Association of long term sodium valproate monotherapy and vitamin D3 levels in epileptic children

Objective: To determine the association of long term sodium valproate monotherapy and vitamin D3 levels in epileptic children Methods: This cross-sectional study was conducted in the Department of Pediatrics, Children Hospital, Pakistan Institute of Medical Sciences, Islamabad for six months from 15th February 2019 to 14th August 2019. A total of one hundred and thirty (n=130) children and adolescents of either gender between age 3-18 years who had a history of two seizures at least 24 hours apart in their life and were on sodium valproate monotherapy for more than one year were enrolled in this study through non-probability, consecutive sampling. Serum vitamin D3 (25-hydroxy vitamin D) levels were measured in all the patients at the time of enrolment into the study. All the demographic data and laboratory investigations were entered on the predesigned proforma and analyzed through SPSS version 17. Results: Vitamin D3 deficiency was found in 47 (36.2%) children which were significantly higher among patients with older age and longer duration of treatment (P<0.05) while gender and BMI of the patients did not show any significant difference (P>0.05). Conclusion: Significant percentage of epileptic children on sodium valproate monotherapy was found to have vitamin D3 deficiency. Therefore we recommend routine screening of vitamin D3 deficiency in all the epileptic children on long-term sodium valproate therapy followed by vitamin D supplementation in deficient patients. &nbsp

Hearing Loss Due to Cyclosporine In Children

ABSTRACT A 13-year-old boy known for steroid-resistant nephrotic syndrome taking cyclosporine for the last four years was referred from one private hospital for non-response to treatment and decreased hearing. On detailed history, it was revealed that hearing loss started after initiation of treatment with cyclosporine during the first year, and the patient was not properly followed for hearing issues. Rather cyclosporine was continued despite no response to treatment. The patient raised alanine transaminase (ALT) and uric acid levels. The drug was discontinued, and ALT and uric acid were normalized on follow-up. Hearing on follow-up improved clinically. It was concluded that children taking calcineurin inhibitors should be screened for hearing when taking them long

Paraquat Poisoning In Children – A Case Report

OBJECTIVES Accidental poisoning in children is a serious public health problem in developing countries, especially where chemicals used in agriculture are ingested. Paraquat is a herbicide which is still used in Pakistan. We report a case of fatal unintentional paraquat ingestion by 3 years old child who could not survive. Lack of care in the storage of paraquat lead to the poisoning but initial inappropriate management was also one factor in the fatal outcome. Detailed history and provision of poison containers are important in the proper management of patients with poisoning

Storm Identification, Tracking and Forecasting Using High-Resolution Images of Short-Range X-Band Radar

second, the isolation of false merger (loosely-connected storms

Fetal Warfarin Syndrome – a case report

A two-month-old male infant presented with history of respiratory difficulty and got admitted with provisional diagnosis of pneumonia. On examination patient was having unilateral nasal hypoplasia and cyanosis with echocardiography showing truncus arteriosus. Detail history revealed that mother had valve replacement and she was taking warfarin during pregnancy. After initial management patient was referred to pediatric cardiac surgery and plastic surgery for further management. Parents were counseled regarding contraception and family planning.

Ivermectin Poisoning with Neurological Manifestations in 10 Years Old Girl – A Case Report

In developing countries, accidental poisoning is a serious public health problem in children. But unintentional poisoning by parents in the form of medication is very rare. Ivermectin belongs to the group of Avermectins and is used in veterinary medicine and in use for human parasitic diseases. We report the case of 10 years old girl given ivermectin by her mother for an unspecified amount. The patient presented to the hospital with seizures and remained in a coma for five days. The patient was managed symptomatically and discharged home in stable condition with parents' counselling regarding child safety

Outcome of everted end-to-end urethroplasty in traumatic bulbar and membranous urethra.

Introduction: Numerous options are available for the surgical management of urethral strictures. Everted End-to-end anastomosis is the utmost effective management for bulbar and membranous urethral strictures with a documented high success rate with low postoperative morbidity. Methodology: This study was conducted at department of Urology, Lahore General hospital, Lahore from May 2012 till May 2014. Total 30 patients were included in the study. Procedure was done by a single surgical team and Uroflowmetry and subjective evaluation was done on 2nd week, 1st month and 4th month and 12th month post operatively. Results: Mean age of patients was 24.43±12.39 years. Mean stricture length preoperatively was 1.83±0.63 cm. On follow up 50% of patients were in each grade whose subjective grading were 1 and 2 at 2 week post operatively. After 1-month post operatively 76.67% patients had Grade-1 and 6.67% patients had Grade-2. After 1 month follow up 63.34% patients presented with grade-1, 20% with Grade-2 and 6.67% presented with Grade-3. Only 80% of the patients at 4th month and 1-year post operatively presented with grade-1 subjective improvement. 10% of the patients had stricture recurrence at 1-month follow up and another 10% had recurrence at 4 months of follow up. Conclusion: Everted End-to-end urethroplasty is treatment of choice for short traumatic bulbar and membranous urethral strictures with a high success rate. Key Words: Urethral Strictures, Everted End-to-end Urethroplasty, Bulbar Urethra, Membranous Urethr