Methodology: A total of 300 children with 174 female, 126 males were studied, who came in OPD in Children Hospital Faisalabad for the evaluation of their short stature, excluding familial short stature and other causes of short stature (endocrinal, renal & other chronic illnesses). IgA, TTG & IgG antibodies were evaluated. These antibodies were measured by ELISA method and patients whose TTG antibodies were 10 times greater than normal were spared form duodenal biopsy, however patients having antibodies less than 10 times but greater than normal or having equivocal results were under gone for intestinal biopsy for confirmation of celiac disease. Results: We detected out of 300 patients 88 patients were having TTG titer > 10% of the normal value. 29 patients were having increase titer but less than 10 time of the normal value and 7 patients were found to have equivocal results. So, 36 patients were sent for biopsy out of them 32 were found positive for celiac disease. Hence, we detected 40% (n=120) children were having celiac disease. All 78 females, 42 males having celiac disease were at 2SD except 4 patients who were at 3SD. Conclusion: We conclude that prevalence of celiac disease is high in patients with idiopathic short stature and it is important to investigate all children with ISS for celiac disease by measuring TTG antibodies.

Objectives: To study antibiotic sensitivity pattern of Salmonella typhi in children with enteric fever. Study Design: Prospective, Consecutive sampling. Setting: Children Hospital and Institute of Child Health, Faisalabad. Period: 6 Months June 2019 to November 2019. Material & Methods: All admitted children of age 1-16 years with strong clinical suspicion of typhoid fever and with no comorbidities were included in this study. Blood cultures and other relevant investigations were performed to rule out other causes of fever. After identification of organism as Salmonella typhi, antibiotics susceptibility testing was done by disk diffusion technique and zones of inhibition were interpreted according to clinical and Lab standard (CLSI) guidelines. Results: Out of 60 patients maximum children were < 5 year and >10 year of age. Maximum cases were admitted during July to September. Male to female ratio was 1.6:1. We were able to send blood cultures of 31 cases (51%) only. Out of them 14 cases (45%) were found culture positive. All culture positive (100%) were found sensitive to meropenem. 92.8% were found sensitive to azithromycin and 7.1% were found sensitive to amikacin. Overall 16 cases treated with meropenem, 10 cases (16%) with azithromycin and one with amikacin. However, 33 cases (55%) responded to ceftriaxone alone. Conclusion: Sensitivity pattern of Salmonella typhi revealed significant proportion of multidrug and extensive drug resistant strain. So, continue surveillance is needed in this regard to find actual burden of XDR typhoid fever. We recommend local district administration and health authorities to launch an awareness campaign regarding sanitation, good hygiene, use of safe of water and mass vaccination of children with conjugated vaccine against typhoid. Alongwith above measures antibiotic stewardship should be started.

Objective: To compare the efficacy of normal saline and inhaled β-agonist inthe treatment of bronchiolitis. Study design: Randomized clinical trial. Settings: The studywas conducted in Paediatric Medicine Department, DHQ hospital/Punjab Medical CollegeFaisalabad. Period: 06 months from 1st October 2013 to 31st march 2014. Results: In thisstudy, 58.33%(n=21) in Group-A and 66.67%(n=24) in Group-B were between 0-9 monthsof age, mean and sd was calculated as 11.43+3.87 months in Group-A and 10.52+3.32months in Group-B, 52.78%(n=19) in Group-A and 61.11%(n=22) in Group-B were male while47.22%(n=17) in Group-A and 38.89%(n=14) were females, mean clinical score in both groupswas recorded as 4.11+1.32 in Group-A and 5.65+1.89 in Group-B, comparison of efficacy inboth groups was recorded which shows 58.33%(n=21) in Group-A and 25%(n=9) in Group-Bwere treated effectively while rest of 41.67%(n=15) in Group-A and 75%(n=27) in Group-Bwere not treated effectively, p value was calculated as 0.008, which is statistically significant.Conclusions: The results of this study reveal that inhaled β-agonists are more effective thannormal saline.

Bacteremia is the presence of viable bacteria in the circulating blood. Bacteremia is diagnosed by blood culture. Yale Observation Scale (YOS) is a scale consisting of six observational items originally and is validated in young febrile children to detect serious illness. If YOS found to be highly accurate, it will help us to design a protocol for early screening and diagnosis of bacteremia in infants so that patient’s morbidity and mortality can be minimized by early treatment. Objectives: To determine the diagnostic accuracy of Yale Observation Scale (YOS) for diagnosing bacteremia, taking blood culture as gold standard. Study Design: Cross-Sectional Validation study. Setting: Department of Pediatrics, D.H.Q Hospital, Faisalabad. Period: 26th May, 2016 to 25th November, 2016. Material & Methods: One hundred and five patients suffering from fever>38 0C, having age from 3-36 months were included in the study. Patients already taking antibiotics, immune compromised, patients with signs and symptoms of malaria or viral infections were excluded. YOS was calculated and blood culture was performed in all patients to diagnose bacteremia. Results: Out of 105 patients, mean age was 12.9±8.24 months. There were 55(52.4%) male and 50(47.6%) female patients. Sensitivity of YOS in diagnosing bacteremia was 90.63%, specificity 79.45%, PPV 65.91%, NPV 95.08% and diagnostic accuracy was 82.86%. Conclusion: YOS can be used as a key diagnostic tool in detecting bacteremia. So, by using this tool many cases in the rural areas can be diagnosed and managed early.

Epilepsy may be defined as recurrent abnormal neuronal discharge leading to seizures or periods of unusual behavior, sensations and sometimes loss of awareness. Valproic acid is a widely-used first-generation antiepileptic drug. It has good efficacy and pharmacoeconomic profiles. But adverse drug reactions are also reported. Thrombocytopenia is one of the adverse effects of valproic acid treatment. But local evidence was lacking. So we conducted this study to get local evidence. Objectives: To see the frequency of thrombocytopenia in epileptic patients taking valproic acid. Study Design: Descriptive cross sectional. Setting: Pediatric Department of DHQ Hospital Faisalabad. Period: 19-06-2017 to 19-12-2017. Material & Methods: 75 children were included. Then after taking informed consent patient’s blood sample was taken for complete blood count in standard vials and was sent to DHQ hospital pathology laboratory to diagnose thrombocytopenia as a count less than 150000cmm, where reports were verified by pathologist. All the data was analyzed by using SPSS version 20. Results: In this study, the mean age of patients was 6.59±3.15 years. There were 43 (57.3%) males and 32 (42.7%) females. In this study, 34 (45.3%) children had generalized type of epilepsy while 41 (54.7%) had focal type of epilepsy. The mean duration of valproic acid treatment was 3.15±2.82 years. The mean dose of valproic acid treatment was 38.40±6.07mg/kg. The mean platelet count 199602.87±58058.85mg/dl and 18 (24%) had thrombocytopenia while 57 (76%) did not develop thrombocytopenia. Conclusion: Thus the frequency of thrombocytopenia is low but still we will advise the patients to screen out themselves for bleeding or bruising.