Objective: To determine the celiac disease using Marsh classification in the paediatric population at the Pak Emirates Military Hospital. Study Design: Cross-sectional study. Place and Duration of Study: Department of Paediatrics, Pak Emirates Military Hospital Rawalpindi Pakistan, from Aug 2020 till Mar 2021. Methodology: Patients of either gender aged 1 to 14 years with three or more clinical features of celiac disease such as chronic diarrhoea, any degree of malnutrition, short stature, abdominal distension, anaemia, and clubbing at the time of admission, were included in this study. Results: There were 97 patients in this study. Among them, 61 (62.9%) were males, and 36 (37.1%) were females. There were 56 (57.7%) patients who were histology positive and 41 (42.3%) patients who were histology negative. There were 37 (38.1%) patients in Marsh III a, 15 (15.5%) were in Marsh III b, and 4 (4.1%) patients were in the Marsh III c category. Gender distribution showed that 33 (58.9%) males were positive compared to 23 (41.1%) females. Even though the frequency was higher among males, the difference was not statistically significant (p-value=0.23). Conclusion: Celiac disease is a possible reason for anaemia among patients with iron deficiency anaemia of unknown origin. Therefore, the histopathological diagnosis should be completed when celiac disease is suspected.

Objective: To look for the associative factors in avoidance of exclusive and non-exclusive breastfeeding among mothers after lower segment Caesarean section. Study Design: Cross-sectional study. Place and Duration of Study: Paediatrics department, Pak Emirates Military Hospital, Rawalpindi Pakistan from Oct to Mar 2020. Methodology: Mothers bringing their infants for vaccination at six weeks of age with babies born with lower segment caesarean section were included in the study. They were asked simple questions regarding exclusive or non-exclusive breastfeeding. Relevant socio-demographic factors were also recorded and compared among mothers breastfeeding their babies and those avoiding it. Results: A total of 500 mothers were included in the study. The mean age of the study participants was 33.576±9.174 years. 336(67.2%) women were primiparous, while 164(32.8%) were multiparous. 208(41.6%) women were actively breastfeeding their child, while 292(58.4%) avoided breastfeeding their babies. 150(72.1%) women were non-exclusively breastfeeding, while 58(27.9%) showed an exclusive breastfeeding pattern. Pearson chi-square test revealed that low education and working outside the home had a statistically significant association with the avoidance of breastfeeding the babies among our target population (p-value <0.05). Conclusion: Avoidance of breastfeeding was a common finding after six weeks of birth among women who delivered the babies via lower segment caesarean section. Mothers with low education and duties to work outside the home were more at risk of avoiding this highly beneficial practice for the baby.

Objective: To determine the frequency of Respiratory Distress Syndrome among preterm neonates born at the Pak Emirates Military Hospital. Study Design: Cross-Sectional Study. Place and Duration of Study: Pak Emirates Military Hospital, Rawalpindi Pakistan, from Aug 2020 to Mar 2021. Methodology: One hundred and sixty-nine neonates with a gestational age of ≤34 weeks of either gender were included in this study. RDS was confirmed by reviewing neonatal medical charts. The frequency of RDS was seen in different groups according to gestational age, gender, weight, hypothermia, sepsis and jaundice. Results: There were 169 patients; among them were 94 (55.6%) males and 75 (44.4%) females. 105 (62.1%) were born by caesarean section, and 64 (37.9%) were normal vaginal delivery. There were 26 (15.4%) neonates, with RDS, and 143 (84.6%) did not have RDS. Among our 169 sample, 26 (15.4%) were in <28 weeks, 96 (56.8%) were in the 28 to 32 weeks and 47 (27.8%) were in >32 week gestational groups. There were 34 (20.1%) who were <1000 g, there were 96 (56.8%) were between 1000 to 1500 g, and 39 (23.1%) were > 1500 g. Hypothermia was found in 43 (25.4%) of neonates; 126 (74.6%) did not have hypothermia. 63 (37.3%) neonates had sepsis, and 39 (23.1%) had jaundice. Conclusion: RDS is a serious problem in our country. Health care providers must plan cost-effective and efficient strategies to detect and treat RDS in the developing world.