiovascular system defects, limb anomalies, genitourinary system, central nervous system and chromosomal anomalies. All data was entered in specially designed performa. Results: We found that overall gestational age was greater than 32 weeks with mean age of 37.190±2.00 weeks. Mean birth weight was 2.938±0.31 Kg. Frequency and percentage of patients according to gender was 60% males and 40% females. Major congenital malformation was seen in 2.9% patients. Among infants with major congenital malformations, cardiovascular system defects were seen in 33.3% infants, limb anomalies 16.7%, genitourinary system 16.7% and central nervous system defects were 33.3%. Parents of 67.7% of cases were cousins. It was observed that only 32.3% of the mothers had taken the recommended daily dose of folic acid in antenatal period. Conclusion: Central nervous system and cardiovascular system defects were the most prominent anomalies detected. Prenatal diagnosis may be helpful in decreasing mortality by offering early termination. [ABSTRACT FROM AUTHOR]

Objective: To determine mean oxygen saturation (SpO2) values in normal newborns and compare mean SpO2 values between term and preterm infants. Study Design: Descriptive Case Series. Setting: Hameed Latif Teaching Hospital Lahore and HIT Hospital, HITEC, IMS Taxilla. Period: March 2023 to November 2023. Methods: The study involved 100 neonates from operation theatre and labor room. Informed consent was obtained from parents. Immediately after birth, pulse oximeter was applied and serial monitoring of oxygen saturation was carried out starting at 1 minute and recording values after every 1 minute till 10 minutes of life. Results: There were 50% male and 50% female neonates. The average SpO2 values were 76.13±10.41 at first minute, 89.68±6.62 at 5 minutes & 95.84±3.65 at 10 minutes of life. Mean SpO2 was significantly high in term babies as compared to preterm babies at one minute and 5 minutes. However there was no significant difference in mean SpO2 at 10 minutes in term and preterm babies. Conclusion: The process of transition to normal postnatal oxygen saturation requires more than 5 minutes in healthy newborns. In healthy term newborn, oxygen saturation rises slowly. SpO2 monitoring may help identifying the infants requiring resuscitation to avoid overexposure to high supplemental oxygen after birth. Many newborns have SpO2 <90% during the first 5 minutes of life. This should be considered when choosing SpO2 targets for infants treated with supplemental oxygen in the delivery room. [ABSTRACT FROM AUTHOR]

Objective: The study aims to ascertain the degree of felt stress among parents of cerebral palsy patients at HIT and POF Hospitals. Study Design: Cross-sectional. Setting: Department of Pediatrics, HIT & POF Hospitals. Period: February 2022 to May 2022. Material & Methods: The study was approved by IRB of HITEC-IMS under approval number HITEC-IRB-22-2021. Using the purposive sampling method, the study included CP children aged under 3 to 10 and caregivers who had experienced stress for three consecutive months. The total score was determined using Sheldon Cohen's perceived stress scale. Scores between 0 and 13 were classified as low perceived stress, 14 to 26 as moderate, and 27 to 40 as high felt stress. Results: Children with the spastic form of CP made up 50% of the population, while those with the dyskinetic ataxic and mix types made up 16%, 8%, and 5% of the total. 66 percent of the children were under 5, 22 percent were between the ages of 6 and 10, and just 12 percent were under 3. With level 4 on the second, the GMFCS level of 3 was the most prevalent. The parents' average age was 31±7.2. Respondents' average stress score was 18.03±8.8. Conclusion: Parents of CP children experience moderate to high levels of stress that are significantly influenced by the employment status of moms and family income. Parents must be stress-free in order to raise children with poor health. [ABSTRACT FROM AUTHOR]

Objective: To explore the diagnostic features and inheritance patterns of spinal muscular atrophy (SMA) in children at three tertiary care public hospitals. Study Design: Retrospective study. Setting: HITEC Institute of Medical Sciences Taxila Cantt. Period: January 2022 to March 2022. Material & Methods: A retrospective review of the medical records of the past ten years from January 2011 to December 2020 of three tertiary care public hospitals was conducted. Socio-demographic characteristics, consanguinity, and diagnostic features (including genetic investigation) were also considered. Results: A total of 70 children were diagnosed with SMA during the research study period and the most prevalent variation found among them was Werdnig Hoffmanver illness (SMA type I), affecting 40-57 percent of the children. The study found that 67 percent of the research group showed a high level of paternal consanguinity. The deletion of a gene, survival motor neuron (SMN1) was discovered in 21 (88%) genetically tested children out of 24, while 17 (71%) genetically studied patients were found to be positive for the deletion of specific apoptotic proteins called neuronal apoptosis inhibitory proteins (NAIP). Conclusion: In our study, SMA type 1 is the most prevalent. This piece of literature emphasizes the importance of antenatal detection and the need to increase awareness among high-risk societies with prevalent consanguineous marriages like Pakistan to lessen the disease load. [ABSTRACT FROM AUTHOR]

Objective: To compare efficacy of nebulised 3% hypertonic saline with 0.9% normal saline for treatment of acute bronchiolitis in children up to 2 years of age in terms of mean days of hospital stay and clinical severity score. Methodology: This Randomized controlled trial (RCT) was done in department of Paediatrics, POF Hospital Wah Cantt from 1st November 2015 to 31st March 2016. Children in group 1 were nebulized with 3% hypertonic saline and group 2 with 0.9% normal saline. Results: In group 1 the mean clinical severity score at the time of admission was 8.46 ± 1.10 and in group 2, 8.7 ± 0.98. In group 1 the mean clinical severity score after 3 days was 2.7 ± 0.87 and in group 2, 4.4 ± 0.999. The mean length of hospital stays for group 1 was 4.23 days ± 1.2 and in group 2 it was 6.4 days ± 1.4. Mean of clinical clarity score after 3 days and mean of length of hospital stay was compared between both groups for which the p value was significant. Conclusion: Hypertonic saline (HS) nebulization has shown improved outcome in bronchiolitis. More studies are required to see the outcome of this method of treatment. [ABSTRACT FROM AUTHOR]

Objective: This study has been carried out to determine the frequency of left ventricular thrombi in dilated cardiomyopathy patients presenting in tertiary care hospitals in Punjab. Methods: This descriptive case series was carried out at Arif Memorial Teaching Hospital Lahore. This study involved 150 children of both genders aged between 4-12 years diagnosed with dilated cardiomyopathy. These children underwent echocardiographic screening for left ventricular thrombi (mass filling the ventricular cavity and distinct from normal endocardium). The frequency of left ventricular thrombi was noted and compared across various subgroups of children based on age, gender and BMI. Written informed consent was obtained from parents of every child. Results: The mean age of the children was 8.5±2.4 years. There were 98 (65.3%) boys and 52 (34.7%) girls with a male-tofemale ratio of 1.9:1. The mean BMI of these children was 26.9±3.0 Kg/m² and 29 (19.3%) children were obese. 63 (42.0%) children had left ventricular thrombi. There was no statistically significant difference in the frequency of left ventricular thrombi across various subgroups of children based on age (p-value=0.979), gender (p-value=0.956), and BMI (p-value=0.731). Conclusion: In the present study, a substantial proportion of children with dilated cardiomyopathy had left ventricular thrombi which due to the associated risk of thromboembolism and CVA warrant routine echocardiographic screening of such children so that timely identification and anticipated management may improve the outcome of children with dilated cardiomyopathy in future pediatric practice. [ABSTRACT FROM AUTHOR]

Situs Inversus Totalis (SIT) is a rare genetic anomaly that causes the heart and abdominal viscera to be positioned in a mirror image of their regular positions. It may present alone or in association with various associated anomalies. Most patients present with no symptoms and are often diagnosed incidentally; however, some have co-existent anomalies and must be ruled out. A male neonate weighing 3.2 kg delivered at term via Em-LSCS presented with transient tachypnea of the newborn (TTN) and was on oxygen dependence in the neonatal intensive care unit (NICU). A General Physical Examination revealed heart sounds on the right side of the chest and empty left scrotal sac. Chest X-ray was done that showed Situs Inversus Totalis and congenital pneumonia. Ultrasonography of the scrotum revealed the absence of the left testis. Situs Inversus Totalis should be evaluated and investigated to rule out associated anomalies, even when the finding is incidental. It is recommended that physicians promote regular medical examinations for their patients, since this practice can aid in the detection of anomalies, hence mitigating the risk of incorrect diagnoses and potential mortality resulting from delayed treatment. [ABSTRACT FROM AUTHOR]