Impact of direct acting antivirals on occurrence and recurrence of hepatocellular carcinoma: Biologically plausible or an epiphenomenon?

Hepatocellular carcinoma (HCC) is a major cause of morbidity and mortality worldwide. Chronic hepatitis C virus infection (HCV) is the most common cause of HCC in many European countries, Japan and Pakistan. Introduction of the new direct acting antivirals (DAAs) has revolutionized the management of HCV worldwide, with high rates of sustained virologic response in patients who could not have tolerated the previous interferon based treatments. However, recently there have been reports raising caution about the long term effects of DAAs, particularly a possible increased risk of HCC. Therefore this review explores the current molecular studies as well as clinical data that investigate the impact of DAAs on occurrence and recurrence of HCC

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

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

Optical Properties and Behavior of Whispering Gallery Mode Resonators in Complex Microsphere Configurations: Insights for Sensing and Information Processing Applications

Whispering gallery mode (WGM) resonators are garnering significant attention due to their unique characteristics and remarkable properties. When integrated with optical sensing and processing technology, WGM resonators offer numerous advantages, including compact size, high sensitivity, rapid response, and tunability. This paper comprehensively investigates the optical properties and behavior of WGMs in complex microsphere resonator configurations. The findings underscore the potential of WGMs in sensing applications and their role in advancing future optical information processing. The study explores the impact of configuration, size, excitation, polarization, and coupling effects on the WGMs properties. The paper provides crucial insights and valuable guidance for designing and optimizing microsphere resonator systems, enabling their realization for practical applications.Comment: 11 pages, 13 figure

Complications of Measles in Malnourished Children, a Descriptive Cross-Sectional Study at a Tertiary Care Hospital Rawalpindi

Objective: To determine the frequency of common complications of measles in malnourished children. Materials and Methods: This study was conducted in the Department of Pediatrics Benazir Bhutto Hospital, Rawalpindi from January 2018 to December 2018. Through a Descriptive Cross-Sectional Study Design, a total of 110 cases of measles with malnutrition presenting to the Paediatrics Department were selected and observations were recorded on follow up. Results: The mean age was 2.7 years (SD±1.2) of which 61% (n=67) were male and 39% (n =43) were female patients. 35.5% (n=39) presented with grade I, 24.5% (n=27) in grade II and 40% (n= 44) in grade III malnutrition. On follow up, pneumonia was observed in 39.1%, diarrhea in 36.4%, otitis media in 10% and encephalitis in 8.1% of children. The most frequent complications were observed in grade II and grade III malnourished children and children of younger age groups. Conclusion: Measles and malnutrition are still calamity in our population as once together, the complications of each other are more prevalent and preventive projects must be designed with full efficacy against both these conditions