Aim: To assess the Safety of weekly Primaquine in Glucose 6 Phosphatase Dehydrogenase (G6PD) deficient children, for radical treatment of Plasmodium vivax malaria Study Design: cross sectional study Place and Duration: Pediatrics Out Patient Department, Liaquat University of Medical and Health Sciences Hyderabad from 11 January 2018 to 31st August 2019 (total 20 months’ duration) Methodology: A sample of 40 patients was studied during study period. Male children between 4 years to 12 years of age having confirmed vivax malaria were included in the study. If G6PD result showed decreased level of G6PD level then, they were enrolled for study. MP was checked by thick and thin slide method. 5 ml blood was taken in anticoagulant bottle for G6PD, liver function test, creatinine, complete blood count, and reticulocyte count tests.  Haemoglobin  < 7 g/dL, reticulocyte count > 4, SGPT > 80, G6PD Level < 60% of normal and creatinine > 1.2 was considered significant. Treatment was given with Artemether and Lumefantrine for 3 days while Primaquine, 0 .75 mg base/kg body weights once a week was given for 8 weeks. Patients were followed at OPD initially on 3rd day of therapy then every week for 8 weeks for any hemolysis.  Results: There was no hemolysis during the first week and 8 weeks after therapy. Most common side effect was abdominal pain 4 (10%). Mean hemoglobin was 11.8mg/dl. Plasmodium vivax was negative on 3rd day of therapy, it was also negative on 8 week of therapy. Reticulocyte count, Liver function test, creatinine were also normal on 8 weeks of therapy. Conclusion: Primaquine 0.75mg//kg/week for total eight weeks is highly effective for the radical cure of Plasmodium vivax in G6PD deficient children. There is no recurrence of Plasmodium vivax after 8 weeks of therapy. We found this regimen safe as there was no hemolysis demonstrated in children.

Aim: To determine the frequency of thrombocytopenia and its severity in relation to level of indirect hyperbilirubinemia in neonates following phototherapy at tertiary care hospital. Study Design: Descriptive study Place and duration:  This study was conducted at Paediatric department (neonatal ward), Liaquat University Hospital, Hyderabad, from 1st August 2020 till 31st Jan 2021 Methodology: All neonates who fulfilled the inclusion criteria presented at pediatric department (neonatal ward), Liaquat University Hospital Hyderabad were included in the study. After written consent, brief history was taken from the mother or family member and complete blood count (CBC) was sent to check the baseline platelet count along with total serum bilirubin, it was repeated after 48 hours of phototherapy. Results: Out of 231 neonates 70 (30.3%) developed thrombocytopenia after phototherapy. In our study 117 neonates (50.6%) were males & 114 neonates (49.4%) were females with the mean age of 5.9307+1.6640 days. The thrombocytopenia was seen in 70 neonates (30.3%) and type of severity was mild, moderate & severe in 52(22.5%), 13(5.6%) & 5(2.2%) respectively. Conclusion: There was a decline in mean platelet count after phototherapy but it was not statistically significant. The treating doctor should also keep in mind, other causes of thrombocytopenia when the patient is receiving phototherapy.

Objective: Frequency of Glucose – 6- Phosphate Dehydrogenase deficiency in neonates presenting with jaundice Study design: A cross-sectional study Place and Duration: Pediatric department, civil hospital Karachi from January to June 2019 Methodology: The study included all infants who were hospitalized in the neonatology unit with jaundice. At the beginning of the trial, the parents of each neonate gave their assent after being assured that there would be no monitoring burden placed on the parents for the examinations. When entering the hospital, the researcher himself completed a predesigned proforma that asked for specific details about the patient's age, sex, ethnicity, jaundice onset age, consanguinity, and family history of G6PD deficiency. Investigations on newborns included measuring serum bilirubin and looking for signs of G6PD deficiency. (Estimation of G6PD enzymes). Sigma Diagnostic G6PD Reagent was used to estimate the G6PD enzymes for the qualitative, visual, and calorimetric assessment of G6PD deficit in red blood cells. When the sample's deep blue colour changes Results: 174 infants with jaundice in total were included during the study period. Participants in the study had an average age of 16.12 +/- 7.2 days. 95 (54.6%) of the 174 study participants were men, and the male-to-female ratio was 1.2:1. It started at an average age of 8.83.8 days. 79 (45.5%) out of a total of 117 (67.2%) participants are Pathans by consanguineous marriage. 23 (13.2%) of the 174 subjects were G6PD deficient. According to a stratified analysis, out of 23 G6PD-deficient newborns, 11 (47.8%) were between 1 and 11 days old, 19 (82.6%) were between 0 and 6 days old, and 14 (60.8%) had blood bilirubin levels below 15 mg/dl. Conclusion: It was concluded that G6PD is a common cause of neonatal jaundice in our setup. Keywords: Neonates, Jaundice, G6PD deficiency

Background: Acute bronchiolitis, a lower respiratory tract infection, is the most common reason for hospitalizing infants and children for breathing issues. Salbutamol dissolved in sterile saline solution was commonly used to treat hospitalized infants with acute bronchiolitis. This study was conducted with the hypothesis that giving bronchiolitis-affected infants 3 % hypertonic saline solution to inhale instead of 0.9% NS+salbutamol would reduce their clinical severity ratings and length of hospitalization. Objective: To compare the clinical severity and length of hospital stay in children with bronchiolitis treated with the 3% hypertonic saline nebulization versus Normal saline and salbutamol Study Design: A randomized controlled trial Place and Duration: This study was conducted at Indus Medical College The University of Modern Sciences, Tando Muhammad Khan from June 2021 to June 2022 Methodology: A total of 120 individuals with acute bronchiolitis were included in this research after exclusions and inclusions. Both the 0.9% normal saline with salbutamol nebulization and the 3% hypertonic saline nebulization (n = 60) were randomly assigned to the two groups. The data was obtained regarding, age, gender, the pattern of presentation, clinical severity at different time intervals, duration of oxygen therapy, length of hospital stay, and rapid or gradual improvement and discharge of the patient from the hospital. Chi-square and unpaired t-tests were employed as test statistics to analyse the categorical data numerical data. The level of significance was set at 5%, with p0.05 (at the 95% confidence interval) being regarded as significant. Results: A total of 32 (53.3%) females made up group I, while 34 (56.67%) males made up group II. In groups I and II, the mean hospital stays were respectively 61.7±14.5 hours and 81.4±18.2 hours. The mean and standard deviation for group I oxygen therapy time was 13.5± 4.2, while group II was 23.8±4.9 hours. Amongst the hypertonic saline group, out of total 60 patients, 55 (91.67%)patients were recovered and discharged rapidly. Meanwhile, in group II, 32 (53.3%) patients were recovered and discharged rapidly. Conclusion: Yet, in terms of symptom relief, oxygenation improvement, and length of hospital stay for a baby with acute bronchiolitis, the 3% hypertonic saline group outperformed the 0.9% normal saline group. Clear clinical improvements and an increase in oxygen saturation were seen in both therapy groups. Keywords: Acute Bronchiolitis, Hypertonic Saline, Normal Saline, Salbutamol

OBJECTIVE:To assess the significance of integrated management of childhood illness (IMCI) check signs and its implication in children (aged 2 months to 5 years) at