[Show abstract][Hide abstract] ABSTRACT: To evaluate children with serologically confirmed Dengue fever in order to identify common clinical features, progress of disease, grades of severity and outcome of cases during the outbreak in 2006.
A cross-sectional, descriptive study was conducted on serologically positive children with Dengue fever (DF) admitted in Civil Hospital Karachi and Liaquat National Hospital between October and November 2006. Various clinical features and laboratory parameters were analyzed for frequencies. Data was also evaluated to identify the common clinical types and grades of infection as classified by WHO.
A total of 35 children were evaluated in the study. Mean age of children was 8.3 +/- 3.5 years and majority was male (54%). Sixty five percent were under 10 +/- 3.5 years of age. Frequent clinical features included fever (97%), vomiting (68%), abdominal pain (68%) and rashes (65%). Gastrointestinal bleeding (61%) and epistaxis (26%) were commonest haemorrhagic manifestations. Thrombocytopenia (86%), anaemia (57%) and Leucopenia (43%) were common laboratory findings. Leukocyte count improved in 2 to 7 days and Platelet count in 2 to 8 days. Dengue haemorrhagic fever (DHF) was seen in 22 children (62%). Majority had Grade-II severity. Mortality was 1 (3%) out of 35 patients.
2006 outbreak of Dengue infection in Karachi showed slight difference in clinical features and course of disease compared to epidemics in other regions, thereby, indicating the need for continuous seroepidemeological surveillance.
Preview · Article · Feb 2008 · Journal of the Pakistan Medical Association
[Show abstract][Hide abstract] ABSTRACT: A controlled, randomized trial was conducted in urban areas of Karachi and Lahore with the aim to look for ways to improve the cost-effectiveness of hepatitis B vaccination. Children under 15 years old (including neonates) were selected and screened for immunization by three regimens according to the frequency and doses of the recombinant vaccine used (Heberbiovac HB, Heber Biotec, Havana). Group A received 10 microg at 0, 1 months; group B (control) received 10 microg at 0, 1 and 2 months (standard regime), and group C received 5 microg at 0, 1 and 2 months. Antibody levels were titrated 2 months after the last dose. Cut-off for seroprotection and hyperresponse were taken as 10 and 100 IU/L, respectively. Nine hundred and ninety children were included and evaluated after discarding those positive for serological hepatitis virus infection markers. Seroprotection rates were 100, 99.7 and 99.7%, and hyperresponse was achieved by 92.7, 99.4, and 97% of the vaccinees in groups A, B, and C, respectively. The same good result was obtained in extreme ages subgroups (< or =1 year and > or =10 years old). The 1-year follow up of the children from Karachi showed good persistence of seroprotection (98, 100, and 99.4%) and hyperresponse (79.7, 96.7, and 87.4%). It is concluded that it is feasible to improve the cost-benefit ratio and compliance of hepatitis B vaccination by means of a two-shots or reduced dose schedule of the vaccine employed in the trial.
[Show abstract][Hide abstract] ABSTRACT: To determine the ratio of disproportionate versus proportionate Intra uterine growth retardation among low birth weight babies using the Ponderal index.
This was a retrospective study. Medical records of babies with weight < 2.5kg delivered in the Obstetric Department were reviewed. The ponderal index was calculated to determine disproportionate and proportionate intra uterine growth retardation among low birth weight babies.
A total of 227 babies were included. Male and Female ratio was equal. Sixty seven percent were delivered vaginally. Only 12 mothers (5.3%) had a history of maternal illness. Eighty nine low birth weight babies (39.9%) had a low ponderal index. Ponderal index in fullterm babies was < 2.2 in 54.3% and in pre-term < 2.0 in 34.9%.
Nearly 40% of low birth weight babies had disproportionate body proportions. This group of babies according to foetal origins of diseases may be predisposed to Diabetes, hypertension and coronary artery disease.
Preview · Article · Jun 2005 · Journal of the Pakistan Medical Association