Aims: To collect and analyze data regarding frequency, pattern, and management of dog bite injuries in children so that it can be reported to health authorities to launch preventive measures plan against dog bite trauma in children and make sure availability of immunoglobulin and vaccine in proper quantity at proper place to prevent its misuse and expiry. Study design: Observational descriptive study. Setting: Department of Pediatric Surgery King Edward Medical University/ Mayo Hospital Lahore. Duration of study: One year from January 2018 to December 2018. Methods: All patients with dog bite injuries admitted through emergency in department of Pediatric Surgery King Edward Medical University/ Mayo Hospital Lahore were included in the study. Demographic data regarding age, gender, mechanism and severity of dog bite trauma and management recorded on detailed Performa. Results: During one year period a total of 445 patients with dog bite injuries presented in pediatric surgical emergency. Out of these 37.8% patients were admitted and 62.2% patients with minor injury were discharged on same day after proper wound management and vaccination in emergency department. Majority were males and most common age at presentation was from 4-8 years. Conclusion: As dog bite injuries are preventable so there is need to give education to children and families about preventive measures against dog bite injuries and proper treatment like immunoglobulin and vaccination. Keywords: Dog bite trauma, children, Frequency, management

Milk a natural rich lacteal secretion that provides all essential nutrients required by body. This study was designed to detect milk adulterants alongwth various physiochemical factors in milk sold in Quetta market. A total of 120 raw milk samples were collected hygienically and subjected to milk adulteration Kit (UVAS Lahore).  Results revealed that overall, 11.66 % samples revealed adulteration with any single chemical adulterant. Water and powdered milk were the major adulterants found almost in all samples. On towns basis Zarghoon town samples were more adulterated (18%) than Chiltan Town samples (5%). Other parameters such as, Electrical Conductivity, pH, Fat percentage, Total Solids and Solid Not Fat were observed below than normal values in most of the samples. Adulterants like Urea, Hydrogen Peroxide, Sorbitol, Boric acid, Quaternary Ammonium Compound, Carbonate, Soap and Alcohol were not detected in any sample. However, Sodium chloride (1.66 %), Formalin (3.33 %), Hypochlorite (2.5 %), Starch (2.5 %) and sugar (4.16 %) were detected. This study explores the potential health hazard due to adulterated milk sold in retail outlets in Quetta market. There is dire need of regular monitoring of milk and its products by concerned food authority.  These findings will help to build a concrete strategy to curtail this problem and improve the life standards of people.

Aim: To find predictive accuracy of pediatric trauma score (PTS) in terms of mortality in the Children’s hospital and institute of child health Lahore. Study design: Cross sectional study. Setting: Paediatric Surgery department, CH & ICH, Lahore. Duration of study: 1st January 2019 to 30th June 2019. Methods: All patients presented with trauma, aged 1-15 years were included in study. All patients with major burn, associated cardiac injuries (e.g., stab heart), victims who required monitoring and hospitalization less than 24 hours, and those referred to other hospitals were excluded from the study. Initial assessment of all patients was done and paediatric trauma score was evaluated in the emergency room. Patients were managed and 24 hours follow-up was done to predict the mortality. Results: From 290 children, 207(71.38%) were males and 83 (28.6%) were females. Mean age of the children was 7.53 years. The most common mode of trauma was Car accident in children 67(23.1%), followed by Auto rickshaw vs. motorcycle n= 50 (17.24%), and auto rickshaw vs. pedestrian 40(13.79%). Mean Hospital Arrival Time in Minutes was 100.31 minutes. Mean paediatric trauma score amongst all children was 7.22. Overall mortality was reported in 27(9.3%) children. PTS < 8 turned out to be statistically significantly related to mortality (P value < 0.001). Patients with diagnostic test characteristics of PTS < 8 to predict mortality were having sensitivity 91.0%, specificity 56.1%, positive predictive value 38.4%, negative predictive value 95.4% and the diagnostic accuracy of 64.1%. Conclusion: By Paediatric trauma score we can predict about the necessity of critical interventions in patients and also, we can predict percentage of mortality in paediatric trauma patients. However, accuracy of paediatric trauma score seems to be moderate in detecting most severe paediatric trauma cases. Keywords: PTS, mortality, hospital arrival time, morbidity, major burn predictor.

Balochistan is the largest province of Pakistan with almost 44% of the country land. Most of the area is rangeland and only 5-7 % area is hardly cultivable and more than 70% population depend upon livestock for their livelihood. Animal rearing is the centuries old occupation of farmers. The province produces 45% and 22% sheep and goat population of the country. Different diseases such as, Enterotoxaemia, sheep and goat Pox, Contagious Caprine Pleuropneumonia, Anthrax and Hemorrhagic Septicemia, Peste des Petits ruminants and Foot and Mouth disease are the most common infections of small and large ruminants. Vaccination covers hardly 10% of the population. The role of livestock in poverty reduction inevitable.  Although animal health care facilities are available throughout the province but still it needs to be expanded and improved. Establishment of new Vaccine production centers in the province may be helpful to cover the vaccination of animals.

Aim: To assess the knowledge of gynecologist & Paediatric Surgeon about the role of folic acid in prevention of neural tube defects. Study design: Cross Sectional Study Setting & duration of study: Department of Paediatirc Surgery, KEMU/Mayo Hospital Lahore from 1st November to 15 December. Methodology: After ethical approval data was collected on a questioner performa created on google doc regarding demographic variables, knowledge about neural tube defects, dose and timing of folic acid supplementation in prevention of neural tube birth defects. Results: 70% of the doctor who took part in this study work between 20-30 year of age. 50% were male & 50% were female. Majority of doctors (80%) have experience of 1-10 years after graduation. The participants doctors include postgraduate residents (68%) followed by consultant (11.1%), Medical Officer, Senior Registrar, Registrar & House Officer. 90.7% were government employee most of them have knowledge about meningomylocele but majority of them (57.4%) did not have proper knowledge about dose and timing of folic acid supplementation for prevention of neural tube defects. Conclusions: We conclude that most of gynecologist and paediatric surgeons don’t have sufficient knowledge about role of folic acid in prevention of neural tube defects, specially meningomyelocele in children. There is a need to launch awareness campaign among healthcare providers through social media, symposium, and newspaper about supplementation of folic acid before conception in women so that this important disability condition/disease incidence may be reduced Keywords: Meningomyeloclele, Folic Acid Supplementation, Prevention