Objective: To determine the prevalence of re-feeding syndrome in children treated for severe acute malnutrition (SAM). Methodology: This cross-sectional study was performed at Department of Pediatrics, King Abdullah Teaching Hospital, Mansehra, Pakistan from October 2020 to April 2021. A total of 186 children of either gender aged 1-5 years and admitted with SAM were included. Children with SAM were given F75-proxy every two hours for 2 days and then were fed with a locally made formula aimed to replace F-100 (F100-proxy), 6 times a day for a further duration of 2 days. After completing three days at the hospital, blood was drawn for measurements of blood and serum levels of phosphate, potassium, calcium and magnesium. Results: In a total of 186 children with SAM, the mean age was 3±1.21 years while 100 (53.8%) children were aged between 1-3 years. There were 146 (78.5%) boys and 40 (21.5%) girls representing a male to female ratio of 3.5:1. Re-feeding syndrome was noted among 25 (13.4%) children. Conclusion: Children with SAM were found to have high prevalence of re-feeding syndrome. Early recognition with appropriate treatment can be the key to a successful outcome in these children.

Objective: The aim of this study is to compare the efficacy of oral ondansetron with oral domperidone in reducing vomiting in children with acute diarrhea. Study Design: Randomized control trial Place and Duration:The study was conducted atChildren Medical Center (CMC) / Dr Habibun Nabi Children Hospital, Airport Road Mingora Swat and Paediatrics department of Central Park Teaching Hospital, Lahore during the period fromJanuary 2020 to September 2020. Methods: Total one hundred and fifty children with ages 1-7 years were presented in this study. Children had diarrhea and vomiting from the last 24-48 hours. Informed written consent was taken from guardians for detailed demographics age, sex, weight, height and residency were calculated. Children were equally split into two groups. Group A received 0.15 mg/kg oral ondansetron with 75 children and group B received 0.5 mg/kg oral domperidone with 75 patients. Post treatment blockage of vomiting was observed after 12-24 hours. SPSS 24.0 version was used to analyze all data. Results: Majority of the patients were males 45 (60%) in group A and 42 (56%) in group B while rest were females 30 (40%) in group A and 33 (44%) in group B. Mean age of the patients in group A was 4.3 ±2.17 years and in group B mean age was 3.08±6.88 years. Mean weight of the patients were 15.07±8.23 kg and 15.02±3.09 kg in group A and B respectively. In group A mean height was 98.07±11.14 cm and in group B mean height was 97.67±18.24 cm. After 12 hours vomiting stopped in group A was 61 (81.3%) and 54 (72%) patients in group B. Efficacy after 24 hours were significantly higher among patients of group A in 69 (92%) children as compared to group B in 60 (80%) cases with p value < 0.05. Conclusion: In this study we concluded that for reducing vomiting in children with acute diarrhea use of oral ondansetron was effective and useful as compared to oral domperidone. Keywords: Acute Diarrhea, Ondansetron, Domperidone, Vomiting

There is little evidence that zinc supplementation will be effective in treating acute respiratory infection (ARI), but it may prevent respiratory infections when taken in conjunction with antibiotics. Objective: To assess the zinc supplementation for acute respiratory infection prevention in infants. Methods: A randomized controlled trail was conducted on 120 acute respiratory infected infants in Pediatric Unit, Qazi Hussain Ahmad Medical Complex, Nowshera from 1st January 2022 to 30th June 2022. Infants having 6-14 months of age with acute respiratory infections were enrolled. Infants were allocated to two groups: Group-I infants receiving Zinc (20 mg/5 mL) in terms of Zinc sulphate (N=60) and Group-II infants taking syrup (Placebo) (N=60). Results: Of the total 220 episodes, the frequency of episodes in zinc and placebo group was 106 and 114 respectively, accounting for 7.78 and 8.68 per child year after 5 months. Based on GEE regression model observed an insignificant decrease of 8% (Adjusted IRR 0.89, 95% CI 0.79-1.01) in episodes of acute respiratory infections in zinc group as compared to placebo group. However, acute respiratory infections episodes (Adjusted IRR 0.36, 95% CI: 0.25-0.35) decreased by 60% in zinc group. Zinc supplementation reduced the acute respiratory days significantly by 14% (Adjusted RR 0.83, 95% CI: 0.76-0.92). Conclusions:  Prophylactic zinc supplementation for two weeks decreased acute lower respiratory tract infection morbidity in apparently healthy infants and improved the infant’s recovery from acute respiratory infections and reduced their hospitalization as compared to placebo group

Objective: To determine the frequency of hypocalcemia in neonates with unconjugated hyperbilirubinemia receivingphototherapy.Study design and setting: Cross sectional study conducted at neonatal intensive care unit, King Abdullah Teaching Hospital,Mansehra for one year from December 2017 to November 2018.Methodology: Total 213 full term stable neonates of either gender with jaundice were studied in this study. Out of which,143 with unconjugated hyperbilirubinemia were exposed to phototherapy while 70 neonates with exaggerated physiologicalhyperbilirubinemia taken as control were not exposed to phototherapy. Serum calcium level was determined through bloodtest before and after 24 hours of phototherapy. SPSS version 22 was used to analyze the data. Frequency and percentageswere used to describe categorical variables like gender and hypocalcemia. Hypocalcemia was stratified by age and genderto see effect modifiers. Post stratified chi-square test was applied in which p value = 0.05 was considered as significancevalue.Results: In study group, 143 neonates who received phototherapy had mean age of 7 days ± 2.62 SD. Total 65% neonateswere male and 35% neonates were female. Mean serum calcium level of neonates before and after provision of phototherapywas 9.28 mg/dl ± 0.23 and 8.54 mg/dl ± 0.68 respectively, which is statistically significant. The frequency of hypocalcemiawas 40% in neonates with unconjugated hyperbilirubinemia after 24 hours of phototherapy.Conclusion: Hypocalcemia is an important complication in neonates with unconjugated hyperbilirubinemia after continuousphototherapy. Hypocalcemia has clinical impact and adds to morbidity, and if left untreated, can lead to mortality.

Objective: To determine the frequency of hypocalcemia in neonates with unconjugated hyperbilirubinemia receivingphototherapy.Study design and setting: Cross sectional study conducted at neonatal intensive care unit, King Abdullah Teaching Hospital,Mansehra for one year from December 2017 to November 2018.Methodology: Total 213 full term stable neonates of either gender with jaundice were studied in this study. Out of which,143 with unconjugated hyperbilirubinemia were exposed to phototherapy while 70 neonates with exaggerated physiologicalhyperbilirubinemia taken as control were not exposed to phototherapy. Serum calcium level was determined through bloodtest before and after 24 hours of phototherapy. SPSS version 22 was used to analyze the data. Frequency and percentageswere used to describe categorical variables like gender and hypocalcemia. Hypocalcemia was stratified by age and genderto see effect modifiers. Post stratified chi-square test was applied in which p value = 0.05 was considered as significancevalue.Results: In study group, 143 neonates who received phototherapy had mean age of 7 days ± 2.62 SD. Total 65% neonateswere male and 35% neonates were female. Mean serum calcium level of neonates before and after provision of phototherapywas 9.28 mg/dl ± 0.23 and 8.54 mg/dl ± 0.68 respectively, which is statistically significant. The frequency of hypocalcemiawas 40% in neonates with unconjugated hyperbilirubinemia after 24 hours of phototherapy.Conclusion: Hypocalcemia is an important complication in neonates with unconjugated hyperbilirubinemia after continuousphototherapy. Hypocalcemia has clinical impact and adds to morbidity, and if left untreated, can lead to mortality.