Objective: To determine the association of long term sodium valproate monotherapy and vitamin D3 levels in epileptic children Methods: This cross-sectional study was conducted in the Department of Pediatrics, Children Hospital, Pakistan Institute of Medical Sciences, Islamabad for six months from 15th February 2019 to 14th August 2019. A total of one hundred and thirty (n=130) children and adolescents of either gender between age 3-18 years who had a history of two seizures at least 24 hours apart in their life and were on sodium valproate monotherapy for more than one year were enrolled in this study through non-probability, consecutive sampling. Serum vitamin D3 (25-hydroxy vitamin D) levels were measured in all the patients at the time of enrolment into the study. All the demographic data and laboratory investigations were entered on the predesigned proforma and analyzed through SPSS version 17. Results: Vitamin D3 deficiency was found in 47 (36.2%) children which were significantly higher among patients with older age and longer duration of treatment (P<0.05) while gender and BMI of the patients did not show any significant difference (P>0.05). Conclusion: Significant percentage of epileptic children on sodium valproate monotherapy was found to have vitamin D3 deficiency. Therefore we recommend routine screening of vitamin D3 deficiency in all the epileptic children on long-term sodium valproate therapy followed by vitamin D supplementation in deficient patients.

ntroduction: The β2 agonists are potent bronchodilators but their repeated and high doses are related to adrenergic side effects. While ipratropium bromide, an anticholinergic bronchodilator has less adverse effects. Objective: To compare the efficacy of combined nebulization of salbutamol-ipratropium bromide with salbutamol alone in children with mild and moderate acute asthma. Materials and Methods: This randomised control trial was done on 80 children aged 5 to 12 years who presented with mild to moderate acute asthma in the emergency department of Children Hospital of Pakistan Institute of Medical Sciences (PIMS) from July 2014 to June 2016 and randomized into 2 groups. In the experimental group each child received 2 nebulizations of combined salbutamol (5mg) and ipratropium Bromide (0.25mg) at presentation and 20 minutes later. Similarly, each child of the control group received 2 nebulizations of 5mg Salbutamol and 2 ml of Normal saline. Asthma clinical score (ACS) was assessed at baseline and then after every 20 minutes up to one hour after the presentation. Results: In the experimental group, the mean + SD ACS at presentation and 60 minutes were 3.50±1.8 and 3.45±1.7 respectively with mean + SD change in ACS of 0.05 ± 0.1. In the control group, the mean + SD ACS at presentation and 60 minutes were 3.70 ± 1.2 and 3.60 ± 1.9, respectively with mean + SD change in ACS of 0.1 ± 0.7. This difference in mean + SD change in ACS between 2 groups was not statistically significant (P=0.6560). Conclusion: There is no statistically significant benefit of adding ipratropium bromide with salbutamol nebulization as compared to salbutamol alone for the management of children with mild to moderate asthma attacks.

Objective: To compare midazolam and diazepam given via intramuscular and intravenous route respectively for management of fits in children presenting in emergency.  Study Design: Randomized controlled study Place and Duration: This study was conducted in Paediatrics Emergency, Ittefaq Trust Hospital, Lahore from 24th June 2013 to 23rd December 2013. Materials and Methods: In this study we took 60 cases and assigned them group A and B (30 cases in each group). Group A was given 0.2mg/kg/dose midazolam via intramuscular route and group B was given intravenous diazepam (0.2mg/kg/dose)for management of fits. Results: Mean age was 2.59±2.88 and 3.55±3.09 years in group A and B respectively. Group A and B included 17 (56.7%) &18 (60%) males respectively while there were 13 (43.3%) and 12 (40%) females in group-A and B respectively. It was observed that in Group A (I/M midazolam) time interval was significantly less as compared to Group-B (I/v diazepam) (5.89±2.63 vs 8.35±2.88 minute) p<0.001 for control of seizure (minutes). Conclusion: Intramuscular midazolam is effective in controlling acute seizures significantly as compared to intravenous diazepam.

Background: Pregnancy outcomes of a borderline oligohydramnios versus normal relatively comes to be slightly increasing meconium‐stained fluid, low Apgar scores and hyper bilirubinemia on follow up as perinatal outcomes and increased risk of C section as maternal outcome. There is currently insufficient evidence to recommend additional perinatal and maternal testing based on a borderline oligohydramnios. Clinical determination is considered in evaluating meconium‐stained fluid, low Apgar scores and hyper bilirubinemia. Objective: The purpose of this study is to determine the adverse perinatal and maternal outcomes in uncomplicated late preterm pregnancies with borderline oligohydramnios. Setting: A total of 38 patients were studied, 19 were with normal AFI and 19 patients were of borderline AFI. Patients with normal AFI were referred as Group 1 and the other as Group 2. This study was conducted at Niazi Medical and Dental College, Sargodha. Population: Pregnant women with normal AFI at term and borderline patients with late preterm pregnancy and borderline oligohydramnios. Methods: This descriptive study was conducted at Niazi Medical and Dental College, Sargodha. This study comprised of 38 patients with normal AFI and border line AFI. Data of 19 patients with normal AFI and 19 patients with border line AFI was collected. The Inclusion Criteria was 19 singleton pregnancies of 36+6 weeks, with AFI ≤ 8 cm and 19 singleton pregnancy 37+ weeks with upto 24 cm AFI. In both groups, Maternal and perinatal outcomes were assessed. The results of both groups were compared in the end. Conclusion: The results of this study indicated that borderline AFI was not a risk for adverse perinatal and maternal outcomes in uncomplicated, late preterm pregnancies.    Int. J. Appl. Sci. Biotechnol. Vol 8(1): 29-32

Background: The term ‘recurrent abdominal pain’ or RAP is defined in terms of duration and frequency of pain. The duration is to be defined as: minimum preceding three months, and over this three-month period, minimum3 episodes of pain having severe intensity causing impairment to perform the daily activities by the affected patients. Over many years, more and more organic causes have been identified because of various advances and better knowledge as well as better investigations tools.  The commonest cause of RAP in paediatric age group is found to be H. Pylori infection and it is also treatable. Objective: To find out helicobacter pylori infection frequency in paediatric age group with recurrent abdominal pain. Study Design: Cross sectional study. Place and Duration of Hospital:  Pediatrics, DHQ teaching hospital Sargodha from 10th June 2018 to 9th December 2018. Methodology: One hundred children with recurrent abdominal pain were selected using non probability consecutive sampling. H. Pylori serology was done and results presented. Results: The mean age was 7.28±2.6 years. H. pylori infection was seen in 27%. More patients belonged to middle socio economic status. Conclusion: Recurrent abdominal pain in paediatric age group is caused commonly by H. pylori infection and it is easily treatable if detected in early stages.