Background: The present study aimed to assess the frequency of treatment related mortality (TRM) among all ALL related mortalities recorded in the paediatric ward. Methods: A cross-sectional study was undertaken at the Department of Pediatric, Children’s Hospital and the Institute of Child Health, Multan, Pakistan between January 2021 and June 2022. The study enrolled all children under the age of 18 years who were diagnosed with acute lymphoblastic leukaemia. Data of individuals who died secondary to a relapsing or progressive disease or those who had not yet started chemotherapy were excluded. The main focus of the study was to measure TRM. All data were collected in pre-defined pro forma. Results: A total of 205 deaths among ALL patients were reported during the study. Of these, 120 (58.54%) cases were associated with TRM. The most common type of ALL immunophenotype was B-cell ALL in 100 patients. Majority of the patients who suffered from TRM were at the induction phase i.e. 69 (57.50%). The most common cause of TRM was sepsis i.e. 100 (83.33%) cases. The second most common cause of TRM was haemorrhagic complications. Conclusion: The results indicated that TRM was a significant contributor to treatment failure in this population. Out of a total of 205 deaths, more than half were attributed to TRM. Among the 100 patients evaluated, B-cell ALL was the most prevalent type. The majority of TRM cases occurred during the induction phase (57.50%), and sepsis was identified as the primary cause of TRM, followed by haemorrhagic complications. Keywords: Acute lymphoblastic leukaemia, ALL, chemotherapy, febrile neutropenia, paediatric cancer, sepsis, treatment-related mortality, TRM

Objective: To determine the frequency of haemophilus influenzae infection in children less than 5 years with acute bacterial meningitis (ABM). Study Design: Descriptive Cross Sectional study. Setting: Department of Pediatric Medicine, The Children’s Hospital and Institute of Child Health, Multan. Period: October 2019 to March 2020. Material & Methods: A total of 165 children aged 5 – 60 months of either gender having acute bacterial meningitis with duration of < 2 weeks were enrolled. Cerebrospinal fluid (CSF) of each child was sent for microbiological analysis. Results: There were 106 (64.2 %) boys and 59 (35.8 %) girls. Mean age was 2.72 ± 1.07 years. Most cases, 112 (67.9 %) belonged to urban areas.  Maternal literacy was positive in 65 (39.4%) cases while 59 (35.8%) were fully vaccinated. Mean disease duration was 56.25 ± 15.36 hours and 112 (67.9%) had duration of illness more than 36 hours. Frequency of Haemophilus Influenzae was noted in 35 (21.2%) cases. Conclusion: Frequency of Haemophilus Influenzae was high among children with acute bacterial meningitis. Early diagnosis and appropriate management might help reducing prolonged hospitalization and disease morbidity related to Haemophilus Influenza.

Objective: To find out different species of plasmodium (P. falciparum and P. vivax) involved in children with malaria at a tertiary childcare hospital. Study Design: Descriptive, Cross-sectional study. Setting: Department of Paediatric Medicine, The Children’s Hospital and Institute of Child Health, Multan. Period: October 2019 to March 2020. Material & Methods: A total of 281 cases of either gender, aged 1 to 12 years and patients with malaria were enrolled. A special template was designed to record study information. Venous blood as five ml sample was drawn and dispatched to institutional laboratory for ICT malaria, complete blood count and giemsa stain smear and observed under light microscope. Data analysis was performed employing SPSS version 24.0. Results: Out of a total of 281 cases, 177 (63.0%) were male ande 104 (37.0%) female. Mean age of study participants was 4.29±2.48 years. A total of 135 (48.0%) children belonged to rural areas and 197 (70.1%) had monthly family income < 25000 rupees. Mean duration of illness was 4.21 ± 2.12 days. Previous history of use of anti-malarial drugs was noted in 62 (22.1%) of our study cases. Plasmodium falciparum was observed in 52 (18.5%) cases and plasmodium vivax in 229 (81.5%). Conclusion: Plasmodium vivax is predominantly more prevalent in our population as compared with plasmodium falciparum in children with malaria. Plasmodium falciparum and plasmodium vivax were significantly linked with age and disease duration. Malaria was noted to be more prevalent among poor families living in slum areas having inadequate sanitation facilities.