Zinc is an essential rnicronutrient with catalytic role in over a hundred specificmetabolic enzymes in human metabolism regulates the expression of the metallothioneingene, apoptosis and synaptic signaling and needed for many aspects of immune system. Thusthe zinc ‘supplementation in patients with acute lower respiratory tract infections might havepotential benefits. Objectives: To evaluate the efficacy of zinc supplementation in patientswith acute lower respiratory tract infections. Study design: Quasi experimental study. Setting:Study was conducted in the pediatrics department Independent hospital Faisalabad; the indoorpatients meeting the inclusion criteria from 26th January to 25th July 2013 were included instudy. Material and methods: 100 children meeting the inclusion criteria were included in thestudy which were divided into two groups with random allocation i.e. Group A (Odd number)& Group B (Even number). Group A was given zinc supplementation 20mg of elemental zincfor 14 days. Along with antimicrobials, oxygen and antipyretics for fever while 50 childrenin Group B were given with antimicrobials. Oxygen and antipyretics for fever without zinc.Results: Baseline clinical parameters were comparable in both groups at admission. Outcomemeasures considered were duration of fever, tachypneoa, chest indrawings and total durationof hospital admission. Effect of zinc supplementation is significant with p-value of less than 0.05for duration of tachypnoea and chest indrawings and total duration of hospital admission whileresult showed p-value equal to 0.05 that is just significant for duration of fever.

Hyperbilirubinemia is the most common abnormal physical finding in first fewweeks of lif and its most common management is phototherapy. Amongst other commoncomplications a less known complication of phototherapy is hypocalcemia. Objectives: To studythe incidence of phototherapy induced hypocalcemia in neonates and to have a comparisonbetween preterm and term neonates. Study design: Descriptive cross-sectional study.Setting: Paediatric Unit II DHQ Hospital Faisalabad, which is a tertiary care centre for all kind ofpatients. Duration of study with dates: Six months from 1-11-2012 to 30-04-2013. Methods:196 neonates with hyperbilirubinemia full term / preterm neonates admitted in pediatric DHQhospital faislabad were selected. Inclusion criteria. 1) Hyperbilirubinemia. 2) No hypocalcemiaon admission. 3) Received phototherapy for hyperbilirubinemia. Serum Calcium levels weremeasured in all neonates before and 48 hours after receiving phototherapy. Incidence ofhypocalcemia among all neonates was calculated as an absolute percentage and the samplepopulation was also divided into preterm / full term neonates to evaluate the incidence ofhypocalcemia in these two groups individually. RESULTS: Mean serum calcium in neonateswas 7.5+- 1.5 mg / dl .16.84 % of neonates were found to have calcium level below the cut offvalue. 33 out of 196 developed hypocalcemia after phototherapy and out of these 54 % werepreterm and 45 % were term neonates < P-value (0.01)>. Conclusion: Phototherapy induceshypocalcemia in neonates more so in preterm neonates. Impact: Consideration for additionalcalcium supplementation should be undertaken in all neonates undergoing phototherapy andfurther randomized trials need to be done with these concerns.

Bacteremia is the presence of viable bacteria in the circulating blood. Bacteremia is diagnosed by blood culture. Yale Observation Scale (YOS) is a scale consisting of six observational items originally and is validated in young febrile children to detect serious illness. If YOS found to be highly accurate, it will help us to design a protocol for early screening and diagnosis of bacteremia in infants so that patient’s morbidity and mortality can be minimized by early treatment. Objectives: To determine the diagnostic accuracy of Yale Observation Scale (YOS) for diagnosing bacteremia, taking blood culture as gold standard. Study Design: Cross-Sectional Validation study. Setting: Department of Pediatrics, D.H.Q Hospital, Faisalabad. Period: 26th May, 2016 to 25th November, 2016. Material & Methods: One hundred and five patients suffering from fever>38 0C, having age from 3-36 months were included in the study. Patients already taking antibiotics, immune compromised, patients with signs and symptoms of malaria or viral infections were excluded. YOS was calculated and blood culture was performed in all patients to diagnose bacteremia. Results: Out of 105 patients, mean age was 12.9±8.24 months. There were 55(52.4%) male and 50(47.6%) female patients. Sensitivity of YOS in diagnosing bacteremia was 90.63%, specificity 79.45%, PPV 65.91%, NPV 95.08% and diagnostic accuracy was 82.86%. Conclusion: YOS can be used as a key diagnostic tool in detecting bacteremia. So, by using this tool many cases in the rural areas can be diagnosed and managed early.

Hyperbilirubinemia is the most common abnormal physical finding in first few weeks of lif and its most common management is phototherapy. Amongst other common complications a less known complication of phototherapy is hypocalcemia. Objectives: To study the incidence of phototherapy induced hypocalcemia in neonates and to have a comparison between preterm and term neonates. Study design: Descriptive cross-sectional study. Setting: Paediatric Unit II DHQ Hospital Faisalabad, which is a tertiary care centre for all kind of patients. Duration of study with dates: Six months from 1-11-2012 to 30-04-2013. Methods: 196 neonates with hyperbilirubinemia full term / preterm neonates admitted in pediatric DHQ hospital faislabad were selected. Inclusion criteria. 1) Hyperbilirubinemia. 2) No hypocalcemia on admission. 3) Received phototherapy for hyperbilirubinemia. Serum Calcium levels were measured in all neonates before and 48 hours after receiving phototherapy. Incidence of hypocalcemia among all neonates was calculated as an absolute percentage and the sample population was also divided into preterm / full term neonates to evaluate the incidence of hypocalcemia in these two groups individually. RESULTS: Mean serum calcium in neonates was 7.5+-1.5 mg / dl .16.84 % of neonates were found to have calcium level below the cut off value. 33 out of 196 developed hypocalcemia after phototherapy and out of these 54 % were preterm and 45 % were term neonates < P-value (0.01)>. Conclusion: Phototherapy induces hypocalcemia in neonates more so in preterm neonates. Impact: Consideration for additional calcium supplementation should be undertaken in all neonates undergoing phototherapy and further randomized trials need to be done with these concerns.

Zinc is an essential rnicronutrient with catalytic role in over a hundred specific metabolic enzymes in human metabolism regulates the expression of the metallothionein gene, apoptosis and synaptic signaling and needed for many aspects of immune system. Thus the zinc 'supplementation in patients with acute lower respiratory tract infections might have potential benefits. Objectives: To evaluate the efficacy of zinc supplementation in patients with acute lower respiratory tract infections. Study design: Quasi experimental study. Setting: Study was conducted in the pediatrics department Independent hospital Faisalabad; the indoor patients meeting the inclusion criteria from 26 th January to 25 th July 2013 were included in study. Material and methods: 100 children meeting the inclusion criteria were included in the study which were divided into two groups with random allocation i.e. Group A (Odd number) & Group B (Even number). Group A was given zinc supplementation 20mg of elemental zinc for 14 days. Along with antimicrobials, oxygen and antipyretics for fever while 50 children in Group B were given with antimicrobials. Oxygen and antipyretics for fever without zinc. Results: Baseline clinical parameters were comparable in both groups at admission. Outcome measures considered were duration of fever, tachypneoa, chest indrawings and total duration of hospital admission. Effect of zinc supplementation is significant with p-value of less than 0.05 for duration of tachypnoea and chest indrawings and total duration of hospital admission while result showed p-value equal to 0.05 that is just significant for duration of fever.