Objective: To determine the frequency of hypertension in our children and explore its relation to obesity to emphasize the importance of routine blood pressure check-ups in outpatient departments and clinics. Study Design: Cross-sectional study. Place and Duration of Study: Pediatric Outpatient Department and Child Ward of the Combined Military Hospital Malir Cantt Karachi Pakistan, from May to Dec 2020. Methodology: A total of 1000 children of 3-13 years selected on consecutive sampling methods with no history of hypertension were enrolled. Three blood pressure readings were recorded using an aneroid sphygmomanometer using the standard protocol, and their weight and height were measured to calculate their BMI. Results: Out of 1000 children, 62 (6.20%) were found hypertensive, out of which 42 (67.7%) were male, and 20 (32.3%) children were females. Overall 42/622 (6.75%) male children and 20/378 (5.87%) female children developed hypertension. Obesity was found in 6.45% of positive cases, while 3.22% of hypertensive children were overweight. The frequency of hypertension linearly increased with increasing age. In addition, 12.9% of cases had a positive family history of hypertension. Conclusion: The frequency of hypertension in the Pediatric population was 6.20%. Male predominance was found in hypertensive cases. Hypertension was more prevalent among children of preadolescent age. Obese and overweight children were more likely to develop hypertension than normal-weight children.

Objective: To determine the frequency of primary and secondary enuresis in the children presenting at outpatient department of Tertiary Care Hospital. Study Design: A cross sectional study. Place and Duration of Study: Outpatient Department of Combined Military Hospital Malir, Karachi, from Feb to July 2019. Methodology: A total of 1200 children with age range of 5-12 years were included in the study. Children presenting with severe acute illness or those with non-willing caregivers were excluded from the study. Result: Out of the total 1200 study participants, 167 (13.9%) children gave the history of enuresis. There were 109 (65.6%) boys and 58 (34.4%) girls. The children with primary enuresis were 141 (84.3%) while 26 (15.62%) children had secondary enuresis. About 31 (18.7%) children had daytime enuresis, 115 (68.5%) had night-time and 21 (12.5%) children had both day and night time bed wetting. About 57 (34.37%) children previously got the treatment for enuresis which included fluid restriction in 21 (12.5%) and desmopressin in 36 (21.87%). Out of them 52 (91.2%) children showed complete response while 5 (8.77%) showed incomplete response. Conclusion: Our study found that enuresis is more frequent among boys. Primary enuresis is more common than secondary enuresis and nocturnal enuresis is more common than diurnal enuresis.

Objective: To find the frequency of known risk factors in cases of severe transient tachypnea of the newborn (TTN) and to measure the effect of inhaled Salbutamol to bubble CPAP on required treatment duration. Study Design: Quasi-experimental study. Place and Duration of Study: Neonatal Intensive Care Unit, Combined Military Hospital, Malir Cantt, Karachi Pakistan, from Nov 2019 to Jun 2020. Methodology: A total of 60 cases of severe TTN, labelled on a predefined criterion were included in the study. The sample was randomized into two groups using an alternate sampling technique. Group-A was treated with bubble CPAP alone, while in Group-B, inhaled Salbutamol was added. The response was measured regarding the time taken to settle respiratory distress. Results: Out of 60 cases, 54(90.0%) were delivered through Caesarean section. A total of 9(15.0%) cases were born prematurely. Polycythemia was found in 10(16.6%) cases. Maternal asthma and gestational diabetes frequency were 8(13.33%) and 12(20.0%), respectively. A significant reduction was seen in the duration of respiratory distress in the study population receiving bubble CPAP with inhaled Salbutamol in the first 24 hours of illness (p-value<0.001). Conclusion: Caesarean section is the most significant risk factor for developing TTN. Adding Salbutamol nebulization to bubble CPAP resulted in an earlier settlement of respiratory distress.

Objective: To study the role of Hydroxyurea in patients suffering from β-thalassemia major. Study Design: Prospective longitudinal study. Place and Duration of Study: Department Paediatrics, Combined Military Hospital, Malir Cantt, Karachi Pakistan, from Nov 2019 to Oct 2020. Methodology: Data from 73 beta-thalassemia major patients was collected using a structured questionnaire containing inquiries about basic socio-demographic details, disease history, laboratory reports and particulars of former treatment regimens. Hydroxyurea was administered, and its effects were noted among the subjects regarding the frequency of transfusion, haemoglobin levels and severity of clinical symptoms. Results: The mean age of study subjects was 9.15±3.99 years, and most study subjects (56.14%) were boys. The preintervention (before administration of Hydroxyurea) levels of Hemoglobin (Hb), mean corpuscular volume (MCV), mean corpuscular haemoglobin concentration (MCHC), and serum ferritin levels were unremarkable when compared to postintervention levels. However, a significant difference was observed in HbF levels. In addition, an encouraging decrease was reported in the self-rated severity (using VAS) of symptoms such as fatigue (p<0.05), weakness (p>0.05), and shortness of breath (p>0.05). In addition, the transfusion interval was significantly reduced (p<0.05). Conclusion: After carefully considering the results, it can be concluded that Hydroxyurea plays a positive role and brings about significant improvement among patients suffering from β-thalassemia major. Keywords: Fetal hemoglobin, Genetic disease, Hydroxyurea, Thalassemia major.