Objective: To determine the frequency of vitamin D deficiency in children/adolescent presenting with night time leg's pain at Sheikh Khalifa Bin Zayed Al Nahyan Hospital Ak CMH Muzaffarabad. Methodology: This was a cross-sectional study, which was conducted at the pediatric Department SKBZ/CMH Muzaffarabad, during six months from July 2021 to December 2021. All the adolescent children presented with leg's pain during sleep at night and both genders presenting at paediatric OPD were included. After obtaining informed consent, a 3ml blood ample was obtained from each case and immediately sent to the Hospital diagnostic laboratory to assess the vitamin D level. All demographic information, including vitamin levels, were documented via study proforma and SPSS version 26 was used to enter and analyze all of the data. Results: A total of 60 adolescent children who presented with leg's pain were studied to observe their vitamin D levels and their average age was 05.93+2.94 years. Out of all, 40 (66.7%) cases were males and 20 (33.3%) were females. Only two children were found with normal vitamin D level, and from all of the remaining 50.0% had vitamin D deficiency (<20 ng/mL) and 46.7% had insufficiency (20–30 ng/mL). Vitamin D deficiency was statistically significant according to age (p-0.006), whereas it was statistically insignificant according to gender (p-0.117). Conclusion: Vitamin D deficiency was observed to be higher among almost all the cases presented with leg's pain during the night. This was an alarming situation to our current generation. According to these findings, it is estimated that vitamin D deficiency increases with increasing age. Keywords: Vitamin D, deficiency, children, leg’s pain

Objective: To assess the vaccination status of children at Gilgit Baltistan and the association of various socio-demographic factors with none or partial vaccination among these children. Study Design: Comparative cross-sectional study. Place and Duration of Study: Department of Pediatrics Combined Military Hospital Gilgit, from Oct 2020 to Mar 2021. Methodology: Children aged 15 months to 10 years presenting with any condition in the Pediatrics OPD were included in the study. Vaccination status regarding basic vaccines, included in the EPI of study participants was confirmed by vaccination card. Education of father, education of mother, type of family (joint or nuclear) and place of living (rural or urban) was correlated with vaccination status of children included in the study. Results: Out of 600 children presenting at the Pediatrics OPD, 390 (65%) patients were males, and 210 (35%) patients were females The mean age of the patients was 5.554 ± 3.85 years. 242 (40.3%) patients were vaccinated, 190 (31.7%) were partially vaccinated, while 168 (28%) patients were not vaccinated for basic vaccines included in the EPI. After applying the chi-square test, low education of father and mother, living in joint family and rural living were significantly related to non-vaccination or partial vaccination of children (p-value<0.05). Conclusion: A large group of children from Gilgit-Baltistan remained non-vaccinated or partially vaccinated even for the basic vaccines included in the EPI program. Children born in joint families, rural areas and parents with a low level of education had more chances of skipping the vaccines.

Objective: To determine the efficacy of probiotics in the prevention of necrotizing enterocolitis in preterm infants. Materials And Methods: This randomized controlled trial was conducted at the paediatric department of CMH Muzaffarabad AJK. All preterm bottle and NG-fed neonates with an age of more than 24 hours and both genders were included. All the study subjects were divided into two groups randomly as group-A and group-B.  Group-A was given probiotics (named Bifidobacterium prophylactically, hiflora, or gutcare, one sachet per day), while in Group-B probiotics were not given. All the cases were taken under observation. If they needed any critical or intensive care, they were excluded from the study and other treatments were given as per hospital protocol. Patients were followed for 7 days. Efficacy in both groups was measured in terms of no occurrence of NEC during one week. All related data was collected on a study proforma. Results: The average age of the neonates in the probiotic group was 11.77 \(\pm\) 6.52 days, and in the control group it was 13.41 \(\pm\) 6.86 days. There were 42.1% boys and 57.9% girls were in the probiotic group, while 54% of males and 46% of females were in the control group. The frequency of NEC was statistically higher in control group 28 (11.9%) compared to the probiotic group 5 (2.1%), indicating the oral probiotic showed significant efficacy (p- 0.001). Conclusion: Oral probiotics have been found to be efficacious, noninvasive, and beneficial in the prevention of NEC. Probiotics must be utilized to prevent necrotizing enterocolitis in preterm newborns in the future, in order to lessen the associated complications and infant mortality.

Objective: To find out prevalence of iron deficiency anemia among hospitalized children aged 6-months to 5 years at a tertiary care hospital of Poonch, Azad Kashmir, Pakistan. Study Design: A cross-sectional study. Place and Duration of the Study: Department of Pediatrics, Sheikh Khalifa Bin Zayed Al Nahyan Hospital, Rawlakot from July 2020 to December 2020. Material and Methods: A total of 189 admitted children of both genders aged between 6 to 60 months were included. At the time of enrollment, age, gender, area of residence and socioeconomic status of all children were noted. To label IDA, a World Health Organization (WHO) criterion was adopted as hemoglobin below 11 g/dL. Chi square test was used to compare data between IDA and non-IDA children considering p-value < 0.05 as significant. Results: Out of a total of 189 cases, there were 103 (54.5%) male. Overall, mean age was 29.3±6.8 months while 106 (56.1%) children were aged between 6 to 24 months. There were 130 (68.8%) children who belonged to rural areas of residence. Socio-economic status was low in 110 (58.2%) children. Malnourishment was identified in 38 (20.1%) children. Gastrointestinal disorders were the commonest reasons of admission found in 82 (43.4%) children. The prevalence of IDA was noted in 103 (54.5%) children. Table-2 is showing association of anemia with respect to various variables studied. Younger age (p=0.0091), rural area of residence (p=0.0039), low socio-economic status (p=0.0036) and malnourishment (p=0.0001) were observed to have significant association with the prevalence of IDA. Conclusion: The prevalence of IDA was high (54.5%) in admitted children aged between 6 to 60 months. Younger age, rural area of residence, low socio-economic status and malnourishment were observed to have significant association with the prevalence of IDA. Keywords: Iron deficiency anemia, hemoglobin, malnourishment, gastrointestinal disorders.