Objectives: To determine the frequency of vitamin D deficiency in children under12 years of age in the absence of significant clinical signs and symptoms in an ambulatory caresettings. Study Design: Descriptive study. Settings and duration: This study was conductedin Pediatric Out Patient Department of KAUH from June 2013 to June 2014. Materials andmethods: Patients attending the pediatric clinic in KAUH Riyadh, KSA, from June2013 to June2014, in which 287 healthy children under 12 years were enrolled. Serum calcium, phosphorus,alkaline phosphatase and 25-hydroxyvitamin D [25(OH) D] were measured .X ray wrists weretaken for radiological evidence of rickets. 25(OH) D levels <50 ng/mL and <25 ng/mL weredefined as insufficiency and severe vitamin D deficiency, respectively. Results: A high prevalenceof vitamin D deficiency is observed in healthy children even in absence of clinical signs andsymptoms. The problem should be highlighted and there is a need to create awareness amongpeople about the etiology of vitamin D deficiency and its prevention.There is a strong need forlong term planning including populationscreening, dietary supplementation with vitamin D andfood fortification.

Objectives: To assess efficacy, safety, and outcome of combination of Sofosbuvir and Ribavirin in various genotypes, inchildren with hepatitis C infection.Study design and setting: It was a quasi-experimental study, conducted at the Gastroenterology and Hepatology Department,Children Hospital Faisalabad, from August 2017 to August 2021.Methodology: 50 confirmed cases of HCV infection aged 5 to 18 years, were given an oral dose of Sofosbuvir and Ribavirindaily for 12 weeks. PCR was assessed at 4 weeks (for Rapid Viral Response (RVR)) and repeated at 8 weeks and 12 weeks(for Early Viral Response (EVR)) and again 12 weeks after the completion of therapy for Sustained Viral Response (SVR)).Primary outcome was the number who achieved an SVR at 12 weeks (SVR12) after completion of treatment with a viralload below quantitation level.Results: Genotype 3 was found in 80% , type 1 in 6% , type 2 in 4% and 10% were untypeable. All children were PCRpositive at presentation; 96% became PCR negative at 4 weeks (RVR), while 100 percent were negative at 8 weeks, 12weeks (EVR), and SVR 12 weeks after completion of 12 week course was 100%.Conclusion: Although majority of patients were Genotype 3, 12 week course of Sofosbuvir and Ribavirin of hepatitisC-infected children was highly effective, with 100 percent PCR-negative cases at 8 weeks and 12 weeks with only minorside effects, and, SVR of 100% twelve weeks after completion of therapy

Background: Toys with magnetic balls and objects can lead to serious consequences in children. We report a child with a history of magic ball (magnetic toy) ingestion. Case Presentation: A 4-years-old girl, previously healthy and developmentally normal, presented to the emergency department of the hospital with a 10 days’ history of vomiting and abdominal pain. Parents took her to different hospitals, where she was treated as a case of acute gastroenteritis and gastritis. Routine laboratory tests were normal, and an abdominal ultrasound also did not reveal any abnormality. Parents also did not report anything unusual in history. An abdominal X-ray was done in the Emergency room, which showed a collection of approximately 18 rounded radiopaque objects in the right lower abdomen with the signs of intestinal obstruction. Magnetic balls were removed after laparotomy followed by uneventful recovery. Conclusion: Awareness about the serious consequences of magnetic toy ingestion and the need to supervise children while playing is emphasized. It is strongly recommended that to reduce further damage, the International Safety Standards for the use of small magnets should be established.

Background: Liver abscess has been reported in children, but amoebic liver abscess is very rare in infants. This is a rare case report of an amoebic liver abscess in a 45-day-old baby. Case Presentation: A 45-day-old male baby was referred to the gastroenterology department with an 8-days history of fever and vomiting off and on. His feed intake was less than usual, but otherwise did not have any other systemic complaints. On examination, the liver was enlarged 3 cm below the coastal margin. Routine labs were conducted along with liver ultrasound and Computed tomography (CT scan) of the abdomen. Ultrasound revealed multiple liver abscesses. CT scan showed cystic lesions in the right lobe of the liver. Enzyme-linked immunosorbent assay test was positive for amoebiasis. The baby was treated with antibiotics and discharged after 2 weeks. He was advised to take oral metronidazole for 4 weeks. After a month, he was reviewed in the follow-up clinic with complete recovery and normal ultrasound. Conclusion: Amoebiasis is endemic in developing countries [1]. It is the second most common cause of mortality after malaria [2]. It is common in adults but rare in small children [3]. Awareness about good hygiene and drinking clean boiled water should be emphasized.

A four-month-old infant, previously healthy and developmentally normal, presented to the emergency department (ER) of a tertiary care hospital with hematemesis and pallor for one day, as well as a three-week history of irritability and intermittent vomiting. The infant was taken to various hospitals in their town, where he was given symptomatic treatment for vomiting and the mother was advised to feed infant. Nothing out of the ordinary was reported by the parents. The infant's symptoms were managed in the ER, and baseline labs were performed to determine the cause of the blood-stained vomiting and pallor. Except for a low Hb level, the baseline labs were normal. An abdominal x-ray revealed a stainlesssteel blade in his stomach. The ingestion of a blade was unknown to the parents. The case was referred to pediatric gastroenterology for further treatment. The blade was removed through endoscopy, and recovery was uneventful. Conclusion: The importance of supervising infants and young children under all circumstances is emphasized