Rota Virus Gastroenteritis in Children Upto Five years of Age

Background: To estimate the proportion and peak age of rotavirus diarrhoea among children of age two months to five years Methods: In this descriptive study five hundred patients with acute watery diarrhoea (AWD) were screened for rotavirus. Stool sample of about 5 ml was taken & tested in the laboratory for group A rotavirus antigen by Enzyme immunoassays (EIA). Results: Mean age of patients with AWD was 12.5 months . Out of 500 patients 147 ( 29.4%) were positive for group A rotavirus. Majority of positive patients 116/147 (78.9%) were in the age group 2 months to 12 months. Conclusions: As there are many types of rotavirus i.e. A, B, C, D, and E so overall burden for all serotypes will be much higher. Rotavirus vaccine is an effective preventive measure available against rotavirus diarrhe

Zinc Supplementation in Children with Acute Diarrhea

Background: To evaluate the effect of zinc supplementation on the outcome of acute diarrhea by comparing it with standard management of acute diarrhea in children. Methods: In this interventional study, total 100 patients, 6 months to 5 years of age were enrolled and were randomly allocated in Group A or Group B . Group A was treated with standard management of acute diarrhoea whereas Group B was given zinc supplementation in addition to standard management protocols. Children were monitored for stool frequency, consistency , state of hydration and any complicating factor. Results: The frequency of stools in group A and B reduced from 16.1 + 4.4 8 stools/day and 15.66+ 4.24 stools/day to 6.80+ 1.99 stools/day and 1.78+ 1.79 stools/day respectively. The consistency of stools in group A and B changed from 3.9 and 3.8 on day one to 2.14 and 1.68 , respectively , on day 7. Conclusion: The zinc supplementation had no effect on the outcome of acute diarrhoea in children. There was no significant reduction in the severity of acute diarrhoea in the children who were given the zinc supplements, in comparison to those who were managed with the standard treatment protocol

Willingness to Pay for Community-Based Healthcare Insurance Schemes in Developing Countries: A Case of Lahore, Pakistan

BACKGROUND: Healthcare costs and poverty are significant barriers to achieving universal access to healthcare. Thus, Community-Based Health Insurance Schemes (CBHIS) are regarded as an influential instrument for providing access to healthcare. For this purpose, this study was carried out in order to assess the community’s Willingness to Pay (WTP) for CBHIS and its determinants among the residents of Lahore City.METHODS: A cross-sectional study was adopted during the period of May 2018 to August 2018 to conduct a standardized questionnaire survey among targeted population of Lahore. A total of 250 households from lower, middle and upper-middle-class areas were approached randomly from which 200 participated in the survey, rendering a response rate of 90.9%. Sample size was determined by using single population proportion formula assuming 5% margin of error and 95% Confidence Interval (CI). Moreover, multiple regression analysis, Pearson’s correlation and t-test were employed to determine relationships between different variables affecting WTP.RESULTS: Sixty-four percent of the respondents were willing to pay for CBHIS. Among the remaining thirty-six% of unwilling the community, income level (p< 0.05, CI=0.34 to 1.11) and education level (p< 0.05, CI=0.52-1.37) were significant predictors of WTP. Moreover, strong positive relation (p<0.05) between people’s awareness and WTP for CBHIS was witnessed. The findings further suggested that the larger population of the willing community was not willing to pay more than 5000 Rs annually.CONCLUSION: Henceawareness level of the community regarding the benefits of CBHIS is a major hindrance. The key policy priority is to increase the community’s awareness regarding the benefits of CBHIS and to increase willingness to pay rate among public.&nbsp

Successful completion of pregnancy after mustard procedure for transposition of great arteries: A rare case from the developing world

Surgical repair of transposition of great arteries has undergone various evolutionary changes over the years. The initial of these treatment options was atrial septectomy followed by atrial switch and the current preferred treatment option is arterial switch operation worldwide. Due to various reasons, like lack of medical and surgical expertise atrial switch operation was commonly in practice in developing countries until few years back. Pregnancy in a patient with history of atrial switch operation poses a unique haemodynamic challenge. We report the case of a successful pregnancy in a 26 years old lady who had undergone Mustard repair surgery in the past in Pakistan

FREQUENCY OF SPONTANEOUS BACTERIAL PERITONITIS IN CIRRHOTIC PATIENTS WITH HYPOALBUMINEMIA

Cirrhosis is a serious and irreversible disease. It is end result of hepatocellular injury that leads to both fibrosis and nodular regeneration. Sub-acute bacterial peritonitis is an important complication. Objective: To determine the frequency of spontaneous bacterial peritonitis (SBP) in cirrhotic patients presenting with hypoalbuminemia. Subject and Methods: This was a Cross sectional study that was conducted at out patient department at DHQ Mandi Bahaudin, BHU Toba and BHU Lurka during July 2018 to December 2018, in which 200 cases selected by non-probability, consecutive sampling were selected. The diagnosis of SBP was made according to standard criteria. Results: Out of total 200 patients in present study, there were 114 males and 94 females with mean age of 49.19±6.671 years. There were 110 cases falling in Child Pugh class C and 90 in Class B. SBP was seen in 60 cases (30%). It was seen in 36 males (31.58%) and 24 females (16.44%) out of their respective groups with p value of 0.69. When SBP was compared with respect to age groups, it also did not reveal any significant difference (p= 0.68). However, significant difference was seen when SBP was seen in different child pugh classes; where out of total 60, there were 44 (40%) in Class C and 16 (17.78%) in class B having p value of 0.02. Conclusion: Chronic liver disease is a high burden disease in low socioeconomic countries like Pakistan. Sub-acute bacterial peritonitis is an important complication and child Pugh class C has a significant association with this. Key Words: SBP, Cirrhosis, hypoalbuminemia

Un análisis empírico de los factores que influyen en el emprendimiento social: Un enfoque de género

[EN] Purpose: This study examines how entrepreneurial ecosystem factors (entrepreneurial finance, entrepreneurial education, physical and commercial infrastructure, culture, and R&D transfer activities) shape social entrepreneurial activities (SEA) of men and women. Design/methodology/approach: Panel data from 35 countries are examined through General Methods of Moments (GMM) with Arellano Bond tests for the period of ten years (2005-2014). Findings: Our results indicate that women are more likely to get involved in creation of social ventures. Further, the selected six entrepreneurial factors modify SEA in a significantly different manner for both genders. Originality/value: Based on this analysis, this study is the first to provide deeper insights for improving the assessment of social entrepreneurial activities in efficiency and innovation driven economies within the entrepreneurial ecosystem.[ES] Finalidad: Este estudio examina el modo en que los factores del ecosistema empresarial (financiación empresarial, educación empresarial, infraestructura física y comercial, cultura y actividades de transferencia de I+D) dan forma a las actividades empresariales sociales (AES) de hombres y mujeres. Diseño/metodología/enfoque: Para un periodo de diez años (2005-2014) se examinan datos de panel de 35 países mediante los Métodos Generales de Momentos (GMM), empleando el test de Arellano Bond. Hallazgos: Nuestros resultados indican que las mujeres son más propensas a involucrarse en la creación de empresas sociales. Además, los seis factores empresariales seleccionados modifican las AES de una manera significativamente diferente para ambos géneros. Originalidad/valor: Sobre la base de este análisis, el presente estudio es el primero en ofrecer una visión más profunda para mejorar la evaluación de las actividades empresariales sociales en economías impulsadas por la eficiencia y la innovación dentro del ecosistema empresarial

Pediatric Posterior Fossa Brain Tumor Surgical Outcome

Objective:  The study analyzed the complications and satisfactory surgical outcomes of posterior fossa brain tumor surgery in Lahore Medical City Lahore. Materials and Methods:  A prospective study was conducted and included 40 children who were diagnosed with posterior fossa brain tumors by history, physical examination, and later radiologically were admitted and operated on at the Pediatric Neurosurgery Department in Lahore medical City Lahore between the period of March 2021 and March 2022. Results:  There were 26 (65%) male and 14 (35% females) individuals among the 40 patients. The average age was 12.5 years. This study found that great surgical outcomes were observed in 10 instances (25 percent), good outcomes in 20 cases (50%), and bad outcomes in 10 cases (25%). The most frequent clinical manifestations were headache (38%), vomiting (30%), ataxia (10%), blurred vision (10%), and cranial nerve palsy (12.5%). The best prognosis is shown in children with Pilocytic astrocytoma, followed by ependymoma, while the poorest outcome is seen in children with medulloblastoma. Conclusion:  Pediatric neurosurgeons continue to face particular difficulty in the surgical treatment of posterior fossa brain tumors. Our study compares the outcomes, complications, and surgical outcomes to prior clinical investigations

THE IMPACT OF ANTIHYPERTENSIVE DRUG THERAPY IN PATIENTS WITH CHRONIC KIDNEY DISEASE: A PROSPECTIVE OBSERVATIONAL COHORT STUDY

Objective: Hypertension (HTN) is both a cause and an effect of chronic kidney disease (CKD). To adequately control blood pressure (BP) in CKD, choosing antihypertensive strategies with the highest nephro-protective effect is crucial for preventing or reversing end-stage renal disease (ESRD) progression and reducing cardiovascular disease (CVD) risk. The present study was therefore designed to evaluate the impact of clinical use of antihypertensive drug therapy in patients with CKD and ESRD. Methods: It is a prospective observational cohort study. The patients were divided into two cohorts i.e.; non-dialysis dependent (NDD) and dialysis-dependent (DD) CKD. This study was conducted for six months in the Nephrology department, Osmania General Hospital, Hyderabad, India. The data collected and entered into Microsoft Excel (2007) and mean, SD and range were calculated using SPSS version 25. Results: Antihypertensive drugs were prescribed alone or in combination based on the co-morbidities associated with CKD and HTN. Loop diuretics (Furosemide and Torsemide) and calcium channel blocker (Amlodipine, Nifedipine and Cilnidipine) were most commonly prescribed antihypertensive drugs. Triple therapy (44.11%) was prescribed mostly in both the cohorts (NDD = 16.66%+DD = 27.45%) of which calcium channel blockers+loop diuretic+sympatholytic accounts for 19.16% (NDD = 5.88%+DD = 13.73%).  Conclusion: The practice of prescribing antihypertensive drugs for the management of HTN and to achieve BP targets in CKD and ESRD remains uncertain. The development of new and revised guidelines is needed to reduce inappropriate variations in practice and promote better delivery of evidence-based treatment