Background: Pakistan has the highest prevalence of Β-Thalassemia major in children and Chronic Hepatitis C (HCV) infection is a common transfusion transmitted infection. After the emergence of new generations of Antiviral drugs labelled as Direct Acting Antivirals (DAAs), substantial eradication of HCV has been reported as 90–95% with fewer side effects as compared to older regimen of Peginterferon with or without Ribavirin. The main objective of this study was to assess the Rapid virological response (RVR) at 4th week, End of treatment response (ETR) at 12th week and sustained viral response (SVR) at 24th week achieved by using direct acting antiviral and to assess their safety. Methods: Retrospective descriptive study was conducted from July 2018 to July 2020 at National Institute of Child Health. All β-thalassemia major paediatric patients with HCV infection and age between 3–14 years were included. Demographic data, liver function test, HCV PCR, and response of antiviral therapy was recorded and analyzed. Safety was determined by adverse effects reported in records and efficacy was documented by clearance of HCV-RNA to see ETR and SVR. Results: Total 21 patients were treated. Mean age was 7.67±3yr and 12 (57%) were male. Mean weight was 19.3±3.2kg. RVR and ETR was achieved in all (100%) and SVR was achieved in 20/21 (95%) patients. Headache in 2(9.5%) and generalized body ache was found in 1 (4.25%) patient. Conclusion: Combined Sofosbuvir and Daclatasvir were found to be effective and safe for treating HCV in Thalassaemia Major Children.

Twenty-five patients with congenital cyanotic heart disease were studied. Skiagrams

Objective: To evaluate the effectiveness of F 75 and F 100 in children with severe acute malnutrition. Study Design: Cross Sectional study. Setting: National Institute of Child Health, Karachi. Period: 1st Jan 2021 to 30th June 2021. Material & Methods: All children with severe acute malnutrition, aged 6 months to 5 years, irrespective of gender were included in the study. Children of parents/guardians who failed to give consent were excluded from the study. Relevant history was recorded. After acute intervention as per departmental standards, F-75 was initiated. When the subject gained weight at the rate of 0.5g per kg/day for three consecutive days, the patient was then administered F-100. Both diets were administered 6-8 times a day. Outcome was recorded by comparing the post treatment mean weight with baseline weight. Results: The mean age of the child and the mother were 30.53 ± 13.37 months and 31.31 ± 6.34 years, respectively. The mean increase in weight was 0.75 ± 0.77 kgs (Pre- and post-treatment). Increase in BMI was 1.12 ± 1.34 kg/m2 while the increase in MUAC was 0.93 ± 0.89 cm. Statistically significant increments were observed in weight, MUAC, and body mass index after administration of F75/F100 diet in the severely malnourished children (p<0.0001). Conclusion: The present study revealed statistically significant increments in weight, MUAC, and body mass index, after administration of F75/F100 diet in the severely malnourished children.

Background Infants need to be exclusively breastfed up to six months of age, and breastfeeding should be continued up to two years of age along with complementary food. In Pakistan, the majority of newborns are not exclusively breastfed. This study was done to compare weight gain between breastfed infants and non-breastfed infants at a tertiary care hospital in Karachi, Pakistan. Methodology This observational cohort study was conducted at the well-baby clinic and vaccination center of the National Institute of Child Health, Karachi, Pakistan, from January 2021 to December 2021. A total of 360 normal term babies (180 in each group) with age below 11 months on either exclusively breastfeeding or other milk feed were included. Data were collected by the duty senior staff nurse of the well-baby clinic and monitored on daily basis by the researchers. The sociodemographic characteristics of mothers of breastfed and non-breastfed babies and birth weight, length, and BMI Z scores of babies in both groups were compared. Results In a total of 360 babies, there were 192 (53.3%) boys and 168 (46.7%) girls. Overall, the mean maternal age was calculated to be 28.1±6.2 years, ranging between 18 and 37 years. The employment status of mothers (p=0.0117) and monthly income of parents (p=0.0388) were significantly different between groups. The mean weight gain in the exclusively breastfeeding group was 4.0±0.5 kg between the first and fifth visit (final visit) in comparison with 4.5±0.5 kg in the non-breastfeeding group (p<0.0001). Conclusion Non-breastfed babies gained significantly more weight in comparison with exclusively breastfed babies. More multicenter trials involving a large proportion of populations are needed to further verify the findings of the present study.

BackgroundChronic liver disease (CLD) is one of the most significant causes of morbidity and mortality among the pediatric age group. The identification of the etiology of the disease is of utmost importance for the effective management of the disease. ObjectiveTo determine the various causes of CLD in pediatric patients attending a large public sector pediatric hospital.