Objective: To compare the mean serum ferritin levels in thalassaemia major patients after giving  deferasirox and deferoxamine. This is a randomised control trial conducted at the Department of Paediatrics, Civil Hospital, Karachi from 29th January 2014 to 28th July 2014. Methods: A total of 160 patients of either gender, with age between 1 to 14 years, who received blood transfusion at least once a month for one  year  and  had  serum  ferritin  >1000  mcg/L  were  included. Each enrolled patient was randomly allocated to group-A (deferoxamine) or group-B (deferasirox). Pre-    and post-treatment iron profile was done in both groups to assess the iron  status  in  the  body.  De- scriptive statistics were applied to calculate mean  and  standard  deviation  for  the  quantitative  vari-  ables.  Frequencies  and  percentages  were  calculated  for  the  qualitative  variables.  Independent  sample t-test was applied to compare mean change in serum ferritin  level  in  both  groups.  Effect  modifiers were controlled by  stratification.  Paired  t-test  was  also  applied  post  stratification  and  p-  value £ 0.05 was considered as significant. Results:  Overall there were 96 male and 64 female patients. The overall mean age of study subjects was 7.54 ± 4.21 years. In the deferasirox group, mean age was 6.35 ± 4.11 years, mean weight wasv18.01 ± 6.74 kg, mean height was 102.04 ± 19.48 cm, and mean duration of transfusion was 7.48 ± 3.99  months/year.  In  the  deferoxamine  group,  mean  age  was  8.74  ±   3.97  years,  mean  weight  was 20.44 ± 6.77 kg, mean height was 102.19 ± 20.85 cm, and mean duration of transfusion was 8.14 ± 3.55 months/year. In the deferasirox group, before treatment mean serum ferritin level was 1385.73 ± 117.01 mcg/L. After treatment mean serum ferritin  level  was  reduced  to  1047.59  ±  117.08  mcg/L.  In the deferoxamine group, before treatment mean  serum  ferritin  level  was  1362.58  ± 134.42  mcg/L. Af- ter treatment mean serum ferritin level was reduced to 1124.36  ±  134.52  mcg/L.  Post-treatment  the serum ferritin level between two groups was significantly different with p<0.01. The mean difference in serum ferritin level in pre- and post-treatment among two groups was highly significant with p<0.01. Conclusion: Deferasirox is an effective, safe and tolerable chelation therapy for the treatment of thalassaemia major with iron overload due to its ability to provide constant chelation  coverage  and  potential to improve compliance.

Background: Protein energy malnutrition (PEM) is mainly due to inadequate intake of food both in quantity and quality. Serum magnesium level can be detected to identify magnesium deficiency in malnourished children. Low magnesium level in these children is associated with illness and death. Objective: To determine the serum magnesium level in protein energy malnourished children who are under the age of 5 years. Study Design: Prospective Cross Sectional study. Setting: The Pediatric department, civil hospital, Karachi. Study period: From July to December 2021. Material and Methods: Total 245 patients of both genders with moderate and severe malnutrition were included. Venous samples were sent to laboratory and a centrifuge machine was used to separate the serum, which was maintained at a temperature of 20°C for serum magnesium test. Atomic Absorption Spectrophotometer was used to measure serum magnesium levels. Descriptive statistics were applied. Frequency and percentage was calculated. Stratification was done using chi square test and p-value ≤0.05 was considered as significant. Results: Total 156 male and 89 female patients were included in the study. Mean age was 26.63±15.17 months. Mean duration of malnutrition was 11.74±4.86 months. Mean mid upper arm circumference (MUAC) was 11.66±0.76 cm. Serum magnesium level was 1.78±0.22 mg/dl. Overall 180 (73.5%) have moderate PEM. Conclusion: Study showed low serum concentration of magnesium in children with PEM. Keywords: Serum Magnesium Level, Protein Energy Malnutrition, Children Under 5 Years.

Pediatric populations from lower-income countries may experience a higher incidence of zinc deficiency, which may cause physical and neurological dysfunctions. This case control study aims to assess different levels of zinc between malnourished and well-nourished children. Our study included 108 participants, all children less than 12 years of age. Out of the 108, 54 were malnourished children (cases), while 54 were well nourished (control group) and were screened for zinc deficiencies. Zinc deficiencies were 4 times more common in malnourished cases than in controls (OR: 3.89 95% CI: 1.1-14.9) with median value of zinc in cases being 91.69 and that of controls was 117.6. Our findings indicate significant deficiencies in malnourished children as compared to well-nourished children. Additionally, our findings support literature surveyed that suggest dietary changes alone would not be able to replenish zinc levels in children.

This research explores the concept of cognitive mapping and underlines the challenge of class consciousness and its effects on the mental maps. Nuanced with subjective mappings, literature lacks comprehensive depictions of lived and navigated space. This study examines two Pakistani novels, Saba Imtiaz’s Karachi, You're Killing Me! and Kamila Shamsie’s Kartography, by using the theoretical framework of cognitive mapping proposed by Frederick Jameson. The comparative analysis reveals the subjective implications of the protagonists' social statuses in both texts. It highlights how different class structures map the same space and location in accordance with their respective social contexts. It also analyses the subjectivity of the depictions and the erroneous nature of city maps depicted in literary works in a way that not every faction of the society can relate to it.

Background: Enteric fever is a common and treatable pediatric bacterial infection, but emerging drug resistance has been a real challenge for treating physicians. Since 2016, Pakistan is facing the epidemic of Extensively drug resistant (XDR) salmonella typhi. Objective: To determine the clinical presentation and current pattern of sensitivity of salmonella species in children diagnosed with enteric fever. Study Design: Descriptive, Cross sectional Place and Duration of Study: Pediatric department of Dr. Ruth K. M. Pfau Civil Hospital Karachi, from July to December 2022. Methods: Medical records of patients 1 month to 12 years of age, diagnosed as enteric fever on positive blood culture for salmonella, were inducted into the study by non-probability convenient sampling. The clinical manifestations of patients and sensitivity and resistance patterns of salmonella were recorded. Data was analyzed using SPSS version 22. Results: A total of 140 children had enteric fever, out of which 60.7% were male. Mean age of the patients was 4.48+2.47 years. Most common symptom was fever in 140 (100%), followed by anorexia in 97 (69.2%) and abdominal pain in 70 (50%). Blood culture reports showed Extensive drug resistance in 105 (75%), Multi drug resistance in 3 (2.14%) and Non-resistance in 7 (5%). Salmonella Typhi isolates were sensitive to Carbapenems in 140 (100%), Azithromycin 139 (99.2%) and Piperacillin/Tazobactam in 60 (42.8%). Conclusion: XDR enteric fever is still the most common resistance pattern identified in admitted patients with enteric fever. Large scale public health measures and antibiotic stewardship are required to fight this disease. Keywords: Typhoid fever, Salmonella Typhi, Drug resistance, Infection, Epidemic