Objectives: To determine the spectrum of pediatric heart disease in a newly established cardiac centre in south Punjab. Study Design: Descriptive Observational Case Series. Setting: Department of Pediatric Cardiology of Cardiac Center Bahawal Victoria Hospital (BVH) Bahawalpur. Period: July 2019 to December 2019. Material & Methods: All consecutive patients of any gender, age range from first day of life to18 years, diagnosed as having heart disease (congenital/ acquired) on Echocardiography were enrolled. Patients of isolated bicuspid aortic valve, premature neonates having PDA or those who already had device or surgical intervention done were excluded from the study. The spectrum of the heart diseases in children was assessed by categorizing them as having acquired, acyanotic and acyanotic heart defects. Results: A total of 624 patients were enrolled in the study on the basis of inclusion criteria. There were 56.7 % male (n=354) while 43.3% were female (n=270) with male to female ratio 1.3:1. Majority of the patients were of infant age group (66%, n=412). Congenital heart disease (CHD) was present in 87% of the patients (n=543) while 13% (n=81) had acquired heart disease (AHD). Acyanotic heart lesions were found in 73.1% of patients while cyanotic congenital heart diseases (CCHD) were 26.9 %. Ventricular septal defect (VSD) was the most common CHD (33%), followed by Atrial Septal defect (14.9%) and Patent ductus arteriosus (13.1%). TOF was the most common CCHD (10.1%) followed by TGA (7.4%). Among AHD, 55.6% were of Rheumatic heart disease (RHD) followed by Cardiomyopathy (27.2), pericardial effusion (8.6%) and infective endocarditis (4.9%). Conclusion: The VSD, ASD, PDA, TOF and TGA remain the most common CHD in descending order while RHD is the most common acquired heart disease in children at our centre.

Objectives: To determine the efficacy of double volume exchange transfusion in term neonates with hyperbilirubinemia due to ABO incompatibility. Materials and Methods: This was a descriptive case series study conducted in the Neonatal Unit, Department of Pediatrics, Sheikh Zayed Hospital, Rahim Yar Khan from 30-09-2016 to 29-12-2017. Results: Total cases were 87, out of which 47 (54.02%) were males with a mean age of 4.32±1.51 days. The efficacy of double exchange transfusion was seen in 28 (32.18%) cases. Conclusion: The efficacy of double volume exchange is seen in 28 (32.18%) out of 87 cases and it is significantly high in cases when the exchange is done within the first 3 days of birth (p= 0.01). Keywords: ABO incompatibility, hyperbilirubinemia, double volume exchange transfusion.