Comparison of chest X-ray with lung ultrasound in the diagnosis of pneumonia in children aged 02 months to 12 years

Objective: To observe the reliability of lung ultrasound in diagnosing pneumonia as compared to chest X-ray.Materials and Methods: This Prospective cohort study was carried out over a period of three months in the Paediatric Department of Benazir Bhutto Hospital Rawalpindi. One hundred patients, 2 months to 12 years of age were enrolled in the study. All the patients were subjected to chest X-ray and lung ultrasound within 12 hours of admission. Data was recorded on predesigned Performa and processed on SPSS version 25. Sensitivity, specificity, positive and negative predictive values were calculated for chest X-ray and lung ultrasound.Results: LUS was found to be more efficient in detecting consolidations (64 out of 100) as compared to CXR (50 out of 100). In 14 patients CXR was not able to detect consolidations but LUS detected the same. Fourteen patients in whom lung ultrasound was positive for consolidations but CXR was negative were subjected to CT chest. Out of these 14 CT scans, 11 were positive and 3 were negative for consolidations. Lung ultrasound was found to have a Sensitivity of 100%, the specificity of 92.30%, PPV 95.31%, NPV of 100%, and accuracy of 97% as compared to Sensitivity of 81%, the specificity of 100%, PPV 100%, NPV of 78% and accuracy of 89% for CXR in the diagnosis of pneumonia in children.Conclusion: Results from our study confirmed by many other studies on the same research question allow us to conclude that Lung ultrasound is a fast, low cost, reliable, radiation-free alternative to chest x-ray in the diagnosis of pneumonia in children. &nbsp

An Evaluation of Haematological Changes in Paediatric Dengue Fever Patients at a Tertiary Care Hospital Rawalpindi During 2019 Outbreak

Objective: The study aimed to evaluate the hematological parameters of patients with dengue fever in order to increase the sensitivity of screening for early diagnosis and as an aid to the early institution of appropriate treatment. Materials and Methods: This study was conducted in Peadiatrics Department Benazir Bhutto Hospital, Rawalpindi for a period of 6 months from July 2019 to December 2019. Results: During the study period of 6 months, 438 dengue serology-positive children were admitted, amongst which 254 were male (58%), and 184 were female (42%). The children's age ranged from 1 month to 12 years, with a mean age of 8.03 years (SD + 3.13 years). Out of 438 children, 254 (58%) were uncomplicated dengue fever (DF), 119 children (27%) developed dengue hemorrhagic fever (DHF). 65 children (15%) went into dengue shock syndrome (DSS). The predominant findings in the complete blood picture (CBC) were Thrombocytopenia (80.1%) and leucopenia (65.1%). Normal leucocyte count was seen in 59 cases (13.68%). Thrombocytopenia (platelets less than 100,000) was seen in 351 patients (80.1%) out of which 30 cases (6.9%) had a platelet count less than 50,000. Leukopenia was found in 285 (65.1%) patients. Most of the patients were positive for NS1 (70.3%). IgM was positive in 62.1% and IgG was positive in 14.8%. Enteric Fever as co-infection was found in 30(6.8%) children. Conclusion: Careful assessment and interpretation of hematological changes in dengue patients allow early diagnosis and institution of appropriate treatment

The Effect of COVID-19 Pandemic on Hospital Visits and Admissions in Paediatric Department, Benazir Bhutto Hospital, Rawalpindi

Objectives: To assess the effect of the COVID-19 Pandemic on hospital visits and admissions of non-COVID-19 patients in 2020 compared to 2019.Material and Methods: This retrospective study was conducted in 2021 at the Department of Pediatrics, Benazir Bhutto Hospital, Rawalpindi comparing the data of non-COVID-19 patients visits and admissions from January to December 2019 with non-COVID-19 patients visits and admissions from January to December 2020. The relevant data was retrieved from the Pediatric Department record on a pre-designed study questionnaire. Data was entered and analyzed in SPSS version-24 for descriptive statistics and analysis. Results: The total OPD visits in 2019 were 112682 patients compared to 63859 patients in 2020 showing a 43.33% reduction. The total number of patients who visited pediatric emergency were 80274 in 2019 and 41182 in 2020, showing a decline of 48.65%. There were a total of 6151 admissions in the paediatric ward in 2019 compared to 2778 admissions in 2020 recording a decline of 54.84%. The admissions in the Neonatal Unit were 5544 in 2019 and 3528 in 2020 with a reduction of 36.36%. The admissions in PICU in 2019 were 2685 and in 2020 the admissions decline to 2011 which is a 25.1% reduction.Conclusion: There was a significant decline in both hospital visits and admissions in 2020 compared to those in 2019

Pattern of Paediatric Mortality of hospitalized patients in a Tertiary Care Hospital Rawalpindi

Introduction: Mortality of children is the prime indicator of a country’s health status and its development. Understanding child mortality among different age groups is one of the valuable public health insights. Therefore, studies regarding child mortality patterns are essential for re-evaluating existing health services. Objective: The objective of this study is to describe the pattern of paediatric mortality in our hospital. Materials and Methods: A retrospective analysis was done with the medical records of Pediatric patients (up to 12 years)who died in the Pediatrics department of Benazir Bhutto Hospital, Rawalpindi from 1stJan2018 to 31stDec 2018. Results: A total of 15,500 children were admitted to the Paediatric department from 1st January 2018 to 31st December 2018. A total of 1738 deaths were recorded. The overall mortality of 11.3% was noted in the cases admitted to the Paediatric Department. Conclusion: Septicemia, Acute respiratory infection(ARI)/Pneumonia, Birth asphyxia, and low birth weight (LBW)/prematurity were the major causes of pediatrics mortality

Impact of Comorbidities on the Severity of Disease & Outcome in Children with COVID 19 at a Tertiary Care Pediatric Hospital, Rawalpindi.

Introduction: Coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), was initially identified in Wuhan, China, in December 2019. The virus affects almost all countries of the world. It has infected humans in all age groups, of all ethnicities, both males and females. It is considered that COVID-19, in those with underlying health conditions or co-morbidities, has an increasingly rapid and severe progression, often leading to death. This study is designed to evaluate the impact of co-morbidities on the severity and outcome of COVID-19 infection in children. Methods: This retrospective observational study was conducted at the pediatric department, Benazir Bhutto Hospital Rawalpindi from March 2020 to September 2021. Every confirmed COVID-19 admitted case according to inclusion criteria was enrolled for the study. Data were retrieved from hospital records; data was recorded on a predesigned study questionnaire, entered and analyzed in SPSS version 24 for descriptive statistics and bivariate analysis. Results: 109 children were enrolled with confirmed COVID-19, of these 64(58.7%) were males and 45(41.2%) were females. The age of the patients ranged from infants to 12 years with a mean age of 27.25 months. Comorbidities were present in 70 patients     (64.2%).CHD was the most common co-morbid condition (n=18, 16.5%). Most of the patients experienced mild to moderate symptoms (n=64.2%) while severe symptoms were found in (n=35.8%) patients. 27 patients (24.8%) required Ventilatory support, and of these 20 patients (18.3%) had underlying co-morbidity. The total number of patients who expired was 27(24.7%), and 30.3% of patients who expired had co-morbid conditions. the patients with co-morbid conditions had a longer stay in the hospital. 35 patients (32.1%)with underlying co-morbidity remained admitted for more than a week and 13 patients(9%)for more than two weeks. Conclusion: Pediatric patients with co-morbidities have a higher risk of severe COVID-19 and associated mortality than children without underlying disease. Children with underlying conditions need to be carefully assessed and closely monitored. Further data are required to define these associations and adequate guidelines to manage high-risk children with COVID-19. Keywords: Coronavirus, COVID-19, Pediatrics, Co-morbidity, Severity, Outcom