Objectives: The anemia of chronic kidney disease (CKD) is commonly normocytic and normochromic. The objective of current study was to see the effectiveness of erythropoietin in correcting anemia in children with CKD. Study Design: Descriptive case series. Setting: Department of Nephrology, at The Children’s hospital and the institute of child health, Multan. Period: From March 2018 to September 2018. Material & Methods: A total of 79 children with CKD were enrolled in this study. A standard dose of erythropoietin 100 IU/kg was given s/c biweekly and after 4 weeks patients were assessed for improvement in Hemoglobin (Hb) level. Data were entered and analyzed using SPSS-18. Results: Of the 79 cases, 48 (60.8%) were boys and 31 (39.2 %) girls. Mean age amongst cases was 9.92 ± 2.60 years and mean weight 19.65 ± 4.71 Kilograms. Mean baseline hemoglobin level of our study cases was 7.88 ± 1.09 gm/dl. Mean hemoglobin level after 4 weeks of therapy with Erythropoietin was 9.22 ± 1.04 gm/dl. Majority of our study cases i.e. 56 (70.88 %) were having stage 1 and 2 of CKD. Correction of anemia (effectiveness) was seen in 72 (91.1%) of our study cases. Conclusion: Recombinant human erythropoietin aid major improvement / correction of anemia in children with CKD. This drug can be safely used in children with CKD disease without any side effects such as hypertension.

Objective: To evaluate the cardiac status of newborns in terms of structural and functional heart diseases. Methodology: This descriptive study was conducted at Paediatric Cardiology Department of “The Children’s Hospital and The Institute of Child Health”, Multan, Pakistan, from January 2017 to December 2019. Neonates aged 0-28 days and referred for echocardiographic evaluation were enrolled. Diagnostic findings were confirmed with the assistance of echocardiography. We were focused on analyzing total number and types of heart diseases along with gender distribution during the study period. Results: During the study period, a total of 2729 newborns were evaluated. We noted 1523 (55.8%) newborns as structurally and functionally normal, 866 (31.7%) had congenital heart disease, 69 (2.5%) duct dependent lesions, 248 (9.1%) persistent pulmonary hypertension and 23 (0.8%) left ventricular (LV) dysfunction but with structurally normal heart. Newborns with LV dysfunction might have hypoxic myocardial damage, metabolic derangements or acute myocarditis. Ventricular Septal Defect (VSD) followed by Patent Ductus Arteriosus (PDA) and Atrial Septal Defect (ASD) were the most frequent types of acyanotic CHD observed in 248 (28.2%), 171 (19.7%) and 100 (11.5%) neonates respectively while Tetralogy of Fallot (TOF) was the most common type of cyanotic CHD 74 (8.5%). Conclusion: VSD followed by PDA, ASD and TOF were the most common types of CHD among neonates. Diagnosis of congenital heart defects in the early age is pointing towards improvement in healthcare facilities.

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