No abstract

Background: Pancytopenia is an intermittent hematological finding in children presenting with erratic clinical features like fever, pallor, petechiae, bleeding, distended abdomen, failure to thrive. Aim: To evaluate the pattern of causes responsible for pancytopenia in children of southern Punjab. Study Design: Randomized control trail. Methodology: We enrolled 121 children, aged 1-15 years with pancytopenia after written informed consent for a period of one year in Pathology department of Children’s Hospital-Multan. Cell morphology was studied through microscopy on blood peripheral film and bone marrow aspiration film. The relevant investigations were performed to assess the pattern of causative agents in pediatric population of Southern Punjab, Pakistan. Data was presented as percentage through SPSS v20.0. Results: Fever, pallor and body-aches were the common (80%) clinical presentations in our patients. Mean ± SD age of patients was 7.1± 3.98 years. 56.50% of patients with pancytopenia had hyper-cellular marrow while 43.50% had hypo- cellular marrow. Aplastic anemia and Acute Lymphoblastic Leukemia were the common causes for pancytopenia. Conclusion: We concluded that aplastic anemia and ALL were the most common causes of pancytopenia in Southern Punjab, Pakistan. Infections and other treatable causes were also important causes of thrombocytopenia present in significant number (21.7%) of patients which we can address timely and reverse the serious outcomes. Keywords: Anemia, Bone Marrow, Megaloblastic and Pancytopenia.

Ulcerative colitis (UC) is a chronic inflammatory bowel disease characterized by inflammation and ulceration of the colon and rectum. Diet is an important part of UC management because it can either aggravate or alleviate symptoms along with medication therapy. A comprehensive literature search was conducted using multiple databases (PubMed and Online Wiley Library) and search engines (Google Scholar) using specific keywords related to UC and diet. The search resulted in a large number of articles, which were then narrowed down by focusing on clinical trials and randomized controlled trials published between 2010 and 2023. According to the research, certain dietary interventions, such as the low FODMAP diet, the Mediterranean diet, and the anti-inflammatory diet, appear to improve symptoms and overall quality of life. Dietary interventions have the potential to help with UC management. The goal should be to provide patients with tailored dietary interventions and other treatments to improve their quality of life. More research is needed to identify the most effective dietary interventions and better understand how they work.

Background: The present study aimed to assess the frequency of treatment related mortality (TRM) among all ALL related mortalities recorded in the paediatric ward. Methods: A cross-sectional study was undertaken at the Department of Pediatric, Children’s Hospital and the Institute of Child Health, Multan, Pakistan between January 2021 and June 2022. The study enrolled all children under the age of 18 years who were diagnosed with acute lymphoblastic leukaemia. Data of individuals who died secondary to a relapsing or progressive disease or those who had not yet started chemotherapy were excluded. The main focus of the study was to measure TRM. All data were collected in pre-defined pro forma. Results: A total of 205 deaths among ALL patients were reported during the study. Of these, 120 (58.54%) cases were associated with TRM. The most common type of ALL immunophenotype was B-cell ALL in 100 patients. Majority of the patients who suffered from TRM were at the induction phase i.e. 69 (57.50%). The most common cause of TRM was sepsis i.e. 100 (83.33%) cases. The second most common cause of TRM was haemorrhagic complications. Conclusion: The results indicated that TRM was a significant contributor to treatment failure in this population. Out of a total of 205 deaths, more than half were attributed to TRM. Among the 100 patients evaluated, B-cell ALL was the most prevalent type. The majority of TRM cases occurred during the induction phase (57.50%), and sepsis was identified as the primary cause of TRM, followed by haemorrhagic complications. Keywords: Acute lymphoblastic leukaemia, ALL, chemotherapy, febrile neutropenia, paediatric cancer, sepsis, treatment-related mortality, TRM