Nzitritional problems of urban communities 183 adapt themselves to available diet, low in calories and low in protein but with protein value about adequate for health, and who eventually cstablish some sort of equilibrium between bodyweight , development and physical activity on the one hand and low intake of food on the other, the need is for more food of the type they are eating today. That diets based on cereals and pulses commonly taken in India have a protein value adequate to cover protein needs of man at all ages has been shown by a number of workers (Payne, 1969; Aykroyd & Doughty, 1964). T h e exceptions are pregnant and lactating women who require a slightly higher concentration of utilizable protein than is present in the diet based on rice and pulses, though even here small supplements of milk can more than adequately cover needs. Infants are also exceptions since they cannot be given solid diet if they are weaned during the 1st year. Protein-rich foods of high biological value, such as milk and eggs, which along with better-quality protein also bring minerals and vitamins, have clearly a vital part to play. Further discussion is beyond the scope of this paper.

Background: This study was conducted to explore the circumstances around which neonates are referred to the pediatric surgical team of Liaquat University Hospital. This influences the surgical management of neonatal emergencies outcome which also turns on awareness of the conditions early diagnosis, proper resuscitation, excellent nursing care, and refer to the proper center, main requirement is the application of a basic neonatal transport unit, whenever necessary these neonates are referred to these centers from wherever they are born. Methods: It is a retrospective descriptive study carried out at Liaquat University Hospital Hyderabad Sindh. This study included every referral neonatal surgical emergency managed by the pediatric surgical team from June 2017 to May 2019. Data were obtained from the patient's files and operation theatre register. This study was conducted over two years from June 2017 to May 2018 in the department of pediatric surgery, Liaquat University of medical health sciences Jamshoro. All the neonates presenting with surgical emergencies were included irrespective of gender, mode of referral, and causes that warrant surgical exploration using sampling of convenience. However, neonates whose carers did not consent to be a part of the study were not included. Inform consent was taken from either of the parents reassuring them about confidentiality, as well as the treatment being unaffected had they chosen to withdraw from a study at any time. The study variables included age, sex, weight, and referral pattern, later data was analyzed using SPSS version 21. Results: Fifty-three neonates were operated in July 2017 to June 2020. Out of 53 neonates, 32 were male and 21 female. The male to female ratio is 1.5:1. Anorectal Malformation 12 (22.6%) Intestinal Atresia 6 (11.3%) and Pneumoperitoneum 5 (9.4%) Hirschsprung's disease 9 (13.2%). Neonates with low birth weight were 5 (9.4%). The basic neonatal referral & transport system was poorer. Age at the time of presentation ranges from 1 to 20 days, a median age was 3 days. Dehydration in mild, moderate, and severe was noted in 38 (71.6%) of the referral neonates. The leading cause of morbidity and mortality was sepsis, mortality was 7 (13.2%). Conclusion: Management of neonatal emergencies the morbidity and mortality were not as high compared to other developing countries. However, improvement in the outcomes will require awareness, early referral to the concerned department, and overcoming difficulties by providing a well-equipped hospital that will provide an outstanding nursing facility and a well-equipped neonatal transportation system. Keywords: Neonatal transport unit, Basic resuscitation, Good nursing care, Neonatal intensive care unit

Objective: To determine mothers' knowledge regarding ORS therapy during diarrhea among children, aged under five years. Methodology: This was a cross-sectional study and was conducted at the pediatric department of Bilawal Medical College for Boys LUMHS/Jamshoro. The study duration was six months, from March 2021 to August 2021. All the mothers, aged 18 to 40 years, who presented with their children under 5 years old with acute diarrhea and were willing to participate in the study were included. After taking demographic information, interviews were conducted with the mothers, and data was gathered. A self-structured questioner was used to assess the maternal knowledge in terms of diarrhea and its severity, the purpose of ORS, the ORS preparation method, the frequency of use, and the type of ORS. All the data was collected via a study proforma, and SPSS version 26 was used for the data analysis. Results: Children’s mean age was 4.0+2.58 years. Most of the children 60.5% were girls and 38.3% were boys. The majority of women, 43.2%, were educated; 30.9% had a secondary education; 21% had a primary education; and only 4.9% were graduates. Majority of the individuals 75.3% belongs to poor socioeconomic status. Overall, 82.7% of mothers were aware of the severity of diarrhea, 91.4% were aware of ORS, 61.7% believed it was used to prevent water loss, 4.9% believed it prevented salt and water imbalances, and 4.9% believed it was used to prevent diarrhea, while 28.4% were unaware. 69.1% of mothers were aware of the ORS preparation method, but 56.8% had no idea how long ORS should be used for. 49.4% of mothers said ORS should be used slowly at small intervals, few said as per demand; and the remaining had no knowledge. Although regarding types of ORS, most of the mothers 71.6% had no idea. Conclusion: As per the study conclusion, most of the mothers had inadequate knowledge of ORS therapy during diarrhea. Numerous factors, including lower socioeconomic status, maternal illiteracy, caregiver ignorance, and the inability to offer therapy, when necessary, are linked to the severity of disease. Keywords: Diarrhea, ORS, Dehydration, knowledge, Mothers

Objective: To determine the frequency of factors responsible for iron deficiency anemia in children under five years of age at tertiary care Hospital. Methodology: This cross-sectional study was done at the paediatric department of Muhammad Medical College MirpurKhas, during six months from October 2020 to March 2021. All the children with of (<5 years), presented at Paediatric OPD and of either gender were included. After taking complete clinical examination, parents were interviewed reading history of diet. After obtaining informed consent from the parents, a 3ml blood sample was taken from each case and was immediately sent to the Hospital diagnostic laboratory for the complete blood count (CBC). Anemia was defined as hemoglobin level <11g/dl. All the data was gathered via self-made study proforma and SPSS version 26 was used for the purpose of data analysis. Results: A total of 58 children with anemia were studied, their mean age was 02.91+1.29 years, mean Hb was 7.22+1.27mg/dl. Males were 56.9% and females were 40.1%. History of Buffalo milk consumption was in 53.4% children, history of pica was in 27.6%, Caffeine containing food history was in 84.5% of the cases, age of weaning <12 months was in most of the cases and non-iron containing food consumption was also commonest. Most of the cases 55.20% had moderate anemia and 43.10% had severe anemia. The severity of childhood anemia was statically significant according to the type of milk consumption, type of food and caffeine containing food (p-<0.05), while it was statistically insignificant according to the gender and age of weaning (P->0.05). Conclusion: As per study conclusion the Buffalo milk consumption, history of pica, caffeine containing food, age of weaning <12 months and non-iron containing food consumption were observed to be the commonest factors responsible for childhood anemia. Key words: Iron deficiency anemia, factors, diet